The populations of westernised countries are ageing. In future, therefore, the frequency of common age-related health conditions is likely to rise among the workforce, as is the proportion taking prescribed medicines. Potentially such factors could increase the risk of accidental injury. An onus is thus being placed on employers to manage any associated risks to health and safety equitably and appropriately. Managers face the dilemma, on the one hand, of ensuring the physical safety of workers and third parties, and, on the other, of avoiding needless restrictions on work opportunity among skilled older workers. A stronger evidence base is needed to underpin such decisions.

To inform risk assessment, we undertook analyses based on cases of occupational injury recorded in the Clinical Practice Research Datalink (CPRD). This research database records, anonymously, all consultations with a family doctor or hospital for people registered with some 590 participating general practices (about 6% of the national population). Cases of workplace injury, as documented over a two decade period, were compared with matched controls in terms of their medical history and use of prescribed medication before the injury event.

Risks were moderately elevated among workers with mental health problems, taking drugs with psychotropic effects, and with problems of vision, hearing and balance; but no important increase in risks was found among patients with diabetes or epilepsy.