1. ©2006 Willem Goedhard, Middelburg Age Management Nijmegen 13 december 2006 Prof. Willem J.A. Goedhard, MD, PhD

2. ©2006 Willem Goedhard, Middelburg

3. Age Management: a new concept Wat is Age Management? Waarom nodig? Age Management in Nederland Ontwikkelingen in de Arbozorg in de toekomst Occupational Gerontology

4. ©2006 Willem Goedhard, Middelburg Waarom Age Management? EU:[ Barcelona 2002,Stockholm 2001] In 2010: > 50% van de 55-64 in arbeidsproces Pensioenleeftijd met 5 jaar omhoog

5. ©2006 Willem Goedhard, Middelburg De toekomst

6. ©2006 Willem Goedhard, Middelburg Langer werken? Hoeveel langer?? Niet eenvoudig te beantwoorden: Hangt o.a. af van goede bedrijfsgezondheidszorg

7. ©2006 Willem Goedhard, Middelburg 122 years

8. ©2006 Willem Goedhard, Middelburg Wat is Age Management? Age Management means managing the Work Ability of personnel and the success of the enterprise. Everyday management from the viewpoint of the life course and resources of people whether the changes are caused by the aging process or by age- associated factors

9. ©2006 Juhani Ilmarinen, Helsinki

10. ©2006 Willem Goedhard, Middelburg Pekka Himanen (born 1973) is a Finnish philosopher1973 Finnishphilosopher

11. ©2006 Willem Goedhard, Middelburg Finland als kennisbasis? An information society is a society in which the creation, distribution and manipulation of information is a significant economic and cultural activity. The knowledge economy is its economic counterpart whereby wealth is created through the economic exploitation of understanding.societyinformation knowledge economy

12. ©2006 Willem Goedhard, Middelburg Recommendations Herman Wijffels (World Bank Institute): Greying of the society? The main challenge is to maintain the vitality of the modern society; “we should invest in vitality”: This implies: No age limits in education (university) [ 2nd Jan Brouwer Conference, Haarlem, 18January 2006 ]

13. ©2006 Willem Goedhard, Middelburg Age Management Toolbox 3 elements: The attitude of the supervisor towards aging workers is the key element: “connecting people”-  Connecting “employer – aging employee”[Nokia] through promotion of work ability E.g. participatory ergonomics

14. ©2006 Juhani Ilmarinen, Helsinki

15. ©2006 Willem Goedhard, Middelburg Aging and Work Individual aging worker: Objectives should be: Health promotion Optimum functional capacity Work ability promotion Skills & knowledge training

16. ©2006 Juhani Ilmarinen, Helsinki

17. ©2006 Willem Goedhard, Middelburg Aging and Work The company with aging workers objectives: Good Age management Lowering costs of sick leave / absenteeism Improvement of productivity

18. ©2006 Willem Goedhard, Middelburg Aging and Work Society objectives: Less age discrimination Decrease of health costs Longer worklives Later pension ages

19. ©2006 Willem Goedhard, Middelburg Waarom Age Management? Bevolkingsontwikkeling, Europa 2005- 457 million 2050 – 454 million 2010-2050: working population: -/- 48 m (=-16%) Dependency ratio: 2010: 4:1, 2050 2:1 Source: FIOH 2006

20. ©2006 Willem Goedhard, Middelburg Waarom Age Management? Aansporingen  werknemers (langer doorwerken) Werkgevers Langer in dienst houden en ouderen in dienst nemen: Investeren in Arbeidsgeschiktheid Arbeidsomstandigheden aanpassen (nb: gezondheid en veiligheid bevorderen) Aanpassen Arbeidsbelasting

21. ©2005 Blokland, TNO (Human Resource Management) Ontwikkelingsgang VergrijzingReorganisatieproblemen Ouderenbeleid Outplacementbeleid Leeftijdsbewust personeelsbeleid Employabilitybeleid Inzetbaarheidsbeleid

22. ©2006 Willem Goedhard, Middelburg Work after 60: Reasons and Motives Greying of the population: –Dependency ratio increases –[65/(20-64)x 100%] EU policy (Barcelona 2002):  Pension Age at 65 years in 2010 [N.B. in Netherlands at approx. 61 years]

23. ©2006 Willem Goedhard, Middelburg Positieve indicatoren Veroudering van de bevolking is goed nieuws, Mensen leven langer, in redelijk goede gezondheid Werkgelegenheid op redelijk peil Werkeloosheid daalt Tijd voor hervormingen op arbeidsmarkt (o.a. pensioenen, langer doorwerken, beleid in bedrijven t.a.v. oudere werknemers)

24. ©2006 Willem Goedhard, Middelburg

25. Disabled Workers and Age Disabled Workers in the Netherlands: 15-44 years: 30% 45-64 years: 70% Causes of Disablement (Chronic Disorders):  psychosocial stress (depressive) disorders; (35%)  musculoskeletal diseases (32%)  general and endocrine diseases (13%)

26. ©2006 Willem Goedhard, Middelburg Determinants of the Working Life Employment --------------------- Employability --------------------- Work Ability --------------------- Aging Process Physical Capacity Chronic Diseases Job Demands Working Environment Ergonomics Work-stresses

27. ©2006 Willem Goedhard, Middelburg “Older Worker”

28. ©2006 Willem Goedhard, Middelburg

29. The House of Work Ability (J. Ilmarinen©) Metaphore of the concept of Work Ability

30. ©2006 Willem Goedhard, Middelburg

32. Aging Aging (semantics) Webster: To grow old or show signs of growing old (gerontology: the scientific study of the process of aging and of the problems of aged(?) people); (NIA, 1978: older/senior 55-64; elderly 65-74; aged 75-84; very aged 85+). Occupational Gerontology: Older Employee: 45- 64 years Elderly Employee: 65+ years

33. ©2006 Willem Goedhard, Middelburg Aging?

34. ©2006 Willem Goedhard, Middelburg Aging is the accumulation of changes in the cells and tissues that increase the risk of death (Harman, 1994). Biological Aging (senescing): ‘The process of change in the organism, which over time lowers the probability of survival and reduces the physiological capacity for self- regulation, repair and adaptation to environmental demands’ (Birren and Zarit, 1985) Primary and Secondary Aging (Busse,1969, Perlmutter,1985 Primary Aging: the result of inherited biological processes that are time-dependent (criteria of Strehler: cumulative, universal, progressive, intrinsic,

35. ©2006 Willem Goedhard, Middelburg Rate of Aging: Biological Age vs. Chronological Age: Needed: a ‘biomarker’ of aging. 1969: Test battery by A.Comfort) comprised 53 measures to be performed! ± 1985: telomeres (bases at the ends of chromosomes) Cell replication: part of the telomere is lost (telomere shortening).

36. ©2006 Willem Goedhard, Middelburg Chromosomal Instability, leading to cell aging and death. Individual rate of aging: influenced by genotype, environment, and gene- environment interactions.

37. ©2006 Willem Goedhard, Middelburg Aging of the workforce Is aging of the workforce a problem? (J-F.Caillard, former President of ICOH, 1994) “….the survival of greater numbers of people into old age has great consequences for the health of the labour force, as many remain in employment with the deficiencies and disabilities that accompany ageing”.

38. ©2006 Willem Goedhard, Middelburg 60+ at work in the Netherlands Employment Rate and age Work after 60: Reasons and Motives Work after 60: Obstacles Incentives to continue working after 60 Lengthening the working life: what should be done?

39. ©2006 Willem Goedhard, Middelburg Prognosis Workforce Netherlands(WRR, 1995) 199019952020 Median age35yrs39yrs29-40yrs Labor participatio n 66%71%75% 15-29jr 50-64 yr 36% 14% 26% 19% 26% 27%

40. ©2006 Willem Goedhard, Middelburg Work after 60: Reasons and Motives [dependency ratio, %] 1900194019802005201020202040 12.112.520.122.824.632.244.4

41. ©2006 Willem Goedhard, Middelburg 60+ at work in the Netherlands Employment Rate and age Work after 60: Reasons and Motives Work after 60: Obstacles Incentives to continue working after 60 Lengthening the working life: what should be done?

42. ©2006 Willem Goedhard, Middelburg Employment Rate and age (key figures) Men X 1.000 Women X 1.000 All X 1.000 Labour Participati on (%) Population8.0668.24016.306 Population 60-64 yrs 414409823 Working Population 60-64 yrs 1144415819.5%

43. ©2006 Willem Goedhard, Middelburg Employment Rate and age age-group 55-64 yrs: changes in last decade IndustryCommercial services 199690.000 (=100%) 125.000 2000133%145% 2004188%185%

44. ©2006 Willem Goedhard, Middelburg Employment Rate and age age-group 60-64 yrs: changes in last decade At work in: menLabour participat ion womenLabour participat ion 199660.00018%18.0005% 200087.00024%26.0007% 2004114.00028%44.00011%

45. ©2006 Willem Goedhard, Middelburg Employment Rate and age age-group 55-64 yrs: changes in last decade IndustryCommercial services 199690.000 (=100%) 125.000 2000133%145% 2004188%185%

46. ©2006 Willem Goedhard, Middelburg Labour participation rate among over-50s

47. ©2006 Willem Goedhard, Middelburg 60+ at work in the Netherlands Employment Rate and age Labour market Between 1995 and 2005 we observed: Decrease of young - middle-aged workers Increase of older workers

48. ©2006 Willem Goedhard, Middelburg 60+ at work in the Netherlands Employment Rate and age Work after 60: Reasons and Motives Work after 60: Obstacles Incentives to continue working after 60 Lengthening the working life: what should be done?

49. ©2006 Willem Goedhard, Middelburg Working population (men x 1000)

50. ©2006 Willem Goedhard, Middelburg Working population (men x 1000)

51. ©2006 Willem Goedhard, Middelburg Working population (men x 1000)

52. ©2006 Willem Goedhard, Middelburg 60+ at work in the Netherlands Employment Rate and age Work after 60: Reasons and Motives Work after 60: Obstacles Incentives to continue working after 60 Lengthening the working life: what should be done?

53. ©2006 Willem Goedhard, Middelburg Work after 60: Obstacles Employees Majority is in favour of early retirement Employers Majority is indifferent or opposed to retirement of employees at 65 years Source: van Dalen en Henkens, NIDI (2003)

54. ©2006 Willem Goedhard, Middelburg Work after 60: Obstacles (opinion of employees) SES statusLow (mean age) high (mean age) able to work until61.6 years65 years expect to work62.462.3 want to work58.559.4

55. ©2006 Willem Goedhard, Middelburg Work until 65? (opinion of employers, n=1054) wenselijkOn- verschillig ongewenst Industry25%41%34% Commercial services 20%42%38% Health care20%44%36% Civil service17%55%28%

56. ©2006 Willem Goedhard, Middelburg Work after 60: Obstacles Other important aspects are: Sick leave and age Disablement pensions and age

57. ©2006 Willem Goedhard, Middelburg Work after 60: Obstacles

58. ©2006 Willem Goedhard, Middelburg Work after 60: Obstacles

59. ©2006 Willem Goedhard, Middelburg Work after 60: Obstacles

60. ©2006 Willem Goedhard, Middelburg Work after 60: Obstacles

61. ©2006 Willem Goedhard, Middelburg 60+ at work in the Netherlands Employment Rate and age Work after 60: Reasons and Motives Work after 60: Obstacles Incentives to continue working after 60 Lengthening the working life: what should be done?

62. ©2006 Willem Goedhard, Middelburg Incentives to continue working after 60 National Government (ministry of social affairs): Taskforce Ouderen en Arbeid (‘Aging and Work’) 2001-2003, research / recommendations Grijs Werkt (‘Grey at work’) 2004-2007, stimulating employers and employees

63. ©2006 Willem Goedhard, Middelburg Incentives to continue working after 60 Change in culture and attitude (regarding workers > 55 years) are necessary: Early retirement or disablement are not the end-points Continuation of employment until 65 Introduction of Age-discrimination act (2004)

64. ©2006 Willem Goedhard, Middelburg Incentives to continue working after 60 Policies aimed at: Job adaptations Continued education / training

65. ©2006 Willem Goedhard, Middelburg Incentives to continue working after 60

66. ©2006 Willem Goedhard, Middelburg Incentives to continue working after 60 Aspects of Age-conscious HR management: Job rotation Investment in older workers (training) Opinions about older workers: –Low productivity and high salaries –time of return of investment: too short Career planning Individual Health management –Fitness –Nutrition

67. ©2006 Willem Goedhard, Middelburg 60+ at work in the Netherlands Employment Rate and age Work after 60: Reasons and Motives Work after 60: Obstacles Incentives to continue working after 60 Lengthening the working life: what should be done?

68. ©2006 Willem Goedhard, Middelburg Aging of the Workforce in the Netherlands It is not considered a threat or a disaster. It is considered a challenge for: The government Employers / organisations HR Managers Employees / trade unions Occupational Health Services

69. ©2006 Willem Goedhard, Middelburg Aging of the Workforce in the Netherlands What are the Challenges? What are possible Solutions? What can be the Perspectives?

70. ©2006 Willem Goedhard, Middelburg Challenges Maintenance of employability and work ability of older workers Prevention of diseases and disability. Combating age-discrimination. How?  Studies on the inter-actions of Aging and Work  age-management  legislation aimed at the protection of older workers

71. ©2006 Willem Goedhard, Middelburg AGE-Management Older harbour-workers should be allowed to adjust their work speed (Jan Baart, Univ. of Rotterdam, 1973) Ageing men and women should have the possibility to regulate their own work, to alter and adjust the order of work tasks, work methods and work speed (Juhani Ilmarinen, FIOH, Helsinki, 1999)

72. ©2006 Willem Goedhard, Middelburg Inter-actions of Aging and Work

73. ©2006 Willem Goedhard, Middelburg Occupational Gerontology GeneticsWork Environment Rate of Aging Development of Chronic Diseases Decreased work ability / employability

74. ©2006 Willem Goedhard, Middelburg Occupational Gerontology = Human Gerontology during the working life At 30 years: start of physiological decline Musculoskeletal functions Cardiovascular / pulmonary functions (X)

75. ©2006 Willem Goedhard, Middelburg Occupational Gerontology (X) Changes in Physiological functions with Age: pulmonary function, oxygen uptake capacity (VO2max) cardiac output [physical exercise can slow down the decrease of VO2max]

76. ©2006 Willem Goedhard, Middelburg Occupational Gerontology = Human Gerontology during the working life At 50 years: start of psychosocial decline (especially at work) Increased vulnerability to Work Stress (X) Reduction in training and development Decreased employability Age-discrimination

77. ©2006 Willem Goedhard, Middelburg (X) Perceived stress and Age

78. ©2006 Willem Goedhard, Middelburg Baroreflex function: Change in heart rate upon standing-up from supine position

79. ©2006 Willem Goedhard, Middelburg

80. Occupational Gerontology In summary: Perception of Work Stress increases with age Baroreflex function decreases with age Baroreflex function is possibly affected by work stress

81. ©2006 Willem Goedhard, Middelburg Copyright ©2004 by the National Academy of Sciences Epel, Elissa S. et al. (2004) Proc. Natl. Acad. Sci. USA 101, 17312-17315 Fig. 1. Scatter plots of chronicity of stress by telomere length in caregivers and perceived stress scores by telomere length

82. ©2006 Willem Goedhard, Middelburg

83. Occupational Gerontology = Human Gerontology during the working life At 50 years: start of psychosocial decline (especially at work) Increased vulnerability to Work Stress Reduction in training and development Decreased employability Age-discrimination

84. ©2006 Willem Goedhard, Middelburg Utility value and learning value in relation to age (10 large scale industries) A study by Boerlijst and van der Heijden (1996) Age-range (years) 40-4647-5253+ Utility value (value of function) 75%70%55% Learning value 35%45%30% Job mobilitymediumlowVery low

85. ©2006 Willem Goedhard, Middelburg Occupational Gerontology = Human Gerontology during the working life At 50 years: start of psychosocial decline (especially at work) Increased vulnerability to Work Stress Reduction in training and development Decreased employability Age-discrimination

86. ©2006 Willem Goedhard, Middelburg Occupational Gerontology Employers about Older Workers: “To retain or to retire, that’s the question!” If not employed Preconceived negative ideas If employed: Positive ideas  cont.

87. ©2006 Willem Goedhard, Middelburg Occupational Gerontology Benefits of Older employees: (Confederation of British Industry; l.c. Collis and Mallier, 2000) Fewer periods of absenteeism Productivity does not fall with age Responding well to training Can cope with changes

88. ©2006 Willem Goedhard, Middelburg Occupational Health Surveillance of older employees Aging: Promotion of Age-consciousness Periodic health checks  Age-associated disorders  Work-associated disorders  Assessment of functional capacity Age-conscious personel policy  Reduction of working hours  Work breaks

89. ©2006 Willem Goedhard, Middelburg Occupational Health Surveillance of older employees  Prevention of Disablement  Maintenance of Work Ability

90. ©2006 Willem Goedhard, Middelburg Prevention of Disablement Strategies for Older Workers Primary Prevention Secondary Prevention Tertiary Prevention

91. ©2006 Willem Goedhard, Middelburg Prevention Strategy ObjectiveMethods Primary prevention Prevent new cases of disablement Good OH Practice Age Management Secondary prevention Early detection of increased risk of disablement Work Ability Index (WAI) Stress screening Tertiary preventionReintegration of disabled workers Occupational medicine and clinical treatment

92. ©2006 Willem Goedhard, Middelburg Age Management at Company Level

93. ©2006 Willem Goedhard, Middelburg Prevention of Disablement Prevention Strategy ObjectiveMethods Primary preventionPrevent new cases of disablement Good OH Practice Age Management Secondary prevention Early detection of increased risk of disablement Work Ability Index (WAI) Stress screening Tertiary preventionReintegration of disabled workers Occupational medicine and clinical treatment

94. ©2006 Willem Goedhard, Middelburg Work Ability and “WAI” Definition: Physically and mentally being able to comply with work demands. Work Ability Index (“WAI”): Questionnaire that enables the measurement of the rate of Work Ability

95. ©2006 Willem Goedhard, Middelburg Perspectives of Aging and Work Promotion of Occupational gerontology Implementation of research findings Promotion of Occupational Health Care Working Conditions will be improved Improvement of health in the working life

96. ©2006 Willem Goedhard, Middelburg Perspectives of Aging and Work The working life will be extended beyond the age of 65 years Compression of morbidity Productive Aging will increase Disablement during the working life will decrease

97. ©2006 Willem Goedhard, Middelburg Perspectives Thomas Perls (New England Centenarian Study): “I don’t think the trick is staying young. I think the trick is aging well” (l.c. Aging under the microscope, NIA/NIH, 2002)

98. ©2006 Willem Goedhard, Middelburg Aging Well? Who can tell? Maybe this old Dutchman! born: 1898 deceased: 2005 107 years old Smoked 20 sigars/day

99. ©2006 Willem Goedhard, Middelburg

100. Aging and Work Thank you for your attention