Older Workers at Risk for Occupational Highway Travel Deaths

Highway transportation incidents are the leading cause of occupational fatalities in the United States, with the highest fatality rates occurring among workers over 65 years old. This rate is three times higher than for younger workers. The results of this analysis demonstrate the need to further implement interventions that consider road safety risks specific to older workers. Employers, health professionals, and workers need to work together to reduce risks for injury and death from highway transportation crashes among older workers. Recommended interventions to prevent crashes and injuries among older workers (e.g., trip planning, refresher driving training, and health screening and promotion) should be more widely disseminated and implemented.


To characterize older workers at highest risk, the CDC analyzed data from the Census of Fatal Occupational Injuries (CFOI) for the period 2003–2010 and compared occupational highway transportation deaths among workers between 55 and 64 years old and 65 years or older with those among workers between 18 and 54 years old. This report describes the results of that analysis, which indicated that workers over 65 years old had the highest overall fatality rate (3.1 highway transportation deaths per 100,000 full-time-equivalent [FTE] workers per year), more than three times that of workers aged 18 to 54 years (0.9 per 100,000 FTE workers). This pattern held across demographic and occupational categories.


The U.S. Department of Labor Bureau of Labor Statistics (BLS) collects CFOI data from multiple sources. To be included in CFOI, the decedent must have been working, serving as a volunteer in a manner similar to a paid employee, or present at a site as a job requirement. As defined in this report, an occupational highway transportation death involved a motorized or non-motorized vehicle and a worker 18 years or older, with the incident occurring on a public road, where the victim was the operator, passenger, or a pedestrian struck in or on the side of the road. Deaths while traveling between work locations are included in CFOI, whereas those during commuting to and from work are not.


During 2003–2010, a total of 11,587 workers 18 years or older in the United States died in occupational highway transportation incidents, of whom 3,113 (26.9%) were 55 years or older. Overall, fatality rates were highest among workers over 65 years old (3.1 deaths per 100,000 FTE workers), followed by those aged 55 to 64 years (1.4 deaths per 100,000 FTE workers). Over time, fatality rates remained relatively stable for workers between 18 and 54 and 55 and 64 years. For workers over 65 years old, a sharp decrease in risk was observed in 2008, but by the end of the study period, their risk for a transportation death remained more than three times the risk among those between 18 and 54 years. In contrast, motor vehicle fatality rates for adults in the general population, including pedestrians, only begin to increase substantially at age 75 years.


Risk for an occupational highway transportation death among American Indian/Alaska Native workers over 65 years old was more than four times the risk among those aged 18 to 54 years. A similar pattern, although of lower magnitude, was observed among white and black workers. For Hispanic workers, the risk for an occupational highway transportation death among workers over 65 years old was more than twice the risk among workers aged 18 to 54 years; for non-Hispanic workers, the risk among workers over 65 years old was more than three times the risk among workers aged 18 to 54 years.


By primary industry, workers in transportation and warehousing accounted for a third of all deaths and had the highest rates across all age groups: 6.5, 10.6, and 21.2 for ages 18 to 54, 55 to 64, and 65 years or older, respectively. By primary occupation, rates were highest in transportation and material moving occupations for all age groups: 7.4, 12.9, and 22.9 for ages 18 to 54, 55 to 64, and 65 years or older, respectively, and these occupations accounted for one half of all deaths.


The distribution of events leading to highway transportation deaths was similar across all age groups, with collisions between vehicles accounting for the largest proportion of deaths in each age group: 43%, 43%, and 48% for ages 18 to 54, 55 to 64, and 65 years or older, respectively. Across all age groups, driving a vehicle was the most common work activity being performed by the decedent. Proportions of pedestrian deaths were small: 12%–13% in all age groups. Among workers over 65 years old, the type of vehicle most often involved was an automobile (23%), semi-tractor trailer truck (22%), or pickup truck (15%), and a greater proportion of deaths involved off-road and industrial vehicles (9%, compared with 2% for the other age groups). Higher proportions of deaths involving semi-tractor trailer trucks were observed for workers aged 18 to 54 years and 55 to 64 years (31% and 37%, respectively).


The safety of older workers who drive motor vehicles at work is of particular concern for employers, health professionals, and occupational safety professionals for at least four reasons. First, older workers bring a wealth of skills and experience to the workplace, making contributions beyond the traditional retirement age of 65 years. Second, starting at age 60 years, drivers involved in a crash are more likely to die from crash-related injuries than are drivers over 60 years old. This greater susceptibility to fatal injury has been found to be more important than excess crash involvement in explaining higher death rates for crash-involved drivers. Third, the ability to drive is affected by physical and cognitive changes associated with normal aging: declines in visual acuity, skill in processing complex visual information, reaction time, executive functioning, and contrast and glare sensitivity; and higher prevalence of comorbid conditions. These factors might be addressed by employers through injury prevention and wellness programs, and by workers through regular health examinations and screenings.


Modifiable behavioral and environmental risk factors for occupational highway transportation deaths include long hours of work, fatigue, occupational stress, time pressure, distracted driving, and nonuse of seat belts. Interventions to mitigate these risk factors will benefit drivers of all ages. U.S. Department of Transportation regulations for drivers of large trucks and buses address many of these risk factors already. In contrast, occupational drivers in non-transportation occupations more commonly use lighter-weight or personal vehicles such as cars and pickup trucks. Conditions of occupational use of these vehicles are largely unaddressed by occupational safety regulations issued by the federal or state governments.


Additional interventions of particular benefit to all older drivers include the following: selection and adaptation of vehicles to better accommodate them; policies encouraging less driving overall, less nighttime driving, and alternative modes of transportation; route and trip planning to reduce stress and fatigue; refresher driver training; and provision of information about medical conditions and medications known to affect driving ability. Employers also should consider allowing drivers to use their judgment to reschedule travel or stop driving in cases of fatigue, illness, bad weather, or darkness.


Prevention of work-related motor vehicle crashes is a shared responsibility between employers and workers, and both groups should take an active role in developing and implementing prevention strategies. Preventing workplace motor vehicle crashes depends on compliance with safety regulations and traffic laws, supplemented by employer-led safety initiatives and worker participation. Higher rates of highway transportation deaths for workers aged 55 to 64 and 65 years or older across industries and occupations support the need for employers to address specific needs and risks among older drivers in their road safety management programs and policies and in health and wellness programs. Resources are available to assist employers, health professionals, and older workers reduce the risk for motor vehicle crashes and injuries.


See the CDC Report