Aspects of occupational aging according to elderly workers: old age, work, and worker health

Population aging promotes meaningful changes in social structures, increasing the presence of older people in the labor market. By exposing this context, this research aims to analyze the following questions: the representation of work for older people, aging at work, and the relationship between the continuity of elderlies in the labor world and the worker's health. A semi-structured interview technique and a focus group with 16 elderly professionals were applied. Data were analyzed using a thematic content analysis technique. As analytical categories, it was highlighted the positive and negative aspects of the elderly at work, the representation of work for the elderly's lives and factors that affect the worker's health. The positive images of the elderly related to work were shown to be anchored to the experience and responsibility in face of work relationships. On the other hand, the negative view was mainly linked to the stigma of unproductivity. Working in old age was associated with income supplementation and personal development. The health of elderly people in work environments was mentioned as being affected by working organizations, including unfitted furniture and working hours, the lack of knowledge of new technologies, intergenerational conflicts and age discrimination. Therefore, it is demanded the development of public policies in order to reduce risk factors for working elderlies health.


Introduction
Population aging has shown to be a challenge for the agendas for public work policies worldwide. The International Labor Organization (ILO) estimates that by 2025 people over 60 are going to represent approximately 30% of the population in Europe and North America, 21% in Asia, and 17% in Latin America (UE, 2021). In this context, population aging is a worldwide growing phenomenon, which was more noticeable in developed countries a few decades ago, but today it has also spread to developing countries, such as Brazil (Batista & Teixeira, 2021). According to the last population projection carried out in 2018 by the Brazilian Institute of Geography and Statistics (IBGE), the population over 60 years old is around 28 million people, which is, 13% of the total of the country. Within this longevity process, life expectancy has increased considerably in recent decades, from 45.5 years in 1940 to 76.3 years in 2019 (IBGE, 2019).
In this scenario, the aging of the workforce is even more present, which gives rise to new central questions for societies. The ILO, in the document "World Employment and Social Perspectives" (ILO, 2018), considers that factors, such as working conditions, the productivity of elderly people, the pension system, and social assistance, must be reformulated in view of the need for the sustainability of this group within the economically active population. Taking into account that much elderly use to return to the labor market in order to complement their income and that old age tends to be related to situations of vulnerability, it is necessary to ensure to elderlies the right to access the labor market as a way to contribute to their human dignity, associated to the labor life planning in all cycles of work (Pazos & Bonfatti, 2020;Dell'isola et al., 2020).
The operational aging perspective proposed by the World Health Organization (WHO) included the formulation of policy actions aimed at "optimizing opportunities for health, participation, and security, to provide quality of life as people get older". This orientation includes participation in social, economic (work), cultural and civic activities (Envelhecimento ativo, 2015). Furthermore, ultimately in the WHO document "The decade of active aging 2020-2030"(World Health Organization, 2021), measures are indicated in order to mitigate discrimination against the elderly in society, that is, to make society more inclusive for elderlies in a broad perspective, which includes the importance of developing inclusive and discrimination-free working environments, taking into account health and safety at work. In general, a decent and healthy work is prioritized, aiming at the economic growth of older people. Thus, the referred document proposes the development of access actions and employment opportunities for this population, concerning health care in the working environment.
In countries where demographic aging shows to be more advanced, studies reveal the effects of work activities on the health conditions of elderly workers (Silva et al., 2022). In Italy, for example, among the factors identified as a source of illness for elderly workers, there are others like ageism (prejudice regarding age) and the work environment itself, which is mainly designed to receive younger workers, unsuitable for the specificities of elderly workers, contributing to musculoskeletal illnesses for this group (Magnavita et al., 2017). Another study in the United Kingdom (Case et al., 2015) indicated that risk factors for illnesses among elderly workers are reinforced mainly in working environments where competitiveness and productivity are stimulated, in association with the fact that these environments are not suitable for the physical and cognitive capacities of this age group. The continuity of elderly people at work related to health and work conditions was also dealt with in an investigation in the Netherlands (Damman & Henkens, 2020). Aiming to promote the participation of this age group at work, the Dutch government took measures to create a work flexibility policy, allowing elderly to work at more flexible times or even at home.
In Brazil, where not formally regulated work relations (informality) is a reality for many workers, elderlies face even more difficulties in getting an occupation in the formal labor market. Even though the participation of these workers in the economically active population is increasing, according to the Labor Market Report (IPEA, 2018), the majority of job vacancies aimed at them are mainly working activities in the informal sector, with fewer opportunities to access professional updating and lower wages. In addition to the prioritization of hiring younger workers for the best vacancies, this also reinforces the exclusion due to age and the depreciation of the knowledge of older workers, which support intergenerational conflicts (Batista et al., 2021). As already identified in other countries, factors such as management policies in Brazil, which focus more on production, profits, and the dynamics of intense work, also contribute to the physical illness of workers, affecting, above all, older people. In addition, the elderly stigmas are observed as a form of violence anchored to ageism (Castro, 2016;Feuser & Goldschmudt, 2020). Violence at work, affecting elderly in many work environments, is associated with psychological and physical disorders and degrades elderly people life's quality . Therefore, it is important to oppose this overall working violence to aging stereotypes by refusing prejudicing attitudes and promoting, for instance, intergenerational mutual learning initiatives (Amorin et al., 2019).
Finally, beyond the opportunity to remain active and sociable through work (Feuser & Goldschmudt, 2020), in Brazil, as in many other developing countries, the participation of older professionals in work activities is mainly associated with financial issues, such, for example, complementing the family income. The Brazilian perspective is that this contingent is going to burst in the following years not only due to aging itself but also because of the New Brazilian Social Security System, by which the minimum average age for retirement is going to significantly increase (Nova Previdência, 2019).
Given this context, the objective of this study is to highlight and analyze questions about the elderly in work environments, relating them to the effects of work on the health of elderly workers, in order to promote future benefits to this group. These questions are: the representation of work for the elderly, aging in work environments, and the relationship between the continuity of the elderly in the labor world and the worker's health. The analysis of these questions is obtained from the perspective of elderly workers themselves.

Sample and ethic
The methodological approach applied was a qualitative exploratory research aiming to investigate and identify the relations between work, elderly workers and worker's health. This kind of work supports the investigation of a growing contemporary phenomenon from reports about the reality of a determined group (Severino,2018;Minayo,2014;Donizelli et al.,2018). For this research 16 participants were selected by convenience, aged between 60 and 82 years, hired in the formal or the informal labor market. The individuals were chosen from the health sector of an active aging program of the City Government Office for Elderly Policies, in Maricá, Rio de Janeiro -RJ, Brazil, where they were enrolled. The study was approved by the Ethical Committee for Research of Sergio Arouca National School of Public Health (CAAE: 05957119.0.0000.5240). Participation in this study was voluntary by acceptance of a Free and Informed Consent Term (IC). To ensure the anonymity of the participants, they were identified by letters and numbers, including information about gender, age, education, and condition of insertion in the labor market.

Data Collect
To answer the objectives of this work, data collection was carried out through a semi-structured interview composed of questions about socioeconomic characteristics and guiding questions. At first, according to the script previously prepared by the researchers, information such as age, gender, race, education level, current occupation and employment relationship was collected individually.
As the theme of this research is related to particularities, perceptions and socio-cultural values, in the second stage of this study, the Focus Group (FG) technique was applied, which is a data production method that provides a collective deepening of the theme. The FG techinique provide insights into knowledge on the topic and verbalization of values, experiences, and beliefs based on group interaction (Trad, 2009;Palazzo & Barbour, 2012;Kinalski et al., 2017;Oliveira et al., 2020). The guiding questions for the FGs, present in this questionnaire were: "The importance of elderlies in the work environment"; "How elderlies relate to their work activities, "and" The relationship between work activity and worker health".
The FGs had the presence of a mediator researcher, who was responsible for weighting the discussions and providing clarifications when necessary, preserving the expression of each participant. The observer researcher was in charge of organizing the support entries with videos and images and the audio recordings of the groups and field notes.
Data collected during the meetings were recorded and later processed by Content Analysis in the thematic modality recommended by Bardin (Bardin, 2011). Therefore, the organization of this material was according to the following steps: Preanalysis, with the floating reading and organization of the collected material, systematizing the topics to be studied and classifying the context and the excerpts highlighted as meaningful; Exploration of the material, comprising the performance of a text clipping in a systematic way, organized into thematic classes, units of analysis and categories; Treatment of the results obtained and interpretation, consisting of understanding of the contents that are relevant to the topic, highlighting inferential performances and a reflective and critical analysis according to the theoretical frameworks addressed and the determinations of the phenomenon being studied (Minayo, 2010;Bardin, 2011;Souza & Santos, 2020;Souza et al, 2020). Table 1 shows the characterization of the research participants. As for the functional category, 75% of the elderlies are retired and 25% are not. Among the retirees, all were reinserted into the labor market, being 19% in informal activity and 81% in informality. Concerning age, the workers in the study presented different job occupations and forms of insertion in the labor market, tending the younger elderlies predominantly to participate in the labor world in informal activities, in contrast to the older ones, who were in informal ones. Remarkably, 63% of the participants were women and 37% were men, while 25% declared themselves black or brown and 75% white. Regarding schooling, 19% of the participants were literate, while the elderlies with only elementary education represented 43% of the sample and those with secondary and higher education added up to 19%, being the higher education elderly all-male in this sample.

Results
The results obtained in this case study through the FGs were organized by selection of the material and skimming. Thus, in the first stage, a coding process was developed, where the data produced were cut according to the most frequent words in the speeches, giving rise to twelve recording units. In the next step, these were condensed according to the theme into six context units. These initial and intermediate stages mentioned above gave rise to the synthesis of meanings and ideas present in the speeches, thus generating three categories of analysis (Table 2), which are to be discussed subsequently.

Positive and negative aspects for elderlies in the work universe
For the elderlies of this investigation, aging is seen as a moment influenced by cultural transversality, giving rise to negative and positive images of old age. The negative view is linked to diseases and social dependence, being anchored to chronological age and biological characteristics, which reinforce the idea of age function limitation and unproductivity. On the other hand, a positive direction related to old age was identified, since it is anchored to the sum of experiences, responsibility, moral values, and beliefs, which, according to the perception of the research, allows a broader form of interpretation of the world.
In summary, for the participants aging is shown to be heterogenic and related to stereotypes, myths, and beliefs supported by interpersonal relations and different social contexts. Both negative and positive interpretations of old age were mentioned in another study of psychosocial analysis on the social representation of active and inactive elderlies (Castro et al., 2020), which shows that the negative one is more evident for them.
Furthermore, for the surveyed, society should see old age as a time of opportunity and autonomy. So, there is a need to incorporate the socio-cultural construction and the heterogeneity of old age in public policies since it occurs differently as each individual gets older according to his/her socioeconomic insertion. All these factors imply the individual's position in social work environments and therefore must be considered in the development of public policies as a way of expanding the inclusion of the elderly in these environments (Lancman et al., 2020). This situation can be illustrated in the following reports: "We are actually discriminated. They say: here comes an old man... Let's get him out!" (P13) "Elderlies deserve an opportunity; they have life experience and teachings that enrich people of the same age or the younger ones." (P6) "The fact is that we are doing what our conscience tells us to do and with dignity. So, you do your recycling work [referring to the colleague], and I do my massage work, trying to improve patients' lives. We have this responsibility as seniors." (P5)

The representation of the work on elderly life
Work in contemporary society involves, besides represent the status of occupation, social recognition and financial organization. Therefore, the work activity has an essential place in the organization of an individual's life (Ferraz & Moura, 2019). Based on the guiding question "How do elderly relate to their work activities?" many workers in this research mentioned a relationship with work activities since childhood, thus confirming the centrality of work activity for this workgroup. In this construction, images of work related to a social position were identified, mainly in the family environment and in the community where they are inserted. It is essential to highlight that for the women in this study, work represents most a kind of social position and satisfaction due to the occupation and activity. In contrast, for the male ones the central meaning of work is the relationship with the status of the breadwinner.
Retirement emerged speeches about the universe of work activity, especially for elderlies reinserted in the labor market, showing to be a crucial stage for the conclusion of a career and recognition for work activities already carried out. This analysis highlights the emotional damage related to the moment of retirement, especially for those who do not have life and activity planning or who depend on their family, which can degrade the quality of life and mental health of elderlies. The occupation of work appears in the speeches as a possible opportunity for a reinterpretation of meanings, occupation of time, to discover new challenges and potentialities. These data corroborate the WHO guidelines which indicated the importance of work activities in contributing to the promotion of active aging (Aging Report, 2021), as demonstrated in the following statements: "Before I was here at this current job, I was experiencing depression problems, feeling useless and not even being able to do activities at home." (P10) "We, who develop work after legal retirement, are not retired from the body, from work activity, because we continue to be very useful to the society and this is what I think and motivates us to live." (P5)

Factors that affect elderly workers' health
Studies in the field of workers' health are based on understanding the relationship between workers and work, in an interdisciplinary way, beyond the work environments, encompassing the social and economic context and their work history (Gomez et al., 2018;Lancman, 2020). In this sense, Lacaz & Santos (2010) list the worker's knowledge as a fundamental part of the debates to improve work environments and relationships.
Based on these assumptions, the participants were introduced to the history of the field of workers' health, based on the Brazilian Federal Law 8.080/1990, the primary legislation for Brazilian public health, and for other policies on Workers' Health (Brasil, 1990). Emphasis was given regarding to the provision on the conditions and organizations of health actions from article 5, which deals with efforts and assistance to workers' health. We can see that this group was unaware of the term worker's health and the existence of public policies that could provide them some health support. The interpretation of this category initially makes the informality of work emerge as a factor of illness, associated with the absence of formal work relations and the lack of social protection concerning the worker's rights. In addition, the lack of professional perspective and unemployment also appear in the analysis as factors of illness for elderly workers.
It was pointed out among the participants of this research that discrimination against older workers is part of their daily lives in the labor market. According to these elderlies, this situation even limits access to better job opportunities with better earnings. For them, the idea that old age is recognized only as a phase of losses in all areas of life affects the chances for reintegration or continuity in the labor market. Studies that address prejudice and the job market for elderlies reveal the impact of ageism in work environments as a factor of illness, which is considered a "social death of the elderly" and promote intergenerational disputes inside and outside the workplace. Respondents consider that the non-recognition of their skills contributes to that older workers' experience returning to work under any working conditions. For them, autonomous employment or self-employment represents a challenge in this sense, being present in their field notes. This issue is evidenced in studies on the participation of the elderly in the selfemployed and informal labor market (Brasil, 1994;Paolini, 2016;Batista et al., 2021).
The health condition of elderly people was also treated in a Norwegian survey (Merkus et al., 2019), which demonstrated that keeping the worker's physical capacity throughout all working life is the key for the maintenance of good health and activity until retirement. Therefore, for the prolongation of elderly labor's life, it is necessary to implement adaptations at work, so that less physical effort is needed and thus leading to less degradation of his/her life.
Another issue raised by this group is the lack of job training opportunities for older people, leading to their exclusion and worse working conditions. This analysis gives rise to the need to encourage the professional updating of older workers as an opportunity to identify new skills. Training planning should consider the specificities of these workers and their initial qualifications, aiming to insert them into society in an inclusive way and with less inequality (Paolini, 2016). This group of older people considers it essential to update on technology, which, according to them themselves, affects the opportunity to participate in work environments compared to younger workers. The limitations placed by the group are already contemplated in specific laws, as stated in the National Brazilian Policy for the Elderly (Brasil, 1994;Brasil, 2003) and are reinforced by chapter VI of the Brazilian Elderly Statute -"From professionalization to the work of the elderly statute", which was shown to them. Based on this group reflection, the participants identified the ineffectiveness of this right in terms of the work context.
Since the group indicated that currently, they are working during long or unregulated hours, working times are presented in this investigation as another impact factor on workers' health, harming health. These conditions imply tremendous physical effort without considering, for example, health limitations arising from the ordinary biological and social process of aging. As an aggravating factor, there is the fragility of work informal relationships, which increases the health weaknesses of older people and the exclusion of this kind of worker (Batista et al., 2021).
Finally, the adaptations of the work environment for old workers are highlighted as a possibility to contribute to their permanence of them in labor activities.
"Older people can only get a job if they set up their own business." (P1) "First, most of the professions that people were used to do are being extinguished and finished. Many [professionals] now speak and use computers and the internet." (P1) "Seniors have no longer the energy they used to do. There should have better and age-appropriate jobs with a shorter workload." (P4)

Conclusion
Population aging represents a worldwide demand for social challenges in the most varied aspects. Elderly in the labor market, the work representation for the elderly, aging at work, and the worker health in old age are some of these aspects. In this direction, as a country experiencing a fast-growing aging process, in Brazil it is urgent to understand the realities of elderlies to reconsider concepts, values, and public policies to promote socially inserted and active aging.
Through this Focus Group study with older workers, it was observed that the presence of the elderly in the job market is referred to the need to maintain family income, social roles, and social security issues. Therefore, it can be identified that elderly are more active and seek broader inclusion and better work opportunities, having negative and positive experiences through this demand, which confirms the necessity to develop and implement public policies.
In addition to the financial issue, the surveyed elderly extrapolated the meaning of work, comprising an individual and collective construction arising from the aging process at work. Thus, the results of this research show that the social representations of elderly were mainly related to the historical and cultural construction, due to which the views about old age are influenced by the social context where these individuals are inserted. The negative view was mainly linked to a decrease in health and unproductivity. On the other hand, as positive factors for the social representations of the elderly, knowledge and experience of older people were claimed. In general, the social actors (the elderly themselves) are shown to recognize the biological influence and work strain on their health. However, they consider that the age factor should not represent a requirement for exclusion from the labor market.
Thus, aiming at better opportunities for equality between young and elderly workers, the employer should attain certain particular circumstances considering the physical, intellectual and psychological conditions of older people, for which public policy is required. For example, from the participants' speeches, a demand is required for changes in the physical space, in the rhythms and forms of work in order to mitigate the risk of accidents and/or illness from work. Besides the physical adaptation to older workers, these measures could reduce, for example, age discrimination, by expanding and incentivizing intergenerational exchanges.
Although this study has shown the relevance of certain aspects of older workers, such as stereotypes and demands on working environments and relations, it is important to highlight that these results represent the reality of a specific group of elderly workers. Therefore, further research is necessary in order to encompass other elderly groups, which experience different realities, as socio-cultural specificities, considering the aging heterogeneity of other Brazilian regions, for example.
On the relation between older workers, work and health, many questions still remain open. For the development of public policies for elderly workers, there are issues like researches based on case studies about age prejudice related to the access of elderly workers, as well as review researches to identify the main difficulties and diseases of elderly workers at their working environments.
Finally, it is noteworthy that the continuity to carry out work activities in old age is an individual choice or need for each one. If necessary, it is crucial to support this work and promote the elderly's health through healthier work environments.
These measures will help encourage them to remain active, considering the social and economic importance that these subjects represent for societies nowadays. As a final remark, it is observed in this study that the awareness of the participation of older people in work activity is an essential piece of reflection for a redirection of public policies for the health care of elderly workers.