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New study backs age-specific fall prevention

By Mari-Len De Guzman

A new University of Toronto study on work-related traumatic brain injuries may be making a strong a case for developing age-specific fall prevention strategies for workers in the construction industry.

The study, Traumatic Brain Injuries in the Construction Industry, found that the patterns of work-related traumatic brain injuries (TBI) among construction workers differ across age groups. For instance, the study revealed that younger workers tend to be injured in the morning while older adult workers’ injuries largely occurred later in the day, said Angela Colantonio, professor of occupational science and occupational therapy at the University of Toronto.

Colantonio is also the Saunderson family chair in acquired brain injury research at the Toronto Rehabilitation Institute, where she co-authored the study with Doug McVittie, John Lewko and Junlang Yin.

Although the correlation between the time of the injuries and the age of the workers still requires further investigation, Colantonio said certain factors might be playing a role in the injury patterns. For example, the time of injury among younger workers may have something to do with their not having enough sleep and being at work at an earlier time, while with older adults, fatigue might be a factor.

“Again, this is speculative and we don’t know if there is a relationship … I personally haven’t found a lot of this in the literature with respect to this injury, and I think we could look at this more closely,” Colantonio said.

Based on the results of the study, however, there seems to be a strong case for developing more targeted, age-specific fall prevention programs to increase the effectiveness of an organization’s injury prevention strategy, she said.  

Colantonio’s team studied data from the Workplace Safety and Insurance Board and the Construction Safety Association of Ontario, covering January 2004 to December 2005, based on non-fatal TBI cases coded as concussion or intracranial injury suffered by employees in one or more of the WSIB’s construction rate groups.

The study found there were 218 cases of TBI in the construction industry that resulted in lost time, health cost and wage loss, between the period covered by the study. The 25–34 age group had the highest TBI occurrence. For the two-year period covered, falls were the most common cause of injury, accounting for 49.6 per cent.

The study also noted that the percentage of falls increased by age groups, from 45.1 per cent in the 17–24 age group to 76.2 per cent in the 55–64 age group.

“This suggests that fall prevention in construction workplace settings is essential,” the study stated. “Although fall prevention is a needed focus to address injuries in the workplace, a more targeted approach aimed at older workers might also be in order.”

Colantonio said some of the strategies that have been effective for fall prevention in older adults is ensuring that medications are reviewed and adjusted. “Because medication, especially in ‘polypharmacy’, as we call it, does increase the risk of falling. Some types of medication that people are on might have sedative effects.” Polypharmacy is a term used when a patient is under multiple medications.

Other factors to consider when designing targeted fall prevention programs for older adults have to do with balance and mobility, said Colantonio. Programs that improve the workers’ strength, balance, flexibility and endurance have prevented and do prevent falls, she added.

This study follows a report from the U.S. National Institute for Occupational Safety and Health (NIOSH) that similarly calls for more target prevention strategies for the aging workforce. Using U.S. Bureau of Labor Statistics data, researchers say older workers are more severely injured and die with greater frequency from work-related injuries than younger workers. Older workers also have longer recovery periods than younger workers.

“As we go forward in time, the demand for workers will grow but fewer workers will be entering the workforce and a larger proportion of the workforce will be older. This is a simple reality of demographics,” NIOSH director John Howard said.

He added that organizations must “take steps to address the special needs of older workers who, more and more, will be staying on the job past traditional retirement age.”

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