For older workers, the most dangerous occupational move may be getting behind the wheel.
Last Friday, the Centers for Disease Control and Prevention released data showing that among highway transportation incidents, which are the leading cause of occupational death in the country, the highest fatality rates occur among workers ages 65 years old and older. In fact, workers in that age group experienced a fatality rate three times higher than workers ages 18 to 54. The unfortunate trend was seen across industries and occupations and among most demographic groups, according to data published in the agency's Morbidity and Mortality Weekly Report (MMWR).
Stephanie Pratt, coordinator of the National Institute for Occupational Safety and Health's Center for Motor Vehicle Safety and lead author of the MMWR report, told me the recent data is consistent with long-term trends, adding that in general all kinds of occupational fatality rates tend to be higher among older workers. In regard to highway transportation deaths, Pratt said that while the rates become more extreme at age 65, the upward trajectory really begins at age 55.
The MMWR report, which is based on data from the Census of Fatal Occupational Injuries from 2003 to 2010, found that among workers ages 65 and older, there were 3.1 highway transportation deaths per 100,000 full-time workers per year. During the time span studied, more than 11,500 workers ages 18 and older lost their lives in occupational highway transportation incidents, with more than 3,100 of such deaths occurring among workers 55 years old or older.Workers in the transportation and warehousing industries experienced the highest rate of such fatalities across age groups, and vehicle collisions caused the largest proportion of such deaths in every age group.
The MMWR data counts incidents involving both motorized and nonmotorized vehicles in which the victim was a driver, passenger or pedestrian. And workers studied weren't just those for whom driving is the main part of the job, such as truck drivers, but workers who need to drive or travel as part of their job, such as salespeople or someone simply walking across the street in the course of performing their job.
While the data studied doesn't allow researchers to definitively say why the risk goes up at age 55, Pratt said we can look toward scientific literature about older drivers in general and make some educated guesses. Not surprisingly, Pratt said that even though workers who are older may be healthier than those who don't work, they still experience the same subtle declines that come with aging, such as deteriorations in vision and range of movement. Older workers may be more likely to be living with a chronic disease or taking medications that affect driving skills as well.
"And we do know that if an older person is injured in a crash they're a lot more likely to die of the injuries," Pratt said.
John Ulczycki, vice president of strategic initiatives at the National Safety Council, said the "demographic bulge" of the baby boomers also plays into their over-representation in the CDC occupational death rates. In addition to issues that naturally come with aging, Ulczycki said it can be particularly challenging to change risky behaviors among older workers.
"We're dealing with a population of people who have been driving for many, many years, may have some bad habits and not the best practices around driving, yet they haven't experienced anything bad so far," he told me. "Dealing with behaviors that get ingrained over many years are more of a challenge."
Both Pratt and Ulczycki said that workers employed as commercial drivers would typically receive more safety training than workers for whom driving is not their primary job duty. Some companies — for example, a pharmaceutical company with thousands of salespeople on the road may offer regular training and education in driver safety, Ulczycki said — but there are millions more workers with small or mid-sized employers who likely get no training at all. Ulczycki said over the years, tens of thousands of employers have taken advantage of the National Safety Council's driver safety training course, "but we have a long way to go to get to a critical mass."
Pratt said the best way to prevent an occupational fatality or injury is to take away the exposure, so employers should consider whether a worker truly needs to travel and whether that travel has to be by personal vehicle, which is the most dangerous mode of transportation. Employers can also provide extra flexibility and education for older workers who need to drive, she said, such as allowing such workers to avoid night driving or providing information on how medications may affect road safety.
Of course, training is part of the equation, "but it's only one of many things that employers can do to protect workers of all ages on the road," Pratt said, adding that rather than taking a regulatory approach, improving driver safety among older workers can be accomplished cooperatively between workers and employers.
"For older workers who bring so much experience to the job, it would be a shame for (driving safety issues) to make it impossible for them to do their job if they want to continue working," she said. "There are fairly simply, practical steps that employers can take, and workers and employers can work together to make these things happen."
Ulczycki said turning around driving-related fatality rates among older workers starts with "employer commitment and understanding the risks." For example, he said, talking on the phone while driving, whether handheld or hands-free, means a driver is four times as likely to be in a crash. It's a risk scenario many employers wouldn't accept for workers on a construction site or in a factory, but overlook for their traveling sales staff — "they're accepting a risk for some that they wouldn't for others," Ulczycki said.
As part of the Occupational Safety and Health Administration (OSHA) campaign against distracted driving, OSHA Assistant Secretary David Michaels reminds employers, “Companies are in violation of the Occupational Safety and Health Act if, by policy or practice, they require texting while driving, or create incentives that encourage or condone it, or they structure work so that texting is a practical necessity for workers to carry out their job.”
"Employers need to understand the risks associated with all of their employees who are driving as part of their job and address it with the same understanding of the risks that may occur in the field or factory," Ulczycki said.
And as the baby boomers move into the 65 and older category and more people put off retirement, occupational driving fatalities aren't likely to turnaround soon.
"If employers aren't thinking about this yet, they need to start thinking about it now," Pratt said.
To read the full MMWR report, click here.
Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for more than a decade.