ELSEVIER Safety Science 21 (1995) 145-161

Aging and occupational accidents

A review of the literature of the last three decades
Lucie Laflamme .~.b, Ewa M e n c k e l ~,b
~' Karolinska hlstitute, Department of International Health and Social Medicine. Division ~'Social Medicine,
S- 172 83 Sundbyberg, Sweden
h National Institute of Occupational Health, Division of Social and Organizational P.Lvchology, S-171 84 Solna,
Sweden

Accepted I June 1995

Abstract

This paper deals with age-related accident risks ( largely in industrial settings), and offers a synthesis
of the scientific literature of the last three decades. It is concerned with large-scale and intra-occupa-
tional studies that have investigated age-related accident frequency, severity or characteristics. It is
maintained that the findings so far shed little light on the expected direction and magnitl:d, of the
relation between aging and occupational accidents. A framework is outlined for the purpose of
identifyingjobs in which aging has either a preventive or an aggravating effect on accident occurrence.
This framework is proposed tentatively as a means for understanding the confusing findings of the
literature review, it is concluded that the safety problems of older workers may well be restricted to
activities that are specifically "age-impaired". Age-related accident problems can also be specific in
terms of injury type. Finally, it is emph~,~ized that further research would benefit greatly from
longitudinal designs, proper exposure measurements, intra-occupational investigations, consideration
of the positive effect of relevant experience on occupational safety, and greater precision with regard
to the type of accident in focus.

1. I n t r o d u c t i o n

Age is a factor of importance in assessing variability in manpower, for it introduces

differences not only between individuals at different ages but also within individuals over
time (Laviile, 1989; llmarien, 1991 ). The decremental theory o f aging proposes that, as a
person a d v a n c e s in age, some work capacities, both physical (e.g., cardiovascular function,
muscle strength, e n d u r a n c e ) and mental (e.g., sensorimotor performance, decision time,
m e m o r y ) , w e a k e n progressively, which in turn lessens the person's ability tc cope with j o b
d e m a n d s ( T e i g e r and Villatte, 1987; Teiger, 1989; Sailly and Volkoff, 1990; Davies et al.,
1991; Gary, 1991 ).

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146 L. Laflamme. E. Menckel / Safe~." Science 21 (1995) 145-161

Nevertheless, by means of compensation, older workers have the capacity to reduce

difficulties in meeting job demands through acquired experience and the more efficient
utilization of resources (Salthouse, 1990; Wan-, 1993; Warr, 1994). But it is only under
particular conditions that they can rely on their compensatory skills for this purpose (Laville,
1989; Teiger, 1989; Volkoff, 1989; Salthouse, 1990; Gary, 1991 ). First, such compensation
is only feasible for so long as job demands remain lower than overall work capacity
(Ilmarien, 1991; Wan-, 1993; Warr, 1994). Second, flexibility in working methods is
essential, compensation not being feasible where work organization and working methods
are rigid, In the long run, rigid work conditions will either force older workers to leave their
jobs or cause them considerable difficulties (Teiger, I989; Ilmarien, 1991). Further, as
body resilience diminishes with age, the probability that bodily trauma is severe or recovery
slow tends to increase.
For these reasons, and given the irreversible aging of the working population in most
industrialized countries, there is a major need to better comprehend the way in which aging.
as an individual process, and work, as an aging factor, interact with one another and affect
individual physical and mental capabilities. The current paper approaches one aspect of this
general question by addressing the specific issue of aging and occupational accidents. It
presents an extensive review of thirty years of research on age-related accident risks ( largely
in industrial settings) and discusses the empirical limits and contributions of the scientific
research conducted over this period. A tentative framework is proposed, with the objective
of distinguishing between jobs in which aging has a preventive and an aggravating effect
on accident occurrence.
Since the question of age-related occupational accident risks has been much studied over
the years, some reviews are already available. Two of these, Hale and Hale (1972) and
Surry (1969), discuss research findif~gs in the field within the frame of a comprehensive
overview of the research literature on occupational accidents, Hale and Hale (1972) from
a psychological perspective, and Surry (1969) from a human engineering one. A later
review, produced by Rhodes ( ! 9 8 3 ) at the beginning of the eighties forms a part of a
broader survey addressing age-related differences in work attitudes and behaviour. A further
and updated review by Hale and Hale (1986) focuses on the accident experiences of young
workers and the relation betweev, accidents and age, special attention being paid to individual
experience as a preventive fac'~or. Finally, Davies et al. ( 1991 ), with a specific interest in
age and job pertbrmance, concentrate on the accident experiences of older workers and the
relation between accidents and aging.
Though these reviews were embarked upon for different purposes, they all concluded
either that the lindings were not consistent or their interpretations not convincing. Several
pointed to the existence of methodological shortcomings, and deplored a rather widespread
lack of theoretical underpinnings.
It appeared also that large-scale studies (national, cross-sectoral, sectoral or within broad
occupational groups) can produce results that conflict with those of studies conducted at
liner levels (controlling lbr occupational exposure or task-related risk factors). But, the
lines of reasoning on which these two kinds of studies rest are quite different (Hale and
Hale, 1986). Large-scale studies are used to investigate whether age is a factor in deter-
mining accident occurrence, regardless of the type of risk encountered; they assume ( which
is highly questionable) that job-related risk factors are equalized between age groups. By
 L. Laflamme, E. Menckel / Safety Science 21 (1995) 145-161 147

contrast, intra-occupational studies address the question of whether exposure to a given

type of job-related risk may help explain age differences in accident patterns. For these
reasons, the two kinds are treated separately in the current review.

2. Material and methods

2.1. Literature s e a r c h

The material was gathered through searches in a variety of data bases relevant to the
occupational arena, through scrutiny of reference lists and lists of publications, and through
personal contacts. Searches were made in the international data bases CISILO, NIOSHTIC,
MEDLINE, PSYCH INFO and in the Swedish data bases ARBLINE and SWEMED. The
key words employed tbr all searches were "accident/injury" in combination with "elderly/
older/age/age factors". "Fatal" and "aging/ageing" were also utilized in the NIOSHTIC
search, while a handful of other key words indexed in the other data bases were also
employed.
Further, the reference lists of a variety of relevant scientific articles were scrutinized, as
too were the reference lists for the Swedish research program "'Good working environment
for the elderly" (based at Sweden's National Institute of Occupational Health) and the lists
of publications issued by "The Swedish National Committee on the European Year of
Older People 1993" (a body whose tasks are commissioned by The Ministry of Health and
Social Affairs).

2.2. Literature selection

A preliminary review of just over 100 references was undertaken, generally by reading
the abstract to the articles. Thereafter, relevant articles (with the exception of those in
languages other than English, French or Swedish) were studied. At the next stage only
refereed articles published in indexed international journals were included. Five reviews
(see above) were examined with great care in order to highlight the issues and knowledge
requirements relevant to the current review.
The criteria employed to make a final selection from among the articles were based on
the tbllowing considerations:
!. The review was to go back to 1970, Surry (1969) and Hale and Hale (1972) having
covered extensively the period up to the beginning of the 1970s.
2. A relevant "event" would be one that had been regarded as an accident (usually a
reported injury of some defined nature and severity), because of the non-uniform defi-
nition of the concept of accident between studies.
3. The accident studies would have to concern industrial work (thus studies dealing with
traffic accidents were excluded).
4. Relative measures by age category (i.e., numerator data) should have been employed.
Although they do not have the same reliability (Hale and Hale, 1986), the following
accident indicators were considered: three for accident frequency (accident/injury fre-
quency, incidence rate, accident ratio); four for accident severity (number of lost working
148 L. Laflamme. E. Menckel / Safety Science 21 (1995) 145-161

days by accident, temporary disability, permanent disability, fatality); and for accident
characteristics, any parameter measured.
Finally, both large-scale and intra-occupational studies were considered provided they
dealt with populations of workers employed in traditional industrial work (thus no pilots,
bus drivers or taxi drivers) and were amenable to comparisons over a reasonable age range
(thus, for example, no study covering solely workers older than 50 would be eligible for
inclusion).
A total of 22 studies met these criteria. They can be classified into three non-mutually
exclusive categories: 16 large-scale studies, 6 intra-occupational studies, 5 studies dealing
with accident characteristics.

2.3. hlformation compiled on each publication

For each article retained, information on the following was compiled:

1. the aim of the study,
2. the industrial sector and occupation concerned,
3. the gender of the workers studied,
4. the age categories taken into account (if there was no scale),
5. the methodology used to test for differences, and
6. the results obtained and their significance.

3. Studies of age and occupational accidents: main findings

The review is presented in the following order. First, large-scale studies are described,
considering accident frequency and accident severity (using various indicalors) in turn.
Second, based on the same parameters, the few studies making intra-occupational compar-
isons are considered. Finally, attention is paid to the in|ormation found in the literature
regarding age-related accident characteristics.

3.1. Large-scale studies of accident frequency and severity

Accident frequency
The studies in Table 1 are listed in chronological order. For each of them, the table
indicates the initial study question addressed, the sectors and occupations covered, in what
way gender differences have been considered ( B o t h = t w o genders aggregated; M /
W = each gender separately; M = men only), the number of age categories considered
(referring to the lowest and highest categories where applicable), the accident-frequency
indicator used, and the results obtained with regard to age-related associations.
A first look at Table 1 reveals that the large-scale studies conducted on age-related
accident frequency are somewhat difficult io compare with one another. Indeed, the sectors,
occupations and age categories considered vary considerably; the data sources and indicators
are not always similar, and, while some studies aggregate male and female ~orkers, others
either consider them separately or study solely male populations.
 L. Laflamme, E. Menckel / Safety Science 21 (1995) 145-161 149

Table I
Large-scale studies o f age and accident frequency: A summary of the research findings

Authors Study question Sector Occupation Gender Age groups Indicator Relation

Simonds and Company vs, Several sectors All categories Both Average age Injury rate Negative
Shafai-Sahrai individual in company
( 1977 ) characteristics

Chelius (1979) Business activity, Manufacturing All categories Both % 18-35 Injury rate Negative;
age distribution category Negative also
and accidents with economic
activity

Dillingharn Age, occupation Across industries Blue-collar, M/W 3 ( - 25, Incid. rate all Negative for M,
( ! 981 a) and injury white-collar, 25--44, occup. positive for W
service 45 + )
Inj, rate by Negative -blue-
occup. collar ( f o r M ; for
W ) ; Other tee.
"'O" form

Dillingham Gender Across industries 8+ 6 M/W 3 ( - 25. Incidence M greater than

(1981b) differences in categories 35--44. rate W; M and W
injury risk by 45 + ) more alike in
occupation homogeneous
occupations

Root ( 1981 ) Industry, IO industries All categories Both 9 ( 16--17I Injury ratio Inverted "'U'"
occupation, age 66 + ) except in some
and accidents industries

Leigh (1986) Individual vs.job Industrial sectors All blue-collar Both Scale Injury rate Negative. age
characteristics loses sig. with
job related
variables

Baker (1987) Ethnicity and Automobile plant Machiner. M 5 ( 15-24/ Mean ft. by Negative
accidents assembler 55-64) age category

Muellcr et al. Personal vs. work Offshore drilling 13 occupations M 3 ( - 25. Incidence Negativeindep.
(1987) history factors units (fleet) 25-34. rate effect of age. but
and accidents 35 + ) hisaer under job
changes

Shahani (1987) Aging and risk of Petrochemical 5 groups Both 5 (21-30/ Frequency "'U"-shaped
accident plant 6i + ) rate
involvement

Butani (1988) Age, experience Coal mining All categories Both 8 ( 15-20/ Accident No relation;
in company and 50 + ) frequency Negative relation
accidents for experience

Mitchell (1988) Age vs. sectorial I I industries 12 occupations Both 6 ( -25/ Incidence Negative age
and occupational 65 + ) rate coefficient sig.
characteristics even with
industry and
occupation
Oleske et al. Injury/illness Car parts and All Both 4 ( - 29/ Incidence Negative
(1989) surveillance manufacturing 50 + ) rate
system companies

Landen and Workers 50 + National study Blue or white- M/W 2 ( 30---49 vs. Injury rate Negative for
Hendricks injury rate and collar 50 + ) with or both genders
(1992) consequences without lost with both
days indicators;
F~r¢-eptblue-
collar W 5 0 +
higher rate than
W 30--49 and
than M 50 +
I50 I.. Laflamme. E. Menckel / Safe~ Science 21 (1995) 145-161

Nevertheless, it can be observed that the most common finding in these studies is that
accident frequency tends to deck-ease as age increases (Simonds and Shafai-Sahrai, 1977;
Chelius, 1979; Dillingham, 198 ! a; Leigh, 1986; Baker, 1987; Muelleret al., 1987; Mitchell,
1988; Oleske et al., 1989; Landen and Hendricks, 1992). But it ~:an also be observed, in
other instances, that accident occurrence is related to age either 9ositively (Dillingham.
1981 a; Diilingham, 1981 b; Landen and Hendricks, i 992), or curvilinearly, taking the shape
of either a "'U'" (Dillingham, 1981 a; Shahani, 1987) or an inverted " U " (Root, 1981 ).
Secondly. some authors did not find any relationship between age and accidents (Root,
1981 ), even after controlling for the firm/sector in which the workers were employed. A
relationship was also found to be absent in a specific sector (Butani, 1988) and in a given
type of occupation (Shahani, 1987). These latter results contrast with those of Mitchell
(1988) who found a persisting age effect (especially for workers younger than 25 or older
than 65) after taking industry and occupation into account.
Thirdly, all occupations aggregated, it was reported that women older than 45 have a
higher injury rate than others, especially than ~hose below 25 (Dillingham, 198 l a). How-
ever, this difference, rather than being attributable to age per se, can be explained by an
uneven distribution between occupations of women in different age groups: women older
than 45 were concentrated in blue-collar occupations, while those younger than 25 were
mainly in white-collar ones (Dillingham, 198 l a ) .
Further, in the particular case of blue-collar female workers, it was observed that those
in higher age groups have not only more accidents than younger ones (Dillingham, 1981 a;
Dillingham, 198 lb; Landen and I-iendricks, 1992) but also more than men of the same age
in the same type of j o b (Landen and Hendricks, 1992).
Conversely, other m e n - w o m e n comparisons indicate that, all occupations aggregated,
men tend to have more accidents than women; but that these difl~rences may well disappear
when occupations where male and female distributions are more similar to ea~.h other are
considered (Dillingham, 1981 b).

Accident severio,
Table 2 presents the results compiled on the relation between age and accident severity.
It is structured in the same way as Table I and refers to the various indicators used to
measure relative accident severity ( n u m b e r of lost working days per accident, disability
incurred, be it temporary or permanent, and fatality rate).
The most common finding in these studies is that age-related accident severity tends to
increase with age. This applies to fatalities (Root, 1981 ; Buskin and Paulozzi, 1987; Mitch-
ell, 1988), permanent disabilities (Root, i 981 ; Mitchell, 1988; Dillingham, 1981 b) and the
average number of lost working days per accident ( Diilingham, 1981 a; Dillingham, 1981 b;
Landen and Hendricks, 1992).
A negative relationship was found in the case of temporary disabilities (Root, 1981;
Mitchell, 1988); in the specific case of amputations (Jensen and Sinkule, 1988); and also,
in some instances, with regard to the average number of lost working days for white-collar
and service workers (Dillingham, 1981 a).
Additionally, in the case of the number of lost days per injury, seemingly the least stable
indicator, U-shaped (Cook and Blumenstock, 1979; Dillingham, 1981a; Dillingham,
 L. Laflamme, E. Menckel / Safety Science 21 (1995) 145-161 151

Table 2
Large-scale studies of age and accident severity: A summary of the research t~ndings

Authors Study question Sector Occupation Gender Age groups Indicator Relation

Cook and Injury ~verity Sawmills All production M Scale ! 8-64 Lost days "U"-shaped
Blumenstock determinants
(1979)

Dillingh,'tm Age, occupation Across industries Blue-collar, M/W 3 ( - 25, Lost days Positive M + W
(1981a) and injury white-collar, 25--44, Penn. dis. "'U'" men;
service 45 + ) posit. W
Fatal "'U'" M and W
Indicators by Fatality same
occup. pattern; Penn.
disab, varies

Dillingham Gender Across industries Aggregated M/W 3 ( -25. Lost days No difference
( 1981 b) differences in occupations 35---44, Mvs. W
injury risk by 45+) Perm. dis. M > W all age
occupation cat
Temp dis. M > W all age
cat.

Root ( 1981 ) Industry. 10 industries All Both 9 ( 16-171 Tcmp dis. Negative,
occupation, age 66+) inverted "'U'"
and accident Perm. dis. Positive
Fatality Positive

Buskin and Fatal injuries and Construction All categories Both no ( 16--171 Fatality Positive
Paulozzi (1987) age 65+ ) (PMRs)

Shahani (1987) Aging and risk of Petrochemical 5 groups Both S (21-30/ Proportion No difference
accident plant 61+) major
involvement accidents

Jensen and Press operator Across 28 states Press oper-tors M/W Scale 18-64 Amputation Negative; N o
Sinkule (1988) amputations late ~ x difference

Mitchell (1988) Age vs. sectorial ! ! industries i 2 occupations Both 6 ( - 25/ Temp dis. Negative
and occupational 65+ ) (-25)
characteristics
Penn. dis. Positive
(65+)
Fatality Posidve
(65+)
All three Positive blue-
collar effect

t.anden and Workers 5 0 + National study Blue or white- M / W 2 (30--49 vs. Injury rate Negative for
Hendricks injury rate and collar 50 + ) with or without both .sexes with
(1992) consequences lost days both indicators;
E,¢ceptblue-
collar W 50 +
higher rate than
W 3{)---49"and
M 50+
 152 L Laflamme, E. Menckel / Safety Science 21 (1995) 145-161

Table 3
Intra-occupational studies of age and accidents: A summary of the research findings

Authors Study question Sector Occupation Gender Age groups Indicator Relation

Giniger et al. Speed and skilled G,'ument industry Speed jobs. W 6 ( - 25/ Accident rate Negative for
( i 983) jobs. experience. Skilled jobs 65 + ) speed jobs;
age. oerfermance None for
skilled jobs

~Jeigh (1986) Individual vs. job Industrial sectors All blue-collar Both Scale Injury rate Negative
characteristics as with indiv.
accident predictors variables;
None when
job-related
variables
enter the
analysis

Shahani ( ! 987) Aging and risk of Petrochemical 5 job families Both 5 (21-30/ Frequency rate "'U"-shaped
accident plant 61 + ) by occupation in 3 job
involvement families (up
to 61 in 2
families);
Negative in 2
families
Mitchell { 1988) Age vs. seetoriai 11 industries Blue-collar, Both 6 ( - 25/ Incidence rate Negative;
and occupational white-collar, 65 + ) Positive
characteristics ~rvice blue-colh'u-
effect even if
control for
age

David and Disability and Municipal services Blue-collar M 5 (17-241 Accident rate "U"-shaped
Bigaouette retirement patterns ( I municipality) workers 65 + ) but higher
(1989) among blue-collar rate for 65 +
workers

Cloutier (1994] Effect of age on Municipal services Traxh M 2 ( - 35 vs. Accident rate Negative
safety and work (domestic) collectors 35 + ) Average lost None
practices days

1981b) and inverted-U shaped (Root, 1981 ) curves as well as no relationship at all have
been reported (Shahani, 1987).
However, a " U " - s h a p e d relation was also reported for permanent disabilities in the case
of male workers (as opposed to a positive one in the case of w o m e n ) and for fatalities, for
both men and w o m e n (Dillingham, 1981a,b).
Finally, all occupations aggregated, m e n - w o m e n comparisons suggest that men tend to
have a comparable average-lost-time-per-injury to women, but higher rates of permanent
disabilities and fatalities ( Dillingham, ! 981 b).

3.2. lntra-occupational studies on accident frequency and severity

Table 3 presents the findings of the few intra-occupational studies that have investigated
age-related accident risks. These are presented in the same manner as in the former tables,
 L. Laflamme, E. Menckel / Safety Science 21 (1995) 145-161 153

with the exception that frequency and severity indicators are considered simultaneously.
As can be observed from the table, several of the studies that have investigated more
thoroughly the relation between age and accidents within similar occupations are still
conducted on a rather large scale. The exceptions are Giniger et al. (1983), David and
B igaouette (1989) and Cloutier ( 1994 ). Only one study has some observation and interview
material to which findings are related (Cloutier, 1994).
It ought to be stressed that some of these studies show that the risk of accidents varies
from one occupation to another (Shahani, 1987; Mitchell, 1988) and that the proportion of
workers by age category can vary tremendously (Shahani, 1987; Mitchell, 1988; David and
Bigaouette, 1989).
As for large-scale studies, a common finding is for there to be a negative relation between
age and accident frequency (Giniger et al., 1983; Shahani, 1987; Mitchell, 1988; Cloutier,
1994). The study conducted by Giniger et al. (1983) suggests that there is no such relation
in ~killed jobs (as opposed to ones involving speed tasks).
A "U"-shaped relation was found by David and Bigaouette (1989), and this was
attributed to the fact that, in their study group, older workers were found in jobs that normally
have younger occupants. A "U"-shaped relation was also reported by Shahani (1987) in
the case of two high-risk (and heterogenous) occupational groups (comprising boilermak-
ers and welders; and, carpenters, insulators, painters and garage mechanics). In both cases
workers between 21 and 30 were those with the highest accident risk, while workers between
41 and 50 faced the lowest risk. For the boilermakers and welders, workers between 51 and
60 had a higher accident frequency than those of 61 and over, for the other group (carpenters,
etc.) the relationship was the opposite.
When accident severity was investigated, which was rather infrcquently, no age-related
differences were found, either for the average number of lost working days by injury, by
occupation (Cloutier, 1994), or for the proportion of serious injuries, by and across occu-
pations (Shahani, 1987).

3.3. Accident characteristics

Table 4 shows that age-related accident characteristics constitute an area of research that
is surprisingly sparsely covered in the age-related accident-risk literature. When it was
investigated, the parameters used to make age comparisons were mainly those that describe
the injury (i.e., nature of the injury, part of body injured, agent/source of injury) or the
type of accident. In two studies an attempt was made to relate age to multivariate accident
characteristics (Oleske et al., 1989; Cloutier, 1994).
One large-scale study (Root, 1981 ) takes one characteristic at a time. it indicates that
one part of the body, the back, is more frequently injured among older workers, while
others, such as the eyes and hands, tend to be injured among the younger (teenagers). Also,
with increasing age, injuries to the legs and body systems become more frequent. As for
the nature of the injury, fractures, hernias and heart attacks are more frequent among older
workers, whereas cuts and lacerations, and also burns, tend to occur less frequently as age
increases. Regarding the source of injury, non-power hand tools are more frequently found
to be the injury source among younger workers, whereas the working surface accounts for
more injuries among middle-aged and older workers. Consequently, in terms of one clas-
 154 L. Laflamme. E. Menckel / Safety Science 21 (1995) 145-161

Table 4
Studie~, o f age-related a c c i d e n t characteristics: A summary of the research findings

Authors Study question Sector Occupation Gender Age groups Indicator and relation

Root Industry, occupation. 10 industries All categories Both 9 ( I6-17/ Nature ofinjur3":
( 1981 ) age and accidents 66 + ( strongly related to age
Part of body: strongly
related to age
T.we of accident:
partly related to age
Source ~ injury:
partly related to age

Sinkule Incidence of National study All Both 2 ( - 50/50 + ) Musculoskeletal

et al. musculoskeletal ( 30 states) injur3": lower
(1986) injuries in aging indidence for workers
workers 50 + than those - 50

/ensen Press operator Across 28 state.~ Press operators M/W Scale ! 8 - 6 4 Amputation:
and amputations negatively related to
Sinkule age
(1988)

Oleske Injury/illness Car part~ and All Both 4 ( - 29•50 + ) Accident t.,pe
et al. surveillance system manuf, a n d i n j u ~ , t.we: some
(1989) companies combinations are more
typical for certain age
groups

Cloutier Effect of age on safety Municipal Trash collectors M 2 ( - 35 vs. Accident patterns:
(1994) and work t -'actices services 35 + ) relation between age
(domestic) and accident pattern

sification of accidents by type, falls (especially at the same level) are more frequent among
older workers, while '~being struck by and striking against" shows a negative relationship
to age.
In the particular case of musculoskeletai injuries, Sinkule et al. (1986) found a lower
incidence rate among older workers; in their view, the skewed distribution might reflect the
so-called "'healthy-worker effect".
Looking at clusters of characteristics, Oleske et al. (1989) found that some - - b u t not all
---combinations of accident type and injury type were more typical of certain age groups.
For example, sprains/strains due to overexertion were more frequent among older than
younger workers; conversely, contusions associated with being struck by an object (boxes
in this case) were more frequent among the young than the old.
Using two age categories cross-tabulated against five accident patterns, Cloutier (1994)
revealed that older (than 35) and younger (than 35) workers performing physically-
demanding jobs did not exhibit the same patterns. Younger workers suffered more cuts to
the hands and legs from sharp or pointed objects, more falls and collisions with vehicles,
containers or other objects, and more contacts with liquids (leading to eye and respiratory
irritation) than expected. For their part, older workers had more accidents resulting in back
and shoulder pain, and showed a greater proneness to falling and slipping.
 L. Laflamme, E. Menckel/ Safety ,~cience21 (1995) 145-16! 155

4. Discussion

4.1. Aging and accideut frequency

Compensation or unequal exposure?

The empirical evidence on age-related accident risks points to the likelihood of the
possession of compensatory ability by oldei" workers (safer work behaviour) rather than to
a deterioration of work capacity that would make them more accident prone than their
younger peers. This provisional judgement rests on comparisons made in several large-scale
studies rain broad job categories such as blue-collar workers (Mitchell, 1988), in some
groups of "'low-risk occupations" (Shahani, 1987) and in some speed jobs in the garment
industry (Giniger et al., 1983). Such a judgement is also in accordance with the findings
of earlier reviews (Hale and Hale, 1972; Hale and Hale, 1986; Surry, 1969; Hale and Hale,
1986; Davies et al., 1991 ).
However, one plausible explanation for this apparent phenomenon lies in the existence
of systematic differences in the exposures to hazards of different age groups. Indeed, the
assumption of equality of risk exposure has little theoretical foundation (Rhodes, 1983;
Hale and Hale, 1986), and has often been refuted empirically (see examples in Dillingham,
1981a; Leigh, 1986; Mitchell, 1988). Thus, in the absence of uniform data on exposures
for various age categories ---or proper control for risk exposure - - the likelihood that an
unequal distribution of risks across age groups is the main factor in the explanation of age
differences is high (Dillingham, 198 la; Hale and Hale, 1972; Rhodes, 1983; Hale and Hale,
1986; Mitchell, 1988; Davies et al., 1991 ). This makes rather questionable the drawing of
any rapid conclusions on the basis of large-scale studies, and in some instances, even from
intra-occupatiomd ones, due to the large occupational aggregations that have been made.

Age-related risk according to a four task-category framework

Even when job content is controlled for, age in itself might not be adequate as an indicator
c f lhe work-related effect of aging. In fact, it might be the case that the relation ought to be
t, nderstood in a more complex manner, taking into account not only age-related restrictions
on individual capacities but also the gains in work performance (and in risk handling) made
possible by appropriate experience. In this respect, in a recent study, Wart (1993) has
suggested that understanding of age-related performance at work would benefit greatly from
it being regarded in the light of three sets of attributes: physical ubilities, adaptability, and
general work effectiveness. While both physical abilities and adaptability would tend to
decline as people grow older (with wide individual variation), general work effectiveness
might remain stable or even increase with age.
Based on these considerations, Warr (1993) has proposed a framework within which
occupational activities are classified into four categories: ( 1) age-impaired, (2) age-coun-
teracted, (3) age-neutral, and (4) age-enhanced. In Warr's view, and this is his primary
concern, age is a negative factor in occupational pen~'ormance for only some kinds of work
activities (i.e., those that fall into just one of the categories out of the four).
Warr's framework (also described in Wart, 1994) can be presented in the form of a
matrix in which what is called a task category correspc~nds to a combination of the values
ef two dichotomous aspects of the individual in relation to work. The first is concerned with
156 L ~ f l a m m e , E. Menckel / Safety Science 21 (1995) 145-161

Table 5
Four categories of job activities and expected relationshipsof performance and accident occurrence with age

Task category Basic capacities vs. task Performance Expected relationshipwith age
requirements enhancement
i.e. ihe acti~,itie.~' are im:reasi:igly exceeded made possible with Performance Accidents
relevant experient e?

1. Age-impaired yes no Negative Positiveor U-

shaped
2. Age-counteracted yes yes None None or inverted-U
3. Age-neutral no no None None
4. Age-enhanced no yes Positive Negative

the question o f whether or not an individual's basic physiological capacities are increasingly
exceeded by task requirements as age increases. This question is answered in the affirmative
for the first two categories and in the negative for the other two. The second is concerned
with whether or n o t " p e r f o r m a n c e enhancemer tt" is made possible by gains from experience
in the j o b (gains which might not be linearly related to age, see Warr, 1994). This second
question is answered ill the affirmative for categories 2 and 4, and in the negative for
categories 1 and 3. Combining these answers generates the four job categories referred to
above.
An adaptation of W a r r ' s framework (Warr, 1993) is presented in Table 5. The first four
columns are adapted from Warr, while the final column incorporates the current authors'
hypotheses on the expected relation between accidents and age for various job categories.
In what follows descriptions are provided of the four classes, and examples are given of
research findings that seem to be in line with the hypotheses presented.
A g e - i m p a i r e d a c t i v i t i e s have the twin characteristics that basic individual capacities are
exceeded by j o b demands to a greater extent in the case of older workers and that their
experience cannot (possibly in the long run) compensate for age-related shortcomings.
Thus, age and performance are negatively related, although not necessarily in a linear fashion
(Warr, 1994). Activities of this kind include continuous rapid information processing and
some forms of strenuous physical activity (e.g., paced activities involving physical or
postural loads). They may involve rapid learning or rapid change. Jobs where examples
have been found of productivity deteriorating with increasing age include those of factory
workers (reviewed in Wan-r, 1994).
With regard to the implications of this for the relationship between age and occupational
accidents, it might be hypothesized that age-impaired activities may generate one of two
possible relations: positive or curvilinear (U-shaped).
Hypothetically, a positive relation would be observed in work situations where demands
are such that deterioration in capacities associated with age makes it impossible to rely on
job experience to compensate for difficulties encountered in performing the occupational
task. Such a relation has been observed in the case of female blue-collar workers in the
large-scale studies of Dillingham (1981a) and Landen and Hendricks (1992),
However, for some other kinds of age-impaired activities, a kind of U-shaped relation
might be expected. This might occur when a combination of age and experience is beneficial
to workers for a certain period of time, but becomes less of an advantage after a certain age.
 L. Laflamme, g. Menckel / Safety Science 21 (1995) 145-161 157

The accident rate would decrease with age over the first period, only to increase over the
next. Such an interpretation of a U-shaped accident-frequency distribution might be applied
to the findings of Shahani's study (1987), conducted in a petro-chemical plant. In this ease,
a U-shaped accident distribution was observed for two"high-risk" occupational categories
(boilermakers and welders; and, carpenters, insulators, painters and garage mechanics). A
further striking example of a U-shaped distribution in line with this hypothesis is to be found
in David and Bigaouette's ( 1991 ) study of a job where older workers had been undertaking
tasks previously performed by younger workers (see also Griew, 1958).
In age-counteractedactivities, older workers may be confronted by increasing difficulties
as a result of a decline in their information-processing or physical capacities, but they are
able to compensate for these in some way. In activities of this kind (such as skilled-manual
and cognitive work) individuals are able to learn how to counteract their deteriorating basic
ability-to perform (Warr, 1993). Examples of age-counteracted activities have been found
among sales staff, mail sorters, shoe-leather cutters and para-professionai family advisers
(reviewed in Warr, 1994).
Regarding the relation between age and occupational accidents it can be supposed that
age-counteracted activities may also produce two different relations: no relation at all or a
curvilinear one (an inverted-U in this case). The relation would be non-existent in cases
where gains in experience immediately counteract any effects of age on capacity. Studies
that exemplify such a relation are those of Giniger et al. (1983) for skilled jobs in the
garment industry, and of Butani (1988) for the coal-mining industry (all occupations
aggregated). In the latter study, moreover, experience in the company (though not in any
specific occupation within it) was found to be negatively associated with accidents, sug-
gesting the possibility that such a general form of experience may have a positive effect m
on performance or on safety. However, as discussed above, job assignments within a
company may also change with age.
On the other hand, a curvilinear relation (of an inverted-U type) is also possible. This
might apply, for instance, in tasks where experience is acquired relatively slowly while
limitations to basic capacities make themselves strongly felt very early on. In our review,
the only study to obtain a result of this kind, a large-scale one in which 10 industries and
occupations were aggregated, was that of Root ( 1981 ). A peak was reached in the injury
ratio in the age range 20-24, only to decline steadily up to the age of 65 and above.
For age-neutral activities, which are generally relatively undemanding and where work
is largely unproblematic and fairly routine, no noticeable age gradient in either direction
might be expected. Warr (1993) points out that there are many occupational tasks of this
kind.
Age-neutral activities are most likely to be associated with the absence of a relation
between occupational accidents and age. A relevant example is to be found in Giniger et
al.'s ( i 983) findings concerning skilled workers in the garment industry. The authors" own
interpretation of this result is that performance in this industry, and in this kind of work
generally, does not depend on specific job demands but rather on the experience of the
worker.
The final task category, that of age-enhanced activities, is characterized by activities that
remain within basic capacities despite advancing years, and performance that is improved
as a result of experience. Such tasks require "'knowledge-based judgements" but impose
158 L Laflamme. E. Menckel / Safety Science 21 (1995) 145-i61

"'no time pressure"; they often involve substantial knowledge relevant to the job (Warr,
1993; Wan-, 1994). It may be supposed that they are more "quality" than "quantity"
oriented, intellectually as well as physically.
A remarkable example of an age-enhanced activity is to be found in Giniger et al.'s
(1983) study of the garment ;.aa_us,ry. In the case of speed jobs in the industry, age-related
limitations to capacity were expected, but gains in experience seem to have worked in favour
of older workers in many respects, including with regard to occupational accidents. This
was also the case among the municipal trash collectors investigated by Cloutier (1994).
Differences in working methods between older and younger workers were revealed, which
suggests the possibility that, despite the physically demanding nature of the work, there
were means of occupational adaptation that had favourable results on both performance and
accident occurrence.

A d d i t i o n a l considerations
The framework posits that there is only one task category where performance is likely to
be impaired by age and, hypothetically, accident occurrence likely to be higher. The aging-
and-accident studies have only been placed in this framework tentatively, but it seems that
it might provide a way forward in understanding the data accumulated so far. Of course,
due to a lack of specification of the activitie~ involved in jobs or occupations, it is difficult
to establish with certainty the relevant activity category ir the bulk of the studies reviewed.
At the same time, it has to be stressed that variation between one type of activity and
another is "continuous rather than discrete" in normal work settings (Warr, 1994). The
categories proposed can be expected to overlap rather than be distinctly demarcated. For
just this reason, even within any one job, age may have different relationships with per-
formance or safety. But since job performance an6 occupational safety will be a function
of both accumulated experience and declining basic capacities, an observed relationship
with age might still be expected to reflect the relative strength of the two types of age-
related influences.
In addition, when considering individual variations in older age groups, there are good
reasons to believe that some older workers, less mentally or physically capable of meeting
job demands, leave demanding and hazardous jobs. Consequently, the possibility of a
selection bias, which leaves in the workforce a select group of older workers (the ' 'healthy
worker effect" ) with a relatively high work capacity (Laville, 1989; Teiger, 1989; Volkoff,
1989) or a greater capacity to work safely (Landen and Hendr;cks, 1992), cannot be
excluded.

4.2. A g i n g a n d a c c i d e n t severity

The empirical evidence on accident severity tends to support the idea of diminishing body
resilience with increasing age. This is mainly revealed by large-scale studies, specifically
in the case of permanent disabilities and, to some extent, with regard to fatal injuries.
Nevertheless, no age-related differences were reported in intra-occupational studies, either
for the average number of lost working days by injury, by occupation (Cloutier, 1994), or
for the proportion of serious injuries, by and across occupations (Shahani, 1987).
 L. Laflamme. E. Menckel/ Safety Science 21 (1995) 145-161 159

To explain the phenomenon of a positive relationship between age and accident severity,
it is common to argue that older workers require a longer period of recuperation because of
physiological changes, associated with age, that affect the body's capacity to heal (Davies
et ai., 1991; Gary, 1991; Rhodes, 1983). However, it has been pointed out that other kinds
of factors may also influence the average time of recovery. These include changes in the
propensity to report minor accidents (which might diminish with age), the influences of
socio-economic actors (e.g., the victim, management, physicians) who determine the num-
ber of recuperation days (Volkoff, 1989), and the type of hazard to which the person is
exposed.

4.3. Aging and accident characteristics

In the light of the current review, it appears that older workers may be at greater risk with
regard to certain specific types of accidents, in particular those incurred to the back and
lower limbs (for examples, see Oleske et al., 1989; Root, 1981; Cloutier, 1994). This
suggests that age-related proneness to accidents might be specific rather than diffuse, and
implies that considering all types of accidents simultaneously may disguise age-related
differences.
As discussed elsewhere (Laflamme, 1990), the accidents to be found in occupational-
accident registers (which is the data source lbr all the studies reviewed) are placed there as
a result of a legal or juridical definition. Unfortunately, such a definition may not suit the
operational requirements of accident research, especially when individual differences due
to age are sought after. Perhaps, and even more importantly, the definition is too wide to
offer support for conceiving and taking preventive measures.

4.4. Methodological shortcomings

Some methodological shortcomings of most of the studies reviewed ought to be re-

emphasized (see also Rhodes, 1983). First, there is a lack of longitudinal investigations,
which makes any statement on individual aging and accidents difficult. In addition, in
several comparisons of accident frequency or severity, statistical techniques requiring a
normally-distributed dependent variable were used without testing the normality assump-
tion. In fact, occupational accidents tend to have a Poisson distribution rather than a normal
one. Moreover, in the absence of proper control for risk exposure, age per se has to be
considered as a weak explicator of accident occurrence. Factors others than age could either
account for the relationship or disguise it.

5. Conclusion

The current review highlights the fact that, in the absence of proper control for the kind
of work performed and risk exposure, any age-related decrease found in occupational-
accident occurrence may be erroneously attributed to the preventive effect of age in itself,
rather than to occupational "age-grading" (Warr, 1994). In the light of the framework
presented, it is suggested that it might only be in some tasks that a negative effect of aging
160 L. Laflamme. E. Menckel / Safety Science 21 (1995) 145-161

on accident occurrence is to be expected. These are tasks where basic capacities are increas-
ingly exceeded by job demands as workers age, and where experience cannot compensate
for this.
The safety problem of older workers may well be restricted and specific: restricted to
age-impaired activities, and specific in terms of injury type. On this latter point, the studies
available do suggest that workers of different ages are susceptible to different kinds of
injuries. On another dimension, as suggested by Giniger et al. (1983), it might be the case
that older workers are less prone to accidents preventable by judgement than they are to
those preventable by rapid response.
in the light of the limitations to which attention has been drawn, it appears that further
research would benefit greatly from longitudinal designs, proper exposure measurements,
intra-occupational investigations, consideration of the positive effects of relevant experience
on occupational safety, and greater precision with regard to the type of accident in focus.
In any event, it should be k r p t in mind that the relationship between age and either safety
or performance at work is reciprocal and not unidirectional. While there are jobs that permit
aging, some others do not; and there are jobs in which people age more quickly (Teiger,
1989).

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