Older workers have more serious injuries

Prevent work-related falls

As the health care workforce ages, the severity of work-related injuries is increasing, requiring new strategies for protecting workers. At the top of the list: Preventing falls, which are already the second most common cause of reportable injury in hospitals.

About one in five injuries in hospitals (21%) involve workers who are 55 or older, according to 2009 data from the U.S. Bureau of Labor Statistics. Almost one in four (23%) registered nurses who are injured are 55 or older. By comparison, older workers sustain 16.5% of injuries overall in general industry.1

A higher proportion of workplace injuries are occurring among older workers, and those workers are likely to have more serious consequences, according to data from the National Institute for Occupational Safety and Health (NIOSH). The median number of days away from work due to injury increases with age and is greatest for workers who are 65 and older, according to the analysis.2

"If employers and others don't take some concrete steps to check this trend, the numbers of injured older workers will continue to grow in the future," says Dawn Castillo, MPH, chief of the surveillance and field investigations branch in NIOSH's Division of Safety Research in Morgantown, WV.

The impact of aging on occupational injuries is especially important in health care. Almost half (45%) of RNs are 50 or older, according to the 2008 National Sample Survey of Registered Nurses, conducted by the Health Resources and Services Administration (HRSA). The average age of employed RNs is 46.3.

"The older workers experience more catastrophic injuries. A fracture is more costly than a sprained ankle," says Jennan Phillips, DSN, RN, assistant professor at the University of Alabama at Birmingham School of Nursing, who spoke on aging at the annual conference of the American Association of Occupational Health Nurses (AAOHN) in Atlanta in May.

Fracture risk higher with age

As people age, their physical changes affect their lives at work as well as at home. They may have bifocals or reading glasses that suddenly alter their depth perception as they're walking, says Phillips. They may have less muscle strength and poorer balance.

And importantly, they are more prone to fracture if they fall, Phillips notes. The NIOSH analysis found that older workers were more likely to have work-related fractures than sprains. Fractures led to a median of 32 days away from work for workers who are 55 or older, and a median of 42 days away from work for workers 65 or older.

There are some important steps employers can take to minimize the risk of falls, says Phillips. For example, walkways and stairways should be well-lit. Floors need to be kept dry and spills should be wiped up promptly, she says.

Preventing falls benefits workers as well as patients and visitors. "While we believe there are certain types of injury events that are more likely among the older workers, in most cases efforts to protect these workers are going to pay dividends by providing protections to the entire workforce," says Castillo.

Injury analysis should include information on age so employee health professionals and risk managers can consider the needs of older workers as the workforce ages, says Castillo. Older workers also may need some awareness about how medical conditions can affect their injury risk, including reduced vision, arthritis, or osteoporosis.

Workplace wellness programs also can help employees cope with chronic diseases and improve strength and flexibility, says Phillips. "The worksite is going to be an excellent place for delivery of health promotion and primary care," she says.

Interestingly, older workers are less likely to be injured due to overexertion than younger workers. They might realize their limitations and may be less likely to perform hazardous lifts, says Castillo. Older workers also may have fewer injuries because their experience makes them more cautious or able to avoid hazards, she says.

"It points to the needs for more research to understand the complexities of safety and health for older workers," she says.


1. U.S. Bureau of Labor Statistics. Case and demographic characteristics for work-related injuries and illnesses involving days away from work, 2009. Available at http://1.usa.gov/mzQBvT .

2. Centers for Disease Control and Prevention. Nonfatal occupational injuries and illnesses among older workers – United States, 2009. MMWR 2011: 60:503-508.

3. U.S. Department of Health and Human Services, Health Resources and Services Administration. The Registered Nurse Population: Findings from the 2008 National Sample Survey of Registered Nurses. Washington, DC, 2010.