In Part 1 and Part 2 of my recently published article, I introduced the need to think about the older workforce and outlined the physiological and psychological changes that impact on older workers. Here in Part 3, my article continues.
Complexity and Interaction of Factors Influencing Neuromusculoskeletal Health of an Ageing Worker
So it can be seen that physical and psychological factors play an important role in the ageing process at an individual level. Figure 1 below creates a schematic representation of additional factors that must be considered when assessing the suitability of current work demands for an ‘ageing’ employee. Such a model may also be used to help highlight where a ‘mismatch’ maybe present and to help prioritise resource.
Figure 1: A conceptual diagram representing the complex interactions of influencing factors on the neuromusculoskeletal health of an’ ageing’ worker.
The starting point for neuromusculoskeletal fitness for each individual will be different as will their course across the model. Good Occupational Health assessment and evaluation will help gain an insight into the individual’s current state of neuromusculoskeletal health. Likewise interview techniques with the worker either from Occupational Health or Line Management supervision can be utilised to identify the potential positive impacts. By plotting a path across the model, thought must be given to how these factors influence the neuromusculoskeletal health of the ‘ageing’ worker.
Other Assessment of Employee Fitness for Work in the Older Workforce
The Work Ability Index (WAI) was developed by Tuomi et al (1996) in Finland. It is an instrument used in clinical occupational health and research to assess work ability during health examinations and workplace surveys. It measures and records the work ability of employees and can be used at an individual, group or organizational level. The index is determined on the basis of the answers to a series of questions which take into consideration the demands of work, the worker’s health status and resources. It can be used to predict work ability in the near future. Recent results of a 28 year prospective study show that perceived poor WAI scores undertaken in midlife are associated with accelerated deterioration in health and functioning and can be used reliably as a predictor of health almost three decades later (von Bonsdorff et al 2011). Such inferences mean that midlife WAI scores can be used as an early predictor of functioning in old age.
Scores obtained from the WAI can be used to prioritize interventions aimed at improving the employee’s work ability. Table 1 below shows how the WAI is scored and corresponding action levels.
Table 1: WAI Scoring System and Associated Action Levels
(Tuomi 2006)
Whilst the WAI assesses more health issues than neuromusculoskeletal health it is deemed a suitable tool for assessment of this, particularly in older workers, who are most likely to have co-existing pathologies, which are likely to be influencing neuromusculoskeletal health.
Best Practice Guidance for Age Management of WRMDs
A good understanding of the causation and complexity of WRMDs in the older worker is essential. Occupational Health and Safety Staff are encouraged to:
1. Assess the determinants of work ability of the older worker
2. Target available resources to identified problem areas. This maybe aimed at an individual, group or organizational level and may include:
- Examination of job demands versus individual capabilities
- Examination of work-rest scheduling
- Shift work guidance
- Examination of current reporting systems
- Provide health promotion, in particular the importance of maintenance of physical activity
- Training on age management to Human Resource Personnel, Occupational Health and Safety Staff and the ‘older’ worker
- Evaluation of job design
- Examination of organizational culture and worker ‘beliefs’
(Buckle et al 2008, Crawford 2011, van dem Berg et al 2008)
3. Consider Policy implications with regards to the neuromusculoskeletal health of the older worker.
- Age strategy
- Prevention of age discrimination
The positive effects of good age management can be seen in Figure 3 below:
Figure 3: The Effects of Age Management (Tuomi et al 2006)
Conclusions
Factors influencing WRMDs in the older workforce are numerous and complex. An increasing understanding of this is emerging. Due to a rapidly increasing ageing population, more research is required on WRMDs in this demographic group. Occupational Health, Safety, Human Factors, Human Resource and Management Professionals all have a role to play in the identification and management of neuromusculoskeletal health in the ageing worker. Current UK legislation and government initiatives are likely to have a positive effect on enabling older workers to remain at work longer, if this is their wish.
References
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Working for a healthier tomorrow: Dame Carol Black’s review of the health of Britain’s working age population. TSO, Norwich
Buckle, P., Woods, V., Oztog, O. and Stubbs, D. (2008)
Workplace design for the older worker: Strategic Promotion of Ageing Research Capacity. University of Surrey
Crawford, J. (2011)
The Ergonomic Challenges of an Ageing Workforce: Manageing the Physical and Mental Workload, Institute of Occupational Medicine, Edinburgh, http://www.iom-world.org
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Balter, P.B. and Balter, M.M., (eds) (1993)
Successful ageing. Press Syndicate of the University of Cambridge, Canada pp1-2
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Balter, P.B. and Balter, M.M., (eds) (1993)
Successful ageing. Press Syndicate of the University of Cambridge, Canada pp1-2
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Balter, P.B. and Balter, M.M., (eds) (1993)
Successful ageing. Press Syndicate of the University of Cambridge, Canada pp1-2
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Tuomi, K., Ilmarinen, J., Jahkola, A., Katajarinne, L. and Tulkki, A. (1996)
cited by Tuomi (2003) see http://www.duurzaamdoorwerken.nl/files/usr_jpeeters/Publicaties/HELSINKI%20STUDIEREIS/Ilmarinen%20presentatie%20WAI.pdf
United Nations Publications, World Population Ageing (2007)
http://www.un.org/esa/population/publications/WPA2007/ES-English.pdf
van dem Berg, T.I., Elders, L. A., de Zwart, B. C. and Burdorf, A. (2008)
The effects of work-related and individual factors on the work ability index: a systematic review. Occup. Environ Med. 66 pp211-220
von Bonsdorff, M. B., Seitsamo, J., Ilmarinen, J., Nygard, C., von Bonsdorff,M. E. and Rantanen, T. (2011)
Work ability in midlife as a predictor of mortality and disability in later life: a 28-year prospective follow-up study. Canadian Medical Association Journal, Early release published at www.cmaj on 31st January 2011.
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Cited by
Balter, P.B. and Balter, M.M., (eds) (1993)
Successful ageing. Press Syndicate of the University of Cambridge, Canada pp1-2
Further Reading
HSE Management Standards for Stress
http://www.hse.gov.uk/stress/standards/
Working Late (Loughborough University)
http://www.workinglate.org/
Oxford Institute of Ageing
http://www.ageing.ox.ac.uk/
