Occupational Fall Risk Assessment Tool for older workers

Background No easy-to-use fall risk assessment tools have been devised to assess occupational fall risk in older workers. Aims To develop an Occupational Fall Risk Assessment Tool (OFRAT) and report its predictive validity and reliability in older workers. Methods The baseline fall risk assessment was completed by 1113 participants aged >= 60 years who worked >= 4 days/month in Saitama, Japan. Participants were followed up for falls during occupational activities for 1 year, and 30 participants were assessed twice for test-retest reliability. The following assessment measures were summed to form the OFRAT risk score: older age, male sex, history of falls, physical work participation, diabetes, use of medications increasing fall risk, reduced vision, poor hearing, executive dysfunction and slow stepping. The scores were then classified into four grades (0-2 points: very low, 3 points: low, 4 points: moderate and >= 5 points: high). Results During follow-up, 112 participants fell 214 times during work. The negative binomial regression model showed that participants with higher grades had a higher incidence rate ratio [95% confidence interval] for falls than those with very low grades (low: 1.64 [1.08-2.47], moderate: 4.23 [2.82-6.34] and high: 6.12 [3.83-9.76]). The intraclass correlation coefficient for risk score was 0.86 [0.72-0.93], and the weighted kappa coefficient for grade assessment was 0.74 [0.52-0.95]. Conclusions The OFRAT is a valid and reliable tool for estimating the occupational fall risk in older workers. It may assist occupational physicians implement strategies to prevent falls in this group. The study revealed that the Occupational Fall Risk Assessment Tool (OFRAT) is a reliable and valid tool for estimating the risk of occupational falls in older workers. The findings suggest that the OFRAT may be useful in occupational health settings to systematically understand the occupational and individual risk factors for older workers and to screen older workers at high risk of occupational falls.