Peter Smith School of Public Health and Preventive Medicine, Monash University

1. The ageing workforce and its implications for occupational health and safety prevention programs and work-injury compensation systems: A Canadian perspective Peter Smith School of Public Health and Preventive Medicine, Monash University

2. Acknowledgements • This work is supported through grants from WorkSafeBC (RS2009-OG03) and the Canadian Institutes for Health Research (111273). • Peter Smith was supported by a New Investigator Award from the Canadian Institutes of Health Research. • Access to data sources was made available through the Statistics Canada’s Data Liberation Initiative via the University of Toronto, and through the Statistics Canada Research Data Centre and the University of Toronto.

3. The Institute for Work & Health • Independent, non-profit research institute in Toronto, Canada • Majority of funding from the Ontario WSIB ($4.7 million) • Plus approx 2.5 million / year from competitive funding agencies • Two broad research goals • to protect the health of workers by studying the prevention of work-related injury and illness. • to improve the health and recovery of injured workers. • Staff of 22 scientists from a variety of disciplines • Approximately 80 FTE staff in total • Governed by a Board of Directors and a Scientific Advisory Committee

4. Compensation systems in Ontario and British Columbia • Lost-time claims (LTCs) • After the day if accident/illness, the worker • is absent from work; or • has reduction in earnings (through fewer hours at old job or • lower wages doing modified work). • No-lost-time-claims (NLTCs) • Worker requires health care (arising from work injury or • illness), but is not absent from work other than the day of • Injury. Also includes modified work for more than seven days at regular pay and hours, even without health care.

5. Overview • Who are older workers and why should we be interested in them? • Older age and the prevention of work injuries. • Older age and the consequences of work injuries. • Related plans for future research in Victoria

6. Who are older workers and why should we be interested in them?

7. Who are older workers? • Human Resources and Skill Development Canada = 45 years or older • Statistics Canada & European Foundation for the Improvement of Living and Working Conditions = 55 years or older

8. Workers’ Compensation policy around older workers in Canada • Loss of earning benefits • End at age 65 for workers who were less than 63-years-old at the time of injury • Workers who are injured when over the age of 63 are paid loss of earnings for up to two years after the date of injury. • In some provinces (e.g. BC) entitlements may be extended past age 65 • Health Care • Is available to workers past age 65, regardless their age at injury • Re-employment • Employer’s obligation to re-employ injured workers ends on the date a worker turns 65 years of age

9. Population Pyramids: Canada (1980, 2000, 2050) Women Men

10. Population Pyramids: Australia (1980, 2000, 2050) Women Men

11. Canada Australia

12. Life Expectancy at age 65. Canada: 1991 to 2006 21 yrs 18 yrs

13. Percent of older persons who are currently working. Canada: 1990 to 2011 Source: Canadian Labour Force Survey

14. Percent of the employed labour force who are over 50 years of age. Canada: 1990 to 2011 app 271,000 workers app 98,000 workers app. 3,6 mill workers app. 1,6 mill workers Source: Canadian Labour Force Survey

15. These trends will continue and may increase Planned age of retirement for respondents age 45 to 49 years of age: 1991, 2002 and 2007 Shellenberg and Ostrovsky, 2008

16. And it is not just healthy workers who want to stay in the labour force Retirement plans for 45 to 59 year olds by level of self-rated health. Canada 2007 Shellenberg and Ostrovsky, 2008

17. Types of employment for workers age 50 and over. Canada: 1996 to 2011 Source: Canadian Labour Force Survey

18. Number of persons and FTE’s over 50 years of age working in temporary work arrangements and first 6 months of a job. Canada 1996 to 2011 Source: Canadian Labour Force Survey

19. Summary • Older workers are an increasing proportion of the labour force • More older people • More wanting to work • A greater percentage in temporary employment relationships • In Canada, 11% of people over the age of 65 are working (up from 6% in 2000) • These trends will likely further increase as more workers “choose” not to retire

20. Older age and the prevention of work injuries?

21. Age and work injury • General assumption that risk of work-related injury declines with age, but that when injuries do occur they are usually more serious

22. Rates of work injuries per 100 full-time equivalents by age groups. Canada 2003-05 Source: Canadian Community Health Surveys, cycles 2.1 and 3.1

23. Percent distribution of lost-time claims in Ontario by age: 1991, 1996, 2001 and 2008

24. Relative change in number of accepted lost-time claims in Ontario: 1996 to 2008 by age group -25%

25. Percent distribution of time loss claims in Victoria by age: 2000-01, 2004-05 and 2008-09 Source: WorkSafe Victoria 2008/09 Statistical Summary (available at ww.worksafe.vic.gov.au)

26. Relative change in number of accepted time loss claims in Victoria: 2000-01 to 2008-09 by age group -12% Source: WorkSafe Victoria 2008/09 Statistical Summary (available at ww.worksafe.vic.gov.au)

27. Rates of accepted claims per 1,000 full-time-equivalents by age group. British Columbia, 1997 and 2007 Source: Smith et al (in progress)

28. Rates of claims accepted per 1,000 full-time-equivalents by age group. British Columbia, 2007 Source: Smith et al (in progress)

29. Rates of wage loss claims per 1,000 full-time-equivalents by age groups. Males only, British Columbia, 2007 Source: Smith et al (in progress)

30. Rates of wage loss claims per 1,000 full-time-equivalents by age groups. Males working in occupation with equipment: British Columbia, 1997-98, 2001-02, 2005-06 Source: Smith et al (in progress)

31. Rates of serious injuries by age per 1000 persons. WorkSafe BC compensation claims Source: Fan et al, 2011

32. Rates of disability claims (10 or more days) per 1000 person-years, Victoria 2001 to 2004 Berecki-Gisolf et al 2012

33. Rates of self-reported time loss work injuries per 1,000 full-time-equivalents. Australia, 2005-06 and 2009-10 (MPHS) Source: Smith et al (in progress)

34. Summary • Compensation boards are dealing with an increasing number of claims from workers over the age of 45 years of age. • Older age is not always associated with a reduced risk of injury – relationship differs by gender, occupational exposures and injury type • The relationship between age and work injury has changed over time. Differences in injury rates are now less pronounced. • In Australia, not all age and gender groups have had reductions in injury risk between 2005-06 and 2009-10. This has changed the relationship between age and work injury.

35. Aging biological, psychological, social and societal change Chronological age Functional age Societal age Organisational age Kooij et al, J Man Psych, 2008

36. Thinking outside of chronological age to understand issues related to the aging workforce • Functional age: what is the relationship between chronic conditions and work injury and recovery from work injury? • Societal age: are older workers treated differently by the health care or compensation system than younger workers, even with the same type of injury? • Organisational age: are older workers treated differently in the workplace than younger workers, even with the same type of injury?

37. Distribution of medically diagnosed chronic conditions among labour force participants by age. Canada 2007 Source: Canadian Community Health Survey, Cycle 4.1

38. Prevalence of medically diagnosed chronic conditions among labour market participants. Canada: 1994 to 2007 46% 107% 36% 164% 58% Source: National Population Health Surveys and Canadian Community Health Surveys

39. Energy reserve Energy Reserve A hypothetical example of the relationship between declining worker capacity and occupational physical demands Occupation with high demands Occupation with moderate demands Occupation with low demands

40. Questions • What is the role that chronic conditions and functional declines associated with age play in the risk of work injury? Palmer et al (2008), OEM, 65, 757 -- 764

42. Chronic conditions and risk of activity limiting injury requiring medical attention. Canada: 2003 – 05. Purple square = women Red square = men Source: Smith et all (in press) JOEM

43. Chronic conditions and risk of repetitive movement injuries. Canada: 2003 – 05. Purple square = women Red square = men Source: Smith et al (in press) JOEM

44. Summary • Limited research is currently available on how changes in function, societal or organisational age impact on risk of work injury • Available data in Canada suggests that chronic conditions associated with older age are associated with an increased probability of both acute work injuries and repetitive movement injuries • Statistically significant risk for arthritis and back problems among both men and women.

45. Older age and the consequences of work injuries?

46. Older age is associated with more severe consequences, even after the same event Percent distribution of types of injuries for lost-time injuries involving falls on the same level. US Data, 2003 Monthly Labour Review, October 2005

47. Percent of severe injuries* after the same event by age group. Ontario 2004 to 2008. Lost-time claims *Injuries to bones/nerves/spinal cord/intracranial injuries and multiple injuries

48. Occupational injury fatality rate by age. US Data, 2007 US Department of Labour, 2008

49. Declining physical function can also influence the ability to return to work Physical capacity required to return to work (% of max) by age: hypothetical example using occupational with moderate physical demands Occupation with moderate demands

50. Mean and median days of wage replacement over the first two years. Lost-time claims, Ontario, 1994 and 2004 Hogg-Johnson et al, in preparation