Transcript Physiology of the Liver

David O. Carpenter, MD
Institute for Health and the Environment
University at Albany
What Proportion of the Workforce
is Female?
Women comprise 46% of the total US labor force at
present. With almost half of the workforce being
women, female employees aren’t exactly a rarity. For
most women today, getting a job is an expected part of
life. This is a big change from past decades. In 1900
fewer than 20% of women participated in the labor
market, while today the number is around 75% and
growing.
Women and the Workforce/Jobs
• The labor-market participation rate for women 25 to 44 years of age - the
average child bearing years - rose from less than 20% to more than 75%
between 1900 and 1999 (Source: Business Week)
• 60% of US women work outside the home, earning $1 trillion each year in
aggregate (Source: Chicago Tribune, 1999)
• Net increase of the workforce between 1992 and 2005, 62% are projected to be
women (Source: U.S. Federal Government, Bureau of Labor Statistics)
• Of working married women, 48% provide half or more of the household
income (they are the primary bread winner and if we pay well, they want your
jobs) (Source: Families and Work Institute Study)
• 99% of working women describe equal pay for equal work as extremely
important aspect of their job to them. Almost one-third say their current job
does not provide equal pay for equal work (Source: AFL-CIO)
Workplace Issues for Women
 Equal pay for equal performance.
 Accommodation for pregnancy, breast feeding and
child rearing without penalties.
 A workplace free of sexual harassment and
discrimination.
 Having the same opportunities for advancement that
are enjoyed by men.
Changes with Age
 Physical changes: reduced strength, flexibility,
balance, sight, reaction time, hearing, dexterity, tactile
feedback and increased body fat.
 Physiological changes: Decreased oxygen exchange,
respiratory and cardiovascular function, higher blood
pressure, more fatigue and less tolerant of extreme
temperatures.
Changes in aerobic power of women, ages 20-64 yr.
JACKSON, ANDREW; WIER, LARRY; AYERS, GRETA; BEARD,
EARL; STUTEVILLE, JOSEPH; BLAIR, STEVEN
Medicine & Science in Sports & Exercise.
28(7):884-891, July 1996.
Figure 1 -Bivariate relationship between age and [spacing
dot above]VO2peak for the NASA/JSC women and the
linear regression line that defines the cross-sectional
decline in aerobic power with age. The published simple
linear regression equations for the NASA/JSC men (Jackson,
A. S., E. F. Beard, L. T. Wier, R. M. Ross, J. E. Stuteville, and
S. N. Blair. Changes in aerobic power of men ages 25-70
years. Med. Sci. Sports Exerc. 27:113-120, 1995) and
women studied by Drinkwater et al.(Drinkwater, B. L., S. M.
Horvath, and C. L. Wells. Aerobic power in females ages 10
to 68. J. Gerontol. 30:385-394, 1975) were used to define
the age-[spacing dot above]VO2peak trends for men and
women and compare with the NASA/JSC women. The
simple linear regression equation that defines the
NASA/JSC women's age-aerobic power trend is: [spacing
dot above]VO2peak = 57.726 - 0.537 (Age), SEE = 6.444.
©1996The American College of Sports Medicine. Published by Lippincott Williams & Wilkins, Inc.
2
Kowalski-Trakofler et al. (2005)
Aging Productivity
 Injury risk and its consequences differ in older workers
 Medical costs rise with age
 Estimated 25% increase from age 40 to 50 to 35% from
age 50 to 60
 BUT, age is less a factor in health care costs than the
presence of such risk factors as smoking, obesity, lack
of exercise, and diabetes!
 There is such a thing as “aging productively” or
“healthy aging”!
How to Manage an Older
Workforce
 Can older workers adapt?
 Can they handle new technologies?
 Are their job skills up to date?
 Can they get along with younger bosses?
Aging: A Balance of Factors
 Possible Limitations
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Mental Capacity
Chronic Conditions
Physical Capacity
 Compensating Factors?
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Attitude
Judgment
Flexibility
Interest in learning new things
Mental Capacity
Laboratory Tests
 Cognition speed

Information retrieval slower, unless material is familiar
 Learning and recall slower, but equally successful
in the end
 Greater retention, higher learning achievement
and more likely to complete a new field of study
than younger workers
Mental Capacity: Relevance to Onthe-Job Performance
 Lab tests do not translate well to actual work settings
 Factors other than psychometric cognitive abilities
appear important to perform well at work
 How well worker gets along with co-workers
 Desire to perform well
 Individual measures are quite sensitive to occupational
class
Physical Capacity: Can Older
Workers Keep Up?
 Physiology
 Maximal strength at 20-30 years
 O2 uptake reduced to 70% (max) by 65 years
 Older adults work closer to capacity
 Match Ability to Job Requirements
 Change in industry from manufacturing to services
 Change in job duties from physical to mental
Work Settings: Employing Older
Workers
 Decreased performance
 For physically demanding work only
 Work uncommonly demands maximal effort
 Non-physical advantages that older workers bring to a
job are rarely measured
 Workers abilities matched to the job results in less
morbidity
 Accommodation thinking rare in industry1
 May change with ADA Amendments Act of 2008
 Workers are changing (aging) and jobs are changing
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1
Eur J App Phys 2003 89:536
Essentials
 Do aging workers need special accommodations?
 A well-designed workplace benefits everyone
 Work stations and job tasks need to be matched to the capacity
of each worker
 There should be no conflict between ergonomic principles vs.
reasonable accommodations
 Are there any specific health and safety concerns related
to aging workers?
 Older workers have fewer injuries, but when one occurs, that
injury tends to be more severe and it takes worker longer to get
better.
 Injuries differ in older workers—there are more musculoskeletal
injuries (especially involving the low back)
 No consistent relationship between aging and work
performance!
Older Workers: Some Best Practices and Strategies for
Engaging and Retaining Older Workers GAO-07-433T
February 28, 2007
 Key Obstacles
 Employer perceptions
 Age discrimination
 Strong financial incentives to retire
 Jobs with inflexible schedule or unmodified physical demands
 Best Practices
 Non-traditional recruiting techniques
 Flexible work schedules
 Adapt to “retirement” schedules
 Strategies
 Make federal government model employer for older workers
 Consider specific legislation
Reinventing Retirement
 Boomers much less likely to associate retirement with
the traditional retirement age of 65.
 Nearly 70% of workers who have not retired report
that they plan to work into their retirement years or
never retire.
 Almost half of workers 45-70 indicate that they
envision working into their 70s or beyond.
Positive Perceptions of Older
Workers
 Loyalty and dedication to the company
 Come to work on time; low absenteeism
 Commitment to doing quality work
 Someone you can count on in a crisis
 Solid performance record
 Solid experience in job/ industry
 Basic skills in reading, writing, arithmetic
 Getting along with co-workers
Strategies for Keeping an Older
Workforce Productive
 Acknowledge changes in physiological function so as
to utilize older worker’s productively more efficiently
 Have an ergonomically appropriate workplace.
 Value experience and “wisdom” rather than just
physical strength.
 Accommodate changes in health status to as great a
degree as possible
Conclusions
 Our workforce is changing markedly, with more older
workers, more women and more minorities.
 These changes require management adjustments in
order to maximize productivity.