Costs of occupational injuries and diseases in Québec

Mistrust among injured immigrant workers: A conceptual framework

BackgroundIn Quebec, injured workers have access to medical assistance, wage replacement indemnities, and rehabilitation measures, with most injuries resolved easily. However, a small percentage of cases require a lengthy rehabilitation process, which is particularly complex when involving immigrants. The therapeutic alliance is at the heart of the process, involving mutual trust and confidence and a degree of consensus about the therapeutic interventions to be used and, ultimately, the return to work.ObjectiveThis article delves into the concept of mistrust as more than the absence of trust, and sheds light on its role in the rehabilitation process of immigrant workers.MethodDrawing from a literature review on mistrust of immigrants in the healthcare setting and comprehensive studies on the rehabilitation process, a conceptual framework for understanding mistrust in this context is proposed.ResultsVulnerable situations, such as precarious employment and/or temporary immigration status, create fertile ground for mistrust. Negative experiences with healthcare professionals or systems further exacerbate mistrust, as do social stigmas within the rehabilitation system. Cross-cultural miscommunications such as differences in communication styles or beliefs about illnesses further complicate matters, emphasizing the need for culturally sensitive approaches.ConclusionAddressing mistrust requires understanding its origins and consequences, as well as providing guidelines for practitioners to enable them to recognize and manage it effectively. Further research is crucial to deepen our understanding of mistrust among immigrant workers and develop strategies for promoting trust and cooperation throughout the rehabilitation process.

How to prevent 3 million deaths worldwide: a systematic review of occupational accident research-a factor- and cost-based approach

Occupational accidents have emerged as a global concern, necessitating a comprehensive examination of their determinants and associated costs. This review aims to summarize, synthesize, and organize the factors and cost drivers of occupational accidents, exploring whether there is a gender perspective. Adhering to PRISMA guidelines, we performed a narrative synthesis to systematically review relevant literature. A systematic search was conducted in the electronic databases PubMed, Web of Science, and Scopus. Two researchers screened all records to eliminate any duplicates, and they selected the articles for full review. A third researcher was consulted to resolve discrepancies and reach a consensus. The analysis of 15 studies revealed diverse perspectives; in terms of determinants, studies on organizational aspects and the theory of human error were grouped together, while in cost drivers, the human capital model and willingness to pay were the most frequently used. Gender, meanwhile, is identified as a determinant variable for accident rate. Additionally, limitations such as data underestimation were noted in the existing literature. The review highlights the need for empirical studies capable of addressing both determinants and cost drivers. It also provides guidelines for researchers to design studies that are more comparable across different contexts, including the gender debate.

Gender and age group-wise inequality in health burden and value of premature death from COVID-19 in India

Background

Earlier studies have focused on the age-group-wise health burden of COVID-19 while few studies have focused on the gender-wise analysis of the burden of COVID-19. The present study estimated the health burden and value of premature mortality from COVID-19 based on gender and age.

Methods

This study was based on secondary data collected from several sources of the government of India. To quantify the health burden, the disability-adjusted life years (DALY) method was used. An abridged life table was used to estimate the fall in life expectancy due to COVID-19. The value of premature mortality was estimated by using the human capital approach.

Results

Among COVID-19 cases, 65.08% were males and 34.92% were females. The overall health burden caused by COVID-19 was 19,24,107 DALY in 2020, 43,40,526 DALY in 2021, and 8,08,124 DALY in 2022. The health burden per 1000 males was more than double that per 1000 females. This was due to higher rates of infection and case fatality rate among males compared to females. The age group 60-64 years experienced the highest loss of healthy life years per 1000 people, while the age group 55-59 years had the highest overall loss. Due to additional deaths from COVID-19, life expectancy decreased by 0.24 years in 2020, 0.47 years in 2021, and 0.07 years in 2022. The total value of premature death in the first three years of the COVID-19 pandemic amounted to 15,849.99 crores INR.

Conclusion

In India, males and the older population were more susceptible to the impact of COVID-19.

Analysis of the average duration of sick leave due to electrical contact in the primary, secondary and tertiary sectors in Spain (2013–2019)

The analysis of the economic impact of occupational health and safety has been side-lined for many years. Various studies have acknowledged the importance of analysing the seriousness of accidents on the basis of the number of working days lost due to injuries sustained in such accidents in different economic sectors. In this longitudinal comparative study, we analyse the average duration of sick leave associated with 4,098,520 accidents that occurred in Spain between 2013 and 2019, and more specifically with 5724 accidents involving direct and indirect electrical contact. Based on the number of lost workdays, the relationship between the seriousness of electrical accidents and the economic sectors where they occur is explored via contingency tables in which statistical Chi-square value (χ2) was calculated. The main results obtained show that the average duration of sick leave shows an upward year-on-year trend in all three economic sectors. In addition, accidents due to direct and indirect electrical contact occur in all sectors, and the injuries produced in this type of accident are more severe than those produced in the sum of all accidents in Spain. Our figures show that the longest duration of sick leave occurs in the primary sector, followed by the tertiary and the secondary sectors. These results should prompt the competent authorisites to require businesses to maintain the equipment and facilities in good order, and to introduce effective supervision programmes that guarantee compliance with the measures enforced and reduce the serious consequences of electrical accidents.

Occupational health and safety practices and associated factors among workers in Ethiopia's Metehara and Wonji sugar industries: a convergent parallel mixed design

INTRODUCTION

Information regarding workers' practices concerning safety measures in Ethiopia's sugar industries is inadequate.

OBJECTIVES

To assess occupational health and safety practices and associated factors among workers in Ethiopia's Metehara and Wonji sugar industries.

DESIGN

A convergent parallel mixed design.

SETTING

Metehara and Wonji sugar industries in Ethiopia (December 2021 through May 2022).

PARTICIPANTS

We used a stratified random sampling method to select 1648 participants for the collection of quantitative data. We employed a purposive sampling method to carry out 20 in-depth interviews in order to gather qualitative data.

PRIMARY OUTCOME MEASURES

We computed the extent of occupational health and safety practices using a 21-item questionnaire. Finally, results were graded as 'good' if ≥60% of them were answered correctly and 'poor' if <60% were correctly answered. We created a qualitative data interpretation from the subject's perspective.

RESULTS

The percentage of good occupational health and safety practices was 29.6% (95% CI: 27% to 32%). Inappropriate provision of personal protective equipment (adjusted OR (AOR)=1.42, 95% CI: 1.10 to 1.83), a lack of strict safety regulation (AOR=1.64, 95% CI: 1.27 to 2.12), a lack of incentives (AOR=1.31, 95% CI: 1.04 to 1.66) and inadequate management support (AOR=1.19, 95% CI: 1.04 to 1.66) were identified as associated factors. Health service usage defects, inappropriate protective equipment use and failure to follow occupational safety commands were identified as challenges.

CONCLUSIONS

Occupational health and safety measures were not used effectively. The qualitative component of this study confirmed that most participants expressed undesirable practices in occupational health and safety measures. Inappropriate protective device provisions, a lack of strict safety regulation, the absence of incentives and inadequate management support were found to be linked with the use of occupational health and safety measures. The contributing factors we identified potentially indicate areas for future intervention.

Cancers: What Are the Costs in Relation to Disability-Adjusted Life Years? A Systematic Review and Meta-Analysis

Cancers currently represent a leading cause of morbidity and mortality, and precisely estimating their burden is crucial for evidence-based decision-making. This study aimed at understanding the average costs of cancer-related disability-adjusted life years (DALYs) and highlighting possible differences in economic estimates obtained with diverse approaches. We searched four scientific databases to identify all the primary literature simultaneously investigating cancer-related costs and DALYs. In view of the different methodologies, studies were divided into two groups: those estimating costs starting from DALYs, and those independently performing cost and DALY analyses. The latter were pooled to compute costs per disease-related DALY: meta-analytic syntheses were performed for total costs and indirect costs, and in relation to the corresponding gross domestic product (GDP) per capita. The quality of included studies was assessed through the Quality of Health Economic Studies instrument. Seven studies were selected. Total and indirect pooled costs per DALY were, respectively, USD 9150 (95% CI: 5560-15,050) and USD 3890 (95% CI: 2570-5880). Moreover, the cost per cancer-related DALY has been found to be, on average, 32% (95% CI: 24-42%) of the corresponding countries' GDP per capita. Costs calculated a priori from DALYs may lead to results widely different from those obtained after data retrieval and model building. Further research is needed to better estimate the economic burden of cancer in terms of costs and DALYs.

Diseases-attributable disability-adjusted life years in copper and molybdenum ore workers in Mongolia: 1999-2019

Most illnesses and deaths in industry workers are associated with occupational diseases (ODs). In recent years, mining has grown rapidly into a major driver of the Mongolian economy. In this study, the organization-based registry data on OD incidence and mortality from the archival data of the 'Erdenet' Copper and Molybdenum Concentrator Plant in Mongolia were used. We estimated the ODs burden in disability-adjusted life years (DALYs) loss between 1999 and 2019. A total of 72,802 DALYs were lost over 20 years, of which 97.5% were due to years lived with disability and 2.5% for years of life lost. The disease burden was high in men, accounting for 76.8% of total DALY. In terms of age groups, among people aged 46-55, DALY accounted for the largest percentage of losses. We found that workplace dust, noise, ergonomics, and vibration were the main factors attributed to the DALYs during the past two decades.

Development of Framework for Estimating Fatality-Related Losses in the Korean Construction Industry

The number of fatalities in the construction industry is highest among all industries; thus, various losses in the form of fatalities in construction represent a significant factor for safety management. If a fatality occurs, it is important to estimate the overall loss, as a significant financial loss occurs for each project participant. However, in studies of the cost of accidents involving a fatality conducted abroad, the framework cannot be applied as it is because insurance types, systems, and legal cost systems differ by country. Therefore, we developed a framework for calculating the fatality loss considering various aspects of labor, industry, and regulations in Korea. This was done in four steps: (i) data collection and criteria selection; (ii) proposed framework development; (iii) conduct of questionnaire surveys for the case study; and (iv) analysis and evaluation of the case study. As a result of the data analysis after the case study of general construction companies, the total fatality loss was estimated to be 2,198,260 USD/person. The contributions of this study are the development of a framework composed of newly discovered items that can acquire reliable data in consideration of the properties of the construction industry.

Awareness of occupational hazards, and attitudes and practices towards the use of personal protective equipment among informal woodworkers: the case of the Sokoban Wood Village in Ghana

We investigated the awareness of occupational hazards, and attitudes and practices towards the use of personal protective equipment (PPE) among informal woodworkers of the Sokoban Wood Village in Ghana. Structured questionnaires were used to collect primary data from 355 woodworkers and analysed using descriptive statistics and logistic regression. The results showed that the workers are aware of PPE and knew about injuries they are exposed to. Most woodworkers had a positive attitude in terms of their perception on the necessity to use PPE but had a low frequency of PPE usage. Educational level, job type, length of service and marital status are the socio-demographic characteristics that significantly influence woodworkers' compliance with health and safety regulations. We recommend that institutions charged with enforcement of occupational health and safety regulations should extend their monitoring roles to informal workers and liaise with local companies to supply PPE to informal woodworkers at subsidized costs.

Epidemiology of occupational injuries among insured workers in Saudi Arabia between 2004 and 2016

This is a retrospective analysis of annual reports on occupational injuries issued by the national social insurance agency of the Kingdom of Saudi Arabia (KSA) for the years 2004 through 2016. For each criterion we calculated an index based on the equation N_Y/N_ref x100, where N_Y is the number of occupational injuries by a specific criterion in a specific year Y, and N_ref is the number of injuries in the corresponding criterion in the reference year, i.e. 2004. We also calculated the number of injuries to number of workers ratio (N_i/N_w) for different occupations and economic sectors to get a clearer idea of the injury trends per worker. In terms of occupational injury rates (with respect to 2004), we observed increases in construction, financing & real estate (economic sectors), among engineers and technicians (occupations), in infections and secondary contusions (injury type), for upper and lower limbs (affected body parts), over falls and “other” causes. Most injuries occurred on Fridays, which is a weekend day in Saudi Arabia. We also observed increased recovery without disability (injury status). However, if we look at the number of occupational injuries per worker, we can see a decreasing trend over time for all occupations and economic sectors, most likely thanks to improved labour law and safety at work practices for insured workers. Our findings are similar to reports from other Persian Gulf countries and reflect current labour health and safety issues in the area.

Man Down Situation Detection Using an in-Ear Inertial Platform

Man down situations (MDS) are a health or life threatening situations occurring largely in high-risk industrial workplaces. MDS automatic detection is crucial for workers safety especially in isolated working conditions where workers could be unable to call for help on their own, either due to loss of consciousness or an incapacitating injury. These solution must be reliable, robust, easy to use, but also have a low false-alarm rate, short response time and good ergonomics. This project aims to improve this technology by providing a global MDS definition according to a combination of three observable critical states based on characterization of body movement and orientation data from inertial measurements (accelerometer and gyroscope): the worker falls (F), worker immobility (I), the worker is down on the ground (D). The MDS detection strategy was established based on the detection of at least two distinct states, such as F-I, F-D or I-D, over a certain period of time. This strategy was tested using a large public database, revealing a significant reduction of the false alarms rate to 1.1%, reaching up to 99% accuracy. The proposed detection strategy was also incorporated into a digital earpiece, designed to address hearing protection issues, and validated according to an in vivo test procedure based on simulations of industrial workers normal activities and critical states.

Findings and views on occupational safety and health teaching at universities

BACKGROUND

Young employees have often poorer occupational safety and health (OSH) skills and knowledge than older employees. Efforts should be made at different educational levels to strengthen young employees' OSH skills and knowledge.

OBJECTIVE

To analyze OSH perceptions and attitudes among university students and to examine OSH professionals' views on OSH teaching.

METHODS

This explorative study employs an iterative multi-method approach, including a paired comparison questionnaire for university students (N = 104) and OSH professionals (N = 40), an OSH questionnaire for university students (N = 130) and a Delphi survey for OSH professionals (N = 26).

RESULTS

OSH perceptions and attitudes were found to vary widely among the students and some expressed somewhat stereotypical views about OSH. The results confirm the need to improve OSH education. To that end, the study reports concrete practical ideas from OSH professionals.

CONCLUSIONS

The findings confirm the need to augment both the quality and quantity of OSH teaching at university level. Ideas are presented for future OSH teaching, along with recommendations for future studies.

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.

Costs of productivity loss due to occupational cancer in Canada: estimation using claims data from Workers' Compensation Boards

INTRODUCTION

Cancer is a leading cause of illness globally, yet our understanding of the financial implications of cancer caused by working conditions and environments is limited. The goal of this study is to estimate the costs of productivity losses due to occupational cancer in Canada, and to evaluate the factors associated with these costs.

METHODS

Two sources of data are used: (i) Individual level administrative claims data from the Workers Compensation Board of Nova Scotia; and (ii) provincial aggregated cancer claims statistics from the Association of Workers Compensation Boards of Canada. Benefits paid to claimants are based on actuarial estimates of wage-loss, but do not include medical costs that are covered by the Canadian publicly funded healthcare system. Regional claims level data are used to estimate the total and average (per claim) cost of occupational cancer to the insurance system, and to assess which characteristics of the claim/claimant influence costs. Cost estimates from one region are weighted using regional multipliers to adjust for system differences between regions, and extrapolated to estimate national costs of occupational cancer.

RESULTS/DISCUSSION

We estimate that the total cost of occupational cancer to the Workers' Compensation system in Canada between 1996 and 2013 was $1.2 billion. The average annual cost was $68 million. The cancer being identified as asbestos related were significantly positively associated with costs, whereas the age of the claimant was significantly negatively associated with costs. The industry type/region, injury type or part of body affected by cancer were not significant cost determinants.

CONCLUSION

Given the severity of the cancer burden, it is important to understand the financial implications of the disease on workers. Our study shows that productivity losses associated with cancer in the workplace are not negligible, particularly for workers exposed to asbestos.

The economic burden of lung cancer and mesothelioma due to occupational and para-occupational asbestos exposure

OBJECTIVES

To estimate the economic burden of lung cancer and mesothelioma due to occupational and para-occupational asbestos exposure in Canada.

METHODS

We estimate the lifetime cost of newly diagnosed lung cancer and mesothelioma cases associated with occupational and para-occupational asbestos exposure for calendar year 2011 based on the societal perspective. The key cost components considered are healthcare costs, productivity and output costs, and quality of life costs.

RESULTS

There were 427 cases of newly diagnosed mesothelioma cases and 1904 lung cancer cases attributable to asbestos exposure in 2011 for a total of 2331 cases. Our estimate of the economic burden is $C831 million in direct and indirect costs for newly identified cases of mesothelioma and lung cancer and $C1.5 billion in quality of life costs based on a value of $C100 000 per quality-adjusted life year. This amounts to $C356 429 and $C652 369 per case, respectively.

CONCLUSIONS

The economic burden of lung cancer and mesothelioma associated with occupational and para-occupational asbestos exposure is substantial. The estimate identified is for 2331 newly diagnosed, occupational and para-occupational exposure cases in 2011, so it is only a portion of the burden of existing cases in that year. Our findings provide important information for policy decision makers for priority setting, in particular the merits of banning the mining of asbestos and use of products containing asbestos in countries where they are still allowed and also the merits of asbestos removal in older buildings with asbestos insulation.

Costs of occupational injuries and illnesses in Croatia

Apart from influencing the quality of life, occupational injuries and illnesses can pose a large economic burden to a society. There are many studies that estimate the costs of occupational injuries and illnesses in highly developed economies, but the evidence for other countries is scarce. This study aimed to estimate the financial costs of occupational injuries and illnesses to Croatian government and employers in 2015. Workers were excluded due to the lack of data. Costs were estimated by analysing available data sources on occupational health and safety. Financial costs were grouped in several categories: medical costs, productivity losses, disability pensions, compensation for physical impairment, administrative costs, and legal costs. Unlike in other studies, the costs of compliance with occupational safety and health regulations were also investigated. In 2015, financial costs to employers were twice higher than costs to the government (HRK 604.6 m vs HRK 297 m). Employers additionally covered around HRK 300 m of compliance costs. Taking into account that financial costs of occupational injuries and illnesses are significant, even without including the costs to workers, policy makers should put additional efforts into their prevention. A prerequisite is transparency in Croatian Health Insurance Fund's expenditures, as well as more detailed data on lost days from work by industries, causes of injury etc. Organisations in charge of occupational health and safety and policy makers should observe relevant statistics in monetary terms too.

Leading and lagging indicators of occupational health and safety: The moderating role of safety leadership

In response to the call for empirical evidence of a connection between leading and lagging indicators of occupational health and safety (OHS), the first aim of the current research is to consider the association between leading and lagging indicators of OHS. Our second aim is to investigate the moderating effect of safety leadership on the association between leading and lagging indicators. Data were collected from 3578 employees nested within 66 workplaces. Multi-level modelling was used to test the two hypotheses. The results confirm an association between leading and lagging indicators of OHS as well as the moderating impact of middle management safety leadership on the direct association. The association between leading and lagging indicators provides OHS practitioners with useful information to substantiate efforts within organisations to move away from a traditional focus on lagging indicators towards a preventative focus on leading indicators. The research also highlights the important role played by middle managers and the value of OHS leadership development and investment at the middle management level.

Healthcare costs and productivity costs of hand and wrist injuries by external cause: A population-based study in working-age adults in the period 2008-2012

BACKGROUND

Hand and wrist injuries are very common at the Emergency Departments (ED), and among the most costly injury types in the working population. The purpose of this study was to explore the causes of non-trivial hand and wrist injuries (i.e., hand fractures, wrist fractures and complex soft-tissue injuries) in working-age adults in order to identify target areas for prevention.

METHODS

Data were extracted from the Dutch Injury Surveillance System, from the National Hospital Discharge Registry and from a patient follow-up survey in working-age adults (aged 20-64 years) in the period 2008-2012. An incidence-based cost model was used to estimate healthcare costs, and an absenteeism model for estimating the productivity costs. Total costs were calculated by external cause, subdivided in their main categories (home, sports, work, traffic and violence) and their most important subclasses.

RESULTS

Total costs of these injuries in The Netherlands were US $410 million per year, of which 75% (US $307 million) productivity costs. Males represented 66% (US $271 million) of the total costs. Within the male group, the group 35-49 years had the highest contribution to total costs (US $112 million), as well as the highest costs per case (US $10,675). Work-related injuries showed the highest costs per case (US $11,797), however, only 25% of the total costs were work-related. The top five causes in terms of total costs were: accidents at home (falls 23%, contact with an object 17%), traffic (cycling 9%) and work (industrial work 4%, and construction work 4%).

CONCLUSION

Hand and wrist injuries are a major cause of healthcare and productivity costs in working-age adults. To reduce the costs to society, prevention initiatives should be targeted at major contributing causes, that are mainly related to activities at home (falls, contact with an object) and accidents at the road (cycling).