© Borgis - New Medicine 4/2006, s. 107-111
*Joanna Bugajska, Iwona Sudoł-Szopińska, Maria Widerszal-Bazyl
Physiological and psychosocial aspects of occupational activity of elderly workers
Department of Ergonomy, Central Institute for Labour Protection – National Research Institute,
Director: Professor Danuta Koradecka, MD, PhD
Summary
Summary
Demographers anticipate that the process of aging of Polish society resulting from the decrease of the birth rate and increase of life-span will continue.
Apart from these tendencies, disadvantageous – from the economic point of view – is the increase of persons not occupationally active because of statutory retirement, so-called earlier or disability pensions or the general opinion mostly expressed by employers concerning the poor health and working ability of aging people. The employment rate of people aged 55-64 years old in Poland is one of the lowest in Europe – 26.9%.
In people aged 45-50, changes in the cardiovascular and musculoskeletal system decreasing their general physical capacity are observed. These changes influence physical fitness, which determines work performance. Regardless of changes in human psychophysical capacity that occur with age, occupational activity is shaped also by the occurrence of chronic diseases.
In this situation, we face the dilemma of what should be done to ensure safe working conditions with regard to increasing numbers of elderly workers, often suffering from chronic diseases, typical of their age.
This review article presents the physiological and psychosocial changes that occur with age as well as advantages and disadvantages of aging workers, and describes preventive actions that need to be undertaken in order to maintain ability to work.
Introduction
The employment rate of aging workers has decreased in almost every country of the EU in recent decades. Therefore, modern societies face the necessity to undertake complex and systematic actions that will allow them to avoid the consequences of adverse changes in the relation of occupationally active persons to the number of those occupationally non-active. According to the opinion of the European Commission, an important element of tackling the problem involves activities aimed at prolonging occupational activity of persons above the statutory retirement age.
There are however several obstacles which hinder the implementation of those actions. First, there is a discrepancy between the general opinion about older workers, mostly the health and employability of this part of the population, and the actual situation. People perceive all older employees as less healthy than their younger counterparts. In fact, a large majority of older employees enjoy good physical and mental health and are able to work productively very well up to 65-70 years of age [1]. Additionally they are productive and make a positive contribution to organizations [2].
On the other hand, the ability to perform work in fact changes with age. This is caused mainly by the decline of physical capacity and fitness and of some psychophysical abilities (e.g. perceptiveness, response rate, efficiency of the sense organs – i.e. vision). Changes in these organs are observed as early as from 45 years of age. At the same time, an increase is observed in the incidence of many diseases of the cardiovascular, respiratory and musculo-skeletal systems and of hormonal and metabolic disorders.
Apart from these age-related changes, a lot of studies and reports have been published on the advantages of employing elderly workers, such as reliable work habits, loyalty to the job and the firm, experience, stability with less turnover, less concern about advancement, equal or better productivity rate, standard fringe benefits not necessarily needed, and willingness to work on a part-time/temporary/seasonal basis [3, 4].
Despite the above advantages, the employment rate of elderly people is still relatively low. One of the objectives of the Lisbon Strategy in the field of employment is to achieve an employment rate for elderly employees (55-64 years old) of 50% in 2010. In 2003 the employment rate for elderly employees was 41.7% for the EU-15 average and 40.3% for the EU-25 average. Large differences in this matter are observed between particular EU countries. According to the National Actions Plans for Employment (NAPEs) data from 2003, the employment rate for elderly employees was high in Denmark and the United Kingdom (60.2% and 55.5% relatively) and low in Poland (27.2%) and in the Slovak Republic (24.6%) [5, 6, 7].
On the basis of the above data, it is necessary to debunk existing myths and stereotypes about elderly workers.
Physiological changes with age and their impact on work ability
The range of problems related to elderly workers is very broad and diverse. It covers different aspect of physiological changes that occur with age, changes in the health status and lifestyle of elderly persons and the influence of the working environment on elderly workers.
According to the present knowledge about physiological changes that occur during aging, some of the most important are those in the cardiovascular and musculoskeletal systems. As they cause decreased physical work capacity and musculoskeletal capacity, physical load of work may be too high for elderly workers. Due to the changes in the cardiovascular system, physical work in hot environment is tolerated worse by aging workers [8, 9]. Thus working tasks which may cause physical overload and tasks performed in a hot environment should be decreased with the workers´ age. Decreased ability for circadian adjustment to night work and increased sleep disturbances observed in aging workers may cause worse tolerance of shift work in aging workers. Therefore all bodies involved/responsible for creating safe and healthy workplaces in organizations should be aware of these aspects and should consider aging workers as more vulnerable subjects in relation to shift and night work [10].
Independently of changes in human psychophysical capacity that occur with age, occupational activity is shaped also by the occurrence of chronic diseases, which additionally should influence organizational changes and adjustment of workplaces to elderly workers´ abilities. In practice this seems to be a little more complicated. The comparison of working conditions with regard to physical workload of workers under and over 45 years of age in EU-15 countries showed that physical work demands (as the sum of tiring postures, moving heavy loads and repetitive work) constitute a big problem in some countries in Europe and are not reduced sufficiently with age.
In the present report the following problems in the mental and social working environment were identified:
– the use of computers at work – too low,
– working with tight schedule – too often,
– performing complex tasks – too seldom,
– learning things at work – too seldom,
– influencing own work schedule, form of working – poor,
– skills matching work demands – poor,
– supervisor support – too seldom.
The data mentioned above constitute part of a report about the status and promotion of work ability, employability and employment in the European Union before accession of the new member countries. In the new members this information is lacking [11].
From the physiological point of view work ability decreases with age too. Working ability is recognized as a complex of interactions involving health, the physical, psychological and social prerequisites of functioning, and personal and environmental factors [12]. In the late 1990s a new concept of work ability was introduced by the Finnish Institute of Occupational Health. The concept emphasizes that individual work ability is a process of human resources in relation to work. On the basis of this concept the Work Ability Index for the measurement of work ability was established [13]. The worldwide career of WAI in research and practice may be explained by its usefulness on one hand and a complex approach to the factors influencing work ability on the other hand. The results of studies on a representative population sample showed that health and functional capacities (i.e. physical capacities and fitness) as well as factors of the working environment influence work ability, measured by WAI. In the oldest group (55-64 years old) the health (symptoms) and physical capacity and work factors (mental strain) were strongly related to the level of WAI. The competence, values and attitudes as well as family and community factors were less significant, and their impact on WAI value decreased with age. The results suggest that the balance between human health resources and work demands and characteristics are also today an important dimension for work ability [14].
A lot of studies indicate that working conditions, especially the demands of physical work (carrying or moving heavy loads, tiring position during work), negatively influence work ability. This explains why blue collars workers in comparison with white collar workers have a lower work ability measured by WAI [15]. Additionally, low WAI score, poor subjective work ability and heavy physical workload, apart from chronic diseases and long-term sickness absence, constitute the highest risk factors of premature departure from working life [16]. Thus, work may reveal the existence of changes connected with age, and this may result in marginalization and even exclusion from employment for older workers exposed to demands at work that are too great for their declining capacity. On the other hand, it may also allow for progress in their working career if the type of work is such that a high value is placed on experience [3]. It has already been proved that working environment influences, on the one hand, the quality of life by limiting everyday life activities but, on the other hand, the quality of life in the so-called "third age” may be increased by the improvement of working conditions during occupational activity [17]. However, when discussing elderly people´s ability to work, one should always consider the great diversity and specific characteristics of this group [18]:
– first, that chronological age is not an indicator of mental or physiological aging, and that differences within the older population are greater than between older and younger groups
– second, that on one hand old people experience gradual decline in visual acuity, auditory sensitivity to tones, muscle strength, fine motor skills, information processing speed and attentional capacity to deal with multiple concurrent tasks, whereas, at the same time, they make use of compensatory strategies of older adults, and benefit from recent training/retraining and tenure in jobs with higher cognitive than physical demands.
Many research studies have shown even more, that there is no reason why elderly people should not stay at work. Older employees can be just as effective and learn as well as younger. The question is if the early preventative measures that will help older people to stay at work should preferably affect the whole workplace or just individuals. According to Ilmarinen J., the focus should be on improving jobs, not individuals [19].
Withdrawal from the work force for health reasons is more common for those in physically demanding jobs. Skilled workers who have had the advantage of lengthy schooling, followed by occupational training, and further use the knowledge thus acquired in general practice where they can progressively widen their experience, often do not work in the most harmful occupational environments and their skills are recognized and valued as they grow older. Thus they are more likely to keep working. In comparison, workers who have to perform physical jobs are also, most often, those who have had the least schooling and the least occupational training. They are subject to exhausting working conditions, which can lead to various diseases and accidents. In this context, their physical capacity is very likely to decline towards the end of their active life. As that makes them more vulnerable at work, they seek retirement earlier. However, the job market has evolved with a lower percentage of workers involved in heavy labour jobs. Thus, many more people may maintain their employment or even pursue a new career as they reach 65 years [3, 20].
Psychosocial stress and elderly workers
Usually it is found that older workers perceive fewer sources of psychosocial stress at work [21]. However, it does not mean that this refers to all kinds of stressors to the same extent.
Job control is one of the key dimensions of the psychosocial work environment. Its relation to health has been demonstrated many times. Results usually indicate that older workers perceive their job control as higher than younger ones. Ilmarinen [11] discussed this issue on the basis of the Eurobarometer information, where two age groups were compared: <45 years and>45 years. The following aspects of job control were taken into account: possibility to regulate work breaks, to influence the order of work tasks, work methods and work pace. In all EU-15 countries taken as a whole, all the above-mentioned aspects of control were perceived to be higher in the older age group. However, differences between countries were found, as well as between genders Nygard et al. [22] in their longitudinal survey provided valuable information about the relation between age and control. Finnish municipal workers were questioned twice, at an interval of 11 years. It turned out that when they got older they started to perceive their work as offering more opportunities for control. Simultaneously with the questionnaire, the researchers carried out a job analysis. On that basis, they concluded that the increase of control observed for elderly workers resulted from a change of perception of control, and not a change of objective features of work.
Social support is another important characteristic of the psychosocial work environment. Many theoretical models, as well as research studies, show a relation between a low support level and a reduced physical and mental health status [23]. The NEXT European Union research project that covered nurses from ten EU member states showed that older nurses perceived support from near associates as lower than younger ones. At the same time, cultural differences were observed. Such a tendency was not detected in Poland, while in Italy and Slovakia a U-shaped relationship between age and peer support was found, i.e. after a decline with age, the social support increased for over fifties [24]. Ilmarinen [11] analyzed the Eurobarometer 1996 results related to the reply to the question of whether respondents discuss work-related problems with their bosses. The result was that workers over 45 discuss their problems less frequently than their younger colleagues.
Aging discrimination is a similar issue to social support. On the basis of Eurobarometer, Ilmarinen [11] concluded that in the EU-15 age discrimination is rare and, at the same time, more often reported by workers over 45 (M= 3.3%, F=3.6%) than under 45 (M= 2.1%, F=2.8%). Other stressors are job demands, job insecurity and work-family conflict. In general, studies demonstrate that older workers perceive their job demands as lower than their younger colleagues. Such a result was observed for general practitioners in the research carried out by Vanagas et al. [25]. Differences concerning job demands for older and younger doctors were particularly high for an increased patient load. The nurse studies under the NEXT project also confirmed a higher level of demands among young nurses (<30) as compared with older age groups [27]. The same trends were observed by Ilmarinen [11] on the basis of Eurobarometer 1996. Workers> 45 years reported less frequently than their younger colleagues that they have to work on tight schedules. However, significant differences related only to male employees from a majority of the EU-15, except Finland, where older workers felt higher time pressure. It is also very important that older employees see their job demands as better adapted to their skills [11, 27]. It seems that the key element distinguishing older and younger workers is not the perceived level of job demands, but rather the feeling of adaptation of demands to skills. The relationship between age and job insecurity depends on which aspect of job insecurity is taken into account, as well as the country. In the above-mentioned NEXT study, the fear of becoming unemployed was lower among older workers [28]. However, the concern related to ability to find a new job after being redundant increased with age in 6 out of the 10 analyzed countries. Regarding the last stressor, work-family conflict [29], among nurses from nine countries participating in the NEXT project, the highest level of that stressor was observed in the group of 30-35 years of age, with a continuous decline for higher age groups.
Preventive actions for maintenance of ability to work
Actions to be undertaken to maintain aging workers in employment can be generalized into 4 main issues:
1. This age group should not be considered as a category apart, but instead age must be considered as one factor of diversity among others in the active population; protective measures that are too targeted or too accentuated tend to marginalize and weaken the position of the populations concerned.
2. Individual and collective changes related to age as well as changes in work techniques (e.g. new forms of working) and organization should be anticipated. The management of human resources can be effectively carried out only over time, so as to prepare appropriate adjustments in work careers and training.
3. The diversity of individual development throughout working life should be taken into consideration, so as to create conditions of equivalent diversity in work careers.
4. Attention should be devoted to favouring the process of building skills and attenuating the process of decline.
On the basis of these few principles, several types of immediate actions can first be defined. The highest priority of action will concern adjustment of working conditions to aging workers´ needs, age-related changes and abilities. As mentioned earlier, postural stresses, extreme exertion, strict time constraints (e.g. as with assembly-line work or the imposition of higher output goals), harmful environments (temperature, noise) or unsuitable environments (lighting conditions), night work and shift work are examples.
In the end, it is worth mentioning the 50+ programmes that are being undertaken in new EU member states under EU structural programmes. The objective of the programmes is to initiate activities aimed at improving the situation of people over 50 years of age, including assistance in finding and retaining jobs. However, we still have to wait for the results of these programmes.
Conclusions
From the literature review presented above, it can be concluded that:
– Aging of society should be perceived not only as a demographic process, influencing the population policy and generating definite organizational problems and economic costs for the state or for the individual, due to the necessity to ensure an effective elderly care system.
– Aging is also the result of the long-term process of improving society´s living conditions and health status.
– A natural consequence of society´s aging is the increase of elderly people´s activity in all areas of life, including occupational life.
– Aging is an unavoidable process for each human being, but its course shows great individual differences, as e.g. limitations in performing work cannot be expected in all areas of occupational activity to the same extent. Physical capacity and fitness decreasing with age and some psychosocial abilities are sometimes compensated by great experience or increase in emotional resistance of elderly people.
– Areas in which the worker´s age has to be taken account of are well identified: heavy physical work, including handling loads, work in hot microclimate and shift work.
It is important to learn about those factors of the working environment and work characteristics which can prematurely decrease work ability and to create working environment conditions and work organization which will be conducive to retaining employment even beyond the statutory retirement age.
Piśmiennictwo
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