Fatal occupational injuries to older workers

The number of American workers age 55 and over (hereafter referred to as older workers) more than doubled from 1992 to 2017.¹ This increase is due both to a rising U.S. population of people age 55 and over and to a higher labor force participation rate for that population.²

Since 1992, the U.S. Bureau of Labor Statistics (BLS) Census of Fatal Occupational Injuries (CFOI) program has published detailed national data on fatal workplace injuries.³ While workers overall saw their fatal occupational injuries decline by 17 percent from 1992 to 2017, older workers incurred 56 percent more fatal work injuries in 2017 than in 1992. This trend is especially pronounced for workers in the oldest group, those age 65 and over. This group experienced 775 fatal occupational injuries in 2017, the highest number ever recorded in the CFOI, representing an increase of 87 fatal injuries since 2016 (the previous series high) and a 66-percent increase since 1992.

In addition to seeing an increasing number of fatal injuries, older workers were more likely than workers in general to be fatally injured on the job. In 2017, the fatal injury rate for workers age 65 and over was 10.3 per 100,000 full-time equivalent (FTE) workers, and the rate for workers age 55 to 64 was 4.6 per 100,000 FTE workers.⁴ Both rates were higher than the rate for all workers (3.5 per 100,000 FTE workers).

Using CFOI data for 1992–2017, this article provides an overview of the fatal occupational injuries incurred by older workers in the United States. In addition, it contrasts the fatal injury experience and latency periods (of injury and death) of older workers with those of workers age 54 and under (hereafter referred to as younger workers). The article also highlights an occupation with a high number of fatal workplace injuries to older workers—farmers. In 2017, older workers accounted for 80 percent of workplace fatalities in this occupation.

Overview

From 1992 to 2017, 38,200 older workers died because of a workplace injury. This figure represents 26 percent of the total number of fatal occupational injuries incurred by all workers during that time. Over the period, workers age 55 and older accounted for 17 percent of all employed workers.

The number of fatal occupational injuries to older workers ranges from a minimum of 1,234 in 1992 (the first year in which CFOI data were published for the entire United States) to a maximum of 1,930 in 2017. (See table 1.) While the number of fatal injuries to workers age 54 and under declined during this time, the corresponding number for older workers increased. (See figure 1.) In recent years, fatal occupational injuries among older workers have accounted for an increasingly large percentage of all fatal occupational injuries. In 1992, 20 percent of fatal occupational injuries were incurred by older workers, and by 2017, that figure had risen to 37 percent. At the same time, workers age 55 and over represented 12 percent of all workers in 1992 and 23 percent in 2017.

Among older workers who died from a workplace injury in 1992–2017, about one-third (13,556) were between the ages of 55 and 59 and 0.4 percent (135) were age 90 and over. (See table 2.)

The states with the highest shares of fatal occupational injuries to older workers in 1992–2017 were Nebraska (39 percent), Iowa (39 percent), North Dakota (37 percent), South Dakota (37 percent), and Wisconsin (35 percent). While Texas and California had the largest numbers of fatal occupational injuries to older workers over the period, their shares were lower (22 and 23 percent, respectively) than the national average (26 percent). (See figure 2.)

During the 1992–2017 period, older workers were more likely to incur a fatal workplace injury than workers in general. In calculating fatal injury rates, the CFOI program has used two different methods: an employment-based method from 1992 to 2007 and an hours-based method from 2006 to 2017.⁵ The hours-based fatal injury rates of workers age 65 and over were 14.9 per 100,000 FTE workers in 2006 and 10.3 per 100,000 FTE workers in 2017. The rates for workers age 55 to 64 were 5.2 per 100,000 FTE workers in 2006 and 4.6 per 100,000 FTE workers in 2017. Hours-based rates tend to be higher for older workers because these workers generally work fewer hours.⁶ In 2007, the last year for which both employment- and hours-based rates are available, workers age 65 and over had an employment-based rate of 10.2 per 100,000 employed workers and an hours-based rate of 13.5 per 100,000 FTE workers. (See table 3 for full details on fatal injury rates by age group.)

Comparing older and younger workers

The fatal injury experience of older workers exhibits some unique characteristics that set it apart from that of younger workers. These characteristics may be due to, among other things, older workers’ different employment patterns, different job tasks, and higher likelihood of incurring an injury resulting in a fatality.

One way to identify areas in which the fatality experiences of two groups differ is to use the propensity ratio measure devised by Reginald Harris.⁷ This ratio measures the prevalence of a particular aspect of an experience in two different groups, regardless of the size of the groups. For example, consider a case in which homicides accounted for 40 percent of the fatalities in group A and 20 percent of the fatalities in group B. The propensity ratio for homicides for group A would be 2.0, meaning that the share of fatalities attributable to homicides for group A is twice (100 percent) as large as that for group B.⁸ A propensity ratio of 1.0 indicates that a particular aspect of an experience has the same prevalence in both groups. In the following analysis, the propensity ratio is used to compare the fatality experiences of older and younger workers.

Table 4 presents propensity ratios, along with fatality counts, by employment status, gender, and race or ethnicity. The data for self-employment clearly stand out. In 1992–2017, self-employed older workers accounted for 35 percent (13,400) of the 38,200 total fatal injuries incurred by older workers. Over the same period, self-employed younger workers accounted for 15 percent (15,977) of the 106,098 total fatal injuries incurred by younger workers. Therefore, the propensity ratio for self-employment for older workers is 2.3 (35 percent divided by 15 percent), meaning that the share of older worker fatalities attributable to self-employed workers was 2.3 times larger than the corresponding share for younger workers. (See table 4.)

In 2003–17, two occupations—farmers and heavy and tractor-trailer truck drivers—had the largest number of fatal occupational injuries to older workers (3,217 and 3,772, respectively).⁹ However, while heavy and tractor-trailer truck drivers accounted for similar percentages of fatal injuries to older and younger workers (16 percent for older workers and 14 percent for younger workers), farmers accounted for a much higher percentage of fatalities among older workers than among younger workers (14 percent for older workers and 2 percent for younger workers). Thus, the propensity ratio for farmers is 6.3, the highest among occupations or occupational groups with 500 or more workplace fatalities from 2003 to 2017. (See table 5.)

The large propensity ratio for farmers is also seen in the events resulting in fatalities among older workers. For the events that precipitated fatal work injuries from 2011 to 2017 (all of which had at least 800 fatalities), the largest propensity ratio was for nonroadway transportation cases (1.9), with the subcategory of nonroadway noncollision incident cases standing out with a ratio of 2.1.¹⁰ (See table 6.) These latter cases include overturns of tractors and all-terrain vehicles (ATVs) for farmers.

Older farmers—a closer look

In 2003–17, 1 in 7 fatally injured older workers was a farmer. Fatally injured older farmers are remarkably similar demographically, particularly when contrasted with other fatally injured older workers. The following are some of the notable characteristics of the 3,217 older farmers who died of an occupational injury in 2003–17:

-        98 percent were self-employed (compared with 23 percent of other fatally injured older workers)

-        99 percent were born in the United States (compared with 86 percent of other fatally injured older workers)

-        98 percent were non-Hispanic White (compared with 77 percent of other fatally injured older workers)

-        96 percent were men (compared with 92 percent of other fatally injured older workers)

-        61 percent incurred their fatal injuries in the Midwest census region¹¹ (compared with 23 percent of other fatally injured older workers)

Fatal injuries to older farmers constitute a larger percentage of fatalities among older workers in certain states. States with high propensity ratios for older farmers include Iowa (propensity ratio of 5.0), South Dakota (4.6), North Dakota (4.5), Nebraska (4.3), Kansas (4.1), Missouri (3.6), Montana (3.6), and Minnesota (3.4). (See figure 3.)

In addition to having similar demographics, fatally injured older farmers are alike with respect to certain aspects of the incidents leading to their deaths. From 2003 to 2017, 47 percent (1,502) of the 3,217 fatal injuries to older farmers involved a tractor,¹² and in most of these cases, the decedent was driving the tractor. Another 10 percent (334) of older farmer fatalities involved other agricultural and garden machinery. In 222 cases (7 percent), an older farmer was killed in an incident involving a tree (e.g., being struck by a falling tree). A total of 218 older farmer deaths (7 percent) occurred in incidents involving ATVs, and another 203 deaths (6 percent) involved animals such as cattle and horses. (See table 7.)

Latency

In a 2013 Monthly Labor Review article,¹³ William J. Wiatrowski describes a “continuum of [injury] severity” that includes the following categories of injury cases:

-        Medical treatment beyond first aid, with no time away from work or restricted activities

-        Job transfer or restriction

-        Days away from work

-        Fatality, which may be further divided into immediate or delayed, often resulting from complications

One aspect of this continuum of severity pertains to whether certain types of cases are more likely to occur among certain groups of workers. Table 8 contains data on fatal occupational injuries to older and younger workers by latency, which is the time between the date of injury and the date of death. The table shows that 93 percent of all older worker fatalities occurred within 30 days of injury, compared with 97 percent for younger workers.

The age data element in the CFOI is the age of the worker at the time of his or her death. Therefore, in the present analysis, a worker injured at age 25 who dies because of complications from that injury at age 60 would be considered an older worker. However, looking solely at cases in which the worker dies within 30 days of his or her injury minimizes any issues arising from differences in age at the time of injury and the time of death. For cases where the date of injury and the date of death were no more than 30 days apart, younger workers were more likely to die on the day of injury (87 percent, compared with 81 percent for older workers), whereas older workers were more likely to die 1 to 30 days after the injury (19 percent, compared with 13 percent for younger workers).

This discrepancy in latency could stem from older and younger workers incurring different types of injuries, suffering injuries of different severity, or having different susceptibility to dying from complications. While the CFOI does not have an exact measure of severity, certain combinations of injuries suggest that older workers are more susceptible to specific types of injuries and/or complications. For example, of the 146 fatal occupational injuries due to hip fractures from 1992 to 2017 (for which the death was within 30 days of injury), 90 percent (131) were sustained by workers age 55 and over and 10 percent (15) by workers age 54 and under.

Conclusion

Older workers account for an increasingly large share of the workforce and of workplace fatalities. Many of these workers, particularly older farmers, face unique hazards in the workplace. With the help of detailed data from the CFOI, safety and health experts can continue to tailor their efforts to best meet the needs of older workers and to keep them safe during their careers.