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Safety and ergonomic considerations for an aging workforce in the US

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Work 33 (2009) 307–315 307
DOI 10.3233/WOR-2009-0878
IOS Press

Safety and ergonomic considerations for an

aging workforce in the US construction
industry
Sang D. Choi∗
Department of Occupational & Environmental Safety & Health, University of Wisconsin-Whitewater, Whitewater,
WI, USA

Received 27 November 2007

Accepted 18 February 2008

Abstract. The US construction workforce is aging as millions of baby boomers move toward retirement age. Older workers
make a substantial contribution to construction in terms of skills and experience. However, construction is still one of the
most physically demanding occupations, hence the health implications for older workers. Descriptions of injuries, illnesses and
fatalities among older workers in the US construction industry from recent literature are presented along with the practical health
and safety interventions that have been proposed including: ergonomic interventions, wellness programs, worksite housekeeping,
training, and safety climate. Understanding the risks and hazards in specific industries could help identify training and intervention
requirements to meet the challenges facing aging workers in these occupational groups.

Keywords: Aging workforce, ergonomics, health interventions, occupational injury, construction

1. Introduction The boom in construction is so widespread that project

Construction remains one of the largest industries
in the United States, historically constituting about 10
percent of the nation’s gross national product and em-
ploying some 10 million workers [44]. The construc-
tion industry is consistently ranked among the most
dangerous and accounts for a disproportionately large
percentage of all occupationally related illnesses, in-
juries, and deaths [13]. This sector recorded 1,224 fatal
work injuries, the highest of any sector and represents
an increase of 8 percent over 2003. The increase was
led by a jump in fatalities among specialty trade con-
tractors (629 in 2003 to 752 in 2004 [7]) is also noted.
∗ Address for correspondence: Sang D. Choi, Department of Occu-
pational & Environmental Safety & Health, University of Wisconsin-
Whitewater, 800 West Main Street, Whitewater, WI 53190-1790,
USA. Tel.: +1 262 472 1641; Fax: +1 262 472 1091; E-mail:
chois@uww.edu.
delays and shortages of materials and labor are com-
mon [60]. Most employees in the construction industry
work full-time and many work over 40 hours per week.
Construction workers may sometimes work evenings,
weekends, and holidays to finish a job or take care of an
emergency. This incredible growth has brought many
inexperienced workers into the field, which may also be
contributing to the relatively high-injury rate compared
to that in other industry sectors [16].
To complicate the situation, the US workforce is ag-
ing as the baby boomers (76 million people born be-
tween 1946 and 1964) near retirement. The US Bu-
reau of Labor Statistics [8] predicts that by the year
2015 there will be 55 million workers 45 years of age
or older in the United States. This is approximately
40% of the US workforce. The most rapid increase in
the growth of the aging population is likely to occur
between 2010 and 2030, when the baby boomers will
reach 65 years of age [1,27]. The bottom line is an

1051-9815/09/$17.00  2009 – IOS Press and the authors. All rights reserved
308 S.D. Choi / Safety and ergonomic considerations for an aging workforce
aging workforce with fewer workers to replace those
who are retiring [31]. In many ways the trend of older
workers remaining in the workforce is beneficial for
the nation’s economy. Their expertise is valuable and
many companies prefer to keep their older employees as
long as possible. Although injured less frequently than
younger employees, older workers require significantly
longer recovery periods and suffer job-related fatalities
at a significantly higher rate [51]. It has been shown
that job characteristics such as high stress, repetitive-
ness, and high physical demand are statistically related
to early retirement [61].
The construction workforce has been growing old-
er as well [41]. With the demise of vocational educa-
tion programs and the opening of high tech industries,
a smaller percentage of young people are attracted to
construction work [9]. Competition for workers, espe-
cially skilled and experienced workers, has intensified.
Companies are struggling to retain their best employees
and to keep them healthy and on-the-job [10]. Howev-
er, there has been very little research on the health and
safety considerations involving older workers in con-
struction, particularly in the United States. Therefore,
the objectives of this literature review are to explore the
evidence pertaining to: 1) injury and fatality issues re-
lated to older workers in the US construction industry,
and 2) safety and health practices associated with the
prevention of the injuries and fatalities in the aging US
construction workforce.
2. Method
Using a systematic approach to literature searching,
the author first defined an initial set of keywords to
guide the identification of relevant studies. Keywords
utilized on the electronic search included: old, older,
age, aging, elderly, worker, health, safety, accident, in-
jury, illness, fatality, occupation, construction, and er-
gonomics. Combinations of these keywords and terms
such as “prevention” or “intervention” were also used
in the search. The search was conducted primarily us-
ing electronic data bases, supplemented by books and
other printed materials retrieved from a network of li-
braries. Studies published in English were drawn from
peer-reviewed journals, conference proceedings, edited
books, and a variety of web-based sources. Electron-
ic resources searched included ABI/Inform, Academ-
ic Search, ACM Digital Library, Applied Science Full
Text, Business Full Text, CINAHL, Emerald, Google
Scholar, NetLibrary, ProQuest, PsycINFO, PubMed,
ScienceDirect, WilsonWeb, and Web of Science. The
injury, illness, and fatality data were also reviewed from
the Bureau of Labor Statistics (BLS) and National Insti-
tute for Occupational Safety and Health (NIOSH). The
search provided three main categories of risk faced by
aging members of the workforce in general: (1) docu-
menting the problem, (2) research on age-related causal
factors including cognitive learning ability, physical
ability, types of injury/illness/fatality related to age,
and (3) research and evaluation of practical health and
safety interventions.
3. Aging workforce – How different?
The aging process is affected by multiple factors,
including genetic makeup, environmental and socio-
economic conditions. Different chronological thresh-
olds have been suggested to define “old age”, with ad-
ditional subdivisions being applied as well (e.g., old-
young, old-old). A common landmark is 65 years
of age, the typical retirement age. Older adults
are not a homogeneous population, and chronologi-
cal age should serve only as an initial reference to the
wide range of transformations experienced by individ-
uals [50].
Age is a major factor in the manpower assessment.
The decremental theory of aging proposes that, as per-
sons advance in age, some work capacities, both phys-
ical (e.g., cardiovascular function, muscle strength,
endurance) and cognitive (e.g., sensorimotor perfor-
mance, decision time, memory), decline lessening the
person’s ability to cope with multiple job demands [33].
The Age Discrimination and Employment Act (ADEA)
indicates that the “older worker” is anyone 40 years or
older. It is this group that will soon make-up the largest
portion of the US workforce. This group is a valuable
economic resource and deserves special attention [31].
4. Cognitive learning ability
Training modifications may be necessary to accom-
modate aging workers; for example participating in an
active task such as on the job training, rather than pas-
sive training [31]. Older workers may also learn more
effectively in hands-on training sessions rather com-
puter or web-based instructional programs [36]. Phys-
iological changes, related to vision and hearing, are
key sensory functions that significantly influence cog-
nition [28]. Vision changes are a part of normal ag-
 S.D. Choi / Safety and ergonomic considerations for an aging workforce
ing including decreased contrast sensitivity, decreased
adaptation to light and dark, and increased sensitivity
to glare. Older individuals require more contrast to re-
solve detail. Sanders and McCormick [54] noted that
55 year olds require almost twice the contrast as 25 year
olds if they are to give the same visual performance.
Older workers need more light in their work areas than
younger workers. Attwood [4] estimated that there is a
50% reduction in retinal illumination (i.e., light to reach
the retina in the back of the eye) at age 50 compared to
age 20.
5. Physical aging
Physical capacities that relate to work performance
of industrial tasks include; strength, range of motion,
speed of movement, fatigue, motor skills and healing
after injury [26]. Longitudinal studies show that mus-
cle strength and power begin declining by approxi-
mately age 40 [39] which is likely related to changes
in the number and size of muscle fibers [35]. These
changes in combination with a slowing in the speed
of nerve conduction may be related to longer reaction
times [24], slower motions, and greater difficulty mak-
ing fine motor adjustments [59]. A combination of fac-
tors which include poor cognitive and physical func-
tioning due to health problems, job dissatisfaction, and
dissatisfaction with injury-related medical care, may be
useful early indicators of the probability of an injury or
adverse health event at work leading to an early with-
drawal from the workforce or to retirement. Brenner
and Ayern [6] reviewed the records of 3,098 construc-
tion workers who had been granted early retirement on
health grounds between 1972 and mid-1996. The mean
annual retirement rate was 5.3/1000 workers. Most
early retirements occurred in the later years of work-
ing life, although 43% of these workers were 60 years
and over, 17% were under the age of 50 years, and 8%
were under the age of 45 years. The mean retirement
age was 56 years, the median 58 years, and the mode
63 years. It should be noted that the 17% under the age
of 50 years, accounted for 45% of the potential working
years lost. These findings suggest that specific indi-
cators can help target early intervention programs for
older workers who are at the highest risk for injury or
early retirement. Older construction workers represent
a particularly vulnerable group with respect to the risk
of occupational disability [46].
309
6. Construction and the aging workforce
The average age of construction workers in 2001
was almost 39 years and there has been an increase of
1.5 years over the last decade. During this period the
median age also increased from 35 to 39 years. The
aging of the construction workforce is also reflected
in the distribution of fatal occupational injuries [41].
Figure 1 shows the distribution of fatal occupation-
al injuries among construction workers by age, 1992
and 2001. The largest proportion of fatal occupation-
al injuries shifted from construction workers aged 25–
34 years to those aged 35–44 years. For construction
workers aged 25 to 34 years, the proportion with fatal
injuries declined (from 27.8% to 21.7%), whereas it
increased for workers aged 65 or older (from 3.9% to
5.9%).
Though older workers suffered injury and illnesses
at a rate proportionately lower than the percentage of
hours worked, the injuries they sustained were general-
ly more severe than those sustained by younger work-
ers [51]. Figure 2 shows that older workers required
more days away from work to recover from a work-
place injury or illness than did their younger counter-
parts. The median number of days away from work
for all workers was 13 days; for those aged 55–64, it
was 19 days, and for those aged 65 and older, it was
30 days. Older workers sustain more severe injuries
than younger workers.
6.1. Injury severity, frequency and type of the aging
workforce
Accident severity tends to increase with age and this
can be seen in the numbers of fatalities, permanent dis-
abilities, or the average number of lost workdays per
accident [12,18,40,52]. The empirical evidence on ac-
cident severity tends to support the argument that body
resiliency decreases with increasing age [33]. Employ-
ees in the 65+ age group die from disabling injuries
at a rate that is about10 times greater than those who
are under 64 years. Employees over 65 years of age
sustain permanently disabling injuries at a rate about
40% greater than those who are under 64 [45].
The back, is more frequently injured among old-
er workers, while eyes and hands, tend to be injured
more frequently among the younger workers [52]. Old-
er workers report more back and shoulder pain, and
were more susceptible to falling and slipping [33]. The
walking/working surface accounted for more injuries
among the middle-aged and older workers and falls at
310 S.D. Choi / Safety and ergonomic considerations for an aging workforce

32
1992
2001
28

24
Fatal injury rate (%)

20

16

12

0
16-19 20-24 25-34 35-44 45-54 55-64 >64

Age categories

Fig. 1. Distribution (%) of fatal occupational injuries among construction workers by age, 1992 and 2001 [41].

35
30
30
Days away from work

25
19
20 17

15
10
10 7
4
5

0
20-24 25-34 35-44 45-54 55-64 >64

Age categories

Fig. 2. Median days away from work for nonfatal injuries and illnesses by age, 2003 [11]

the same level are more frequent among older work-
ers. Conversely, accidents that involve being struck by
an object or striking against objects decline with age.
Among older workers fractures, hernias, and heart at-
tacks are more common, while cuts, lacerations, and
burns tend to occur less frequently. Sprains/strains due
to overexertion occur more frequently among the older
workers. However, injuries resulting from being struck
by an object were more frequent among younger work-
ers.
Slip, trip and fall accidents generally induce longer
sick-leave periods [30]. On average men and women
aged 45 years or older have a somewhat longer sick
leave period than younger workers of the same gender.
The most common accidents occurred when climbing
on a ladder in metal machine work, electrical work,
and building and construction work. More than half of
these climbing accidents were due to sliding or break-
age of the ladder, missing a step on a ladder, making an
unsuccessful step from a secure foothold, or the tilting
of the support that a ladder was on [30]. Moreover,
an elderly construction worker with the same degree
of injury severity as a younger person is more likely
to die from his/her injuries [29,47]. Result of several
studies have suggested that older workers have more
accidents because of poor motor coordination, lack of
 S.D. Choi / Safety and ergonomic considerations for an aging workforce
cognitive agility, sensory deficiencies, and the longer
time required to learn new jobs or function in new situa-
tions [5,47,48]. However, results of other studies show
that younger workers have more accidents because of
inattention, impulsiveness, over estimation of capaci-
ty, pride, recklessness, and lack of family responsibili-
ties [5,43].
6.2. Contributing occupational risk factors
Older workers are less likely to respond quickly to
distress conditions and see critical aspects of a proce-
dure as work situations change. They are more like-
ly to become exhausted and less likely to work at full
strength or full attentiveness for the whole shift [26].
Other factors that contribute to construction workers’
injuries include: repetitive, forceful and prolonged ex-
ertion of upper limbs during use of construction tools
especially powered hand tools. Frequent and heavy
lifting, along with pushing, pulling, or carrying heavy
objects any significant distance, exposure to prolonged
awkward postures, and vibration from various tools can
all contribute to injuries. Jobs or working conditions
where these types of risks are combined can increase
the probability of injury. The level of risk depends on
how long construction workers are exposed to this envi-
ronment, how often, and the intensity of exposure [42].
One function that is very sensitive to age is regulation
of posture [34] which is not readily apparent in com-
mon and stable working positions (standing or sitting)
but it becomes obvious in situations of disequilibrium
that require precise adjustments, strong muscular con-
traction, or joint movements at extreme angles. These
adjustments become more problematic when the work
has to be performed on an unstable or slippery base,
or when a worker experiences a jolt or possible shock.
Accidents due to loss of balance become more frequent
with age [34].
7. Discussion
With older workers becoming more prevalent with-
in the construction industry there is a growing need to
consider aging workers safety. Businesses that change
their perceptions of older workers, (value and contri-
bution to the workplace), will be able to take advan-
tage of the changing demographics. Older workers
bring the benefit of desirable construction experience
to the workplace. They often have specific knowledge
of construction methods; experience in process man-
311
agement and material handling that can help improve
productivity and bring safety to the workplace [28].
A question for construction managers and safety pro-
fessionals is whether current occupational safety and
health programs are sufficient to protect older work-
ers? The World Health Organization (WHO) recom-
mends that the workplace should be adjusted to accom-
modate changing physical work capacities for vision,
hearing, and muscle strength are likely to occur with
aging [57]. The ideal work situation is one that matches
the demands of the job with the abilities of the employ-
ee [31]. Injury prevention strategies or interventions
are outlined below.
7.1. Ergonomic interventions
Ergonomic interventions entail matching the task,
the tools, and the environment, to the needs of the
worker with the goal of achieving a healthy, produc-
tive workplace [2]. Because older workers may strug-
gle with work demands, using ergonomics to improve
work design, the work environment, and tool design
becomes extremely important [31]. A job safety and
health analysis should be performed with the age and
physical capacity of the employee in mind [45]. Er-
gonomically designed workstations are an important
contributor to worker safety and health. For instance,
lifting hazards can vary from job site to job site; there-
fore, lifting training programs must be site-specific.
Before attempting to develop the training program, the
foreman and/or company safety personnel should eval-
uate the job site materials that will be used throughout
the construction project. Having the appropriate site
set up from the beginning of the project can prevent
injuries. Adequate amounts and types of mechanical
material handling equipment, such as forklifts and hand
carts available so that workers do not feel they have to
lift and carry everything manually. Employees should
be trained in the use of the material handling equip-
ment that is on-site. Training with the specific types of
materials that will be used throughout the job and the
hazards associated with their use are also needed [32].
Something as simple as a handle on the power tool
could help to improve the safety and health of all
users [58]. Excessive hand and arm vibrations were
another concern for construction contractors. This is
because there tends to be extensive usage of power tools
on a daily basis. Without the proper protection, con-
struction workers may develop injuries to their hands
and arms, which can be painful and/or disabling. The
most common type of personal protective equipment
312 S.D. Choi / Safety and ergonomic considerations for an aging workforce
used when handing vibrating tools was anti-vibration
gloves [15]. These helped to lower the amount of vi-
bration that affects workers on a day-to-day basis. Tool
manufactures are also critical links in the ergonomics
process. There is a great need for ergonomically de-
signed hand tools for older workers in the construction
trades. Poorly designed hand tools increase the amount
of vibration transmitted to the hands, increase the forces
required to operate the tool, and place workers in awk-
ward postures and positions to operate them [58].
7.2. Wellness and fitness programs
The lack of personal fitness in the US population
has a tremendous impact in the workplace [22]. Ex-
cessive weight and lack of flexibility and strength in
the general workforce take a toll on employees. Em-
ployers sustain losses through Worker’s Compensation
or related healthcare costs. To reverse this trend em-
ployers need to promote employee fitness opportuni-
ties or suffer financial consequences [25]. Research
has shown that exercise dramatically increases physi-
cal fitness, muscle size, and strength in older individu-
als [53]. Besides rejuvenating muscles, resistance ex-
ercise also enhances bond strength, limiting the risk of
osteoporosis and fractures of the hip, spine, and wrist.
Exercise also improves balance [31]. In addition, the
psychological benefits of exercise support a sense of
overall well-being which is an effective mechanism for
dealing with stress. Frequently workers are on projects
for prolonged periods that may require them to be away
from home, which adds to their stress level. Exercise
can help reduce the intensity of the anxiety that comes
from the uncertainty inherent in the construction busi-
ness. Keeping older workers physically fit has many
benefits, including financial benefits that may be real-
ized in the form of reduced insurance costs or lower
injury rates [31,37].
7.3. Physical environment
Good housekeeping at the worksite is essential to
reducing injury rates [30]. Slip, trip and fall accidents
are all too common for the older worker and are as-
sociated with longer sick leaves [38]. For men and
women, the first approach to preventing slip, trip and
fall accidents should be to improve the orderliness of
their workplaces. Flooring must be free from oil, water
and other materials and appropriate ladders provided.
It is also important to control anchoring devices so as
to prevent falls to a lower level, and keep outdoor work
areas free from snow and ice. Adapting the workplace
for an aging workforce may, therefore, involve reduc-
ing the need for elevated work and eliminating the use
of ladders wherever possible [26].
7.4. Positive safety and health climate
Creating and maintaining a culture of safety with-
in an organization is a key responsibility for manage-
ment, safety and health professionals [55]. Failure to
maintain a culture of safety may result in lack of en-
forcement of safety regulations and negative attitudes
toward enforcement procedures. This breakdown can
be a significant predictor of accident rates after con-
trolling for age and tenure [55]. Due to changes to the
physical environment and to working conditions of em-
ployees [19], particular attention has been paid to the
physical and cognitive characteristics of jobs. Many
organizations have found that their accident rates lev-
el off after periods of continuous improvement [21].
This has encouraged a search for new methods and ap-
proaches and a growing interest in social-psychological
factors, in particular the safety attitudes. A large num-
ber of accidents could be avoided as the factors are un-
der the control of those involved in them. For exam-
ple, workers taking risky short cuts to meet deadlines.
This is in contrast to the idea that an accident happens
because of some momentary lapse of concentration or
slip [20]. When workers are able to work fewer hours
or move to jobs that match their present work capac-
ity, they appear to compensate by being more aware
of job safety [49]. Consequently, they are less likely
to experience job-induced health and safety problems.
Selective work may challenge many traditional labor
agreements and managerial policies. Safety and health
professionals attempting to create a positive safety cul-
ture may find that many job conditions and occupation-
al safety programs are no longer appropriate for an ag-
ing workforce. To address this issue health and safety
professionals must form stronger alliances with human
resource professionals. In some situations, input from
health and safety professionals may encompass efforts
to educate line management, staff, and workers about
the changing needs of an aging workforce [57].
7.5. Adequate training
Age accounts for only a small portion of the vari-
ance in performance. Job complexity does not moder-
ate the effects of age, and older workers who received
recent task training were shown to be performed bet-
 S.D. Choi / Safety and ergonomic considerations for an aging workforce
ter than those who did not receive recent training [31].
It is suggested that older people are quite capable of
learning new skills, tasks and procedures, but that the
training strategies may need some modification for the
older learners [17]. These training modifications may
significantly improve the learning efficiency of older
workers. Costs associated with any additional training
or extended practices may be offset by lower turnover
and absenteeism rates among older workers. It is rec-
ommended that training be considered an investment
rather than a cost [31]. A combination of factors in-
cluding poor cognitive and physical functioning due
to health problems, job dissatisfaction, and dissatisfac-
tion with injury-related medical care, may be useful as
early indicators that an injury or adverse heath event
at work might lead to an early withdrawal from the
workforce. These findings support the idea that specific
indicators can help target early intervention programs
for older workers who might be at the highest risk for
early retirement. Older construction workers represent
a particularly vulnerable group with respect to the risk
of occupational disability. Possible interventions in-
clude appropriate job modifications, more attention to
chronic health problems, and wellness programs target-
ed to older workers [46]. Occupational therapy (OT)
practitioners can also offer industrial rehabilitation ser-
vices/interventions such as return-to-work programs,
injury-prevention education, work-site analyses, and
modified duty/activity adaptation [23].
8. Conclusions
The US construction industry’s injury, illness, and
fatality trends, and the practical health and safety inter-
ventions for older construction workers were reviewed.
By understanding the age profile of the workforce, con-
siderations can be given to task assignment, workhours,
workspace design and performance expectations rela-
tive to the age of the workers [26]. The decision makers
in the construction industry need to make the necessary
changes to accommodate an aging workforce if they
wish to remain competitive. Ladders, for example, are
most often involved in falls among older construction
workers. Researchers suggest that this may be due to a
decline in balance and coordination among these work-
ers. Loss of control of postural stability, which could
be related to increased risk of falling, tends to begin
in the age group that is between 50 to 60 years of age.
Reduced strength many also affect on older worker’s
313
ability to recover balance or lost footing in attempt to
avoid a fall [56].
Older workers are more likely to make errors than
younger workers unless proper adjustments are made
to the workplace, task design, time demands or strength
requirements. Literature also shows that older workers
have decreased capacity in areas such as vision, hear-
ing, strength, balance, memory, response time, action
time, decision making and cognitive processing [26,
31]. Construction project management teams and the
safety and health professionals need to be aware of what
these physical and cognitive changes are and design
interventions to help accommodate them. One source
of interventions can come from the administration of
a construction project and include: (1) maintain older
workers at lesser elevations wherever possible, (2) train
safety and health leaders and require accountability for
a measurable safety and health system, (3) consider
necessary reaction time when assigning older workers
to tasks, (4) provide training opportunities that allow
for practicing new tasks, (5) increase the frequency of
breaks, (6) allow more time between steps within tasks,
(7) reduce required overtime to avoid fatigue and im-
prove alertness, and (8) encourage workers to change
positions frequently and stretch muscle groups appro-
priately.
Education may be an effective tool; older workers
need to understand age related changes. Older workers
need to beware of the types of hazards that are poten-
tially more threatening to their health and safety on the
job and at home and to learn how to avoid them or work
around them. If workers know how to approach age
related physiological changes they may begin to think
about the tasks they are performing today and look for
new ways to complete those tasks in the future thus
minimizing exposure to hazards. Educating members
of the workforce may begin to produce new ways to
reduce the hazards they are now exposed to through
cooperative efforts between management, engineering
and first line supervision.
It is important to note that any new approaches should
be considered early on in the planning stages of the
construction process. Safety and health issues need to
be addressed and be designed/engineered into the con-
struction project from the beginning. This preparation
needs to take place during the initial planning stages and
on a continuing daily basis with the protection of the
site-specific workforce in mind. Engineering changes
could include: (1) developing lighter materials that are
easier to handle, (2) modifying the work area to better
accommodate the worker, (3) minimizing manual ma-
314 S.D. Choi / Safety and ergonomic considerations for an aging workforce
terial handling by the pre-placement of materials at an
easy accessibility level, (4) improving illumination, (5)
eliminating heavy lifts, (6) providing an adequate sup-
ply of material handling equipment like, carts, forklifts,
and cranes, (7) eliminating long and/or heavy reaches
from ladders, (8) reducing noise levels, (9) designing
working platforms for tasks specific loads with ade-
quate access to work areas, and (10) reducing dust and
other airborne particulates.
Construction environments are inherently danger-
ous, effective safety and health programs can make the
difference between life and death. Research is needed
to refine job skills and task requirements in relation to
age so that safety professionals might determine how
to best minimize the age-related injuries. These da-
ta would be beneficial to the construction industry in
planning interventions and ensuring healthier work en-
vironments and procedures for all workers in the future.
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