Case 4 EPH2022 Flashcards
(111 cards)
1
Q
What is occupational health (OH)?
A
Promotion & maintenance of physical, mental & social wellbeing of workers in all occupations & extends to improvement of working environment & work to be good for safety & health
2
Q
What are the main components for OH?
A
- OH legislation & policies to protect health of workforce
- Reduction of risks from exposure to workplace hazards
- Health promotion for those at work
3
Q
What considerations must OH practice include?
A
Environmental health considerations & holistic management of workforce.
E.g. hazardous waste management & disposal in chemical plant, prevention of outbreaks of occupational infections, emergency preparedness & response.
4
Q
What does a holistic approach mean?
A
To provide support that looks at the whole person, not just their mental needs.
5
Q
What are occupational exposures that can have negative health effects?
A
- Safety: objects, substances that injure worker e.g. working heights, spills, confined spaces, electrical wiring
- Chemical: environmental smoke, acids, pesticides, carbon monoxide, flammable liquids, paints, etc
- Biological: e.g farms, zoos, hospitals, vets exposed to biological hazards (blood, fungi, virus, insect bites, etc)
- Physical: harm body without touching e.g. radiation, sunlight, noise, extreme high/low temperatures
- Ergonomic: hazard put strain on body over time. E.g. sedentary lifestyle, repeated movements, vibrations
- Work organisation hazards: WP violence, discrimmination, harrassment, etc
- Psychological: stress, burnout, etc
6
Q
What are the major types of occupational diseases & injuries?
A
- Occupational lung diseases
- Occupational cancers
- Occupational & work-related skin diseases
- Occupational reproductive disorders
- Occupational noise-induced hearing loss
- Occupational infections
- Occupational traumatic injuries
7
Q
Explain occupational lung diseases
A
- Respiratory system easily accessible for airborne toxic agents
- Common: occupational asthma, LC, bronchitis, pulmonary infections, dust disease
8
Q
Explain occupational cancers
A
- Occupational carcinogens include chemical substances, e.g. benzene, asbestos, radiation, viruses
- Most common cancers due to workplace exposures: lung, bladder, skin & liver
9
Q
Explain occupational & work-related skin diseases
A
- Workers in agriculture, forestry, manufacturing (e.g. metal workers), florists, hairdressers, etc higher risk due to range of irritants or alergens exposed to skin.
- Most common are dermatitis & skin cancer
10
Q
Explain occupational reproductive disorders
A
- Limited researh
-
Exposures in females: menstrual cycle irregularities, infertility, early menopause, cross placenta to baby.
* Foetal & developmental effects from maternal exposures: peterm delivery, prenatal death, low birth weight, hearing dysfunction
11
Q
Explain occupational noise-induced hearing loss
A
- Workers in manufacturing, mining, transportation, agriculture & military at high risk
12
Q
Explain occupational infections
A
- Blood-borne diseases (hep B,C, HIV) & droplet-borne infections (measels, TB, varicella) can be transmitted from patients to healthcare workers (HCW).
- Also vector-borne diseases (malaria, dengue, Lyme disease), water & food-borne diseases (from poor sanitation & unsafe water = cholera & typhoid), zoonoses among veterinarians, farmers, agricultural & forestry workers (rabies, lepospirosis)
13
Q
What are 2 examples of work-related diseases?
A
- Work-related MSDs
- Stress-related ill-health
14
Q
Explain work-related MSDs
A
- Physical risk factors: rapid work pace, repetivie motion, vibration, sedentary lifestyle
- Pyschosocial factors: high job demands, lack of job control, boring (monotous) work = increased risk
- Interventions such as stretching exercises, implementation fo ergnomic measures = help prevent MSDs
15
Q
What are MSDs?
A
injuries & disorders that affect body’s movement or musculoskeletal system (i.e. muscles, tendons, ligaments, nerves, discs, blood vessels, etc.)
16
Q
What is work related stress?
A
‘Harmful physical & emotional responses that occur when the requirements of the job do not match the capabilities, resources or needs of the worker’
17
Q
Explain work-related stress
A
- New forms of work organisation & employment patterns (more temporary & independent contracting) bring job flexibility but also lower control & increase job insecurity.
- Present as: emotion lability, anxiety, depression, insomnia, suicide.
- Adverse health outcomes: risk of CVD, MSDs symptoms, impaired immune functions, gastrointestinal disorders
18
Q
What are the most common occupational diseases?
A
Lung & skin cancer coz of substantial surface area in direct contact with toxic substances
NIHL & MSDs from physical factors in workplace.
19
Q
Why are occupational & work-related diseases underdiagnosed?
A
- Difficulty in establishing cause-and-effect relationships (skin cancer can be due to exposure of hydrocarbons or excessive sunlight exposure)
- Long latency between occupational exposure & onset of illness
- Lack of good understanding among health practitioners about hazards at work
- Limited ability of workers to provide an accurate report of (past) exposures. Many developing countries, not required to inform workers of hazards.
- Financial liability associated with finding a disease of occupational origin - employers maybe reluctant to recognize disease
Technological evolutions & changees in employment patterns = new occupational disease, making even more complicated
20
Q
What are special populations of workers?
A
- Child labour
- Female workers
- Disabled workers
- Migrant workers
- Shift workers
21
Q
Why is child labour a special population of workers?
A
- Greater exposure to hazards than adults coz tend to do menial jobs & involve high exposures of toxins
- Using hand tools designed for adults = higher risk of fatigue & injury
22
Q
Why are female workers a special population of workers?
A
- Work for smaller industries/organisations & have less opportunity for work control
- More likely to work in informal sectors (domestic work, street vending, sex work) with accompanying low social status and lack of legislative protection.
23
Q
Why are disabled workers a special population of workers?
A
- Reasonable accomodations are: changes made to work environment, job responsibilities, etc
- Aim is to ensure disabled people have same access to everything involved in performing & keeping a job as a non-disabled person.
24
Q
Why are migrant workers a special population of workers?
A
*
* many perform 3D (dirty, dangerous, demanding) jobs
25
What are some problems for migrant workers?
* Affected by poor nutrition & endemic diseases, often have lower educational backgrounds, inadequately trained to deal with potential hazards.
* Language barriers
* Often not familiar with local health & safety practices & regulations.
* Accomodation available often temporary & crowded with limited shared facilities, restricted access to medical care & other social services.
* May encounter racism, xenophobia & exploitation coz of legal status
26
Why are shift workers a special population of workers?
* Can take form of fixed shifts (work same shift period) or rotating shifts (shifts differ over time)
* Consequences: sleep deficits, minimal work performance, psychological health effects, reproductive disorders, metabolic disorders, gastrointestinal disorders, cancer, CVDs
* Shift work-related ill health can increase with time of exposure.
27
What occupational factors impact well-being?
1. Workload
2. Duration
3. Intensity
4. Psychological stress
5. Access to WHP resources
28
* Why is well-being, safety & physical health important for OH?
| which model check doc
* Contributes to changing paradigm that besides safety issues, good workplace health (physical & psychosocial health) is equally important coz impacts work capacity. & performance of organiation.
* More holistic approach to understanding of occupational & work-related diseases, prevention & management.
29
What is toxicology?
Study of nature & mechanisms of toxic effects of substances on living organisms & ther biological systems
30
What are toxic substances?
* Poison
* Ability to cause harm/damage to living organisms
31
How can chemicals cause ill-health to exposed populations?
* Entry of chemicals in water supplies
* Effects of toxic vapours contaminating environment of public places & housing complexes
* Presence of chemicals in land where buildings or rereational activities are planned = land contamination
* Deliberate release of toxic chemicals, either during war or act of terrorism.
32
What are the exposure routes of chemicals in the body?
1. Ingestion (oral)
2. Injection
3. Dermal (skin)
4. Inhalation
5. Mucous membranes
33
Explain the exposure route of **ingestion** & how chemicals are distributed in the body
* Absorption of administered dose in gastrointestinal tract (Gastrointestinal tract - stomach, intenstines, liver,etc)
* Sometimes absorption through mucous membrane of mouth (under toungue = sublingual)
34
Explain the exposure route of **injection** & how chemicals are distributed in the body
* Direct administration into bloodstream
* usually given into **vein (intraveous)** but sometimes (rarely) into **artery** & into **muscle (intramuscular)**
* Substance distributed slower after intramuscular injection than intravenous injection & rate depends on blood flow to muscle.
35
Explain the exposure route of **dermal** & how chemicals are distributed in the body
* One of most common routes of exposure
* Certain dry material (pesticide dusts, powders, liquid pesticides, etc) enter body through **quick skin absorption**
* Skin absopriton pattern vs rate of entry through skin = different for different parts of body
36
What factors infleunce the rate of dermal exposure of a chemical?
* toxicity of chemical on skin
* Rate of absorption
* Size of skin area contamined
* Length of time chemical is in contact with skin
* Amount. ofchemical present on skin
37
Explain the exposure route of **inhalation** & how chemicals are distributed in the body
* inhaled via nose & breathing tubes (trachea, bronchi & bronchioles) into lungs and into thinly lined air cells (alveoli) surrounded by blood vessels.
* Very quick to body & short blood route to lungs & brain which is why you faint, dizzy & long blood route to rest of body (feel fatigue) but skin could get a rash, irrtated, etc.
38
Explain the exposure route of **inhalation** & how chemicals are distributed in the body
* inhaled via nose & breathing tubes (trachea, bronchi & bronchioles) into lungs and into thinly lined air cells (alveoli) surrounded by blood vessels.
* Very quick to body & short blood route to lungs & brain which is why you faint, dizzy & long blood route to rest of body (feel fatigue) but skin could get a rash, irrtated, etc.
39
Short & long blood route?
Very quick to body & short blood route lungs to brain which is why faint, fatigue, dizzy & long blood route to rest of body (why you might feel fatigue) but skin e.g. maybe a rash, irritation.
40
Explain the exposure route of **mucous membranes** & how chemicals are distributed in the body
Substances enter body following absoprtion through mucous membrane of rectum or vagina.
41
Describe the toxicodynamic phase
| look at image!
* How toxic substance affects the cells and organs of human body
* Effect (reversible/irreversible)
* Effects depend on: **concentration & half-life**
42
Define dose
* determines potential toxicity of a substance.
* Amount of harmful substance that enters living organism at one time.
* **No substance is poisonby itself:** dose that makes substance poison.
43
What is important for assessment of harmful effects of a substance entering the body?
Quantity of substance & duration of exposure
44
How is toxic dose determined?
* Dose which reachs the body by inhalation, ingestion, skin, etc.
* Processes that take place once toxic substance is within body
45
What are the processes that take place once toxic substance is in the body?
* Rate of absorption (RA): RA from gut (if oral), RA of breathing (if inhaled) & blood flow (if injection)
* Binding to proteins, fat, & other tissue = may prevent toxin from reaching target organ
* Metabolism by processes usually in liver, kidney, intestine that turn toxin into less harmful chemicals
* Excretion through urine, faeces, bile/breath, skin
46
What is exposure dose (ED)?
Amount of harmful substance present in environment or source from which harmful substance enters living organism, i.e. amount of contamined air, water, & liquids that come into contact with the body
47
What is absorbed dose (AbsD)?
Exact amount of harmful substance entered in living organism & is absorbed by it.
48
What is administered dose (AdsD)?
Amount of harmful substance given (administered) to living organism.
49
What is target dose?
Dose of toxic substance that reached target organ.
50
What is total dose?
Sum of all individual doses, from all exposure routes.
51
What is TD0?
TD0 is maximum dose that would cause harmful effects to 0% of the population
52
What is TD10?
TD10 is dose that would cause harmful effects to 10% of the population
53
What is TD50?
TD50 is the dose that would cause harmful effects to 50% of the population: 50% will get symptoms.
54
What is TD90?
TD90 is the dose that would cause harmful effects to 90% of the population.
55
*What is threshold dose?
| correct?
Dose at which a toxic effect is first observed or detected.
56
What is LD50?
Statistically derived dose at which 50% of individuals will be expected to die (based on experimental observations). Most frequently used estimate of toxicity of substances. E.g. LD60 = 60% of people expected to die.
57
What is LC50?
The calculated concentration of gas deadly to 50% of a group when exposure is inhalational. Occasionally LC0 and LC10 are also used.
58
What is effective dose?
Effectiveness of therapeutic substance. Often, ED refers to beneficial effect, e.g. relief of pain.
Dose effective for 0% of the population would be indicated as ED0, a dose effective for 10% of the population would be ED10,
59
Why is it important to know the TD & ED of chemicals?
Indication of safety agent
60
What is the dose-response curve (DRC)?
* Shows size of effect/response to particular dose of drug used in treatment of disease/chemical that has potential to cause beneficial/harmful effects.
* Provides indication of doses at which particular harmful effect is likely to occur, & information about when maximal beneficial effect would occur.
61
How is DRC calculated?
DRC calculated experimentally by using lowest possible dose & noting response, then increasing dose at consistent increments & determining the response.
62
*What is **N**o **O**beserved harmful or **A**dverse **E**ffect **L**evel (NOAEL)?
Highest level/dose at
63
Why is NOAEL & LOAEL important?
Important aspect of risk assessment in drug development. Determining NOAEL values informs the choice of dose used in clinical trials.
64
*What is **L**owest **O**bserved **A**dverse **E**ffect **L**evel (LOAEL)?
65
What is half life?
Time taken for quantity of toxin in body to be reduced to half its original level through elimination processes.
66
How can half life vary between individuals?
Depends on genetic make-up, state of health, age, etc
Also depends on the **site** in which toxin is found (e.g. cadmium HL in blood is roughly 5-7 **days** but in liver it is roughly 7 **months**, in kidney roughly 15 **years**)
67
Why is half life important?
Coz it provides a timescale during which toxic effects may decrease due to fall in concentration in body & also indicates how long a toxin is likely to remain in body
68
What are occupational exposure limits (OELs)?
Regulatory values which indicate levels of exposure that are considered to be safe (health-based) for a chemical substance in the air of a workplace.
69
*What are the benefits & limitations of OEL?
Benefits:
* OEL works & proper way to contribute to healthy work environment & workforce and to protect worker from health effects.
Limitations:
* 'safe' levle of exposure can be difficult to determine for agents such as allergens & carcinogens
* Researchers always give. higher OEL for economic reasons because it is what we as a society & politicians think is an **acceptable risk**
70
What are the threshold limits for airborne exposures?
* **T**ime-**W**eighted **A**verage (TWA) exposure limit
* **S**hort-**T**erm **E**xposure **L**imit (STEL)
* Ceiling value
71
What is TWA?
Maximum average concentration of chemical in air for normal 8 hour working day & 40 hour week
72
What is STEL?
Maximum average concentration to which workers can be exposed for short period (usually 15 min)
73
What is ceiling value (CEV)?
Concentration that should NOT be exceeded at any time.
e.g. on average may be 10ppm but may **never exceed this value**
74
What are the EU regulations for safety & health?
* Council Directive 89/391/EEC 1989 - introduction of measures to encourage improvements in safety & health of workers @ work.
* Carcinogens & Mutagens Directive
75
Explain the council directive 89/391/EEC
* Aim = eliminate risk factors for occupational diseases & accidents
* Employer shall establish means & measures for protecting workers, involving activities of prevention, information & training of workers.
* Employer shall implement measures on # of general principles of prevention, among which: **avoiding risks**, **combating risks at source**, **replacing dangerous substances by less/non-dangerous**, & giving **collective protective measures** priority over** individual protective measures**
* Requires all MS. toensure employees are informed & consulted about health & safety matters at workplace.
76
What is the carcinogens & mutagens directive?
* Stricter requiremens for carcinogenic/mutagenic substances where it should be replaced as far as possible regardless of economic considerations.
* If this is not possible, companies should use **closed systems**, **ensure exposure is reduced to lowest level possible** through combination of measures including **limitation of quantities of substances present & the number of workers exposed. **
77
What is the role of the EU?
* Research of, investigation into, & treatment of exposures, documenting them for other medical disciplines, public health, and government.
* Advise/provide governments or regulatory bodies with appropriate information to facilitate policy formation & regulation in relation to import, export, manufacture, & use of potentially harmful chemicals.
78
What is the precautionary principle?
* Enables decision-makers to adopt precautionary measures when scientific evidence about environmental or human health hazard is uncertain & stakes are high
* To some, it’s unscientific & an obstacle to progress, others, it’s an approach protecting human health & environment.
* Not a law, it is simply a principle
79
What are the hierachy of controls?
1. Elimination
2. Substitution
3. Engineering controls
4. Administrative controls
5. PPE
80
What is **elimination** in the hierachy of controls?
* Removes hazard at source from production process
* Removes health risk completely & used for carcinogens such as asbestos and benzene, etc.
81
What is **substitution** in the hierachy of controls?
replacement of a hazardous chemical with a chemical that is less hazardous and presents lower risks
82
What are **engineering controls** in the hierachy of controls?
* Reduce/prevent hazards from coming into contact with workers.
* Controls can include: modifying equipment or workspace, using protective barriers, ventilation, and more.
* Engineering controls can cost more upfront than administrative controls or PPE. However, long-term operating costs tend to be lower, especially when protecting multiple workers.
83
What are **administrative controls** in the hierachy of controls?
* Establish work practices that reduce duration, frequency, or intensity of exposure to hazards.
This may include:
* work process training
* job rotation
* ensuring adequate rest breaks
* limiting access to hazardous areas or machinery
* adjusting line speeds
84
*What is **personal protective equipment** in the hierachy of controls?
* Equipment worn to minimise exposure to hazards, e.g. gloves, safety glasses, hearing protection, hard hats, and respirators.
* Not rely on PPE alone to control hazards when other effective control options are available.
* Can be effective, only when workers use it correctly & consistently.
* Might seem cheaper than other controls, but can be costly over time. Especially when on a daily basis.
* When other control methods are unable to reduce hazardous exposure to safe levels, employers must provide PPE. This includes:
while other controls are under development
when other controls cannot sufficiently reduce the hazardous exposure
when PPE is the only control option available
85
What is. thereasonable clause?
* If control measures are highly costly & refers to only 1 person, which can also be solved by PPE e.g. (coz only 1 person who had to work for 1 hour a day in toxic environment), then there is an **acception**.
* In EU, if it comes to control measures = always **collective protection **that goes before individual protection. Meaning if you have control measures which have large impact on total working population, that is preferred than protection of 1 individual.
86
What is a hazard?
* ability of a substance to cause harm.
* Can be physical, chemical, biological, ergonomic, or psychosocial in nature.
87
What are physical, chemical, biological, ergonomic & mechanical, & psychosocial hazards?
* Physical: exposure to extreme temperatures, sunlight, noise, vibration, radiation
* Chemical: organic & inorganic chemicals
* Biological: infectious organisms(e.g. viruses, bacteria), prions & proteins
* Ergonomic &mechanical hazards: result from poor design of workstations & disorganised systems of work.
* Psychosocial hazards: contribute to & cause workplace stress
88
What are risks?
* likelihood of harm or undesired event occurring, & consequences of its occurrence. Probability that substance/agent will cause adverse effects under conditions of use and/or exposure, and the possible extent of harm.
* Risk = Toxicity × Exposure
* It is a probability, a number between 0 and 1. This might sometimes be expressed as a ratio, e.g. one in a million.
89
What is risk management?
In managing risk, setting standards, & communicating with public about hazards, public health agencies regulatory bodies must balance risks of hazardous agent with its benefits to society = therefore risk assessment procedure
90
What is risk assessment & what are the 4 steps for risk assessment?
* process of evaluating the risks to workers’ safety and health from workplace hazards.
Steps include:
1. Hazard identification
2. Dose-response assessment
3. Exposure assessment
4. Risk characterization
91
What is hazard identification?
Involves extensive search of published scientific evidence of adverse effects associated with exposure to particular chemical & similar substances.
More than one hazard may result from exposure to single substance.
92
What is dose-response assessment?
* Detailed study of available toxicological data with understanding of dose-response curve, threshold effects, elimination half-lives, LD50s, NOAEL, & LOEL.
* May also be other relevant data e.g. epidemiological studies & incident reports.
93
What is exposure assessment?
* Study of frequency, duration, magnitude, concentrations, & doses of chemicals to which humans will be exposed.
* Includes possible pathways and routes of entry, noting that individual may be exposed to more than one source of chemical, or more than one chemical.
* Exposures may be both acute and chronic.
94
What is risk characterization?
* Brings together other 3 steps to estimate risk & make recommendations for risk management, including setting of exposure standards & industrial codes of practice.
* Will include detailed consideration & analysis of robustness of toxicological data, appropriateness of analytical procedures & modelling techniques, & reasonableness of assumptions, including magnitude of uncertainty & safety factors.
95
How can you assess exposure?
* Environmental monitoring
* Biological monitoring
* Both monitoring complement each other in assessment of health risk in the exposed worker
96
Explain environmental monitoring
* Undertaken to measure external exposure to harmful agents. Monitoring to ensure exposure is kept within ‘permissible levels’ to prevent occurrence of disease.
* Variations in age, gender, pre-existing disease, genetic makeup, & social habits (eg smoking) influence individual susceptibility & must be considered in applying findings from exposure assessment to exposed population
97
What are 3 types of environmental monitoring?
1. Spot measurement - sample air drawn withiin tube & directly measure concentration of compound in air on the **SPOT** so not very accurate, rough indication
2. Personal monitoring - many compounds, monitoring devices & they give warning when its too high
3. Stationary monitoring
98
What is biological monitoring?
* Measurement & assessment of workplace agents or their metabolites.
* Measure in fat tissue, blood, air, metabolism, urine, excreta, expired air
* Measure not through measuring compounds in air, but measure what happened & how it entered body by measuring into the body.
* Feature of biological monitoring when compared to environmental monitoring = for a particular individual, takes into account exposure from all routes of absorption. E.g. for workplace exposure to organic solvents, skin absorption may be a significant route of entry of solvent into body, & ambient environmental air monitoring might be less useful as an indicator of exposure than biological monitoring.
99
What are advantages & disadvantages of environmental monitoring?
**Advantages**
* Proxy for exposure through inhalation - if you have to work very hard, breath more air & with same concentration in air, get a lot more chemicals into body = not same for everybody
* Basis for exposure standards
* Sometimes also warning
**Disadvantages**
* Skin exposure not taken into account
* Use of PPE not taken into account
* Work methods, hygiene is not taken into account
* Physical activity, medication, etc is not taken into account
100
What are advantages & disadvantages of biomonitoring?
**Advantages**
* All exposure routes are taken into account
* Workmethods, hygiene is taken into account
* Physical activity, medication, etc is taken into account
**Disadvantages**
* No standards available
* Not suitable for compounds with short half life (<2hrs)
* Expensive
101
How does unemployment affect health?
1. Financial problems = lower living standards = reduce social integration and lower self-esteem.
2. Trigger distress, anxiety & depression not only among unemployed themselves but also among partners and children.
3. Impact health behaviour, being associated with increased smoking and alochol consumption and decreased physical exercise.
102
What are the trends of unemployed & precarious workers?
* Precarious jobs more common among low educated people, low-income countries & those previously in long-term unemployment
* Precarious workers often employed in physically demanding/hazardous jobs
* Vicious cycle: unemployment contributes to ill health & ill health increases likelihood of unemployment.
* Economic rec sessions lead to increases in unemployment & precarious work, especially among people with a lower SEP.
103
What are health promoting factors?
1. Job motivation/career
2. Competencies
3. Structure, social support
4. Growth and development
5. Income
6. Physical condition
104
What are the various developments affecting work & health?
1. Major developments in work in recent decades
2. recent developments & threats e.g. corona crisis
3. Demographic change
105
What are the various developments affecting work & health?
1. Major developments in work in recent decades
2. recent developments & threats e.g. corona crisis
3. Demographic change
106
What are the major developments in wok in industrialized countries?
| See graphs
1. Intensification of work demands:
* No general trend but people with high quantitative job demands, & mental demands is high.
* Over decades, work in industrialised countries is characterised by high job demands.
* Increase coz your parents had to work harder than your grandparents & you probably have to work harder than your parents coz, we increasing workload as way we pay our increase in wealth?
2. Digital revolution and robotization
3. Flexibilisation:
* More flexibility in industrialised countries.
* Permanent employment decreasing
* Self-employment is also increasing.
* Self-employed & flexible employment account for more than 35% of the flexible contracts nowadays.
107
What are the recent developments & threats?
Corona crisis:
* Far-reaching implications for way people live & work across Europe and the globe
Short term effects/implications in relation to work, e.g:
* Massive job losses in particular sectors
* Application of reduced work hours
* Importance of human resources
* Increase of teleworking
Long term effects? - not yet known.
108
What are demographic changes for age?
| See graphs
*** 1950: **
Peak = baby boomers
Generation born directly after WWII
*** 2020:**
These are now babyboomers (60, 65 years old now retiring) but see proportion of elderly is becoming larger.
109
What are demographic changes in the reduced labour participation?
* Retirement ages increasing in every European country coz gap/pensions have to pay more for people getting older so government wants us to work longer.
* Still see age group 55-65 years still lagging behind so elderly people have more difficulties to participate in work (not from dropout) as compared to younger ages. For women, this is a larger difference.
110
What are theconsequences of an ageing workforce?
* Ageing workforce & reduced labour participation pose a threat for sustainability of pension systems & health care systems!
* Need for extended working careers/ late retirement
* Need for increased participation rate
111
What are theconsequences of an ageing workforce?
* Ageing workforce & reduced labour participation pose a threat for sustainability of pension systems & health care systems!
* Need for extended working careers/ late retirement
* Need for increased participation rate
