School of Risk Control Excellence Workers’ Compensation Aging and Obesity in the Workforce 1 Hour

2 Disclaimer The information, examples and suggestions presented in this material have been developed from sources believed to be reliable, but they should not be construed as legal or other professional advice. CNA accepts no responsibility for the accuracy or completeness of this material and recommends the consultation with competent legal counsel and/or other professional advisors before applying this material in any particular factual situations. This material is for illustrative purposes and is not intended to constitute a contract. Please remember that only the relevant insurance policy can provide the actual terms, coverages, amounts, conditions and exclusions for an insured. All products and services may not be available in all states and may be subject to change without notice. References to the services of external third parties are provided solely for convenience and CNA disclaims any responsibility with respect thereto. CNA is a registered trademark of CNA Financial Corporation. Copyright © 2011 CNA. All rights reserved.

3 Learning Objectives At the end of this course you should be able to: ■ Describe the physical limitations affecting the aging workforce ■ Discuss the workforce demographics found in a plant that can affect injuries ■ Indentify factors that impact injuries in relation to obesity

4 What is the number one issue that will affect all industries in the United states besides the economy? It will affect all industries and they will all be fighting over the same employees.

5 CURRENT POPULATION More than 40% of Construction workers are Baby Boomers. By 2015 – 55 million workers 45 or older. Nearly half of all workers will be considered aging. 14 to 15 million people will be in Those between ages 24 and 54 will only increase 5%. These demographics predict an exodus of experienced workers from this industry.

6 Age of Workers Percent Growth in U.S. Workforce by Age: Source: U.S. Census Bureau

7 Current Worker Population The point is: Those in the age range of 24 to 34 are not increasing. Those are projected to decrease. Those over 55 will be increasing. How are you going to keep your operations on cost and on quality? Aging Workers: Creating the Environment for a Healthy Workforce: A Medical and Biomechanical Approach – R. Wayne Clifton, PE, CSP; Connie Vaughn-Miller, CPE Monthly Labor Review – February 2004, Labor Force Projections to 2012: The graying of the US workforce, Mitra Toosi

8 Baby Boomers ■ Has your organization recognized the need to leverage the aging workforce to produce on the job site or in the plant? ■ What about your competitors? ■ These fundamental questions must be reviewed!

9 Physical Limitations ■ Physical capabilities decline with age (around 50). ■ These relate to the following tasks: Strength Range of motion Speed of movement Fatigue Motor skills Balance Ergonomics, How to Design for Ease & Efficiency, Karl Kroemer, Henrike Kroemer, Katrin Kroemer-Elbert

10 AS WE AGE Maximal Strength Muscle Mass Bone density Visual and Auditory Acuity Fitness Aerobic Capacity Cognitive Speed/Function Obesity Arthritis High BP Diabetes Depression/Heart Disease Menopausal/Post Menopausal Issues

11 ■ Driving and operating large equipment requires responding continuously to spatial and temporal (time) information from the environment and equipment. ■ Motor control is critical for coordinating movements of the head, neck, and upper and lower limbs. ■ Motor control is also critical when: ■ using powered and non-powered tools, going up and down ladders, manually handling materials and braking, steering, and turning. Also ability to work overhead, reaching, bending and kneeling. ■ Reduce motor control can effect quality if critical measures are needed. Physical Limitations (continued)

12 ■ Strength decreases in older workers. ■ In construction job site settings, workers still have to lift, lower, push, pull, and carry material. ■ Many of the designs and work task setups do not take this decrease in strength into consideration. Thus, the older worker may not have the maximum strength to apply. ■ We have to look at the design to take advantage of: ■ Leverage ■ Handle designs ■ Mechanical advantages Physical Limitations (continued)

13 Balance ■ The sense of balance is affected by age. ■ We can lose as much as 40% vestibular hair and inner ear nerve cells. ■ Combining vision and strength shifts, maintaining balance becomes a much more difficult endeavor. Examples: Ladders, scaffold, other elevated work, roof edges, etc. ■ Rethink how we are using these and who will be allowed to use them

14 Aging Trends – Average Loss Work Days

15 With this in mind… Here are the key questions Is your workforce physically capable of doing their job now? Will your workforce be physically capable of doing their job 10 years from now? How many more bends, twists and lifts do they have left? What effect is this having on my company besides safety? ■ Encouraging findings indicate that age-related errors and performance are manageable.

16 Consider the following strategies: 1. Review your organizations safety and engineering requirements. Are job limits, work method techniques, and organizational policies accommodating to the known and expected capability shifts of older workers? 2. Limit frequently changing job requirements. Changing requirements negatively impacts older workers’ abilities to leverage past experiences. 3. Allow older workers certain flexibility in approaching the job. Let them leverage their knowledge and wisdom. Consider how they make the job easier for themselves. (only if methods are safe) Controls and Suggestions (continued)

17 Consider the following strategies: 4. Leaner concepts; - Reduce walking and climbing of ladders (fatigue) - Ergonomic workstation adjustments - Getting materials off the floor, 5. Improve illumination. 6. Reduce or eliminate heavy lifting and long reaches. 7. Consider reaction time when assigning older workers to tasks. 8. Hiring using Post offer Physical Capacity Evaluations Controls and Suggestions (continued)

18 Areas for Management to Review Demographic Analysis ■ What is the age of the workforce? ■ What is the total population? ■ List by job type. ■ Are more than 10% over 50? ■ What type of injuries are occurring? ■ What will change in the next 5 to 10 years? ■ What is the profile of the future?

19 ■ What are the risk factors creating the injuries? ■ What are the ergonomic/biomechanical Issues? ■ How do the risk factors impact aging? ■ How is the aging work force impacting productivity? ■ How can we begin to mitigate/reduce the risk factor? ■ Does transitional/return-to-work (RTW) take into consideration aging? ■ Do long term plans include aging? Areas for Management to Review (continued)

20 Definitions of Obesity ■ Obesity: Body Mass Index (BMI) of 30 or higher. ■ Body Mass Index (BMI): A measure of an adult’s weight in relation to his or her height, specifically the adult’s weight in kilograms divided by the square of his or her height in meters. ■ BMI was developed in the 1940’s, but is still used by today’s physicians. CDC – National Center for Health Statistics;Prevalence of Overweight, Obesity and Extreme Obesity Among Adults: United States, Trends Through

21 Definitions of Obesity ■ Obese is generally defined as a BMI of 30. ■ Morbidly obese is defined as a BMI of 40. ■ Super obese is defined as a BMI of 50 or more.

22 Scope of the Problem ■ The most obese workers file twice as many WC claims as healthy weight workers. ■ The most obese have 13 times more lost workdays than healthy weight workers. ■ Workers Compensation medical claims cost are 6.8 times higher for the most obese workers. ■ Obesity could result in as much as 34.5% increase in healthcare costs for obesity-related health problems* Source: Ostbye, T. Obesity and Workers Compensation. Archives of Internal Medicine, April 23, 2007 Emerging Risks in Workers Compensation, Workers Compensation Educational Conference, Robert Hartwig, PHD, CPCU, President Insurance Information Institute * Source: Thomas J. Bukowski. Weighting down safety Health and Safety Magazine, April 2013 from the Trust fo America’s Health and the Robert Wood Johnson Foundation report

23 ■ Indemnity costs are 11 times higher for most obese workers than healthy weight workers. ■ The body parts most prone to injury are: back, lower extremities, wrist, and hands. ■ The most common causes of these injuries were falls, lifting, and slipping. Obesity Increases Workers Compensation Cost, 1/25/2010www.medicalnewstoday.com/articles/68795.php Scope of the Problem (continued)

24 AS WE AGE Throat Sleep Apnea Increased fatigue and alertness Heart Cardiac Arrest, Heart Disease Upper and Lower Arms Constricted blood vessels Vibration Syndromes Safety and Health magazine – April 2013 Thomas J. Bukowski, Associate Editor Face and Eyes Incorrect use of PPE ■ More difficult to fit ■ Less Comfortable, less use Upper/Lower Back ■ Equipment Capacity limits- fall protection, ladders, bucket trucks ■ Increased risk of back injury due to added upper body weight Lungs Asthma: dyspnea Shortness of breath Decreases ability to take in air, increasing fatigue Wrists and Hands Restricted blood flow Vibration Syndromes Carpal Tunnel Syndrome Arthritis Waist Large abdomen May be difficult to fit into machinery or PPE

25 Percent of Obese (BMI > 30) in U.S. Adults 1990 No Data <10% 10%–14% Centers for Disease Control & Prevention (CDC)

26 Percent of Obese (BMI > 30) in U.S. Adults 1999 No Data <10% 10%–14% 15%–19% 20%–24% Centers for Disease Control & Prevention (CDC)

27 Percent of Obese (BMI > 30) in U.S. Adults

28 Percent of Obese (BMI > 30) in U.S. Adults

29 Percent of Obese (BMI > 30) in U.S. Adults

30 Obesity and Worker Compensation ■ Study released in July 2009 found California total annual estimated cost for overweight and obesity was approximately 41.2 billion. ■ Lost productivity costs associated with overweight and obesity was 8.2 billion. The Economic Costs of Overweight, Obesity, and Physical Inactivity Among California Adults – 2006,

31 CNA Claim Findings ■ CNA completed a survey of our workers’ compensation (WC) files. ■ WC adjusters were randomly selected with 10% of the adjusters and 8% of open or reopened files represented. ■ Findings: 85% of respondents indicated that they have dealt with overweight/obesity issues on their claim files in the last six months. 7% of claim files in the survey have overweight/obesity issues. When asked to determine the effects of obesity (no effect, limited effect, some effect, or considerable effect), 58% indicated a considerable effect.

32 ■ Top two diagnoses on affected claim files were backs (47%) and knees (31%). ■ Male/female split for affected files was 50%-50%. CNA Claim Findings (continued)

33 What Employers Can Do ■ Many companies have avoided identifying individuals who are obese because there is a perceived stigma of being discriminatory. ■ One of the solutions is to contact TrestleTree ®  a company specializing on how to address the problem of obesity or offer voluntary programs and incentives for those who are motivated to take part.

34 ■ Things to do: Make on-site programs, like Weight Watchers ®, available at work. Sponsor or subsidize health club memberships. Work with group health vendors to develop more programs to target obese populations. Implement a healthy eating campaign which should include healthy options in cafeterias and vending machines. Replace candy bowls with fruit bowls at the front desk What Employers Can Do (continued)

35 ■ Things to do: Encourage employees to walk during their lunch. Incorporate walking meetings when possible. Provide employee assistance programs for private counseling or community-based weight management programs. Offer incentives, such as discount on health care premiums. Encourage the drinking of water instead of sugary drinks Incorporate stretch breaks into meetings What Employers Can Do (continued)

36 Learning Objectives Review: ■ Describe the physical limitations affecting the aging workforce. ■ Discuss the workforce demographics found in a plant that can affect injuries. ■ Indentify factors that impact injuries in relation to obesity.

37 Questions?

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