Impact of differential injury reporting on the estimation of the total number of work-related amputations

Organisational factors and under-reporting of occupational injuries in Sweden: a population-based study using capture-recapture methodology

Objective

To estimate the magnitude of under-reporting of non-fatal occupational injuries (OIs) by different organisational factors in Sweden for the year 2013.

Methods

Capture–recapture methods were applied using two data sources: (1) the national OI register and (2) records from a labour market insurance company. To assure comparability of data sources, the analysis was restricted to the public sector and private companies with at least 50 employees. OIs were matched using personal identification number and reported injury dates (±7 days). Organisational factors were obtained from the national labour market register and injury severity (no healthcare/only outpatient/hospitalised) from the National Patient Register. Total number of OIs and ascertainment by data sources were estimated assuming data source independence.

Results

There were an estimated 98 493 OIs in 2013. Completeness of reporting OIs to the national register and to the insurance company was estimated at 73% and 43%, respectively. No report to either source was estimated at 15 000 OIs (~15%). Under-reporting to the national register differed by selected organisational factors, being higher among organisations in the public sector, those with more females, with a younger workforce and with a higher proportion of immigrants. Overall under-reporting was more common in agriculture (19.7%), other services (19.3%), commerce and hospitality (19.1%), health (18.4%) and education (18.4%). Under-reporting decreased as injury severity increased, with little variations across sectors of economic activity.

Conclusions

Results suggest considerable under-reporting of OIs in Sweden and differential under-reporting by organisational factors. Results are relevant for official estimates of burden and for setting priorities for workplace safety and prevention.

Mine Safety and Health Administration's Part 50 program does not fully capture chronic disease and injury in the Illinois mining industry

BACKGROUND

The Mine Safety and Health Administration (MSHA) requires reporting of injuries and illnesses to their Part 50 program. A 2011 study indicated that the Part 50 program did not capture many cases of injury in Kentucky, causing concern about underreporting in other states.

METHODS

MSHA Part 50 reports from Illinois for 2001-2013 were linked to Illinois Workers' Compensation Commission (IWCC) data. IWCC cases not found in the Part 50 data were considered unreported.

RESULTS

Overall, the Part 50 Program did not capture 66% of IWCC cases from 2001 to 2013. Chronic injuries or illnesses were more likely to be unreported to MSHA.

CONCLUSIONS

The majority of occupational injuries and illnesses found in the IWCC from this time period, were not captured by Part 50. Inaccurate reporting of injuries and illnesses to the Part 50 program hinders MSHA's ability to enforce safety and health standards in the mining industry.

Impact of Occupational Injuries on Nonworkers' Compensation Medical Costs of Patient-Care Workers

OBJECTIVE

The aim of this study was to estimate the extent to which work-related injuries contribute to medical expenditures paid for by group health insurance.

METHODS

Administrative data on OSHA recordable injuries spanning 2010 to 2013 were obtained for female patient care workers (n = 2495). Expenditures were aggregated group health insurance claims for 3 and 6-month periods before/after injury. Group health insurance plan type, age group, and job category were control variables.

RESULTS

Being injured is associated with the odds of having expenditures at both 3 months, odds ratio (OR) 2.17 [95% confidence interval (95% CI) 1.61 to 2.92], and 6 months, 2.95 (95% CI 1.96 to 4.45). Injury was associated with $275 of additional expenditures (95% CI $38 to $549) over 3 months and $587 of additional expenditures (95% CI $167 to $1140) over 6 months.

CONCLUSIONS

Injury was associated with increased odds of positive expenditures and increased expenditures paid for by group health insurance.

Same-level fall injuries in US workplaces by age group, gender, and industry

BACKGROUND

As the workforce ages, occupational injuries from falls on the same level will increase. Some industries may be more affected than others.

METHODS

We conducted a cross-sectional study using data from the Bureau of Labor Statistics to estimate same-level fall injury incidence rates by age group, gender, and industry for four sectors: 1) healthcare and social assistance; 2) manufacturing; 3) retail; and 4) transportation and warehousing. We calculated rate ratios and rate differences by age group and gender.

RESULTS

Same-level fall injury incidence rates increase with age in all four sectors. However, patterns of rate ratios and rate differences vary by age group, gender, and industry. Younger workers, men, and manufacturing workers generally have lower rates.

CONCLUSIONS

Variation in incidence rates suggests there are unrealized opportunities to prevent same-level fall injuries. Interventions should be evaluated for their effectiveness at reducing injuries, avoiding gender- or age-discrimination and improving work ability.

The Impact of Contract Operations on Safety in Underground Coal Mines

OBJECTIVE

The aim of this study was to test for differences in injury rates for contractor-operated underground coal mines relative to owner-operated mines in Kentucky, controlling for other covariates.

METHODS

We used disparities between MSHA contractor data and surface reclamation permit data to identify mines operated by contractors. We then used negative binomial regression to estimate injury rates from 1999 to 2013, controlling for mine and controller characteristics available from MSHA and the Energy Information Administration (EIA).

RESULTS

Contractor-operated mines with 15 or fewer full-time equivalent workers (FTEs) had a statistically significant 57% higher covariate-adjusted reported traumatic injury rate than similar mines without contract operators. Larger contractor-operated mines did not have a statistically significant elevated rate.

CONCLUSIONS

We detected a significant elevation of traumatic injury rates only among the smallest contractor-operated mines. This increase appears substantial enough to warrant attention.

The direct cost burden of 13years of disabling workplace injuries in the U.S. (1998-2010): Findings from the Liberty Mutual Workplace Safety Index

INTRODUCTION

Although occupational injuries are among the leading causes of death and disability around the world, the burden due to occupational injuries has historically been under-recognized, obscuring the need to address a major public health problem.

METHODS

We established the Liberty Mutual Workplace Safety Index (LMWSI) to provide a reliable annual metric of the leading causes of the most serious workplace injuries in the United States based on direct workers compensation (WC) costs.

RESULTS

More than $600 billion in direct WC costs were spent on the most disabling compensable non-fatal injuries and illnesses in the United States from 1998 to 2010. The burden in 2010 remained similar to the burden in 1998 in real terms. The categories of overexertion ($13.6B, 2010) and fall on same level ($8.6B, 2010) were consistently ranked 1st and 2nd.

PRACTICAL APPLICATION

The LMWSI was created to establish the relative burdens of events leading to work-related injury so they could be better recognized and prioritized. Such a ranking might be used to develop research goals and interventions to reduce the burden of workplace injury in the United States.

Use of multiple data sources for surveillance of work-related amputations in Massachusetts, comparison with official estimates and implications for national surveillance

BACKGROUND

Accurate surveillance of work-related injuries is needed at national and state levels. We used multiple sources for surveillance of work-related amputations, compared findings with Survey of Occupational Injuries and Illnesses (SOII) estimates, and assessed generalizability to national surveillance.

METHODS

Three data sources were used to enumerate work-related amputations in Massachusetts, 2007-2008. SOII eligible amputations were compared with SOII estimates.

RESULTS

787 amputations were enumerated, 52% ascertained through hospital records only, exceeding the SOII estimate (n = 210). The estimated SOII undercount was 48% (95% CI: 36-61%). Additional amputations were reported in SOII as other injuries, accounting for about half the undercount. Proportionately more SOII estimated than multisource cases were in manufacturing and fewer in smaller establishments.

CONCLUSION

Multisource surveillance enhanced our ability to document work-related amputations in Massachusetts. While not feasible to implement for work-related conditions nationwide, it is useful in states. Better understanding of potential biases in SOII is needed.