Towards a longer and better working life: a challenge of work force ageing.

The aim of this overview is to describe the background of work force ageing and its consequences in the society, to introduce concepts for the solutions, to emphasize the actions needed, to point out the new challenges for occupational health, to review the targets of work life improvements, and to highlight the new innovations needed. Work life must be lengthened for the sake of society. Early retirement and low employment rates of 55-64-years old employees make the dependency ratios an increasingly heavy burden. New innovations and concepts like promotion of work ability and age management training have been effective tools for the increase of employment rates and decrease of age discrimination in Finland. The increase of the prevalence and incidence rates of work-related symptoms and diseases during ageing is a serious challenge for occupational health experts. The better adjustments of the working life with the individual health is a crucial element for a longer career. The European working life has not improved markedly for workers over 45 years between 1996 and 2000. Therefore, evidence based concepts should be widely and effectively implemented and new innovations created. A better co-operation between macro-, meso and micro levels is necessary, social partners should create mutual programmes in work places and a new deal is needed between the generations. Life course approach combines the needs and possibilities of different generations. Age management takes into consideration the different strengths of the diverse work force.

Promotion of work ability, the quality of work and retirement.

In this study, the validity of a model designed to promote the work ability of aging workers was examined. The target areas of work ability promotion were searched for the characteristics that explain work ability the best. In addition, the way work ability relates to the quality of work and retirement was examined. The subjects (n = 1101) participated in the follow-up study on aging Finnish workers in 1992 and 1997. The results consistently supported the model for promoting work ability. All four areas of focus-(i) work demands and the environment; (ii) work organization and the work community; (iii) the promotion of workers' health and functional capacity; and (iv) the promotion of professional competence-proved to be strongly associated with work ability. Good work ability was associated with a high quality of work and the enjoyment of staying in one's job. It also predicted active and meaningful retirement.

[Aging of the working population in the European Union]. / L'invecchiamento dei lavoratori nell'Unione Europea.

The working population over 50 years of age will grow considerably during the next 15 years. After 2010, the number of retired people over 65 years of age will be almost double that of 1995, with a strong impact also on working conditions and the labour market. Work ability is a dynamic process that changes, through its components, throughout life and is the result of the interaction between individual resources (including health, functional capacity, education and skills), working conditions, and the surrounding society. Work ability creates the basis for the employability of an individual, which can be supported by a number of actions (e.g. legislation on work and retirement) and social attitudes (e.g. age discrimination). Consequently, the prevalence of limitations in work ability varies significantly according to how it is evaluated and the frequency of work disability can vary considerably in different times, locations and populations. The Work Ability Index, created and used in a Finnish 11-year longitudinal study, has been proved a useful practical tool for the assessment of workers' fitness and a good predictor of work disability. Measures able to restore, maintain or promote work ability depend on the current work status and the needs of the target groups, and must concentrate on work content, physical work environment and the work community. The actions targeted towards the individual, on the other hand, concentrate on strengthening the health status and functional resources of the workers and developing professional expertise and skills. Correctly targeted and integrated measures improve work ability of ageing workers and therefore lead to improved work quality, increased productivity and also improved quality of life and well-being. They also have positive long-term effects on the "third age", when the worker retires.

Metal-age: a process for improving well-being and total productivity.

The knowledge on aging and work is vast enough for starting interventions at enterprises. Metal-Age provides tools for (1) attracting the interest of both management and employees, (2) planning interventions, and (3) setting priorities.

Towards the 24-hour society--new approaches for aging shift workers?

The new "24-hour society" increases night work and the diversity of flexible work-hour patterns. At the same time, the number of older shift workers is growing in most developed countries due to the general aging of the working population. Together with new experimental and epidemiologic data on the alarming relationship of shift work to fatigue, performance, accidents, and chronic health effects like coronary heart disease, there is reason to believe that shift work may become a major occupational health and safety problem in the near future. The prevention of shiftwork-related health and safety problems will be a major challenge for the employer, employees, and occupational health professionals during the next few decades. The present paper shortly summarizes the current knowledge on the relationship between shift work, aging, and health and outlines practical countermeasures and research needs to improve the health and well-being of aging shift workers.

Finnish research project on aging workers in 1981-1992.

The objective of this follow-up study of aging workers was to determine changes in the work, life-style, health, functional capacity, and stress symptoms of Finnish municipal employees from 1981 to 1992. In addition, factors that predict improvement or decline in the ability to work were studied. With the use of this information, attempts were made to produce practical measures to decrease the work-related health risks of elderly workers and increase factors promoting work ability. Along with the stress-strain model applied in the study, the reference frame of the World Health Organization (WHO) was used. The WHO model emphasizes the interaction between work, life-style, aging, and health. Work, life-style, health, work ability, and stress symptoms were studied through the use of comprehensive questionnaire surveys in 1981, 1985 and 1992. Initially, all the subjects (N = 6257) were employed in municipal occupations. During the follow-up, the data were supplemented by information on disability to work and mortality. The changes in work, life-style, health, work ability, and stress symptoms were examined among employees who worked in the same job (N = 924) during the entire follow-up period.

Life-style, aging and work ability among active Finnish workers in 1981-1992.

OBJECTIVES: Life-style is an important factor in explaining the changes in health and well-being in old age. In this study life-style was defined according to Abel's definition as combining life chances and life conduct. The main question concerned the change in life-style components and work ability over a 11-year period. METHODS: The study population comprised workers who responded to a questionnaire in both 1981 and 1992 and were still working in 1992 (N = 924). The changes in the dimensions of life-style (hobbies, living habits, life satisfaction) were tested with Pearson's chi-square test. The associations between life-style, work ability, and health were analyzed by correspondence analysis. RESULTS: Physical activity was the life-style factor that showed a major change; it increased among both genders. All other leisure-time activities decreased during the follow-up. The women's satisfaction with their life situation increased, but the men were less satisfied at the end of the study. Work ability, as measured with the work ability index, was a crucial factor in these changes. If the work ability remained good, the respondents were also more active and more satisfied with their life. This effect of work ability was strong, especially with respect to the men's satisfaction with their life situation. CONCLUSIONS: Life-style, work ability, and perceived health are highly associated, and studying them separately may give a simplistic view of the interaction between aging and work. In the future, more comprehensive approaches should be applied.

Aging, work, life-style and work ability among Finnish municipal workers in 1981-1992.

OBJECTIVES: This study was designed to explain changes in work ability through occupational and life-style factors. METHODS: Work ability was measured by an index describing workers' health resources in regard to their work demands. The work factors mainly included physical and mental demands, social organization and the physical work environment. The life-style factors covered smoking, alcohol consumption, and leisure-time physical exercise. The first questionnaire study was done in 1981 and it was repeated in 1992. The subjects (N = 818) were workers in the 44- to 51-year-old age group in the beginning of the study who were active during the entire follow-up. The improvement and, correspondingly, the decline in work ability were analyzed by logistic regression models. RESULTS: Both the improvement and the decline in work ability were associated more strongly with changes in work and life-style during the follow-up than with their initial variation. The model for improved work ability included improvement of the supervisor's attitude, decreased repetitive movements at work, and increased amount of vigorous leisure-time physical exercise. Deterioration in work ability was explained by a model which included a decrease in recognition and esteem at work, decrease in workroom conditions, increase in standing at work, and decrease in vigorous leisure-time physical exercise. CONCLUSIONS: Social relations at work can promote or impair the work ability of elderly workers. Although the work ability of elderly workers generally declined with aging, both older and younger workers were also able to improve their work ability.

Changes in the work ability of active employees over an 11-year period.

OBJECTIVES: Changes in the work ability of active employees were followed over a period of 11 years. METHODS: Men and women in the same occupation (N = 818) in 1981-1992 assessed their work ability according to an index on current work ability, physical and mental work demands, diagnosed diseases, work impairment from disease, sickness absence, work ability prognosis, and psychological resources. Their mean initial age was 46.9 (range 44-51) years. The means and standard deviations of the work ability index and the prevalence rates of 4 work ability categories were followed with respect to age, gender, and job content. RESULTS: The mean work ability index declined significantly in 11 years for both genders. Its association with age and work was strong. Age of > or = 51 years and physical work load were critical factors affecting the work ability of both genders. At the mean age of 58 years, at least 25% of the installation, auxiliary, or transport workers had a poor work ability rating, as did the women doing kitchen supervision, auxiliary, and home care work. The annual rate of decline in work ability was highest for women aged 51 years at the onset of the study. Female teachers showed a less dramatic decline in work ability than male teachers. CONCLUSIONS: Work does not seem to prevent a decline in the work ability of men and women as they age. Therefore, measures to promote work ability should be started before the age of 51 years, especially for workers in physically demanding jobs.

Effects of 10 h time zone changes on female flight attendants' circadian rhythms of body temperature, alertness, and visual search.

The aim of the study was to analyse the effects of rapid time zone changes on the circadian rhythms of flight attendants. The mean age of the 40 female subjects was 30.0 (SD = 6.9) years. Measurements of oral temperature, alertness, and visual search were performed at two hour intervals two days before the flight from Helsinki to Los Angeles, during the second and the fourth day in the USA and during the second and fourth day after the return flight to Finland. The body temperature desynchronized and the phases of the alertness and visual search rhythms shifted rapidly in the USA. After the return flight, the acrophases of the circadian rhythms delayed during the second and fourth day in Finland. During the fourth day the acrophase of alertness was 35 min and the acrophases of body temperature and visual search were 2 h 2 min and 3 h 8 min delayed, respectively. The mathematical model based on the C-, S- and W-process theory of alertness explained 25-96% of the variation of observed mean alertness of the subjects in different conditions. It is concluded that the duration of the de- and resynchronization process of the flight attendants' circadian rhythms is on the average longer than 9 days during and after round flights over ten time zones. The mean alertness of the subject can be predicted with considerable accuracy using the mathematical model.

Thermoregulation during rest and exercise in the cold in pre- and early pubescent boys and in young men.

Eight minimally dressed pre- and early pubescent boys (age 11-12 yr) and 11 young adult men (age 19-34 yr) rested for 20 min and exercised on a cycle ergometer for 40 min at approximately 30% of their maximum oxygen consumption (VO2max) at 5 degrees C. To quantify the added increase in metabolic rate because of cold, a separate test was carried out at 21 degrees C at rest and at equal work rates as in the cold. Both groups were similar in subcutaneous fat thickness and VO2max per kilogram body weight. Rectal temperature increased slightly during the exposure to the cold, but no significant difference was observed between the boys and men. In the cold, the boys had lower skin temperatures than the adults in their extremities but not in the trunk. The boys increased their metabolic rates in the cold more than did the men. As a result, the boys maintained their core temperature as effectively as the adults. Similar age-related differences in thermoregulatory responses to cold were observed when two boys and two men with equal body sizes were compared. Our results suggest that there may be maturation-related differences in thermoregulation in the cold between children and adults.

Musculoskeletal capacity and its changes among aging municipal employees in different work categories.

Aging effects on musculoskeletal capacity were studied among 83 subjects over a four-year period beginning at about 51 years of age, and the associations between work demands and musculoskeletal capacity were studied in a cross-sectional investigation comprising 137 subjects (mean age about 55 years). The follow-up study showed significant changes in musculoskeletal capacity, maximal isometric trunk strength having decreased 16-22% and 9-10% among the men and women, respectively, and maximal trunk muscular endurance and back mobility having increased 21 and 14%, respectively, among the men. The cross-sectional study showed statistically significant differences in isometric handgrip strength and leg mobility among the men and in isometric trunk flexion strength and trunk muscular endurance among the women in the three studied work groups. The investigation suggested that changes in musculoskeletal capacity can be marked after the age of 50 years and that physically heavy occupations do not maintain a sufficient level of capacity among elderly workers.