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Ergonomics and the Aging Workforce

Ronald J Lott Ph.D, CPE


Introduction


1. As ergonomic practitioners (ergonomists) are we holistic in considering all possible ergonomic risk factors during evaluations and assessments?

2. As ergonomic practitioners (ergonomists) do we only consider the usually recognized ergonomic risk factors, i.e. repetition, frequency, forces, posture and heavy lifting?

3. As ergonomic practitioners (ergonomists) are we familiar enough with the non-worksite risk factors that may contribute to ergonomic related injuries and illnesses?

4. As ergonomic practitioners (ergonomists) do we thoroughly consider that the average age of the American workforce has been over 40 years of age for over a decade due to the “becoming of age” of the Baby Boomers, and that there are non-occupational age related medical disorders that directly contribute to the occurrence of muscular skeletal medical disorders?


Today, most manufacturing facilities find that most of their employees are over 50 years of age. Now with lay-offs, with the more senior employees remaining, will that average increase—probably.

An aged workforce provides challenges in devising and maintaining health and safety programs. This relates to the health status of workers simply because of their age and the non-occupational related medical disorders affecting their ability to tolerate exposures to workplace hazards. As such, it is possible, because of these non-occupational medical disorders, that injuries or illnesses occur, which are designated as being caused by the hazards in the workplace when in reality, the cause of many may be secondary to pre-existing non-occupational medical disorders.

Statistics indicate that the general population from which the workforce is selected has a number of age related, non-occupational medical disorders that may directly contribute to the risk factors for ergonomic related disorders. Some of these include:
  • More than 8 percent of the general population has Diabetes Mellitus a disorder which interferes with use of glucose;
  • With age the Basal Metabolic Rate decreases
  • One in three adult men and women has some form of CVD Disease (CHD), 21.2 percent have hypertension and 2.5 percent have had a stroke.
  • Among blacks, 9.6 percent have heart disease, 5.2 percent have CHD, 29.2 percent have hypertension and 3.2 percent have had a stroke.
  • Among Hispanics, 9.2 percent have heart disease, 6.0 percent have CHD, 19.6 percent have hypertension and 2.8 percent have had a stroke.
This provides a challenge for the health and safety manager, and ergonomists since the Health Insurance Portability and Accountability Act of 1996 (HIPAA) prohibits inquiries about a worker’s medical conditions except by authorized personnel. However, there are methods to protect workers without actually knowing an individual’s medical conditions. This can be accomplished with a viable system of better communication between supporting medical personnel and the facility’s safety & health personnel. Such communication requires that the ergonomic practitioner be familiar with certain non-occupational medical disorders in order to provide medical personnel appropriate information about workplace risk factors that may relate to these disorders. Since their limitations related to HIPAA are less, if sufficient information is provided, better decisions concerning the actual causes and methods of prevention can be made. To make the assumption that medical personnel always have an index of suspicion concerning the full spectrum of the specifics of workplace hazards is not sufficient.

Communicating with Medical Support Personnel

The repetitious use of muscles and tendons, used frequently, requiring degrees of force, in awkward postures under certain environmental conditions requires the expenditure of energy. As such, one of the four (4) recognized sciences of ergonomics is Physiology in consideration of the consumption of energy. Energy consumption in the human body is dependent upon the availability of Oxygen and Glucose as well as the Metabolic Rate, and the health of the systems responsible for delivery of blood to body.

Krebb Cycle or Citrus Acid Cycle

The Krebb Cycle is the physiological mechanism which produces energy for use by cells from the hydrolysis of adenosine triphosphate (ATP) to adenosine diphosphate (ADP) and phosphoric acid (Pi), which releases energy. This process includes the availability of oxygen through the respiratory tract and glucose, primarily through the gastrointestinal tract. These together produce ATP or energy.

Certain non-occupational medical disorders such as Type 1 and Type 2 Diabetes Mellitus (DM) can complicate this process of energy production and availability to the cells of muscles. 8% of the general population has DM.

If the proper information is provided to medical personnel concerning the stresses of a job, the greater the index of suspicion they will have to consider the contribution of non-occupational medical disorders and that relationship to the onset of the illness or injury. As such more thorough medical evaluation and histories are likely to be conducted.

Basal Metabolic Rate

The basal metabolic rate, or BMR, is the minimum calorific requirement needed to sustain life in a resting individual. Thyroxin, produced by the thyroid gland is a key BMR-regulator which speeds up the metabolic activity of the body.

BMR reduces with age. After 20 years, it drops about 2 per cent, per decade.

The type and amount of activity, with consideration of the environmental temperature affect the metabolic rate. In addition, disorders of the thyroid gland increase in an aged population.

The Harris-Benedict formula (BMR based on total body weight)

The Harris Benedict equation is a calorie formula using the factors of height, weight, age, and sex to determine basal metabolic rate (BMR). This makes it more accurate than determining calorie needs based on total bodyweight alone. The only variable it does not take into consideration is lean body mass. Therefore, this equation will be very accurate in all but the extremely muscular (will underestimate caloric needs) and the extremely obese (will overestimate caloric needs).

Men: BMR = 66 + (13.7 X wt in kg) + (5 X ht in cm) - (6.8 X age in years)

Women: BMR = 655 + (9.6 X wt in kg) + (1.8 X ht in cm) - (4.7 X age in years)

Note: 1 inch = 2.54 cm
1 kilogram = 2.2 lbs

If the proper information is provided to medical personnel concerning the stresses of a job, the greater the index of suspicion they will have to consider the contribution of non-occupational medical disorders and that relationship to the onset of the illness or injury. As such more thorough medical evaluation and histories are likely to be conducted.

Cardio-Vascular Disease

As previously indicated, statistics indicate that the general population from which the workforce is selected has a number of age related, non-occupational medical disorders that may directly contribute to the risk factors for ergonomic related disorders. Some of these include:

  • More than 8 percent of the general population has Diabetes Mellitus a disorder which interferes with use of glucose;

  • With age the Basal Metabolic Rate decreases

  • Over 147,000 Americans killed by Cardio Vascular Disease (CVD) in 2004 were under age 65.

  • One in three adult men and women has some form of CVD Disease (CHD), 21.2 percent have hypertension and 2.5 percent have had a stroke.

The cardio-vascular system is made up of arteries, veins and the heart which delivers oxygen, glucose, and other nutrients to organs such as muscles, tendons, and ligaments. Certain anatomical changes to the arteries such as atherosclerosis and arteriosclerosis interfere with this delivery. A major cause of these disorders is related to the levels of lipids (cholesterol) in the blood. Elevations of cholesterol are common with aging. Often workers are under treatment for these conditions to include hypertension (high blood), hyperlipoprotenemia (high cholesterol), high triglycerides, or other cardio-vascular disorders such as arrhythmias (with medications or artificial pace makers), stints in blood vessels of the heart, etc. Any or all of these disorders may be a risk factor as a contributing factor in the development of an ergonomic related medical disorder.

If the proper information is provided to medical personnel concerning the stresses of a job, the greater the index of suspicion they will have to consider the contribution of non-occupational medical disorders and that relationship to the onset of the illness or injury. As such more thorough medical evaluation and histories are likely to be conducted.

Pulmonary Disease

One of the primary components of energy production in the human body is oxygen (O2). Normal atmospheric O2 is 21% which is diffused through the walls of the alveolar sacs in the lungs as a function of concentration and pressure with the exchange of CO2. Changes in lung tissue over time due to environmental exposures, and particularly in the case of a smoker, occur which may interfere with the transfer of these gases.

Since O2 is a primary component of the production of ATP (see Krebb Cycle) for energy to muscles, interference with the availability of O2 subjects a worker to the risk of the development of ergonomic related medical disorders.

If the proper information is provided to medical personnel concerning the stresses of a job, the greater the index of suspicion they will have to consider the contribution of non-occupational medical disorders and that relationship to the onset of the illness or injury. As such more thorough medical evaluation and histories are likely to be conducted.

Summary

The more orientation the ergonomic practitioner (ergonomist) has of, not only the usual worksite ergonomic risk factors, but also those non-occupational medical disorders related to age and the physiology thereof, the more proficient we can be in protecting workers. With this orientation our partners in the medical community will be more proficient in not only the treatment and return to duty of injured workers, but the prevention of illnesses or injuries in the evaluated worker and others.
 

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