The Impact of the Aging Workforce on Occupational Medicine: A Narrative Review

Population aging is changing the workforce and the practice of occupational medicine. Older workers bring experience, judgment, and knowledge. But they may also have wider differences in physical reserve, sensory function, sleep tolerance, chronic disease, and recovery after illness or injury. This review examines the effects of these changes on work ability, fitness-for-work assessment, injury prevention, health surveillance, sickness absence, return to work, and workplace accommodation. We conducted a narrative review of PubMed-indexed, English-language human studies from database inception to June 2026. The search covered aging workers, occupational medicine, work ability, physical and cognitive capacity, chronic disease, work injury, shift work, workplace accommodation, return to work, and age management. We included 46 publications after screening for relevance. We grouped the evidence by theme. We did not perform a meta-analysis or formal risk-of-bias assessment. The evidence supports assessment based on function, job demands, hazards, and available controls rather than age alone. The strongest evidence supports broad principles. These include reducing the mismatch between worker capacity and job demands, improving ergonomic and fatigue controls, supporting chronic disease management, and using individual, time-limited accommodations. Other important issues include multimorbidity, polypharmacy, frailty, sarcopenia, burnout, ageism, organizational justice, and digital adaptation. But the intervention evidence is varied and limited by observational study designs, inconsistent definitions, and the healthy worker effect. Occupational medicine is moving from one-time medical clearance to long-term management of work ability. Occupational physicians should combine clinical findings with job analysis, prevention, rehabilitation, and organizational advice. Sustainable work needs age-inclusive design, fair access to training and accommodation, and regular review of risk controls.