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The
Early Aging Workforce
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The Early Aging Work Force Downloadable eBook version Only $9.99
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To review the book's table of contents, click here. To read the afterward by Dr. Tony Lynch, click here. To read "reviews," click here.
TABLE OF CONTENTS
Preface: A brief outline of how the author came to his
current stance on worker education and an introduction to some of
the people who provided him with insight.
Introduction:
Health care cuts are spiraling globally, worker absenteeism and
disability statistics rise steadily, and hospitals increasingly
become catchment areas for chronic and often terminal illnesses. As
a result, attention is focussing on accountability of individuals
for the consequences of their behavior and habits. This approach
will eventually affect all of us and we must prepare accordingly.
Foreword: by Dr. Tony
Lynch, M.D., Ph.D.,ACBOM,CIME,MROCC
Chapter 1: The Early-Aging Work Force
This chapter examines the problem of the Early-Aging Work Force in
industry and demonstrates how premature aging of the work force
contributes to worker injury and disability.
Chapter 2: Sit and Feel Good
Some of the postures we use in our work places can damage our
health; every day postures we take for granted can also be
damaging. Sitting is used as an example. A brief history of this
posture is offered and some of its harmful effects are discussed.
Readers will also learn how situations develop which may cause
workers to become a part of the Early- Aging Work Force.
Chapter 3: Real Men Don't Breathe
Society does not encourage us to breathe properly. Recognize the
potential harm in this and learn how to implement proper breathing
techniques--with almost immediate noticeable benefits.
Chapter 4: The Big Picture
A specific example from industry shows how the postures required by
a personıs job may propel him or her towards injury and disability
and may affect the workerıs whole life.
Chapter 5: Disabled While You Sleep?
A sleeping position may set a background for injury at work, and
conversely, a personıs work may be responsible for his or her
sleeping positions.
Chapter 6: Carpal Tunnel - A Twist of the Wrist?
A definition and explanation of what Carpal Tunnel is, how Carpal
Tunnel Syndrome develops and how to identify the risks in your
occupation. Prevention techniques are offered for both home and work
environments.
Chapter 7: Prevention - A Band-Aid Solution?
How to use a simple biofeedback technique to increase
personal awareness of harmful repetitive or sustained wrist
postures.
Chapter 8: Don't Stick Your Neck Out!
Various case studies of injured workers, whose injuries demonstrate
the need for us to be more aware of our neck posture. Also a
discussion of some of the problems we encounter because of lack of
awareness and education of good posture.
Chapter 9: So What's The Problem?
What is actually happening to one's body when problem neck postures
are neither identified nor addressed. After reading this chapter,
the reader will be in a position to confidently discuss this issues
with employers or physicians.
Chapter 10: Where Did These Problems Begin?
Many of the problems we see in the work force are actually well
entrenched by time we were age 16, and we need to consider how
essential prevention is in the schools.
Chapter 11: The Chin Tuck
A simple preventative exercise to minimize potential neck problems
and a review of an actual project in an industry where this
exercise proved effective.
Chapter 12: Just Grit Your Teeth and Keep Going. . . and Going. .
. and Going
Repeatedly clenching or grinding your teeth can cause havoc with
your body and significantly increase your level of fatigue and
consequent risk of injury. Steps to take for this problem and a
simple preventative exercise.
Chapter 13: Stress Out - Burn Out
Reminders of the distinction between the values of positive stress
and the effects of negative stress, and of the importance of finding
productive coping techniques.
Chapter 14: The Long And The Short Of It
Many physical problems can be caused by stress on muscles and
ligaments because a person apparently has one leg longer than the
other! Learn the differences between a true and an apparent leg
length difference, and gain confidence to discuss this issue with
your physician or other health professionals, and insist on proper
treatment to resolve either problem.
Chapter 15: Check It Out
Failure to report early symptoms or failure to find a physician who
will respond to these symptoms can have a disastrous affect on your
life. An actual case history is used as an example of the
consequences of untreated problems. Some simple range of motion
checks are offered to warn you of potential problems in your neck
and back.
Chapter 16: M. V. A. Pain: Here -To- Stay Pain?
Injuries sustained in a motor vehicle accident are not always given
due consideration, and some unrecognized problems can prolong the
period of recovery. Psychological issues may be present which
would also benefit from recognition and attention.
Chapter 17: Just What Are You Fit For?
A functional capacity evaluation is used to determine the
capabilities for work of those considered unfit to return to their
former occupations. This chapter clarifies what this process
entails and re-asserts why early intervention might have prevented
the need for such a procedure.
Chapter 18: The Good, The Bad, And The Just Plain Ugly!
Various attitudes existing in industry towards injury reduction.
Which category does your employer fit? You, the individual,
may be the only one who really cares about your well being, so
determine to implement personal injury- prevention techniques in
your life.
Chapter 19: Corporate Cooperation
For management in industry, a step by step framework for
implementing the lessons in this book, including quality assurance
and ongoing vigilance in injury prevention.
Chapter 20: Early Intervention:
A review of what should be the joint philosophy of both workers
and management . Only combined cooperation and early intervention
can produce lasting results.
Postword; A summary of other services offered by Hugh
Afterword by Doctor Tony Lynch
Soft tissue disorders are a major cause of worker impairment, functional
limitations and disability. These disorders are not a new phenomenon. In 1773,
Ramazzine described these disorders:
Various and manifold is the harvest of diseases reaped by certain workers from crafts and trades that they pursue. All the profit they get is fatal injury to their health, mostly from two causes. The first and most potent is the harmful character of the materials they handle. . . . The second, I ascribe to certain violent and irregular motions and unnatural postures of the body, by reason of which, the natural structure of the vital machine is so impaired that serious diseases gradually develop therefrom.
Most work - related injuries are seen by both the family doctor and/or physiotherapists. The overwhelming majority of these injuries, are musculoskeletal injuries-- those involving the nerves, tendons, muscles and supporting structures of the body. While the causes of soft tissue injuries have not been fully elucidated, it is believed these injuries usually involve multiple causes. The World Health Organization has recognized soft tissue disorders as having both ³personal² and ³work- related² causes.
For an occupational health professional, managing these injuries requires addressing both the medical and occupational factors that may present barriers to an individual returning to work. If these barriers are not dealt with promptly and appropriately, they can lead to significant time loss, and in a proportion of cases, to long term disability. The problem may be further aggravated if the injured worker is only seen by a family doctor or specialist who is not aware of the interplay of factors which influence a worker rejoining his or her company. In the majority of cases, minimal or no intervention is required beyond accommodating the injured worker with temporarily modified transitional duties. Too often workers are re-injured, despite having been through occupational rehabilitation services or having left a job due to the original injury, or in other circumstances both internal and external to work.
The Code of Occupational Medical Ethics of the Canadian Medical Association recognizes the concept of meaningful work as important to a person's well being in both the physical and psychosocial aspects of life. The first paragraph of the Code of Occupational Medical Ethics also states: ³[Physicians must] consider first the well being of the employee. Accord the highest priority to the health and safety of the individual in the work place.²
However, this position statement , as those in other areas of occupational medicine, can produce ethical dilemmas in choosing between a worker's health and corporate goals. To address these sometimes conflicting goals, one medical association produced a statement entitled, "Early return to work after illness or injury". The guidelines suggest:
Prolonged absence from work may be detrimental to a patient, and returning to work as soon as possible without endangering the patient's health and safety should be encouraged. An early return to work after an illness or injury (work -related or otherwise) benefits a patient socially and financially. It also preserves a skilled and stable work force for the employer.
This position paper was followed by a similar position paper from another medical association, and the recommendations of these two organizations were adopted by the Canadian Medical Association as a policy . Physicians working in occupational medicine have responsibilities to patients as workers but have constraints placed on them by the priorities of the patientsı workplace management and environment. Some rehabilitation programs do not always recognize that the body has the potential for self-healing in the first few weeks after an injury. The authors of the CMA policy note :
Facilitating early return to work by better communication within the work place and treatment centres, including job demand analysis, and work place modification may be of more significance than the actual medical treatment.
The general consensus among occupational health professionals is that facilitating a patient's early return to work through the use of modified duties is possibly the most cost effective intervention they can offer both the worker and employer.
The Scale of the Problem.
During the last 15 years, the number of work accidents has remained fairly
stable; however, since 1980 the average cost of claims has risen by 180% . In
Canada, a typical employer paid approximately $5000 per employee towards
workers' compensation, disability insurance, and in lost productivity and
related expenses. This does not take into account the indirect costs to the
injured worker through lost wages and the negative psychosocial effects on the
worker and his or her family. In Alberta the number of lost time claims
decreased from 37,800 in 1991 to 31,800 in 1995. Paralleling this trend the
average of time lost to temporary disability claims dropped from 53 in 1991 to
43.3 in 1995. The fully funded cost per lost -time -claim was $12,700 in 1991
and $11,700 in 1995. However, with the improved economic conditions, the
Workersı Compensation Board has now seen an increase in new claims and lost time
claims reaching a four year high in 1996. The trend has continued into 1997 in
most industry sectors. New claims are up 20% and lost time claims have increased
by 11% over 1996 numbers. The majority of claims (75%) are in the manufacturing
and constructions sectors.
The Economic Burden of Illness in Canada, a 1993 report by Health Canada, attempted to quantify the costs, both direct and indirect, related to illness and injury. The indirect costs were estimated by measuring the present value of lost productivity due to long and short term disability and premature death. Musculoskeletal diseases of all types, and injuries, ranked second and third after cardiovascular diseases. Direct costs were estimated at $2.47 billion and $3.12 billion respectively. Indirect costs were estimated to be $15.33 billion and $11.22 billion, giving total costs (direct and indirect) of $17.79 billion and $14.34 billion. (For cardiovascular diseases this was $19.72 billion). Overall, indirect costs were highest for musculoskeletal diseases (18%), followed by cardiovascular disease (14.5%), and injuries (13.2%).
Similarly , in Britain for 1996, the number of working days lost due to back problems rose fourfold from 1976. Over 80 million days are lost due to registered disability. The cost to the British economy in those years was the equivalent of $12 billion (U.S.). In the U. S. A., in 1989, the annual W. C. B. costs (medical and indemnity payments) due to low back disorders were estimated at $11.4 billion (U.S.) per year. This figure does not include indirect costs such as lost production and the training of new workers. While the number of disability cases appears to be dropping or stabilizing, the individual costs are increasing.
In an attempt to lessen this epidemic, various bodies have enacted primary preventative initiatives for ergonomic standards for the work place. Legislation has been introduced by the government in British Columbia, policy standards have been introduced by individual companies world wide, and, in the U.S.A. new ergonomic standards are being proposed by OSHA (Occupational Safety and Health Administration). The proposed legislation is meeting opposition in Congress because of the potential enormous cost to employers. Merely making ergonomic changes ignores part of the WHO definition of soft tissue disorders as having both ³personal² and ³work -related² causes. These new standards place the emphasis on ³work -related² but ignore the ³personal.² From my experience, for ergonomic changes and safe guards to be effective, the workers also need to take some responsibility. Their part in the solution is to take time to make changes in postural habits as explained in the text of this book, to protect themselves and benefit from ergonomic change provided by the company.
Currently, as one means to reduce the number of disabilities in a workforce, pre-employment medical examinations are being tried. These examinations have proven unreliable in some areas, are fraught with difficulties and can be construed as discriminatory.
This book may be our best hope. What Hugh Gilbert, PT, offers to both workers and employers is an insightful, simple, self-help book. It gives the work force the tools to identify and minimize existing and potential postural problems which may place them at a high risk of injury and/or disability. For employers, it presents a structured outline of how to determine organizational problems in their individual companies and how to deal with them.
The onus now changes. It is not only on the employer to provide safe working conditions, but also on the workers to make corrections to their postural maladaptations in order to remedy problems and make maximum use of the ergonomic changes in their work environment. The additional advantage for the workers is that they can not only lessen the chances of future injury but can carry over the benefits gained from the program into their home and leisure activities.
--Dr. Tony Lynch, MD, PhD, ACBOM, CIME, MROCC
Dr. Tony Lynch is the Medical Director for Concept Health, an international organization of occupational physicians. He is certified in occupational and aviation medicine, and is a Canadian/FAA Aviation Medical Examiner. Dr. Lynch resides in Calgary, Alberta.
Reviews
Hugh Gilbert combines the science of
body mechanics with the healing wisdom that only a true spiritual
master could convey. Not only is this a very practical guide to rid
yourself of pain forever, it's a pathway to understanding your body
on a whole new dimension.
-Dawn Holman, author and internationally acknowledged human
relationship authority.
This book may be our best hope. What
Hugh Gilbert, PT, offers to both workers and employers is an
insightful, simple, self-help book. It gives the work force the
tools to identify and minimize existing and potential postural
problems which may place them at a high risk of injury and/or
disability. For employers, it presents a structured outline of how
to determine organizational problems in their individual companies
and how to deal with them.
-Dr. Tony Lynch, MD, PhD, ACBOM, CIME, MROCC
For more information, or to schedule an appointment, call 888-255-3639, or Email info@journeysend.ca.
In Calgary, contact the Ogden Physiotherapy and Rehabilitation Center at 403-236-0106.
Copyright © 2006 Hugh Gilbert, PT, ~ Calgary Physical Therapy ~ Hugh's Book - The Early Aging Workforce