Which interventions are used in the rehabilitation,return,and stay at work process of aging workers having suffered an occupational injury? A scoping review

Abstract

BACKGROUND:

Considering current labour shortages, the recent increase in the number of aging workers in the labour market is deemed economically beneficial. However, due to specific characteristics (e.g. biological, generational), aging workers take longer to recover and return to work after an occupational injury. Yet, few studies have examined the rehabilitation, return, and stay at work process of aging workers and current knowledge makes it difficult for stakeholders to identify which interventions to use with this specific population.

OBJECTIVE:

This study aimed to describe which interventions are used in the rehabilitation, return, and stay at work process of aging workers having suffered an occupational injury.

METHODS:

We conducted a five-step scoping review. Five databases were used for the literature search. A qualitative analysis of the retained manuscripts was conducted.

RESULTS:

Our analysis led to the extraction of information from seven manuscripts that concern the rehabilitation, return, and stay at work process of aging workers who suffered an occupational injury exclusively. We identified 19 interventions (e.g. work capacity development, work task modifications, permanent part-time work, and alternative roles) and were described according to the different phases of the Cycle of Work Disability Prevention (CWDP).

CONCLUSIONS:

This study offers informative, non-prescriptive, and operational interventions useful for stakeholders who support aging workers. Furthermore, it is a knowledge base to develop future projects that promote the rehabilitation, return, and stay at work process of aging workers.

Keywords

Older worker occupational injury occupational rehabilitation intervention return-to-work stay-at-work scoping review

1 Introduction

Labour shortages are being felt in many countries worldwide and Canada is no exception [1]. The growing number of young adults prolonging their higher education along with lower birth rates has led to a shortage of young workers entering the labour market [2, 3], thereby increasing the potential shortage of skilled workers and creating a void [4]. In addition, the Canadian population aged 55–64 will increase by approximately 16% between 2010 and 2030 [5], to represent nearly 30% of the active population [5]. Statistics show that in 2000, there were 1,748,900 workers in Canada aged 55 and over, while recent data show a marked increase to 5,231,400 in 2022 [6]. This growing number of aging workers is a notable labour resource as it can meet significant labour needs [2].

Recognized as a skilled population [2], aging workers are necessary [4] to counterbalance labour shortages [2, 7]. They are beneficial to the companies that hire them because they have knowledge of the trade and a large working experience [8] along with company-related expertise [4, 9].

The literature also identifies many benefits for aging workers to stay at work. Active aging, which includes work, is seen as a solution to the demographic challenges of the aging population [10, 11]. Work helps aging workers to remain mentally alert, which decreases depressive symptoms and psychological disorders, while maintaining better mental health [8]. Work also helps to maintain good physical fitness [9], decrease the number of major diseases [8], improve functional independence, and preserve cognitive abilities [8, 12]. Staying at work is linked to an overall better health of aging workers [13].

However, aging is not without risk to the workers [8, 14]. In fact, in 2021, aging workers represented 21,8 % (60 364) of injured workers in Canada [15], experiencing significant periods of disability [8 , 17]. Some authors state that, considering the natural process of aging, the risk of occupational injury, the severity of injuries, and the duration of the disability period increase with age [14 , 19]. Hence, there appears to be a link between aging workers and occupational injuries that take aging workers longer to return to work (RTW) [3 , 20] and leads to the increased use of rehabilitation services [3 , 17].

Various factors specific to aging workers lead to a long and complex rehabilitation, return, and stay at work process, thus increasing the associated costs [16, 21]. While some authors recognize that individual factors need to be considered (e.g. health conditions, severity of injury) [22], environmental factors must also be taken into account [3, 14]. Some studies identified workplace-related factors, such as post-injury and work absence management, to explain the link between aging workers and their prolonged work absences following occupational injuries [22]. Although, the scientific literature suggests best practices to support the process, such as using a personalized approach adapted to each worker [20, 23], other studies have indicated that an important number of aging workers do not receive modified work accommodations and are less likely to receive timely injury rehabilitation [14].

It is unclear to what extent stakeholders have, or have not, been able to adapt to aging workers. However, some authors do suggest that stakeholders feel less equipped, having few resources to address the specific needs of aging workers [8 , 24]. Although the number of scientific papers concerning aging workers is increasing [8 , 24], few studies have examined the interventions provided during and after disability periods [19]. Therefore, current knowledge makes it difficult for stakeholders (i.e. employers, insurers and rehabilitation professionals) to identify which interventions to focus on when taking into account the specificities of aging workers [8, 16]. Some stakeholders, such as employers, may worry about how their business will be impacted by the rehabilitation timelines and the RTW process [26]. Although they do acknowledge the increasing presence of aging workers in the workplace, some employers perceive a lack of information guiding them in the RTW process, e.g. how to identify appropriate work tasks and adaptations [26]. Some healthcare professionals state that they lack the knowledge of the many aspects to be considered in the work disability management of aging workers [20, 25]. As such, few clinical settings offer services that meet the unique needs of aging workers [16, 24]. Whereas insurers must apply strict regulations which can limit the possibilities of adapting and individualising rehabilitation services to the specific needs of aging workers [16, 20]. However, few studies offer in-depth information concerning the full role that the insurer plays in this process [16].

While the burden of labour shortages is heavily felt, the literature supports the idea that aging workers can help to alleviate part of this burden. As described above, when aging workers suffer occupational injuries, many factors related to the stakeholders involved can positively or negatively influence the rehabilitation, return and stay at work process [16, 20]. Numerous studies describe the best practices and interventions to be used by the different stakeholders in order to facilitate the process and ensure an early and sustained RTW. However, the majority of these studies are geared towards workers of all ages, giving little information on the best practices and interventions to be used with regards to the specific needs of aging workers. Considering 1) the marked increase in the number of aging workers in the labour market, 2) the increased risk of prolonged disability following an occupational injury, and 3) their specific needs in terms of support during the rehabilitation, return and stay at work phases, the objective of this study is to describe which interventions being used in the rehabilitation, return, and stay at work process of aging workers having suffered an occupational injury are currently being used.

2 Conceptual framework

Since the aim of this study is to describe which interventions are currently being used in the rehabilitation, return and stay at work process of aging workers, a clear understanding of the different concepts surrounding this process is needed. Numerous studies have looked into these concepts and various factors that can influence the success of this multidimensional process [14 , 27–31].

For the purposes of this study, we will build on Young et al.’s (2005) four phases of the RTW process and the main concepts of Audet et al.’s (2022) Occupational Injury Management Continuum. We present the Cycle of Work Disability Prevention (CWDP) in aging workers as a five-phase dynamic process; Phase 0 – Prevention, Phase 1 – Rehabilitation, Phase 2 – Return-to-work, Phase 3 – Stay-at-work, and Phase 4 – Reduction of consequences of an occupational injury (see Fig. 1).

Fig. 1

Cycle of Work Disability Prevention (CWDP)^rmbox1.

Should an occupational injury occur, the aging worker will enter phase 1 (rehabilitation) [29]. The rehabilitation phase consists of interventions geared towards providing a conducive environment for healing and developing work capacities. In some circumstances, there may be a complete cessation of work [29], while in other cases, the aging worker may remain in their regular or modified work functions throughout phase 1. In cases where an aging worker was completely off work during phase 1, the RTW phase (Phase 2) will begin with the initial RTW [29]. Whereas for aging workers who remained at work during phase 1, the RTW phase will be done conjointly with phase 1 when modified work tasks or work hours are adopted as main interventions. In some cases, aging workers may go directly from phase 1 to phase 3 if no work modifications are needed following the occupational injury. The stay-at-work phase (Phase 3) begins when the RTW phase has been completed [29] and the aging worker is able to work efficiently according to their employer’s expectations. Phase 3 consists of interventions used to maintain a healthy and safe environment allowing the aging worker to remain at work [29] while being able to adapt their work functions in accordance to their naturally changing capacities throughout the years, thereby maintaining a positive margin of manoeuvre 1 (MM)^rmbox2 2 between their work capacities and work demands [33, 34].

Prior to, during, or after phase 3, the CWDP proposes a fourth phase aimed at reducing the consequences of an occupational injury (Phase 4) [30]. This phase consists of interventions, generally put forth by the employer, in order to reduce the negative consequences of an aging worker’s occupational injury, e.g. on other employees during their work absence (phase 1) or during the RTW phase [30]. The employer may also use interventions to make changes in order to avoid negative consequences of future occupational injuries, e.g. restructuring the enterprise or modifying job positions [30].

Since the CWDP is a non-linear dynamic process, there may be a to-and-fro of interventions between different phases before each phase is actually considered completed [29, 30]. This to-and-fro is dependent on multiple factors such as the aging worker’s evolution throughout the process, the ability of the employer to adapt and provide work modifications, and the support from other stakeholders throughout the process.

As shown in Fig. 1, a prevention phase (Phase 0) [30] is found following phases 3 and 4. This prevention phase consists of all interventions used to reduce [30] and ideally avoid the onset of occupational injuries. In doing so, the CWDP may be completely avoided. Although this may appear to be a utopian thought, it encourages all stakeholders involved in striving towards the maintenance of occupational health of aging workers. As such, and in accordance to the literature, this entails that several stakeholders from all four systems (workplace, healthcare, worker, compensation) must be involved in every phase [16 , 34–37].

3 Method and analysis

3.1 Design

A scoping review, based on Arksey and O’Malley’s methodological framework (2005) was used to provide an extensive view of the literature available by examining the amount, range, and the nature of our specific field [38 –41], the CWDP process of aging workers having suffered an occupational injury. The scoping review was chosen because of its relevance for emerging fields [40], such as aging workers. As this study is a scoping review, it is exempt from Institutional Review Board approval.

To increase the scientific rigour of this article, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR)³ 3 checklist was used to report the information [42].

3.2 Procedure and analysis

To ensure scientific rigour this scoping review used a five-step systematic design [38 –40].

3.2.1 Step 1: Identification of the research question

In order to successfully review the literature, a research question must first be clearly identified. To ensure that the study includes as many relevant manuscripts as possible, the question must be broad [38–41 , 43]. It must also include specificities concerning the aim of the study and its target population, along with its most important concepts [38 –40]. The primary question for this study was: What are the interventions used in the process of rehabilitation, return, and stay at work of aging workers having suffered an occupational injury? Considering that the scoping review has an exploratory nature, the authors could nuance and refine the question as they reviewed the scientific literature [39].

3.2.2 Step 2: Identification of relevant studies

The search strategy was developed with a consulting librarian [30]. The main areas of interest for this study were rehabilitation, occupational therapy, gerontology, ergonomics, management, and psychology. Since the subject reaches several areas of interest, the search strategy needed to be broad and inclusive. To do so, different combinations of keywords were used in relevant databases (see Table 1). The keywords were based on the four main concepts related to the research question: 1) Aging workers, 2) Occupational injuries, 3) Interventions, and 4) Rehabilitation, return, and stay at work process. The databases (See Table 1) were chosen for their frequency of use in the scientific literature and their content relevance. Subsequently, a secondary search was done by manually reviewing the reference lists of the selected manuscripts in order to identify other relevant manuscripts. Third, a manual search was done in Google by using the search strategy keywords in order to ensure proper literature saturation by including the gray literature. Due to the large number of results generated by Google searches, we relied on the relevancy ranking that brings the most relevant results to the first pages [45]. Hence, the titles and short descriptions found in the first ten pages were screened [45]. Lastly, a manual search of research reports and practical guides addressing our subject was conducted on occupational health and safety websites.

Table 1
Search strategy

Keywords (with French equivalent) * Databases and search engines

“older worker”, “aging worker”, “older employee”, “senior worker”, “wounds”, “injuries”, “occupational injury”, “work-related injury”, “workplace injury”, “occupational rehabilitation”, “vocational rehabilitation”, “rehabilitation program”, intervention, tool, work, “return to work”, RTW, “back to work”, “work resumption”, reintegration, “Return to work program”. APA Psych INFO (EBSCO), CINAHL (EBSCO), MEDLINE (EBSCO), ProQuest Dissertations and Theses Global (ProQuest), Scopus (Elsevier)

Keywords (with French equivalent) *	Databases and search engines
“older worker”, “aging worker”, “older employee”, “senior worker”, “wounds”, “injuries”, “occupational injury”, “work-related injury”, “workplace injury”, “occupational rehabilitation”, “vocational rehabilitation”, “rehabilitation program”, intervention, tool, work, “return to work”, RTW, “back to work”, “work resumption”, reintegration, “Return to work program”.	APA Psych INFO (EBSCO), CINAHL (EBSCO), MEDLINE (EBSCO), ProQuest Dissertations and Theses Global (ProQuest), Scopus (Elsevier)

* The terms were searched in the titles, abstracts, and key words. Each word was used in its singular and plural form. Different combinations of the key words were used.

3.2.3 Step 3: Selection of studies included in the review

Once the manuscripts were selected, all the identified references were integrated into a reference management software (i.e. Endnote). The Endnote database was then imported into Covidence, a web-based software for managing systematic reviews. Following the elimination of duplicates, the literature selection was done by two reviewers (a research assistant and the first author) who separately screened the relevance of all selected manuscripts using a two-step approach in Covidence: 1) selection from titles and abstracts, and 2) selection from full-text readings. Conflicts over the admissibility of manuscripts were resolved by incorporating a third reviewer (the last author).

In order to select the manuscripts relevant for this study, the following inclusion criteria were used: 1) manuscripts dealing with workers having suffered an occupational injury, 2) manuscripts dealing with the interventions used in the rehabilitation, return, and stay at work process, and 3) manuscripts dealing with interventions geared solely towards aging workers. To ensure that the interventions reviewed were specific to aging workers, the following exclusion criteria were used: 1) manuscripts dealing with aging workers with disabilities not related to an occupational injury (e.g. leisure activities, cancer, heart surgery), and 2) manuscripts that included workers of all ages. Only manuscripts from the last 15 years were selected in order to have a contemporary portrait of the situation. For feasibility reasons, only English and French literature were retained. The selection criteria were pretested on a sample of five selected manuscripts to ensure their clarity for the research team.

Throughout the selection process, the reviewers met regularly to discuss their findings and rule on the inclusion or rejection of manuscripts. These regular communications heightened the reviewers’ reflexivity and guarded against undue influence from one person’s perspective. Inter-rater agreement was also monitored regularly throughout the process. In total, seven manuscripts were retained for extraction and charting of data, as shown in Fig. 2.

Fig. 2

Manuscript selection flow chart.

3.2.4 Step 4: Extraction and charting of data

The first author conducted the extraction of information from the manuscripts that were selected at the end of step 3. An extraction grid was used in order to reduce variability and biases related to the manuscript reviews [46]. The extraction grid was constructed according to the Template for Intervention Description and Replication (TIDier) [47] to describe as accurately as possible the interventions used in the CWDP process of aging workers having suffered an occupational injury. The grid was first tested by two members of the research team (first author and research assistant) as they independently conducted the extraction of five manuscripts. After this pretest, both agreed on the structure of the extraction grid and the final version of the grid was accepted without modification. The first author then completed the extraction of the remaining manuscripts, and the last author periodically revised the extraction.

3.2.5 Step 5: Review, summarisation and reporting of the results

In order to identify the key themes and knowledge gaps, the selected manuscripts were systematically reviewed. The data was first analysed by using descriptive statistics (e.g. number and types of manuscripts selected, years of publication). In order to group the data extracted from the selected manuscripts by meaning, a thematic analysis was then conducted. To interpret results and facilitate comparison between studies, the data was classified according to our five-phase dynamic process; Phase 0 –Prevention, Phase 1 –Rehabilitation, Phase 2 –Return-to-work, Phase 3 –Stay-at-work, and Phase 4 –Reduction of consequences. This step was completed by the first author and periodically revised by the last author.

4 Results

4.1 Description of retained manuscripts

Once the manuscript selection was completed, a total of seven manuscripts were retained for this scoping review. Table 2 shows the noteworthy characteristics of these manuscripts.

Table 2
Description of retained manuscripts

Number of

manuscripts (%)

Publication language

English 5 (71.4 %)

French 2 (28.6 %)

Publication dates

2020 to date 2 (28.6 %)

2015 to 2019 4 (57.1 %)

2014 and prior 1 (14.3 %)

Types of manuscripts

Article 4 (57.1 %)

Research report 3 (42.9 %)

Countries of origin (continent)

Australia (Oceania) 1 (14.3 %)

Canada (North America) 4 (57.1 %)

England (Europe) 1 (14.3 %)

USA (North America) 1 (14.3 %)

Study design

Literature review 2 (28.6 %)

Prospective observational cohort study 1 (14.3 %)

Systematic review 1 (14.3 %)

Mixed methods study 3 (42.9 %)

	Number of
Publication language
English	5 (71.4 %)
French	2 (28.6 %)
Publication dates
2020 to date	2 (28.6 %)
2015 to 2019	4 (57.1 %)
2014 and prior	1 (14.3 %)
Types of manuscripts
Article	4 (57.1 %)
Research report	3 (42.9 %)
Countries of origin (continent)
Australia (Oceania)	1 (14.3 %)
Canada (North America)	4 (57.1 %)
England (Europe)	1 (14.3 %)
USA (North America)	1 (14.3 %)
Study design
Literature review	2 (28.6 %)
Prospective observational cohort study	1 (14.3 %)
Systematic review	1 (14.3 %)
Mixed methods study	3 (42.9 %)

4.2 Interventions used in the rehabilitation, return, and stay at work process of aging workers having suffered an occupational injury

The seven studies found in this scoping review identify specific interventions used by different stakeholders throughout the aging workers’ CWDP process (see Annexe 2 for which manuscripts identified the interventions). These interventions along with the stakeholders’ roles and responsibilities are presented in this five-phase dynamic process. Although some interventions may cross over into different phases, they have been placed in the phases in which they appear to be predominantly used. However, three interventions were found throughout the entire process and are therefore presented as such, as shown in Table 3.

Table 3
Interventions identified according to the CWDP phases

Phase 0 Prevention Phase 1 Rehabilitation Phase 2 RTW Phase 3 Stay-at-work Phase 4 Reduction of Consequences Throughout the process

Identification of at-risk workers (n = 3) Work capacity development (n* = 4) Return-to-work plan (n = 7) Work autonomy (n = 2) None were identified Multi-component interventions (n = 3)

Job demands analysis (n = 3) Work-tasks training (n = 3) Work accommodations (n = 7) Permanent work accommodations (n = 3) Communication (n = 7)

Promoting proper work techniques (n = 4) Claims management training (n = 1) Informing (n = 3) Permanent part-time work (n = 2) Supporting (n = 6)

Promoting physical activity (n = 1) ACT 45+ (n = 1) Alternative roles (n = 3)

Fostering a culture of safety and support (n = 2)

Phase 0 Prevention	Phase 1 Rehabilitation	Phase 2 RTW	Phase 3 Stay-at-work	Phase 4 Reduction of Consequences	Throughout the process
Identification of at-risk workers *(n = 3)	Work capacity development (n = 4)	Return-to-work plan (n = 7)	Work autonomy (n = 2)	None were identified	Multi-component interventions (n = 3)
Job demands analysis (n = 3)	Work-tasks training (n = 3)	Work accommodations (n = 7)	Permanent work accommodations (n = 3)		Communication (n = 7)
Promoting proper work techniques (n = 4)	Claims management training (n = 1)	Informing (n = 3)	Permanent part-time work (n = 2)		Supporting (n = 6)
Promoting physical activity (n = 1)		ACT 45+ (n = 1)	Alternative roles (n = 3)
Fostering a culture of safety and support (n = 2)

*n = number of articles that address this intervention.

4.2.1 Phase 0: Prevention interventions (5)

1) Identification of at-risk workers: Some authors have found that early identification of the aging workers at risk of suffering an occupational injury allows the employer to put forth work accommodations and offer specific skill training as preventive measures [48, 49]. Targeting physical and mental health conditions is a proactive behaviour that improves the aging workers’ work capacities and safely maintains their work participation [48]. “Proactive identification . . . may be a useful first stage in beginning to improve the work function of older adults who have health and workplace problems and are at risk of increasing limitation.” [48, p. 1726]. To do so, some employers use a monitoring system, such as event reporting, which is

“ . . . used by the [health and safety] team to alert management and units when an increased incidence of workplace accidents is found. This data will also . . . enable the health and safety team to identify workers who stand out by having frequent absences from work in order to analyse their situations and develop interventions better adapted to their needs.^rmbox4 4 ” [50, p. 45].

2) Job demands analysis: “A job demands analysis defines the physical, mental, and cognitive skills a job requires, through formal and informal methods, to help determine a proper fit for workers” [49, p. 313]. Once the employer has identified the aging workers at risk of suffering occupational injuries, a job demands analysis will help determine the work tasks to be adapted [48]. Matching task demands to the aging worker’s capacities and skills (job matching), can improve work safety and prevent work absences of aging workers [49]. However, the employer may require the help of healthcare professionals, such as occupational therapists, to complete the job demands analysis [49].

3) Promoting proper work techniques: Employers may offer training on ergonomic work techniques (i.e. proper work postures and proper lifting) prior to or following occupational injuries and with yearly refresher courses [49 –51]. These training sessions use case studies with examples of the consequences of improper lifting techniques along with education on the human anatomy, body mechanics, injuries, and more [51]. The aging worker has the shared responsibility [50, 51] of understanding why proper techniques should be used and applying them throughout their work shifts [51].

4) Promoting physical activity: “Physical activity can contribute to improved mental and physical wellbeing, particularly in older adults” [51, p. 14]. Improved general health may contribute to injury prevention, thereby reducing occupational injury rates among aging workers [51]. As such, some employers will have “policies encouraging an integrated strategy to maintain health both at work and at home” [48, p. 1726]. Some employers may promote general health among aging workers through tailored exercise programs put in place in collaboration with healthcare professionals who specialize in fitness, such as exercise physiologists or kinesiologists [51]. These programs are based on the aging workers’ limitations, capacities, and interests and may be done in the workplace (e.g. during breaks or during regular onsite workouts), or on their own time (e.g. at home or in a fitness center) [51]. Ideally, these programs are combined with information promoting the benefits of healthy lifestyles through educational programs such as posting signs displaying information on the importance of physical activity and healthy living (e.g. encouraging the use of stairs) [51].

5) Fostering a culture of safety and support: “Workplace culture is the shared behaviors and norms within an organization, such as values, routines, and traditions” [51, p. 34]. Fostering a culture of safety and support may necessitate workplace environmental changes that focus on the entire workplace, beginning with managers and specific workplace leaders [50, 51]. Although more difficult and longer to implement, it appears that fostering a culture of safety and support will offer a safe environment with lowered risks of occupational injuries for aging workers [48, 51]. Key actions that were identified are: 1) frequent communication between management and aging workers, 2) transparency, to develop trusting relationships, 3) teamwork, 4) promotion of worker empowerment, and 5) elimination anti-social behaviours [48, 51]. The employer can also foster a culture of safety and support by implementing clearly detailed and well-communicated policies regarding the health and the retention of aging workers [52]. This is done by senior managers, through every level of management, and workplace leaders, including the workers themselves [51].

4.2.2 Phase 1: Rehabilitation interventions (3)

1) Claims management training: Workplace stakeholders, such as managers, return-to-work coordinators (RTWC), and direct supervisors, must be aware of the complexities of the CWDP process in order to guide the aging workers who often lack the knowledge on the laws, policies, and administrative aspects involved [51]. Hence, some employers will offer claim-specific training “to ensure managers, and subsequently injured workers, are provided with adequate information to make appropriate decisions throughout the claim and [CWDP] process” [51, p. 26]. This training overlooks key aspects, such as 1) the aging worker’s rights and responsibilities, 2) the aging worker’s compensation process, 3) the roles and responsibilities of the stakeholders involved, 4) the aging worker’s skill development, and 5) supporting the aging worker through regular meetings or phone calls [51]. By providing the proper information to the aging workers and allowing them to be actively involved, there is a possibility for reduced work absence duration and an increased potential for an early RTW [51].

2) Work capacity development: Following an occupational injury, the aging worker will develop their work capacities through strengthening and endurance exercises in a clinical setting with the supervision of healthcare professionals [49] and by using work-tasks simulations [53]. This allows to match the aging worker’s skills to task demands, hence facilitating the resumption of work [49]. Prior to beginning the work capacity development, a job demands analysis may be done by an occupational therapist [49, 53]. Once it is deemed safe, the work capacity development may be continued in the workplace environment [49, 53] in collaboration with the employer and an occupational therapist [49].

3) Work-tasks training: Prior to beginning the RTW phase, some employers will offer aging workers training, or updating, related to work tasks that may need specific skills or abilities [49 , 53]. Doing so will improve function and productive behaviors [49] and facilitate the RTW and Stay-at-work phases of the process [49 , 53]. Work-tasks training, including education and training sessions in the workplace, are found to be effective for safely returning aging workers to work [49 , 54].

4.2.3 Phase 2: Return-to-work interventions (4)

1) Return-to-work plan: To ensure a successful RTW, it is best “to return to work discretely, even if for a limited time, than to prohibit [the aging worker] from work engagement until remission has occurred” [49, p. 313]. The progressive RTW plan, which is usually developed by a healthcare professional (e.g. occupational therapist, doctor) and the employer (e.g. RTWC) is a communication tool that clearly identifies the aging worker’s work schedule [51, 53], such as arrival and departure times, hours and days worked [51 –53], removal of overtime hours, and tailored break times (e.g. number and duration) [52]. The RTW plan may also include a checklist of the duties and tasks [51, 53] to which regular work tasks are gradually reintroduced [52].

2) Work accommodations: “Work [accommodations] are one of the most effective strategies to enable [RTW] and to prevent work loss” [48] (p. 1723–1724) and can increase the probability of a quick RTW [48 , 50–52]. They can be offered in different ways.

Alternate duties: Alternate duties are work tasks that have been changed [48, 52] and “which are not part of a worker’s regular duties but may represent predefined possible suitable duties” [51, p. 31]. They are described as temporary work assignments given to the aging worker during the RTW phase [48, 50].

Tasks reorganisation: Some of the aging worker’s regular tasks may be shared with colleagues or the quantity of work tasks is reduced according to the aging worker’s abilities [52].

Workload modifications: The employer may reduce the physical loads (e.g. reducing the weight of the manipulated objects) or decrease the mental workload by temporarily reducing the work responsibilities/expectations or reducing the information to be processed [52].

RTW checklist: A RTW checklist is a communication tool that is used to ensure that the appropriate work accommodations are put into place [51]. The checklist includes regular tasks, alternate duties, and modified work tasks that the aging workers can do during their RTW [51]. It can include any specifications of the aging worker’s present capacities that must be respected (e.g. workloads) [51].

Work environment adaptations: The employer may change the layout of the workstation [52] or provide specific equipment (e.g. an adjusted work seat) [50]. Work environment adaptations are among the main types of interventions used with aging workers [48 , 53].

3) Informing: In order to facilitate the aging workers’ RTW, some employers will provide information concerning the roles and responsibilities of each workplace stakeholder in preparation to and during the RTW phase [51]. This information must be shared early in the RTW phase because the roles and responsibilities may have changed since the occupational injury [51]. Changes within the workplace’s functioning may also have occurred during the aging worker’s absence [52]. Since the “immediate supervisors play a key role in assisting aging workers to RTW through accommodations⁵ 5 Loosely translated from Negrini et al. (2020).” [52, p. 48], they must be informed on the ways of adapting the work environment and tasks to fit the aging worker’s needs [49]. One study identified the use of a job dictionary as being a tool that can facilitate the transmission of specific information. “Job dictionaries provide a detailed breakdown of tasks performed in each job role and the frequency with which these tasks are performed” [51, p. 30]. This will allow the RTWC to easily identify work tasks and alternative roles that may be given to the aging worker during the RTW phase [51].

4) ACT45+ (Work Accommodations for Older Workers Aged 45 and Over):

ACT45 + is a tool that has been developed to “document the work accommodations implemented that have been helpful or that you would have wished for in the return-to-work process” [52. p. 48]. It can help the employer, the healthcare professional, and other stakeholders involved in identifying which accommodations can be used during the RTW phase [52]. The ACT45+, used throughout the RTW phase, is a 37-item questionnaire with eight subscales; 1) RTW plan and follow-up, 2) Work schedule and workplace, 3) Workload, 4) Work tasks, 5) Occupational health, 6) Support from co-workers, 7) Support from the immediate supervisor, and 8) Information and training [52]. Answers to the questionnaire help identify which accommodations have already been implemented and those that need to be put into place in order to facilitate the aging worker’s RTW phase [52].

4.2.4 Phase 3: Stay-at-work interventions (4)

Some interventions in this phase may resemble those found in the RTW phase. Whereas the RTW interventions are generally applied temporarily as the aging worker’s condition improves, the stay-at-work interventions are used in a permanent fashion in order to ensure that the aging worker remains at work in a sustainable manner [52].

1) Work autonomy:⁶ 1 “Studies have shown that work autonomy increases productivity, job efficacy, and work performance; studies have also shown that older workers with more job control stay at work longer” [54, p. 33]. Some employers put in place programs and policies that allow aging workers to have more leeway in their decision-making [50, 54]. One example of work autonomy would be allowing the aging worker to choose the way or the order in which certain tasks are done [54]. Another example would be eliminating time constraints by allowing the aging worker to have the flexibility of choosing their work schedule (e.g. start and finish times and break times) [50].

2) Permanent work accommodations: When an aging worker is unable to regain their full capacities and permanent functional limitations are indicated, the employer may put in place permanent work accommodations specific to the worker’s needs [50]. These work accommodations are similar to those found in the RTW phase, however they are permanent. Permanent work “accommodations can maintain the productivity and effective work function of those who stay at work” [48, p. 1724].

3) Permanent part-time work: In cases where the aging workers are unable to regain the capacities and skills needed to accomplish their prior roles efficiently, employers can offer part-time work on a permanent basis [51]. Allowing a “RTW in a part-time capacity” [51, p. 29] can also have a positive motivational impact on the aging worker wanting to stay-at-work longer [51].

4) Alternative roles: If work accommodations may not be offered and if “part-time [work] is not feasible then investigation into whether other roles that may utilise a worker’s skills are available” [51, p. 31] in order to maintain a working relationship [49]. Some employers will consider reassigning aging workers to other positions in lower-risk areas within the workplace [50]. For example, the aging worker may be offered a role in training or mentoring other workers [51]. To ensure that the changing of roles is successful, upskilling (i.e. professional training) will be offered as soon as it appears that the aging workers are unable to fully return to their previous roles [51].

4.2.5 Phase 4: Reduction of consequences of occupational injuries

No interventions for reducing the consequences of an aging worker’s occupational injury were identified in the seven manuscripts.

4.2.6 Interventions implemented throughout (3)

Three interventions used with aging workers were identified as being used consistently throughout each phase of the CWDP process.

1) Multi-component interventions: Although the use of a single intervention may help aging workers during the CWDP process, it may not be as efficient as using multiple interventions that target different phases of their recovery [51]. Therefore, using “multiple interventions implemented at different time points: pre-injury (injury prevention), at time of injury, post-injury and ongoing . . . is likely to yield the most positive results” [51, p. 6]. As such, multi-component interventions use a combination of interventions having different or similar individual objectives [48, 51] where their main goal is to help the aging worker rehabilitate, RTW, and stay-at-work [53].

According to some authors, multi-component interventions are most efficient when they combine job-focused vocational rehabilitation through aging worker training and education, a RTW plan, communications between the employer and healthcare professionals, modified ergonomics and work environment, work accommodations, and modified work hours and duties [53, 54]. Some employers will also “package together programs and policies that, in sum, address different dimensions of the RTW process, including healthcare, case coordination, and work modifications” [54, p. 34].

2) Communication: Described in all seven studies, maintaining adequate and constant communication among all stakeholders is a key factor to the success of aging workers’ CWDP process [49]. The main goal to having communication among the stakeholders is to reduce barriers to the process [51] and “to facilitate continuity in the process of returning the older worker to gainful employment” [49, p. 310].

Communication begins as soon as an aging worker suffers an occupational injury, e.g. the worker advises their immediate supervisor, while early and frequent discussions should be had between healthcare professionals and the employer [50]. Communication is maintained throughout the entire CWDP process, e.g. “the worker must keep in touch with the workplace case manager during the work absence” [50, p. 49] and through regular meetings with the immediate supervisor [50 –52]. Healthcare professionals can facilitate this process by helping “ . . . workers adjust to work as well as manage supervisor relationships by facilitating conversations” [49, p. 315]. Communication must continue beyond the worker’s return to full-work duties in order to prevent re-injury or other occupational injuries [48 , 54].

3) Support: Offering support to aging workers is done in all phases of the CWDP process [48 –54]. Adequate support will promote and encourage the involvement of the aging worker throughout their process [49].

Employers, usually the RTWC [50, 51], will show support by responding immediately following the occurrence of an occupational injury and managing it until the aging worker has returned to full duties [51]. Supporting the aging worker is done by respecting their recovery rate, adjusting work expectations, acknowledging the aging workers efforts, giving positive feedback, listening actively, having colleagues share or help accomplish certain job tasks, and providing emotional support [50, 52].

In some instances, employers may themselves need and receive support through guidance from the healthcare professionals involved [48 , 51]. Healthcare professionals can coordinate the rehabilitation services and work accommodations to be implemented during the RTW phase [53] by assisting employers in the implementation of rehabilitation programs and interventions in the workplace environment [49].

5 Discussion

The aim of this study was to describe the interventions currently used in the CWDP process of aging workers having suffered an occupational injury. Following the extraction of information from seven manuscripts, nineteen interventions were identified. The analysis of the results revealed three main findings: 1) multiple interventions should be combined to improve the success of the CWDP process of aging workers, 2) interventions identified lack specificity in relation to ageing workers, and 3) stakeholder roles and responsibilities are unevenly described across interventions and throughout the different phases of the process.

5.1 The added value of multi-component interventions

Although the literature shows that isolated and one-dimensional interventions are still being used, many authors suggest that using multiple interventions throughout the CWDP process is more effective for an early RTW [30 , 56]. Hence, it is recommended to combine a rehabilitation program, with adequate clinical management and workplace interventions rather than using them individually [36]. Interestingly, all of the manuscripts in this scoping review described more than one intervention, suggesting that multiple interventions should be used to improve the success of the CWDP of aging workers. However, little information is given on how and which interventions should be combined, nor when they should most appropriately be implemented. This finding concurs with Nastasia et al.’s (2019) conclusions indicating that although the combination of different interventions in both clinical and workplace environments is discussed in the literature, few studies specify which interventions are best to combine together.

As recommended by Lecours et al. (2022), this study used the TIDieR grid [47] to structure the intervention descriptions and to enhance the quality of the information found in the seven manuscripts [57]. However, in accordance with their findings, the information on interventions used with aging workers is heterogeneous and specific details are lacking. For example, when considering the TIDier criteria, although some authors give examples of which interventions to combine, little information was given on which stakeholders (who) are responsible for applying these interventions and information is lacking on how these interventions are to be implemented. These shortcomings can lead to gaps in the information that would otherwise be relevant to the stakeholders when using these multi-component interventions with aging workers. Also, the lack of specifications on how to implement and conduct multi-component interventions leaves in abeyance a number of questions on how stakeholders should collaborate to optimise the CWDP process of aging workers. Despite the lack of information available on the concrete steps for incorporating multi-component interventions, they should be preferred as opposed to isolated interventions.

This scoping review also found that none of the manuscripts identified interventions to be used in Phase 4 (Reduction of consequences). This may be due to the fact that this concept is relatively new, having been introduced by Audet et al.’s in 2022. By reducing the consequences of occupational injuries, such as decreased organizational productivity and work overload on colleagues [30], overall negative impacts will be reduced during the CWDP process. Since this phase can overlap into phases 2 and 3, the workplace stakeholders at different organisational levels should remain proactive throughout the CWDP process. Hence, we recommend that this phase be retained in the CWDP process and incorporated into multi-component interventions.

Further research is warranted in order to gain knowledge on which intervention combinations would be most efficient and which interventions should be included in Phase 4. The following key points are suggested when using multi-component interventions with aging workers:

Due to the variety of interventions used, multi-component interventions necessitate the involvement and collaboration of all stakeholders;

The interventions used should focus on the needs of every stakeholder involved;

Multi-component interventions should be used in every phase of the CWDP process, including phase 4.

5.2 Interventions identified lack specificity in relation to ageing workers

Aging workers having suffered an occupational injury have certain specificities that must be considered during the CWDP process [8 , 50]. The interventions identified in this study overlap with some interventions that are documented for the general population of workers and lack specificities on how they are adapted to aging workers. This makes it difficult for stakeholders to understand the differences and nuances in the use of these interventions with aging workers as opposed to using them with younger workers. In fact, the interventions described in our results are found in the literature as being part of “best practice” interventions, which are similar to those used with younger workers [34, 54].

The lack of specificity towards aging workers may lead to inadequate or insufficient support during their CWDP process [50, 51]. This, along with the lack of knowledge and understanding of aging workers’ needs, may explain why aging workers’ sick leaves are longer [58, 59]. It begs the question, should “best practice” interventions presently being used be changed in order to create newer age-specific “best practice” interventions geared towards aging workers? Further research is needed to explore the experiences of all stakeholders involved concerning the efficiency of interventions presently being used with aging workers and to document the needs of all stakeholders involved.

Recent studies suggest ways in better utilizing current interventions with regards to aging workers’ specificities. Some authors recommend that stakeholders adapt and personalize the interventions to the aging workers’ needs and specificities [23, 59]. While others recommend that stakeholders should identify aging workers’ individual strategies and motivations prior to choosing the interventions to be used [59]. Others suggest that work accommodations should be available to aging workers as a preventive measure whether or not they have suffered an occupational injury [60]. An exploratory study on the relationship between the margin of maneuver (MM) and the RTW conducted by Durand et al. (2009) concluded that an adequate MM can increase the RTW success rate of workers even after prolonged work disability [32]. Considering that aging workers generally need more time to RTW, we feel that the concept of MM should be better utilized throughout the CWDP process and further exploration into how the MM concept can be developed with this population is warranted.

5.3 Stakeholder roles and responsibilities are unevenly described

The CWDP process utilises a core set of activities in which each stakeholder from the four systems (i.e. workplace, healthcare, compensation, aging worker) has one or more specific roles and responsibilities [29–31 , 37] in each phase as they intervene with aging workers. However, the results of this study highlight that stakeholder roles and responsibilities are unevenly described.

5.3.1 Workplace system

Numerous studies have identified the workplace system as having a key role in supporting workers having suffered an occupational injury [20 , 61]. Our study found this is also true with aging workers. Employers, along with other stakeholders within the workplace, have key roles in supporting and promoting the aging workers’ engagement throughout their CWDP process [48 , 54].

Workplace stakeholders, such as colleagues, immediate supervisors, RTWC, managers, union representatives, and prevention specialists, may be involved in the different CWDP phases [19 , 37]. However, stakeholder involvement within the workplace system is uneven. Some studies identified that RTWCs have little involvement during the rehabilitation phase [50] and many immediate supervisors do not have the basic information necessary about the aging workers prior to and during the RTW phase [48]. The lack of implication from the RTWC and immediate supervisor in the early phases may lead to late RTW preparation thereby prolonging the aging worker’s work absence [50]. Although many studies emphasize the importance colleagues have on facilitating or hindering the RTW and stay-at-work phases [19 , 62], this study found little information concerning their involvement.

Despite these shortcomings, the workplace system was found to be involved in phases 0 to 3. Similar to other writings, this study found that the workplace system has a key role in aging workers’ CWDP processes. Their role may appear to be more influential on the success of the aging workers’ process than the role of other stakeholders [16], however, our results also indicate that the workplace stakeholders need the support and collaboration of stakeholders from other systems in order to optimise their interventions.

5.3.2 Healthcare system

In this study, the healthcare system (e.g. rehabilitation professionals, treating physician) was found to have a leading role in Phase 1 (rehabilitation) and Phase 2 (RTW). Although the healthcare system is actively involved in eight of the nineteen interventions, its stakeholders have a key role in only two interventions (work capacity development and development of a RTW plan). Otherwise, they have a guidance and support role for the workplace and worker systems (e.g. by assisting the workplace in selecting adequate work accommodations while facilitating communications between the worker and the workplace). This coincides with other studies that indicate that health professionals are solicited, when needed, [36] to assess job demands and make recommendations to the workplace stakeholders as to which work accommodations best facilitate the RTW [36].

These findings may be explained by the lack of current documentation concerning the positive influence that healthcare professionals may have on the CWDP process of aging workers [20]. Another factor may be the influence of compensation system’s policies and regulations on healthcare service delivery [20], such as limiting the number of treatment sessions offered [16].

When considering that one of the difficulties of preventing occupational injuries and limiting prolonged work disability is due to a lack of understanding [63] of the injury and healing processes of aging workers, it would be wise to make better use of rehabilitation professionals’ expertise in order to raise awareness among other stakeholders. Through collaboration, knowledge sharing, and understanding of the aging workers’ CWDP process, the overall outcomes can be improved [64].

5.3.3 Compensation system

According to the literature, the compensation system influences the process through its disability pension and insurance benefits policies [19, 20]. Hence, this system impacts the way other stakeholder systems intervene [16, 20]. The literature also indicates that case managers from the compensation system can facilitate communications between the employer and healthcare professionals [53, 54].

However, this scoping review found that the compensation system was rarely mentioned in the interventions that were identified. In fact, it was only briefly mentioned in the rehabilitation and RTW phases. This result is similar to other studies, where the role of the compensation system is insufficiently documented [16]. The lack of documentation on the influence, contributions, and responsibilities of the compensation system may be due to the fact that interest in and knowledge of this system is only now emerging [20]. Considering how the compensation system’s policies and regulations appear to play a vital role in this process, more research on its involvement is needed, specifically with regards to aging workers.

5.3.4 Aging workers

The worker must evolve in a process that is influenced by various stakeholders and systems [19]. Planning and collaborating with other stakeholders is required for the aging workers to successfully participate in their CWDP process [49]. However, our results indicate that the aging worker rarely has an active role. This agrees with other studies that found that the worker’s role is rarely mentioned [35] and that there are many factors over which the worker has no control [19].

Similarly to what is found in the literature [35], the main purpose of the nineteen interventions identified in our study is to assist the aging worker throughout their CWDP process. Yet, our results show that the aging worker plays an active role in the implementation of only five interventions. Rather, the aging worker follows the recommendations or undergoes the interventions which are applied by other stakeholders. This passive approach to the aging workers’ participation in their own CWDP process may have adverse effects on its success by being less inclined to fully invest themselves.

Since the interventions found in this study directly concern aging workers, they should be at the heart of every intervention [50]. For example, considering that the aging workers know best what the daily work tasks entail, they should be directly involved in the work accommodations selection process [36]. Involving the aging worker actively in every phase and intervention will promote their engagement [36] throughout the entire CWDP process [57, 65]. As seen in the literature on motivation and self-determination, aging workers need to perceive that they have control over the interventions used [66, 67]. In order to stimulate the aging workers’ involvement and motivation, stakeholders are encouraged to prioritise interventions that foster the aging workers’ active participation and to use approaches such as consulting the aging worker in order to utilise their expertise [8, 48] in every phase of the CWDP process.

The aging workers’ CWDP process is dynamic and complex and incorporates numerous interventions. The roles and responsibilities of all stakeholders involved are equally important. Further studies in this field should ensure that every system is evenly documented which will optimise the sharing of roles and responsibilities of each stakeholder involved [19].

The following key points are suggested concerning stakeholder involvement with aging workers:

Lack of information found in this study concerning certain stakeholders may not be representative of the actual quantity and quality of involvement and should not be interpreted as a diminished importance of their roles and responsibilities;

Stakeholders from the four systems must collaborate throughout all phases of the CWDP process;

It is imperative that the influence from the four stakeholder systems be considered at par;

The entire CWDP process needs to be shared by every stakeholder while using coherent actions;

All stakeholders should be involved early in the process, as soon as phase 1, following an occupational injury;

Aging workers must be actively involved in every phase of the CWDP process.

5.4 Study strengths and limitations

In agreement with scoping review specifications [38, 40], a transparent and rigorous method was used to describe the interventions used in the CWDP process. The five-phase conceptual framework proposed allows to clearly identify in which phase each intervention can be found. This includes the representation of the stakeholders involved. By doing so, this optimises the understanding of the importance of each stakeholder’s roles, responsibilities, and actions within the different interventions throughout the process. Also, the broad approach used for identifying potential references not only in five databases, but by including a manual search in Google and in occupational health and safety websites ensured that the most up-to-date references were included in our review. However, since the aim of this scoping review was to describe the interventions currently being used, the quality of the included manuscripts was not assessed. Hence, the effectiveness of interventions cannot be determined. The quality of the descriptions of the interventions found is variable and lacked numerous details, which affects the precision of what we can describe.

6 Conclusion

Aging workers are increasingly present in the labour market and are essential to counter the effects of labour shortages caused by the decreased numbers of younger workers. However, the risks of suffering an occupational injury are present and when they occur, the CWDP process is longer than for their younger counterparts. This study aimed to describe which interventions are currently being used in the CWDP process of aging workers having suffered an occupational injury. The analysis of seven manuscripts helped to identify nineteen interventions dispersed throughout four of the five CWDP phases (prevention, rehabilitation, RTW, and stay-at-work). The analysis helped to shed light on the interventions presently being used with aging workers. It brought to light the lack of information and details on these interventions. It also brought forth the absence of interventions identified in Phase 4 (Reduction of consequences). Further studies are needed to understand the effectiveness of the interventions currently being used with aging workers, to explore how interventions can be adapted to the specificities of aging workers, to identify interventions that are essential in Phase 4, and to explore the needs of all stakeholders involved throughout this process. These future studies should be done with the inclusion of stakeholders from the four systems. As such, the next step to this research is to undertake a series of interviews with different stakeholders in order to have a clear understanding of what the CWDP process of aging workers entails and to identify specific needs as to adequate interventions.

Ethical approval

Not applicable

Informed consent

Not applicable.

Conflict of interest

No conflict of interest to declare

Footnotes

Acknowledgments

The authors want to acknowledge all collaborators who participated in the study

Funding

This work was supported by the first author’s doctorate scholarship from the Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris) and the Chaire de recherche UQTR (jr) sur la sante des travailleurs vieillissants.

Since the rehabilitation, return-to-work, and stay-at-work phases are components of the Cycle of Work Disability Prevention (CWDP), the rehabilitation, return and stay at work process will be referred to as the CWDP process from here on end.

“The possibility or freedom a worker has to develop different ways of working to meet production targets, without having adverse effects on his or her health”. [33, p. 1246]

Refer to Annex 1 for the completed checklist of this scoping review.

Loosely translated from Dubois et al. (2019).

Loosely translated from Negrini et al. (2020).

“Work autonomy refers to the latitude the individual is allowed in doing his/her work (Breaugh, 1999)” [].

References

Fields

, Uppal

, Larochelle-Côté

. L’incidence du vieillissement de la population sur les taux d’activité du marché du travail. Statistique Canada; 2017.

Castonguay

, Laberge

. Longévité: Une richesse. Québec: Centre interuniversitaires de recherche en analyse des organisations; 2010. Report No. RP-01.

Berecki-Gisolf

, Clay

, Collie

, McClure

. The Impact of Aging on Work Disability and Return to Work. JOEM. 201;54(3):318–27. doi:10.1097/JOM.0b013e31823fdf9d.

Hursh

, Lui

, Pransky

. Maintaining and enhancing older worker productivity. J. Vocat. Rehabil. 2006;25(1):45–55.

Wallin

, Fjellman-Wiklund

. Act with respect: Views of supportive actions for older workers after completion of comprehensive vocational rehabilitation services. WORK. 2019;62(4):585–98.

Statistiques Canada Caractéristiques de la population active selon le sexe et le groupe d’âage détaillé, données annuelles. Gvt Canada (Tableau : 14-10-0327-01). 2023

Larin

. Pé nurie de main-d’oeuvre: un ⪡ creux historique ⪢ surviendra en 2030. Le Journal de Québec [Internet]. 2021 Nov 20. Available from: https://www.journaldequebec.com/2021/11/20/penurie-de-main-doeuvre-un-creux-historique-surviendra-en-2030.

Lecours

, Robitaille

. Comment le travail après la retraite influence-t-il la santé des travailleurs vieillissants ? Un examen de la portée. Revue annuelle d’ergothérapie. 2020;12 36–46.

Cromwell

. Returning Older Workers to the Job: Tapping expertise, addressing fears. Contemporary Rehab. 2009;65(1):1–3.

10.

Walker

, Maltby

. Active ageing: A strategic policy solution to demographic ageing in the European Union. Int J Soc Welf. 2012;21, 117–30.

11.

Lulle

. Reversing retirement frontiers in the spaces of post-socialism: active ageing through migration for work. Ageing Soc. 2020;41, 1308–27.

12.

Farrow

, Reynolds

. Health and safety of the older worker. Occupational Medicine. 2011;62(1):4–11.

13.

Van Eerd

, Steenstra

, Cullen

, Irvin

. Aging and MSD: Strategies for OlderWorkers. Centre of Research Expertise for the Prevention of Musculoskeletal Disorders; 2016, pp. 1-4.

14.

Algarni

, Gross

, Senthilselvan

, Battie

. Ageing workers with work-related musculoskeletal injuries. Occupational Medicine. 2015;65(3):229–37.

15.

Association of Workers’Compensation Boards of Canada (AWCBC). National Work Injury, Disease and Fatality Statistics. Canada: AWCBC; 2022, pp. 1-569.

16.

Lecours

, Laliberté

, Lord

, Leonard

, Ruel

. The Process of Rehabilitation, Return and Stay at Work of Aging Workers Who Suffered an Occupational Injury: A Portrait Based on the Experience of Canadian Stakeholders. J Occup Rahabil. 2022;32(4):790–802.

17.

Prud’homme

, Duguay

, Busque

. Indicateurs de lésions professionnelles selon l’âage. Montréal: IRSST; 2015. 23p. Report No.: DS-010.

18.

Okunribido

, Wynn

, Lewis

. Are older workers at greater risk of musculoskeletal disorders in the workplace than young workers? - A literature review. Occup Ergon. 2011;10(1,2):53–68.

19.

Lecours

, Bédard-Mercier

. L’expérience de retour au travail des personnes vieillissantes ayant subi une atteinte a la sante : un examen de la portée. CJA. 2022:1-12

20.

Durand

, Coutu

, Tremblay

, Sylvain

, Gouin

, Bilodeau

, et al. Insights into the Sustainable Return to Work of Aging Workers with a Work Disability: An Interpretative Description Study. J. OccuRahabil. 2020;31(1):92–106.

21.

Commission fédérale de coordination pour la sécurité au travail. Les travailleurs âgées ne se blessent pas plus souvent, mais différemment. Confédération Suisse: CFCST. 2018. [Accessed on august 30th 2023]. 3p. Available from: https://www.prevention-au-bureau.ch/magazine-en-ligne/article/les-travailleurs-ages-ne-se-blessent-pas-plus-souvent-mais-differemment/

22.

Smith

, Bielecky

, Koehoorn

, Beaton

, Ibrahim

, Mustard

, et al. Are age-related differences in the consequence of work injury greater when occupational physical demands are high? Am J Ind Med 2014;57(4):438–44.

23.

Kooij

, van de Voorde

. Chapter 4: Strategic HRM for Older Workers. In: Bal PM, Kooij D, Rousseau DM (editors). AgingWorkers and the Employee-Employer Relationship. Switzerland: Springer International Publishing; 2015. pp. 57-72.

24.

Evans

, Conte

, Gilroy

, Marvin

, Theysohn

, Fisher

. Occupational therapy - meeting the needs of older adult workers? WORK 2008;31(1):73–84.

25.

Cichy

, Leslie

, Rumrill

, Koch

. Population aging and disability: Implications for vocational rehabilitation practice. J Vocat Rehabil. 2017;47(2):185–96.

26.

Piktialis

. Adaptations to an Aging Workforce: Innovative Responses by the Corporate Sector. Generations. 2007;31(1):76–84.

27.

Loisel

, Durand

, Berthelette

, Vézina

, Baril

, Gagnon

. Disability prevention new paradigm for the management of occupational back pain. Dis Manage Health Outcomes. 2001;9(7):351–62.

28.

Loisel

, Durand

, Brail

, Gervais

, Fakardeau

. Interorganizational collaboration in occupational rehabilitation: perceptions of an interdisciplinary rehabilitation team. J Occup Rehabil. 2005;15(4):581–90.

29.

Young

, Roessler

, Wasiak

, McPherson

, van Poppel

, Anema

. A developmental conceptualization of return to work J Occup Rehabil 2005;15(4):557–68.

30.

Audet

, Lecours

, Nastasia

. Experiences in the Return-to-Work Process of Workers Having Suffered Occupational Injuries in Small and Medium Size Enterprises. WORK. 2022;74(7):1–19.

31.

Larivières

, Bussières

, Brisebois

, Viau

, Sutton

, Vinet

, et al. L’incapacité et le retour au travail. Montréal: IRSST; 2021. [Accessed on august 30th 2023]. Available from:https://retourautravail.irsst.qc.ca/

32.

Durand

, Vézina

, Baril

, Loisel

, Richard

, Ngomo

. Margin of manoeuvre indicators in the workplace during the rehabilitation process: a qualitative analysis. J Occup Rehabil. 2009;19(2):194–202.

33.

Durand

, Vézina

, Baril

, Loisel

, Richard

, Ngomo

. Relationship between the margin of manoeuvre and the return to work after a long-term absence due to a musculoskeletal disorder: an exploratory study. Disabil Rehabil. 2011;33(13-14):1245–52.

34.

Franche

, Cullen

, Clarke

, Irvin

, Sinclair

, Frank

, et al. Workplace-based return-to-work interventions: a systematic review of the quantitative literature. J Occup Rehabil. 2005;15(4):607–31.

35.

Durand

, Corbière

, Coutu

, Reinharz

, Albert

. A review of best work-absence management and return-to-work practices for workers with musculoskeletal or common mental disorders. WORK. 2014;48(4):579–89.

36.

Nastasia

, Durand

, Coutu

, Collinge

, Cibotaru

. Workplace Practices for Healthy and Sustainable Return toWork. Montréal: IRSST; 2019: 124p. Report No.: R-1047.

37.

Corbière

, Mazaniello-Chezol

, Bastien

, Wathieu

, Bouchard

, Panaccio

. Stakeholders’ Role and Actions in the Return-to-Work Process of Workers on Sick-Leave Due to Common Mental Disorders: A Scoping Review. J Occup Rehabil. 2020;30(3):381–419.

38.

Arksey

, O’Malley

. Scoping studies: towards a methodological framework. International Journal of Social Research Methodology. 2005;8(1):19–32.

39.

Levac

, Colquhoun

, O’Brien

. Scoping Studies: Advancing the methodology. Implement. Sci. 2010;5(69):1–10.

40.

Colquhoun

, Levac

, O’Brein

, Straus

, Tricco

, Perrier

, et al. Scoping reviews: time for clarity in definition, methods, and reporting. J Clin Epidemiol. 2014;67(12):1291–4.

41.

O’Brien

, Colquhoun

, Levac

, Baxter

, Tricco

, Straus

, et al. Advancing scoping study methodology: a web-based survey and consultation of perceptions on terminology, definition and methodological steps. BMC Health Serv Res. 2016;16, 305.

42.

Tricco

, Lillie

, Zarin

, O’Brein

, Colquhoun

, Levac

, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018;169(7):467–73.

43.

Peters

MDJ

, Marnie

, Tricco

, Pollock

, Munn

, Alexander

, et al. Updated methodological guidance for the conduct of scoping reviews. JBI Evid Synth. 2020;18(10):2119–26.

44.

Daudt

, van Mossel

, Scott

. Enhancing the scoping study methodology: a large, inter-professional team’s experience with Arksey and O’Malley’s framework. BMC Med Res Methodol. 2013;13(48):1–9.

45.

Godin

, Stapleton

, Kirkpatrick

, Hanning

, Leatherdale

. Applying systematic review search methods to the grey literature: a case study examining guidelines for school-based breakfast programs in Canada. Syst Rev. 2015;4(138):1–10.

46.

Deeks

, Higgins

JPT

, Altman

. Chapter 10:Analysing data and undertaking meta-analyses. In: Higgins JPT, Thomas J, Chandler J, Cumpston M, LiT, Page MJ, Welch VA (editors). Cochrane Handbookfor Systematic Reviews of Interventions version 6.3(updated February 2022). Cochrane, 2022. Available fromwww.training.cochrane.org/handbook

47.

Hoffman

, Glasziou

, Boutron

, Milne

, Perera

, Moher

, et al. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ [Internet]. 2014;348(mar07 3):g1687–7.

48.

Wilkie

, Cifuentes

, Pransky

. Exploring extensions to working life: job lock and predictors of decreasing work function in older workers. Disabil Rehabil. 2011;33(19-20):1719–27.

49.

Early

, Walsh

, Douglas

. The occupational therapy practitioner’s role in health promotion, injury prevention, and role participation for the older worker. WORK. 2019;63(2):309–18.

50.

Dubois

, Bentein

, Marchand

.Réadaptation au travail chez les 45 ans et plus dans le secteur de la santé et des services sociaux. Montréal: IRSST; 2019, 104p. Report No.: R-1060.

51.

Gray

, Sheehan

, Iles

. Interventions to support the return to work or recovery at work of older healthcare workers. Australia: Insurance Work and Health Group School of Public Health and Preventive Medicine; 2021. PP. 1-44.

52.

Negrini

, Corbière

, Dubé

, Gragnano

, Busque

, Lebeau

, et al. Quels sont les déterminants du retour au travail durable des travailleurs seniors ayant subi une lésion psychologique ou physique? Montréal: IRSST; 2020; 86p. Report No.: R-1116.

53.

Steenstra

, Cullen

, Irvin

, Van Eerd

, IWH Older Worker Research team A systematic review of interventions to promote work participation in older workers. J Safety Res. 2017;60, 93–102.

54.

Van Eerd

, Smith

, Vu

. Implications of an aging workforce for work injury, recovery, returning to work and remaining at work. OOHNA JOURNAL. 2019:30-36.

55.

Aubé

, Rousseau , V , Morin

. Perceived organizational support and organizational commitment. J ManagPsychol. 2007;22(5):479–95.

56.

Institute for Work and Health (IWH) Seven ‘Principles’ for Successful Return toWork. Toronto:IWHdisability prevention tools; 2007 Mar (rev. 2014). [Accessed on august 30th 2023]. pp. 4. Available from: https://www.iwh.on.ca/tools-and-guides/seven-principles-for-successful-return-to-work

57.

Lecours

, Coutu

, Durand

. Description des stratégies favorisant l’adoption de comportements préventifs chez les travailleurs ayant subi une lésion professionnelle: Une revue critique de la littérature. Montréal: IRSST; 2022. 89 p. Report No.: R-1166.

58.

Commission des normes, de l’équité, de la santé et de la sécurité du travail (CNESST). Portrait des lésions professionnelles chez les travailleurs de 55 ans et plus, 2002-2011. Québec: CNESST; 2014, pp. 1-42.

59.

Richard

, Durand

. Workers Age 55 and over Working with Pain. A Descriptive Interpretive Study. J Occup Rehabil. 2020;30(2):211–20.

60.

Gignac

MAM

, Kristman

, Smith

, Beaton

, Badley

, Ibrahim

, et al. Are There Differences in Workplace Accommodation Needs, Use and Unmet Needs Among Older Workers with Arthritis, Diabetes and No Chronic Conditions? Examining the Role of Health and Work Context. Work Aging Retire.. 2018;4(4):381–98.

61.

Caroll

, Rick

, Pilgrim

, Cameron

, Hillage

. Workplace involvement improves return to work rates among employees with back pain on long-term sick leave: a systematic review of the effectiveness and cost-effectiveness of interventions. Disabil Rehabil. 2010;32(8):607–21.

62.

Tjuin

, MacEachen

, Stwine

, Ekberg

. The social interaction of return to work explored from co-workers experiences. Disabil Rehabil.. 2011;33(21-22):1979–89.

63.

Roquelaure

. Promoting a Shared Representation of Workers’ Activities to Improve Integrated Prevention of Work-Related Musculoskeletal Disorders. Saf Health Work. 2016;7(2):171–4.

64.

Calvet

, Vézina

, Laberge

, Nastasia

, Sultan-Taieb

, Toulouse

, et al. Integrative prevention and coordinated action toward primary, secondary and tertiary prevention in workplaces: A scoping review. WORK. 2021;70(3):893–908.

65.

Balbulal

, Foster

, Wolf

. Facilitating Transfer of Skills and Strategies in Occupational Therapy Practice: Practical Application of Transfer Principles. Asian J Occup Ther. 2016;11(1):19–25.

66.

Ryan

, Deci

. Self-Motivation theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol. 2000;55(1):68–79.

67.

Gosselin

, Morin

, Bélisle

. Capter 4: La motivation et la satisfaction. In: Gosselin E, Morin D, Bélisle L (editors). Comportement organisationnel: Aspects humains des organisations (6th ed.). Chenelière Éducation. 2022:134-85

	Number of
	manuscripts (%)
Publication language
English	5 (71.4 %)
French	2 (28.6 %)
Publication dates
2020 to date	2 (28.6 %)
2015 to 2019	4 (57.1 %)
2014 and prior	1 (14.3 %)
Types of manuscripts
Article	4 (57.1 %)
Research report	3 (42.9 %)
Countries of origin (continent)
Australia (Oceania)	1 (14.3 %)
Canada (North America)	4 (57.1 %)
England (Europe)	1 (14.3 %)
USA (North America)	1 (14.3 %)
Study design
Literature review	2 (28.6 %)
Prospective observational cohort study	1 (14.3 %)
Systematic review	1 (14.3 %)
Mixed methods study	3 (42.9 %)