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Data on many work-related illnesses and injuries are being missed because health care providers are failing to get good occupational histories, according to a director at NIOSH.
“In the occupational safety and health field, for decades we have been making this recommendation: that physicians routinely ask questions on occupational history,” says Paul A. Schulte, PhD, director of the NIOSH education and information division in Cincinnati. “Now, we’re not capturing all the occupational diseases and injuries that occur.”
Schulte says that in his review of past research and data on occupational illnesses and injuries, which appears in the June 2005 Journal of Occupational and Environmental Medicine, the publication of the American College of Occupational and Environmental Medicine, he found that while occupational injuries account for thousands of deaths and millions of disabling injuries every year in the United States, their full health, economic, and social impact remains underappreciated.
He says an integrated approach to assessing the rates and impact of occupational injury would lead to a more accurate picture of the true cost — in lives, health, and dollars — of workplace disease and injury. “At the bottom of the pyramid, we have the need to continue to encourage physicians to take an occupational history, to get that additional information,” he says.
Integrating data-monitoring and analysis systems would allow researchers to understand the full magnitude of occupational injury and disease and to guide decisions regarding prevention and intervention programs, says Schulte. Recent estimates suggest that 55,000 Americans die of occupational causes each year. If occupational injuries and diseases were classified as a separate cause of death, they would be the eighth-leading cause of death in the United States, falling between diabetes and motor vehicle accidents.
Occupational injury and illness also accounts for a high rate of disabling occupational injuries — 3.8 million per year in the United States. Worldwide, occupational factors may account for 800,000 deaths and 100 million injuries, Schulte reports. The economic burden of occupational injuries and diseases is great as well. The most comprehensive available data suggest direct and indirect costs of $155.5 billion per year in the United States alone; based on less complete data, annual direct costs for medical care are estimated at $14.5 billion, he reports.
As high as those figures are, Schulte says, they likely underestimate the true burden of occupational illnesses and injuries, especially once the hidden social costs — impact on labor relations, family and community life, and mental health, etc. — are considered. Another major challenge is that many occupational diseases have several contributing factors and long latency periods, sometimes with many years between a toxic exposure and the first signs of illness.
As a result, Schulte says, some deaths, especially ones resulting from multiple etiologies such as cardiovascular diseases and psychological disease, are likely never tied back to an occupational exposure, illness, or injury. “We’re still not getting complete reporting or a true picture of occupational injuries and illness being a risk factor,” he says. “There are some other issues that don’t seem to be captured in OSHA statistics, such as transportation injuries and deaths, so they’re often underestimated.”
Lacking a comprehensive monitoring system, researchers rely on piecemeal data sets to estimate the true rates and costs of work-related illness and injury.
In addition to giving occupational health and safety professionals insight into prevention of workplace injuries and illnesses, better data gathering is essential for guiding policy decisions regarding the effectiveness, feasibility, and impact of occupational safety and health interventions, Schulte continues.
For more information, contact:
- Paul Schulte, PhD, Director, Education and Information Division, Robert A. Taft Lab, National Institute for Occupational Safety and Health, 4676 Columbia Parkway, Cincinnati, OH 45226. E-mail: [email protected].
Data on many work-related illnesses and injuries are being missed because health care providers are failing to get good occupational histories, according to a director at NIOSH.
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