Occupational disease surveillance data sources, 1985

Acute joint pain in the emerging green collar workforce: Evidence from the linked National Health Interview Survey and Occupational Information Network (O*NET)

BACKGROUND

Green jobs are a rapidly emerging category of very heterogeneous occupations that typically involve engagement with new technologies and changing job demands predisposing them to physical stressors that may contribute to the development of joint pain.

METHODS

We estimated and compared the prevalence of self-reported acute (past 30 days) joint pain between green and non-green collar workers using pooled 2004-2012 National Health Interview Survey (NHIS) data linked to the Occupational Information Network Database (O*NET).

RESULTS

Green collar workers have a higher prevalence of acute joint pain as compared to non-green collar workers. Green collar workers with pain in the upper extremity joints were significantly greater than in the non-green collar workforce, for example, right shoulder [23.2% vs 21.1%], right elbow [13.7% vs 12.0%], left shoulder [20.1% vs 18.2%], and left elbow [12.0% vs 10.7%].

CONCLUSIONS

Acute joint pain reported by the emerging green collar workforce can assist in identifying at risk worker subgroups for musculoskeletal pain interventions.

Validity of parental work information on the birth certificate

Background

In the most recent revision (2003) of the U.S. standard certificate of live births, the National Center for Health Statistics recommended that all states collect maternal and paternal usual occupation. Because such information might be useful in the surveillance of job-related risk areas, we assessed the quality of parental work information on the U.S. birth certificate.

Methods

Occupational histories obtained from maternal interviews with Texas (USA) participants in the National Birth Defects Prevention Study were linked to and compared with parental work information on birth certificates. With occupational information from interviews serving as the gold standard, we assessed the quality of occupational information on the birth certificate with measures of sensitivity, specificity, and the kappa statistic.

Results

Of the 649 births available for study, parental occupation agreed between the birth certificate and interview for 77% of mothers and 63% of fathers with similar agreement by case-control status. Among occupations and industries with 10 or more workers by interview, sensitivity of the birth certificate information ranged from 35% to 100% for occupational groups and 55% to 100% for industrial sectors. Specificities of occupations/industries studied ranged from 93 to 100%. Kappa statistics for maternal occupations (0.76 to 0.90) and industries (0.59 to 0.94) were higher than those for paternal occupations (0.48 to 0.92) and industries (0.47 to 0.89). Mothers were frequently misclassified as homemakers or otherwise unemployed while the paternal information was often missing altogether on the birth certificate. Women who worked as health diagnosing and treating practitioners were the least likely (0%) and women in food preparation or serving occupations were the most likely (65%) to be misclassified as not employed on the birth certificate. Among fathers, the proportion of missing occupations was the lowest for occupations in business or financial operations (0%) and highest for occupations in food preparation and serving (30%).

Conclusion

Sensitivity of occupation/industry information on birth certificates varies although the specificity of such information may exceed 95%. Quality of this information also varies by maternal and paternal occupation with misclassification as homemaker a limiting factor among maternal and missing information a limiting factor among paternal work information.

Development of a surveillance program for occupational pesticide poisoning: lessons learned and future directions

The authors describe the growth from 1987 through 1996 of the Occupational Pesticide Poisoning Surveillance Program at the Texas Department of Health. The program was initially based on a Sentinel Event Notification System for Occupational Risks (SENSOR) model, using sentinel providers to report cases, supplementing the passive reporting by physicians that was required by law. The model was evaluated after five years, and significant changes were implemented to improve case ascertainment. Current active surveillance methods emphasize collaboration with a number of agencies and organizations for identification of cases and follow-up. The number of confirmed occupational cases increased from 9 workers in 1987 to 99 workers in 1996. The evolution from a passive system to an active surveillance program expanded the number of reported cases and strengthened inter-agency collaborations.

Can we monitor socioeconomic inequalities in health? A survey of U.S. health departments' data collection and reporting practices

OBJECTIVE

To evaluate the potential for and obstacles to routine monitoring of socioeconomic inequalities in health using U.S. vital statistics and disease registry data, the authors surveyed current data collection and reporting practices for specific socioeconomic variables.

METHODS

In 1996 the authors mailed a self-administered survey to all of the 55 health department vital statistics offices reporting data to the National Center for Health Statistics (NCHS) to determine what kinds of socioeconomic data they collected on birth and death certificates and in cancer, AIDS, and tuberculosis (TB) registries and what kinds of socioeconomic data were routinely reported in health department publications.

RESULTS

Health departments routinely obtained data on occupation on death certificates and in most cancer registries. They collected data on educational level for both birth and death certificates. None of the databases collected information on income, and few obtained data on employment status, health insurance carrier, or receipt of public assistance. When socioeconomic data were collected, they were usually not included in published reports (except for mothers educational level in birth certificate data). Obstacles cited to collecting and reporting socioeconomic data included lack of resources and concerns about the confidentiality and accuracy of data. All databases, however, included residential addresses, suggesting records could be geocoded and linked to Census-based socioeconomic data.

CONCLUSIONS

U.S. state and Federal vital statistics and disease registries should routinely collect and publish socioeconomic data to improve efforts to monitor trends in and reduce social inequalities in health.

[Mortality registries as a source for detecting health disorders probably of occupational etiology]

Study aim was to assess Andalucian death certificate records to find potential occupational disease problems. Methodology proposed by Rutstein (1983) has been adapted. We had checked Seville City Council Mortality Registry (1987-89) and Andalucian Mortality Registry (1975-85). In the former 8.1% of diagnoses and in the latter 8.6% of diagnoses have one included in the Sentinel Health Event (occupational) List. Accurate occupation data in the Seville City Council Mortality provides appropRiate information about occupational diseases. Limitations of the occupational data in the Andalucian Mortality Registries make it impossible to find the majority of potential occupational diseases, and occupation data were even worse during the second period of study (1980-85).

Cumulative trauma disorders of the hand and wrist in the auto industry

Surveillance for cumulative trauma disorders (CTDs) of the hand and wrist was carried out in five US automotive plants from 1985 to 1986, using Occupational Safety and Health Administration (OSHA) Form 200 injury and illness logs and medical insurance claims. Results using both record sources indicated that hand and wrist disorders may be more common in foundries than in other types of automotive plants. Similarly, in assembly plants, employees in certain departments appeared to be at higher risk for CTDs. Although our results are based on small numbers of cases, they suggest plants and departments that might be targeted for more detailed investigation.

The relationship between work-related and non-work-related injuries

A case-control study of occupational injuries sustained by 914 male hourly workers employed in two Tenneco manufacturing divisions in 1987 was undertaken to examine the association between occupational and non-occupational injuries. Its aim was to evaluate whether employees who experienced a work-related injury were more likely to have sustained a previous non-work-related injury compared to individuals who did not experience a work-related injury. A statistically significant association between occupational injuries and past non-occupational injuries was seen when all workers compensation (WC) claims were analyzed (OR = 1.41) and when claims involving indemnity for lost time were analyzed (OR = 1.82). In addition, both workers who had occupational low-back injuries and workers who had occupational non-low-back injuries also had significantly higher risks of such injuries from a non-occupational origin (OR = 1.91 for low-back injuries and OR = 1.44 for non-low-back injuries). The findings suggest that elements other than workplace hazards (such as life-style and physical and psychological factors) may predispose an individual to both occupational and non-occupational injuries.

An analysis of occupational blood lead trends in Manitoba, 1979 through 1987

BACKGROUND

While regulations for workplace lead exposure become more strict, their effectiveness in decreasing blood lead concentrations and the method by which this is attained have not been evaluated.

METHODS

An analysis was conducted of 10,190 blood lead samples from employees of 10 high-risk workplaces collected in Manitoba, 1979-87, as part of regulated occupational surveillance.

RESULTS

A significant decrease in blood lead concentrations was observed overall as well as for each individual company. A 1979 government regulation to reduce blood lead to below 3.38 mumol/L (70 micrograms/dl) was followed by a drop in blood lead concentrations; a 1983 order to reduce blood leads to below 2.90 mumol/L (60 micrograms/dl) was not followed by such a drop. Longitudinal analysis by individual workers suggested that companies were complying by use of administrative control, i.e., removing workers to lower lead areas until blood lead levels had fallen, then returning them to high lead areas.

CONCLUSION

Focusing upon blood lead as the sole criterion for compliance is not effective; regulations must specifically require environmental monitoring and controls. Biological surveillance serves as "back-up" to environmental surveillance and this database illustrates the usefulness of a comprehensive centralized surveillance system.

Occupational sentinel health events: an up-dated list for physician recognition and public health surveillance

An occupational sentinel health event (SHE[O]) is a disease, disability, or untimely death, which is occupationally related and whose occurrence may: 1) provide the impetus for epidemiologic or industrial hygiene studies; or 2) serve as a warning signal that materials substitution, engineering control, personal protection, or medical care may be required. Following survey of scientific literature, a list of 50 disease conditions linked to the workplace was presented in 1983; these were codable within the framework of the International Classification of Diseases system (ICD-9). Three criteria were used for inclusion: documentation of associated agent(s), of involved industries, and of involved occupations. The up-dated list contains 64 diseases or conditions and a bibliography of literature citations. The list is useful for the practicing physician in occupational disease recognition, for occupational morbidity and mortality surveillance, and as a periodically up-dated database of occupationally related diseases.

A computer program for analyses of vital statistics-based occupational mortality data

Routinely collected vital statistics mortality data (death certificate data) on occupation and industry are useful for (1) generating hypotheses about potential occupational hazards and (2) identifying occupational mortality differentials possibly associated with socioeconomic and life-style factors. This paper presents a Fortran program that analyzes occupational mortality using vital statistics and census data. The user can form any desired grouping of age, race, occupation (or industry), and cause of death codes for analysis. The program also allows stratification on social class or other user-defined correlates of occupation such as smoking behavior. Furthermore, program output can be used for Poisson regression analysis of mortality rates.

Health and socioeconomic consequences of occupational respiratory allergies: a pilot study using workers' compensation data

Growing evidence suggests that individuals with occupational allergies have long-term health and employment problems. Workers' compensation claims for allergic respiratory disease allowed in Ontario 1975-1981 were reviewed for demographic, risk factor, and exposure data. Diagnoses listed in these 244 claims were reassessed for consistency with criteria for occupational respiratory allergies. Twenty-eight percent of the 154 claimants who met the criteria were granted a permanent disability award from the workers' compensation board (WCB). In response to a questionnaire mailed 2-8 years after claim allowance, 77% of those traced reported improvement, but 59% still required medication and 85% still suffered symptoms. Seventy-six percent of claimants left their employer. Seventy-five percent of those who left did so due to their allergic condition; 95% suffered long-term income loss. The unemployment rate for this cohort was 36%, well above that for the general population. Older workers with longer duration of symptoms and longer duration of exposure prior to the claim had the worst prognoses. The data were consistent with previous studies in suggesting that occupational respiratory allergies may result in serious health and socioeconomic consequences. Exploring the feasibility, acceptability, and potential usefulness of WCB data, it is suggested that this source merits further consideration both for descriptive as well as prognostic studies.

Occupational disease surveillance data sources, 1985

Health department epidemiologists in 50 states, New York City, and the District of Columbia were surveyed in 1985 about seven potential data sources for occupational disease surveillance. Reported sources of occupational disease data were: automated workers' compensation claims (63 per cent of the 52 respondents); provider reports (62 per cent); death certificates with occupation or industry (60 per cent); cancer registries with occupational histories (35 per cent); birth certificates with parent's occupation (27 per cent); non-cancer disease registries (13 per cent); and hospital or insurance records (8 per cent).