Work-Related Exposures And Injuries Among The Aging United States Workforce

Abstract

Introduction: Work-related hazards may compromise the health and safety of workers, especially that of aging workers. An employee’s health and safety behaviors in the workplace are a result of interplay among physical and psychosocial work characteristics. Injuries are likely to occur in conditions where there is a mismatch between the capabilities of the employee and the work requirements. Limited longitudinal research efforts have specifically focused on the injury experiences, and their consequences among the aging workforce. Methods: This longitudinal study, conducted among a cohort of United States (U.S.) adults aged 50 years and above, enabled: i) investigation of the associations between work-related physical factors and injuries; ii) comparison of the injured and uninjured workers for any new functional limitations, and reduced working hours post injury; iii) analyses of associations between psychosocial work factors and injuries; iv) comparison of two common approaches for analyzing longitudinal data with injuries as an outcome. The cohort to conduct these analyses was obtained from the Health and Retirement Study (HRS), a biennial nationally representative panel study of U.S. adults. The HRS respondents who were working for pay in the year 2004 (n = 7,212) formed the cohort for analyses investigating the associations between physical work requirements and injuries, and the consequences of such injuries. The cohort to investigate the association between psychosocial work factors and injuries included 3,305 working adults who responded to the HRS’s psychosocial and lifestyle questionnaire in the years 2006 and 2010. Each of these cohorts were followed until 2014. Crude and adjusted incident rate ratios, and hazard ratios were obtained from generalized estimating equations (GEEs) and marginal structural models (MSMs), and Cox Hazard models. Variables included as confounders were demographic, health-related variables, and other work characteristics. Results: Those whose jobs required excessive physical effort, lifting heavy loads, and stooping/kneeling/crouching all/almost all the time, compared to none/almost none of the time, had over twice as high the risk of experiencing injuries. The MSMs (IRR: 2.62, 95% CI: 2.14, 3.20) provided an estimate higher than the GEEs (2.09, 1.67, 2.62). Injured, compared to uninjured adults, had a higher risk for having a functional limitation and reduced working hours post injury. Finally, important gender-based differences were identified when the modeled exposures included combinations of two psychosocial factors. Conclusions: Several physical and psychosocial factors elevated the injury risks among the aging workforce. It is therefore important to holistically investigate all exposures that may affect the risks for injuries in this population.