Counting matters: implications of undercounting in the BLS survey of occupational injuries and illnesses

Development and Cognitive Testing of Occupational Safety and Health Questions for a Youth Survey: Addressing the Research Needs for a Vulnerable Working Population

BACKGROUND

While more than 2.5 million U.S. high students worked in 2020, data to assess how work affects this group are sparse. To facilitate such research, a set of occupational safety and health questions for inclusion on the Youth Risk Behavior Surveillance System (YRBSS) and other youth-focused surveys was developed.

METHODS

Survey questions about occupational experiences of young workers were adapted from other surveys or created de novo. Key audiences were engaged to define priority topic areas and develop draft questions, which were further refined through cognitive interviews with working youth.

RESULTS

Twenty-one resulting questions spanned multiple work-related topics: employment status; health outcomes; psychosocial exposures; and safety climate. Cognitive testing revealed that youth (aged 14-19) had difficulty with temporal concepts. Some difficulties reflected the propensity of youth to engage in multiple, online, and informal jobs. During 3 rounds of interviews, questions were adjusted to better reflect youth employment circumstances and language. Four states added at least 1 work-related question to their 2023 Youth Risk Behavior Survey questionnaire, and the full set of questions has been disseminated to federal agencies and partners.

CONCLUSION

Including tailored questions about employment in surveys of youth will facilitate occupational health surveillance for this group. Analysis of resulting data can help to close knowledge gaps, provide current prevalence data, inform policy, and allow development of focused prevention and intervention strategies to reduce adverse outcomes among young workers.

Time series, seasonality and trend evaluation of 7 years (2015-2021) of OSHA severe injury data

PROBLEM

Employers are required to report severe work-related injuries (e.g., amputation, inpatient hospitalization, or loss of an eye), to the Occupational Safety and Health Administration (OSHA). This study examined the OSHA severe injury reports (SIRs) public microdata to understand time-related trends and patterns.

METHODS

This study included all SIRs from January 2015 to December 2021 (84 months). We employed time series decomposition models (classical additive and multiplicative, X-11, and X-13ARIMA-SEATS) to evaluate monthly seasonal effect and seasonally adjusted trend of SIRs. We developed data visuals to display trends from different models with the original data series. We compared number of daily SIRs by day of the week, and yearly trends by 2-digit NAICS and separately by 1-digit OIICS injury event.

RESULTS

There were a total of 70,241 SIRs in this 7 year period; ranging from 8,704 to 11,156 per year, and 600 to 1,100 per month. Seasonally adjusted trend indicated a gradual increase of SIRs over time until October 2018, then a steeper decrease until August 2020, and staying somewhat flat for the rest of the months. Seasonality indicated more SIRs were reported in the summer months (June, July, August). Daily SIRs indicated a weekday average of 34 (SD = 9) and weekend average of 11 (SD = 5). The Manufacturing and Construction industries reported the highest yearly SIRs. Contact with objects and equipment, and falls, slips, trips were the most numerous injury events associated with SIRs.

DISCUSSION

Although Federal OSHA SIR data do not include SIRs from state-plan jurisdictions, the data provide a timely national trend of SIR. This is the first known time series analysis of SIRs.

PRACTICAL APPLICATIONS

The findings of this study highlight the ability of researchers to use the SIRs as a timely indicator to understand occupational injury trends by specific industries and injury events.

Societal burden of work on injury deaths in New Zealand, 2005-14: An observational study

Background

Work poses increased risk of injury not only for workers but also for the public, yet the broader impact of work-related injury is not quantified. This study, utilising population data from New Zealand, estimates the societal burden of work-related fatal injury (WRFI) by including bystanders and commuters.

Methods

This observational study selected deaths due to unintentional injury, in persons aged 0-84 years using International Classification of Disease external cause codes, matched to coronial records, and reviewed for work-relatedness. Work-relatedness was determined by the decedent's circumstances at the time of the incident: working for pay, profit, in kind, or an unpaid capacity (worker); commuting to or from work (commuter); or a bystander to another's work activity (bystander). To estimate the burden of WRFI, frequencies, percentages, rates, and years-of-life lost (YLL) were estimated.

Results

In total 7,707 coronial records were reviewed of which 1,884 were identified as work-related, contributing to 24% of the deaths and 23% of the YLL due to injury. Of these deaths close to half (49%) occurred amongst non-working bystanders and commuters. The overall burden of WRFI was widespread across age, sex, ethnic and deprivation sub-groups. Injury deaths due to machinery (97%) and due to being struck by another object (69%) were predominantly work-related.

Interpretation

When utilising a more inclusive definition of work-relatedness the contribution of work to the societal burden of fatal injuries is substantial, conservatively estimated at one quarter of all injury deaths in New Zealand. Other estimates of WRFI likely exclude a similar number of fatalities occurring among commuters and bystanders. The findings, also relevant to other OECD nations, can guide where public health efforts can be used, alongside organisational actions, to reduce WRFI for all those impacted.

Occupational Disease in New York State: An Update

An assessment of occupational disease in New York State was undertaken that partially replicated and expanded earlier work from 1987. Utilizing an expanded conception of occupational disease, the assessment used a variety of data sources and methods to provide estimates of mortality and morbidity of occupational disease; workers exposed to specific workplace hazards; disparities in occupational disease among racial/ethnic groups and gender; costs and distribution of costs of occupational disease; and accessible occupational medical resources. Examples of the pathways work may impact health in some of the major health issues of current import including stress-related health conditions; substance use; and overweight/obesity were included. The report contains recommendations for addressing the problem of occupational disease in New York State and advocates for the convening of a statewide group to develop an occupational disease prevention agenda.

Recordkeeping Error or Strategic Seasonal Substitution?: The Seasonality of Occupational Injuries in SOII and MarketScan

OBJECTIVE

I compare the seasonal patterns observed in the Survey of Occupational Injuries and Illnesses (SOII) to claims data from the IBM® MarketScan® Research Databases.

METHODS

I construct monthly injury rates and claims rates by supplementing occupational injuries and other claims data with hours data from the Current Population Survey and estimate seasonal effects using an Unobservable Components Model.

RESULTS

While workers' compensation data and the SOII display similar seasonal patterns, the year-end decline in the MarketScan data is 1/3 to 1/2 the magnitude observed in the SOII. Short-term disability and private health insurance claims display seasonal patterns inversely related to occupational injuries.

CONCLUSIONS

Part of the year-end decline in occupational injuries observed in the SOII is likely due to recordkeeping error. There is also some evidence of strategic seasonal substitution between various health-compensation alternatives.

An Environmental and Societal Analysis of the US Electrical Energy Industry Based on the Water–Energy Nexus

To meet rising energy demands, power plant operations will expand, influencing the interactions between the water–energy nexus and society. However, a major challenge is integration of social dimensions within electricity generation. To address this, we generate a baseline dataset using US public data (2014–2019) from the Energy Information Administration and US Bureau of Labor Statistics. We identify the rate of energy consumed, CO2, SO2 and NOx emissions generated, and water used per MWh net electricity as well as employee wellbeing per unit MW capacity during electricity generation. Rates of energy consumption (MMBtu/MWh) decreased 4.9%, but water consumption and withdrawal (m3/MWh) both increased 0.93% and 0.31%, respectively. Emissions of CO2, SO2 and NOx decreased 22.64%, 75% and 25% MT/MWh, respectively. Thermoelectric cooling withdrawal and consumption is led by natural gas (50.07%, 38.31%), coal (29.61%, 25.07%), and nuclear energies (13.55%, 18.99%). Electric power generation contributes 0.06 injuries–illnesses/TWh and 0.001 fatalities/TWh, of which fossil fuels contributed 70% and 15%, respectively. Fossil fuels led in average annual employment (0.02 employees/MW) with low cost salaries (USD 0.09/MW) likely due to high collective capacity, which is declining. Estimated rates in this study and framework will aid power industry transition and operational decision makers.

Cabin crew health and fitness-to-fly: Opportunities for re-evaluation amid COVID-19

Aircrew fitness-to-fly is among the elements that make aviation the safest form of long-distance transport. The health of cabin crew is a crucial determinant in carrying out safety-related duties. 'Fitness-to-fly' is associated with defined workplace conditions, for which airlines have a legal duty to ensure fitness for employment. We explored the literature on fitness-to-fly to obtain a pragmatic assessment of the challenges for aeromedical examinations. Regulations promulgated by aviation regulatory authorities and airline-internal policies have similar status and meaning, yet there is no harmonised approach internationally, and an inability to conform periodic medical assessments to actual operational fitness. The COVID-19 pandemic has highlighted the need to better understand fitness-to-fly criteria. Fitness-to-fly measures are mainly based on self-reported data and there is a need for a 'safety' factor for self-reports. Aeromedical evaluations should evolve from meeting medical standards to include pandemics as an element of the overall risk of aircraft operations. Re-evaluating criteria for fitness-to-fly assessment will further the goal of linking research to the actual needs of public health decisionmakers. If airlines are to resume operations at pre-pandemic levels, they must demonstrate to the public and public health agencies that fitness-to-fly assessment is appropriate and effective.

A scoping review to identify strategies that work to prevent four important occupational diseases

BACKGROUND

Despite being largely preventable, many occupational diseases continue to be highly prevalent and extremely costly. Effective strategies are required to reduce their human, economic, and social impacts.

METHODS

To better understand which approaches are most likely to lead to progress in preventing noise-related hearing loss, occupational contact dermatitis, occupational cancers, and occupational asthma, we undertook a scoping review and consulted with a number of key informants.

RESULTS

We examined a total of 404 articles and found that various types of interventions are reported to contribute to occupational disease prevention but each has its limitations and each is often insufficient on its own. Our principal findings included: legislation and regulations can be an effective means of primary prevention, but their impact depends on both the nature of the regulations and the degree of enforcement; measures across the hierarchy of controls can reduce the risk of some of these diseases and reduce exposures; monitoring, surveillance, and screening are effective prevention tools and for evaluating the impact of legislative/policy change; the effect of education and training is context-dependent and influenced by the manner of delivery; and, multifaceted interventions are often more effective than ones consisting of a single activity.

CONCLUSIONS

This scoping review identifies occupational disease prevention strategies worthy of further exploration by decisionmakers and stakeholders and of future systematic evaluation by researchers. It also identified important gaps, including a lack of studies of precarious workers and the need for more studies that rigorously evaluate the effectiveness of interventions.

Toward an Expanded Focus for Occupational Safety and Health: A Commentary

Powerful and ongoing changes in how people work, the workforce, and the workplace require a more holistic view of each of these. We argue that an expanded focus for occupational safety and health (OSH) is necessary to prepare for and respond rapidly to future changes in the world of work that will certainly challenge traditional OSH systems. The WHO Model for Action, various European efforts at well-being, and the Total Worker Health concept provide a foundation for addressing changes in the world of work. However, a paradigm expansion to include the recognition of worker and workforce well-being as an important outcome of OSH will be needed. It will also be vital to stimulate transdisciplinary efforts and find innovative ways to attract and train students into OSH professions as the paradigm expands. This will require active marketing of the OSH field as vibrant career choice, as a profession filled with meaningful, engaging responsibilities, and as a well-placed investment for industry and society. An expanded paradigm will result in the need for new disciplines and specialties in OSH, which may be useful in new market efforts to attract new professionals. Ultimately, to achieve worker and workforce well-being we must consider how to implement this expanded focus.

Motor vehicle towing: An analysis of injuries in a high-risk yet understudied industry

OBJECTIVES

National fatality rates for commercial tow truck operators exceed those of other first responders who also perform traffic incident management services. The objectives of the current study are to (1) characterize causal factors associated with injuries among commercial tow truck operators engaged in roadside assistance through analysis of coded and free text data obtained from U.S. Occupational Safety and Health Administration (OSHA) investigation files, and (2) utilize supplemental data sources to analyze environmental factors for injuries in which commercial tow truck operators were struck by roadway traffic.

METHODS

Searches of OSHA's online IMIS database were performed to identify investigations of incidents in which tow truck operators were injured while performing roadside assistance duties. Freedom of Information Act (FOIA) requests were submitted to obtain full investigation files for each case. Coded and narrative text analyses were performed to identify causal themes across the identified cases.

RESULTS

One-hundred and six cases of tow truck operators being killed or severely injured were identified in IMIS; 41 FOIA requests for related investigation documents were fulfilled. Two major event type themes were identified which accounted for 9 in 10 of the cases identified. These were (1) 'struck-by' incidents, which were primarily injuries resulting from contact with roadway traffic, rolling vehicles and equipment or other non-motorized objects; and (2) 'caught-in or -between' incidents, which were primarily injuries resulting from being pinned beneath and between vehicles and being caught in moving parts.

CONCLUSIONS

The towing industry should provide initial and refresher safety training on vehicle loading and unloading, defensive techniques when exposed to traffic on roadways, and proper wheel chocking and braking procedures. States should include tow trucks as a first responder vehicle type in their "Move Over" laws and implement public awareness campaigns to protect all first responders, including tow truck operators.

Plaintiff Attorney's Issues and Perspective: The Injured Worker as Claimant

Injured workers deal with many struggles while healing, forced on them by problems within the workers' compensation system itself. The physician's role is critical in mitigating complicating factors that have a negative impact on recovery. The workers' compensation system is meant as a safety net, guaranteeing prompt medical care; therefore, the applicable causation standard is lower than scientific probability. Physicians treating injured workers must remember legal, ethical, and moral obligations to patients. Injured workers should not be treated differently from patients who suffered a similar injury at home. Nonmedical factors must be analyzed in deciding whether a person is legally disabled.

Physicians' opinions about the causes of underreporting of occupational diseases

Occupational diseases cause an important burden on health and economy; however, they are substantially underestimated. We aimed to investigate the opinions of physicians about causes of underreporting of occupational diseases. We collected data with a questionnaire, listing 30 possible causes for underreporting of occupational diseases. 478 physicians participated in the study. The first 3 most frequent causes perceived as "very important" are; employers' perception of occupational safety and health services as a loss of revenue (64.9%), prevalent employment without a legal contract (64.6%), and prevalent employment as subcontracted (59.4%). 52.1% of the physicians worked or currently working as an occupational physician. With the increase of working year as an occupational physician, there was a statistically significant decrease in the strength of importance for 17 of the 30 statements. This finding may be one of the important causes of underreporting of occupational diseases.

Bloodborne Pathogens Standard Enforcement at the Occupational Safety and Health Administration: The First Twenty-Five Years

Bloodborne pathogen exposures continue to be an occupational health concern of high importance. It is uncertain whether national regulations and enforcement have an impact on employer action for reducing risk. The goal of this research was to determine whether citations issued under the Occupational Safety and Health Administration’s Bloodborne Pathogens Standard changed over time given these changing risks and controls. Researchers analyzed 31,066 inspections. There were 77,142 citations issued between 1991 and 2015. The highest frequency is the time period just after revisions of the 2001 standard. There were striking levels of noncompliance, most evident in Exposure Control Plan and Recordkeeping violations. No other pattern or change was evident. In the time periods after 2005, numbers of citations remained steady or declined. As new bloodborne pathogens emerge annually, it is essential to continue to focus on enforcing the standard to keep employers in compliance and workers protected.

Medical marijuana laws and workplace fatalities in the United States

AIMS

The aim of this research was to determine the association between legalizing medical marijuana and workplace fatalities.

DESIGN

Repeated cross-sectional data on workplace fatalities at the state-year level were analyzed using a multivariate Poisson regression.

SETTING

To date, 29 states and the District of Columbia have legalized the use of marijuana for medicinal purposes. Although there is increasing concern that legalizing medical marijuana will make workplaces more dangerous, little is known about the relationship between medical marijuana laws (MMLs) and workplace fatalities.

PARTICIPANTS

All 50 states and the District of Columbia for the period 1992-2015.

MEASUREMENTS

Workplace fatalities by state and year were obtained from the Bureau of Labor Statistics. Regression models were adjusted for state demographics, the unemployment rate, state fixed effects, and year fixed effects.

FINDINGS

Legalizing medical marijuana was associated with a 19.5% reduction in the expected number of workplace fatalities among workers aged 25-44 (incident rate ratio [IRR], 0.805; 95% CI, .662-.979). The association between legalizing medical marijuana and workplace fatalities among workers aged 16-24, although negative, was not statistically significant at conventional levels. The association between legalizing medical marijuana and workplace fatalities among workers aged 25-44 grew stronger over time. Five years after coming into effect, MMLs were associated with a 33.7% reduction in the expected number of workplace fatalities (IRR, 0.663; 95% CI, .482-.912). MMLs that listed pain as a qualifying condition or allowed collective cultivation were associated with larger reductions in fatalities among workers aged 25-44 than those that did not.

CONCLUSIONS

The results provide evidence that legalizing medical marijuana improved workplace safety for workers aged 25-44. Further investigation is required to determine whether this result is attributable to reductions in the consumption of alcohol and other substances that impair cognitive function, memory, and motor skills.

The Occupational Cost of Being Illegal in the United States: Legal Status, Job Hazards, and Compensating Differentials

Considerable research and pervasive cultural narratives suggest that undocumented immigrant workers are concentrated in the most dangerous, hazardous, and otherwise unappealing jobs in U.S. labor markets. Yet, owing largely to data limitations, little empirical work has addressed this topic. Using data from the 2004 and 2008 panels of the Survey of Income and Program Participation, we impute legal status for Mexican and Central American immigrants and link their occupations to BLS data on occupational fatalities and occupational hazard data from the Department of Labor to explore racial and legal status differentials on several specific measures of occupational risk. Results indicate that undocumented workers face heightened exposure to numerous dimensions of occupational hazard - including higher levels of physical strain, exposure to heights, and repetitive motions - but are less exposed than native workers to some of the potentially most dangerous environments. We also show that undocumented workers are rewarded less for employment in hazardous settings, receiving low or no compensating differential for working in jobs with high fatality, toxic materials, or exposure to heights. Overall, this study suggests that legal status plays an important role in determining exposure to job hazard and in structuring the wage returns to risky work.

Employer knowledge of federal requirements for recording work-related injuries and illnesses: Implications for occupational injury surveillance data

BACKGROUND

Accuracy of the Bureau of Labor Statistics Survey of Occupational Injuries and Illnesses (SOII) data is dependent on employer compliance with workplace injury and illness recordkeeping requirements. Characterization of employer recordkeeping can inform efforts to improve the data.

METHODS

We interviewed representative samples of SOII respondents from four states to identify common recordkeeping errors and to assess employer characteristics associated with limited knowledge of the recordkeeping requirements and non compliant practices.

RESULTS

Less than half of the establishments required to maintain OSHA injury and illness records reported doing so. Few establishments knew to omit cases limited to diagnostic services (22%) and to count unscheduled weekend days as missed work (27%). No single state or establishment characteristic was consistently associated with better or worse record-keeping.

CONCLUSION

Many employers possess a limited understanding of workplace injury recordkeeping requirements, potentially leading them to over-report minor incidents, and under-report missed work cases.

Work as an Inclusive Part of Population Health Inequities Research and Prevention

Despite its inclusion in models of social and ecological determinants of health, work has not been explored in most health inequity research in the United States. Leaving work out of public health inequities research creates a blind spot in our understanding of how inequities are created and impedes our progress toward health equity. We first describe why work is vital to our understanding of observed societal-level health inequities. Next, we outline challenges to incorporating work in the study of health inequities, including (1) the complexity of work as a concept; (2) work's overlap with socioeconomic position, race, ethnicity, and gender; (3) the development of a parallel line of inquiry into occupational health inequities; and (4) the dearth of precise data with which to explore the relationships between work and health status. Finally, we summarize opportunities for advancing health equity and monitoring progress that could be achieved if researchers and practitioners more robustly include work in their efforts to understand and address health inequities.

Evaluation of a state based syndromic surveillance system for the classification and capture of non-fatal occupational injuries and illnesses in New Jersey

BACKGROUND

This preliminary study evaluates a real-time syndromic surveillance system to track occupationally-related emergency room visits throughout New Jersey.

METHODS

Emergency Department (ED) chief complaint fields were evaluated from 79 of 80 hospitals in NJ in 2014, using work-related keywords and ICD-9 E-codes, to determine its ability to capture non-fatal work-related injuries. Sensitivity analysis and descriptive statistics, were used to evaluate and summarize the occupational injuries identified.

RESULTS

Overall, 11 919 (0.3%) possible work-related ED visits were identified from all ED visits. Events with the greatest number of ED visits were slips, trips, and falls (1679, 14%). Nature of injury included cuts, lacerations (1041, 9%). The part of the body most affected was the back (1414, 12%). This work-related classifier achieved a sensitivity of 5.4%, a specificity of 99.8%, and a PPV of 2.8%.

CONCLUSIONS

This evaluation demonstrated that the syndromic surveillance reporting system can yield real-time knowledge of work-related injuries.

An Approach to Assess the Burden of Work-Related Injury, Disease, and Distress

The true burden (morbidity, mortality, disability, cost, pain, distress) of occupational and work-related diseases and injuries is unknown, and what is reported as burden is significantly underestimated. This underestimation affects the way decision-makers view investments in research and worker protection, which in turn has a substantial impact on national welfare and public health. To better describe the societal and individual burdens of occupational and work-related diseases and injuries, we propose an approach to gauge what is known about burden and where new assessments may be made. This approach consists of 4 elements to consider in burden assessments: (1) utilizing multiple domains, including the individual worker, the worker's family, the community in which the workplace is located, the employer, and society as a whole; (2) taking a broader view of the work-relatedness of disease and injury; (3) assessing the impact of the entire working-life continuum; and (4) applying the comprehensive concept of "well-being" as an indicator in addressing contemporary changes in the nature of work, the workplace, and the workforce. Further research on burden and enhanced surveillance is needed to develop these elements.

Workers' compensation claims not reported in the Survey of Occupational Injuries and Illnesses: Injury and claim characteristics

BACKGROUND

Underreporting in the nation's primary source of non-fatal occupational injury and illness data are well documented, but worker-level characteristics of unreported cases have not been fully explored.

METHODS

Bureau of Labor Statistics' Survey of Occupational Injuries and Illnesses (SOII) data were linked to Washington workers' compensation claims to identify injury and claim characteristics associated with unreported cases. Workers' compensation administrative date data were used to characterize timing of disability and SOII case eligibility.

RESULTS

Based on claim date data, one in five lost time claims with an injury date in the survey year were likely ineligible for SOII case reporting during the survey year. Among SOII-eligible claims, those involving sprains or strains, employer protests, and those not eligible for work disability payments until months after the initial injury were least likely to be reported in SOII.

CONCLUSIONS

SOII case capture is limited both by its cross sectional survey design and employer underreporting. Am. J. Ind. Med. 60:264-275, 2017. © 2017 Wiley Periodicals, Inc.

Under-recording of work-related injuries and illnesses: An OSHA priority

INTRODUCTION

A 2009 Government Accounting Office (GAO) report, along with numerous published studies, documented that many workplace injuries are not recorded on employers' recordkeeping logs required by the Occupational Safety and Health Administration (OSHA) and consequently are under-reported to the Bureau of Labor Statistics (BLS), resulting in a substantial undercount of occupational injuries in the United States.

METHODS

OSHA conducted a Recordkeeping National Emphasis Program (NEP) from 2009 to 2012 to identify the extent and causes of unrecorded and incorrectly recorded occupational injuries and illnesses.

RESULTS

OSHA found recordkeeping violations in close to half of all facilities inspected. Employee interviews identified workers' fear of reprisal and employer disciplinary programs as the most important causes of under-reporting. Subsequent inspections in the poultry industry identified employer medical management policies that fostered both under-reporting and under-recording of workplace injuries and illnesses.

CONCLUSIONS

OSHA corroborated previous research findings and identified onsite medical units as a potential new cause of both under-reporting and under-recording. Research is needed to better characterize and eliminate obstacles to the compilation of accurate occupational injury and illness data.

PRACTICAL APPLICATIONS

Occupational health professionals who work with high hazard industries where low injury rates are being recorded may wish to scrutinize recordkeeping practices carefully. This work suggests that, although many high-risk establishments manage recordkeeping with integrity, the lower the reported injury rate, the greater the likelihood of under-recording and under-reporting of work-related injuries and illnesses.

Reported work-related injuries and illnesses among Hispanic workers: Results from an emergency department surveillance system follow-back survey

BACKGROUND

Research suggests Hispanic workers underreport injuries/illnesses to their employer.

METHODS

The National Electronic Injury Surveillance System-occupational supplement was used to conduct a follow-back study of workers treated in emergency departments (EDs) from June 2012 through December 2013.

RESULTS

An estimated 448,000 (95%CI 230,000-665,000) Hispanic workers treated in EDs for a work-related injury or illness were represented by 362 completed interviews. Of these, an estimated 443,000 (95%CI 228,000-657,000) workers reported the injury or illness to their employer or were self-employed. The majority had not heard of workers' compensation. Only 10% expected workers' compensation to cover their medical payment while 62% expected payment to be covered by their employer.

CONCLUSION

We characterized our respondent workforce who reported their injury or illness. We determined that NEISS-Work data are not the most appropriate source to capture underreporting of work-related injuries and illnesses to employers among Hispanic workers. Am. J. Ind. Med. 59:621-629, 2016. © 2016 Wiley Periodicals, Inc.

Using emergency department surveillance data to assess occupational injury and illness reporting by workers

OBJECTIVE

Researchers from the National Institute for Occupational Safety and Health (NIOSH) share detailed methodologies from conducting two follow-back studies initiated in 2010 that were designed to assess whether workers reported their injuries and illnesses to their employers and to identify worker incentives and disincentives for reporting work-related injuries to employers.

METHODOLOGY

Study respondents were sampled from the National Electronic Injury Surveillance System occupational supplement (NEISS-Work), an emergency department-based surveillance system. Telephone interviews were used to collect information directly from workers.

OUTCOMES

Among persons treated in emergency departments who could be identified as working at the time of injury or illness, most reported their injury or illness to their employer. Our studies did not assess if these reported injuries and illnesses were recorded on the Occupational Safety and Health logs.

DISCUSSION

Our approach suggests that emergency department-based surveillance data are limited in their utility to investigate underreporting among workers. Am. J. Ind. Med. 59:600-609, 2016. © 2016 Wiley Periodicals, Inc.

Characterizing emergency department patients who reported work-related injuries and illnesses

BACKGROUND

Per a Congressional directive and funding, this study describes worker and workplace characteristics of emergency department (ED) patients who reported their injury/illness to their employer. The study also responds to Congress's request to enumerate injured/ill self-employed workers and workers with chronic conditions.

METHODS

We conducted a follow-back study on injured/ill workers, including self-employed, identified from a national ED surveillance system from June 2012 through December 2013.

RESULTS

An estimated 3,357,000 (95%CI: 2,516,000-4,199,000) workers treated in EDs reported their injury/illness to their employer or were self-employed. Of those, 202,000 (95%CI: 133,000-272,000) had a chronic condition. Of all reporters, excluding self-employed, 77% indicated they received instructions as to whom to report.

CONCLUSION

The study did not identify underreporting issues and revealed that medical records data may not be appropriate for assessing underreporting. Additional research is needed to examine workplace characteristics that encourage injury and illness reporting. Am. J. Ind. Med. 59:610-620, 2016. © 2016 Wiley Periodicals, Inc.

Employer reasons for failing to report eligible workers' compensation claims in the BLS survey of occupational injuries and illnesses

Background

Little research has been done to identify reasons employers fail to report some injuries and illnesses in the Bureau of Labor Statistics Survey of Occupational Injuries and Illnesses (SOII).

Methods

We interviewed the 2012 Washington SOII respondents from establishments that had failed to report one or more eligible workers’ compensation claims in the SOII about their reasons for not reporting specific claims. Qualitative content analysis methods were used to identify themes and patterns in the responses.

Results

Non‐compliance with OSHA recordkeeping or SOII reporting instructions and data entry errors led to unreported claims. Some employers refused to include claims because they did not consider the injury to be work‐related, despite workers’ compensation eligibility. Participant responses brought the SOII eligibility of some claims into question.

Conclusion

Systematic and non‐systematic errors lead to SOII underreporting. Insufficient recordkeeping systems and limited knowledge of reporting requirements are barriers to accurate workplace injury records. Am. J. Ind. Med. 59:343–356, 2016. © 2016 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc.

Injury Risk and Noise Exposure in Firefighter Training Operations

INTRODUCTION

Firefighters have high rate of injuries and illnesses, as well as exposures to high levels of noise. This study explored the relationship between noise exposure and injury among firefighters.

METHODS

We recruited firefighters undergoing vehicle extrication and structural collapse emergency response training at a highly realistic training facility. Demographics, health status, body mass index (BMI), and history of serious injuries (i.e. injuries requiring first aid treatment, treatment in a medical clinic or office, or treatment at a hospital) were assessed at baseline, and daily activities, injury events, and near misses were assessed daily via surveys. Participants' noise exposures were monitored for one 24-h period using noise dosimeters. We used a mixed-effects logistic regression model to estimate the odds of injury events and near misses associated with noise exposure as an independent variable.

RESULTS

Of 56 subjects, 20 (36%) reported that they had ever suffered a serious injury during firefighting activities, and 9 (16%) reported a serious injury within the past year. We estimated rates of 6.6 lifetime serious injuries per 100 FTE 16.1 serious injuries per 100 FTE within the past year. Our models indicated a significant increase in injury events and near misses among those with higher BMI, and as well as a dose-response relationship between near misses/injuries and increasing noise levels. Noise levels >90 dBA in the 30 min prior to time of injury or near miss were associated with substantially increased odds ratios for injury or near miss. Our models further indicated that perceived job demands were significantly associated with increased risk of injury or near miss.

CONCLUSION

Our results suggest that noise exposures may need to be incorporated into injury prevention programs for firefighters to reduce injuries among this high-risk occupational group.

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.