Disabling and fatal occupational claim rates, risks, and costs in the Oregon construction industry 1990-1997

This study estimated injury and illness rates, risk factors, and costs associated with construction work in Oregon from 1990-1997 using all accepted workers' compensation claims by Oregon construction employees (N = 20,680). Claim rates and risk estimates were estimated using a baseline calculated from Current Population Survey data of the Oregon workforce. The average annual rate of lost-time claims was 3.5 per 100 workers. More than 50% of claims were by workers under 35 years and with less than 1 year of tenure. The majority of claimants (96.1%) were male. There were 52 total fatalities reported over the period examined, representing an average annual death rate of 8.5 per 100,000 construction workers. Average claim cost was $10,084 and mean indemnity time was 57.3 days. Structural metal workers had the highest average days of indemnity of all workers (72. 1), highest average costs per claim ($16,472), and highest odds ratio of injury of all occupations examined. Sprains were the most frequently reported injury type, constituting 46.4% of all claims. The greatest accident risk occurred during the third hour of work. Training interventions should be extensively utilized for inexperienced workers, and prework exercises could potentially reduce injury frequency and severity.     

Natural rubber latex allergy workers' compensation claims: Washington State healthcare workers, 1991-1999

Occupational reaction to natural rubber latex experienced by healthcare employees was examined using data of all workers' compensation claims filed by state-insured healthcare employees in Washington State for the period 1991-1999 (n = 65,703). As latex reaction is not a condition for which there are specific identification codes, these claims were estimated by coupling source and nature of injury records that were consistent with reactions to latex. It was found that the claim rate was on average 2.66 per 10,000 state-insured healthcare workers annually. The most common condition experienced was dermal (84.3%), and most common body part affected was the hand (70.0%). Because few claims cited respiratory or conjunctivitis as reaction experienced, little evidence was discovered to support that glove powder acted as a widespread latex allergen transmitter in healthcare environments. Most cases did not require indemnity payment for lost work time (81.2%), suggesting most reactions were minor. The average cost per natural rubber latex claim was $2,759.10, compared to $3,178.18 for the average healthcare worker claim for all causes. Overall, the average cost per state-insured healthcare worker employed during this time was under $0.74 per year. Nursing aides/orderlies were the most frequent healthcare occupation filing a claim (33.2%). The majority of claimants were female (87.9%), and unmarried workers (52.0%) filed slightly more claims than married workers (48.0%). In comparison with other workers' compensation claims filed by healthcare workers during this period, 0.34 percent of the total was potentially related to natural rubber latex, with other common healthcare workplace items cited more frequently as source of occupational injury.     

A preliminary investigation of the effects of a provider network on costs and lost-time in workers' compensation

OBJECTIVE: We sought to compare lost-time days and average and median workers' compensation claims costs between injured workers managed by OMNET Gold (OG) physicians and those managed by physicians not participating in OG. OG is a statewide health care provider network coordinated by occupational medicine physicians and established by the Louisiana Workers' Compensation Corporation (LWCC) to manage the medical care of injured workers. METHODS: We identified and contrasted 158 lost-time claims managed by OG physicians and 1,323 claims managed by physicians not participating in OG during the first year of network operation (August 1, 2003 to July 31, 2004). RESULTS: The average and median costs for a non-OG claim was $12,542 and $5,793, whereas the average and median costs for an OG claim was $6,749 and $3,015. The average and median number of lost-time days for an OG claim was 53.4 and 34.0 and 95.0 and 58.0 for a non-OG claim. The mean differences were statistically significant. CONCLUSIONS: A small network of physicians may have an effect on the duration of lost-time and workers' compensation costs.     

Workers' compensation claims from latex glove use: a longitudinal analysis of Minnesota data from 1988 to 1997

Allergic reaction experienced by health care workers from latex glove use has increasingly become the focus of researchers evaluating occupational sources of injury in health care settings. Many studies have attempted to estimate the prevalence of latex sensitization among health care workers by using various methods, but the findings have been inconsistent and do not predict reactivity. This study used workers' compensation data from Minnesota from 1988 to 1997 to assess allergic reactivity rates, injury severity, and costs associated with latex allergic reactions. The average reactivity rate was 7.1 claims per 100,000 health care workers, and total cost associated with the claims averaged $0.295 per health care employee. Using empirical cost data from another study, it was found that it is not cost-beneficial for health care institutions to globally adopt latex glove-free policies solely on the basis of workers' compensation costs.     

Occupational heat illness in Washington State, 1995-2005

BACKGROUND: Little information exists describing the incidence of heat-related illness (HRI) among non-military working populations. An analysis of HRI cases utilizing workers' compensation data has not been previously reported. METHODS: We used both ICD-9 and ANSI Z16.2 codes with subsequent medical record review to identify accepted Washington State Fund workers' compensation claims for HRI over the 11-year time period from 1995-2005. RESULTS: There were 480 Washington workers' compensation claims for HRI during the 11-year study period. NAICS industries with the highest workers' compensation HRI average annual claims incidence rate were Fire Protection 80.8/100,000 FTE, Roofing Construction 59.0/100,000 FTE, and Highway, Bridge and Street Construction 44.8/100,000 FTE. HRI claims were associated with high outdoor ambient temperatures. Medical risk factors for HRI were present in some cases. CONCLUSIONS: HRI cases occur in employed populations. HRI rates vary by industry and are comparable to those previously published for the mining industry.     

Surveillance and assessment of workplace assault injuries: analysis of Rhode Island workers' compensation claims 1998-2002

OBJECTIVE: To analyze workplace assault by rate, injury severity, and trends using Rhode Island workers' compensation claim data. METHOD: A total of 6402 workers' compensation assault claims from Rhode Island for the period of 1998 through 2002 was analyzed. Data from the U.S. Department of Labor was used to derive estimates of injury rates. RESULTS: An average rate of 27.7 assaults per 10,000 workers was found and varied only marginally across years. Females filed 75% of all assault claims, though injuries to males resulted in longer periods of indemnification. The total cost of workplace assaults was 7,025,997 dollars, averaging 1097 dollars per claim, and average indemnification duration was 16.8 days per claim. While the assault rate was relatively stable, a notable decline in both cost and indemnification periods over time was discovered. CONCLUSION: The assault rate found was among the highest reported to date, demonstrating that workplace violence remains a significant threat to employee safety. While a decline in incident severity was discovered over time, many outcomes were still serious. Preventive interventions to reduce incidents of workplace assaults among groups at the highest risk should be given highest priority.     

Work-related burns in Washington State, 1994 to 1998

This article describes an investigation of work-related burns in Washington State during 1994-1998. Workers' compensation data were used to describe the general characteristics of burn injuries, estimate industrial claims rates, and compare nonhospitalized and hospitalized burn cases. The completeness of workers' compensation data as a source for surveillance was evaluated. During 1994-1998, a total of 20,213 burn claims were accepted by the workers' compensation system. Hospitalized burn cases represented only 1.5% of burn claims but incurred 55% of the costs. In addition, workers' compensation data underestimated the frequency and rate of burns. Although workers' compensation claims rates decreased during 1994-1998, work-related burns remain a problem in Washington State. Several industries (e.g., roofing, foundries, and aluminum smelting) were identified as priorities for prevention of burn hospitalizations, which incur the greater cost and time loss.     

Assessment of occupational eye injury risk and severity: an analysis of Rhode Island workers' compensation data 1998-2002

BACKGROUND: Occupational eye injuries have been recognized as a serious health risk to workers and are in need of further investigation to develop effective interventions. METHODS: Rhode Island workers' compensation claims of ocular injury between 1998 through 2002 (n=8,877) were examined. The Current Population Survey was used to estimate occupational employment levels as a baseline for rate calculations. RESULTS: The estimated ocular injury claim rate was 32.9 per 10,000 workers (95% CI=32.3-33.6), with the cost of claims totaling $1,514,666 and averaging $171 per claim. The highest estimated claim rate of all occupations was found for construction laborers of 373.7 per 10,000 workers (95% CI=267.1-480.3). Relative to the durable manufacturing industry, the highest risk of injury resulting in disability indemnification was the wholesale trade industry (OR=2.18, 95% CI=1.19-4.01, P<0.05). CONCLUSIONS: Many of the eye injuries reported were likely preventable. Greater diligence, training, and safety precautions are needed to reduce the risk of eye injury to employees.     

The effects of removing a statutory barrier to workers' compensation for farm workers.

In 1983 the Washington State Supreme Court ruled unconstitutional a unique exemption that excluded farm workers from workers' compensation if they had not earned $150 in continuous work with the same employer. In order to examine the effect of removing this restriction, workers' compensation data were analyzed to examine the number of farm workers covered, the number of claims submitted, and claim acceptance rates before and after the ruling. Although the 1983 ruling appears to have had a significant impact on the treatment of claims, no increase in utilization of the workers' compensation system was observed. Further intervention is required if the objective of treating farm workers equitably is to be realized.     

Epidemiology of compensable work-related ocular injuries and illnesses: incidence and risk factors

Incidence rates of work-related compensable ocular injuries/illnesses and associated risk factors were estimated by using a state-managed workers' compensation database. The annual incidence rate was estimated to be 537 per 100,000 employees. The majority of the ocular injuries and illnesses resulted from foreign bodies in the external eye (incidence rate 194 per 100,000 employees). Incidence rates for superficial eye injury, atopic conjunctivitis, burn, keratitis, chronic conjunctivitis, and contusion were 168.3, 30.9, 28.0, 23.4, 17.9, and 15.3 per 100,000 employees, respectively. The highest incidence rate was observed in the agricultural sector, with male employees having higher rates than female employees. Cooks, housekeepers, and food service workers had higher risk of atopic conjunctivitis (relative risk, 3.2 to 7.3) compared with other workers. The majority of the atopic conjunctivitis illnesses and burn injuries were associated with chemical exposures. Reduction of exposures and targeted intervention among high-risk workers should reduce the incidence of work-related ocular injuries and illnesses.     

Workplace violence in Oregon: an analysis using workers' compensation claims from 1990-1997

One of the most serious occupational problems in the workplace is the occurrence of violent assaults. This study examined 2028 workers' compensation claims of workplace violence from Oregon between 1990 and 1997, and used Current Population Survey data for risk analysis. The rate of workplace violence was 1.86 per 10,000 employees annually (95% confidence interval, 1.78-1.94), with females and workers under 35 years of age experiencing the most violence. The average claim resulted in approximately 40 days of indemnity and $6200 in costs. Workers on evening and night shifts had significantly higher rates of being victims of violence, as did those working on weekends. Preventative interventions should be targeted at younger workers and those with less tenure. Special measures should be focused on ensuring the safety of evening/night-shift workers and weekend employees.     

Work-related upper limb amputations in Taiwan, 1999-2001

BACKGROUND: Work-related upper limb amputations account for a significant number of occupational injuries. This study analyzes the nationwide incidence of work-related amputations of upper limbs in Taiwan by using the workers' compensation database. METHODS: A total of 2,950 cases were retrieved and analyzed from the database of workers' compensatory disability claims between the years 1999 and 2001. RESULTS: The cases were workers with an average age of 39.1 years, of whom 23.0% were female, the highest percentage of cases was in the 30-49 age group, but the incidence based on insured population was the highest for those under 20 years old. About 96% of the cases involved finger amputation, and 85% of all amputations were related to common powered machines. The average annual incidence of disability claims due to occupational amputation of upper extremities was 12.5 per 100,000 workers. Claims were most prevalent among manufacturing workers and male workers. The male to female risk ratios ranged from 2.62 for manufacturing workers to 9.05 for transport, storage and communication workers by the Poisson regression analysis. CONCLUSIONS: Young male manufacturing workers were at high risk of occupational amputation of upper extremities in Taiwan. These results provide an epidemiological base for developing a prevention strategy.     

The effect of workplace based strengthening on low back injury rates: A case study in the strip mining industry

The purpose of this study was to demonstrate the effect of a once a week exercise program focused specially at lumbar extensor strengthening. This is a comparative study where workers volunteered to exercise were compared to workers who did not exercise. Low back claims for one year were noted to document efficacy of the training program. Change in strength was also noted. There was a 54% to 104% increase in strength during a 20 week program. The incidence of back injuries in the exercise group was 52 injuries per 200,000 employee hours versus the industry average of 1.09 back injuries per 200,000 employee hours. The average incidence of injury for the previous nine years at the company participating in the program was 2.94 injuries per 200,000 employee hours. The injury incidence in the workers not exercising was 2.55 injuries for 200,000 employee hours. The average workers' compensation liability dropped from $14, 430.00 per month to $380.00 per month for the study year. The significant increase in strength associated with the exercise program correlated with the greatly reduced incidence of back claims.     

Occupational injury among Rhode Island adolescents: an analysis of workers' compensation claims, 1998 to 2002

OBJECTIVES: We sought to examine occupational injuries sustained by adolescent workers during a 5-year period. METHODS: Workers' compensation claims from Rhode Island were used to assess injuries of 15- to 19-year-old employees (n = 8321) from 1998 to 2002. Baseline employee population estimates were derived using the Current Population Survey. RESULTS: The annual estimated adolescent claim rate was 6.6 per 100 workers (95% confidence interval = 6.1-7.1), with annual average costs of $614,182. Injury rates increased with employee age, hours worked, and for day and nightshift employees relative to evening shift workers. The highest proportion of claims by industry was in eating establishments, and the average indemnification duration was 13.0 days. CONCLUSIONS: Specific emphasis should be placed on increasing safety training and preventative interventions for teenagers in hazardous occupations and for those working longer hours.     

Risk factors for physical assault. State-managed workers' compensation experience

BACKGROUND: The estimation of incidence and evaluation of risk factors associated with nonfatal occupational assault injuries have rarely been documented in a statewide population context. A state-managed workers' compensation system can provide estimates of incidence of such injuries and allow evaluation of risk factors. METHODS: Using claims data from the state-managed West Virginia Workers' Compensation, the incidence rates of workplace injuries resulting from physical assault were estimated for the period 1997-1999. Data on potential risk factors were obtained from the claim-related electronic data files, and the risk associated with each factor was assessed using proportional injury ratios (PIRs). RESULTS: During the study period, 2122 compensated injuries were associated with workplace violence. The incidence of assault injuries was 108.2 cases per 100,000 employee years. Women sustained a higher incidence than men. Healthcare workers, public safety workers, and teachers accounted for almost 75% of all assault injuries. Workers in these occupations also differed from each other with regard to seasonality and timing of assault, perpetrator-victim relationship, and types of injury. Evidence of gender-occupation interaction indicated higher risk of assault injury in men compared to women across the three leading occupations. Nighttime work shifts were associated with greater risk of assault for female healthcare workers (PIR=1.8; 95% confidence interval, 1.09-2.87). CONCLUSIONS: The healthcare sector sustained the bulk of assault injuries in West Virginia. Although the majority of healthcare-sector employees were women, the risk of assault injuries was higher in male employees. Risk factors and injury characteristics identified in this study, particularly for three high-risk occupations, should help develop strategies for preventing workplace violence. Protecting female healthcare workers on night-shift duty, especially in nursing home settings, appears to be an important target for intervention.     

Injuries and illnesses from wood framing in residential construction, Washington State, 1993-1999

The construction industry is associated with high rates of work-related injury. We used workers compensation data to describe the injuries and illnesses, claim rates, and claim costs associated with wood framing activities in construction. From 1993 to 1999, there were 33,021 accepted state fund workers compensation claims with direct costs of over $197 million. The average annual claim rate was 45 per 100 full-time equivalent. Statistically significant downward trends were noted in claim rates for all injuries and illnesses, compensable time loss claims, eye and fall injuries. However, these trends were not statistically significantly different from those observed in all other construction risk classes combined. The information in this report can be used to guide prevention efforts and to evaluate the effectiveness of Washington state initiatives to reduce injury and illness rates in wood frame construction.     

Assessing latex allergy among health care employees using workers' compensation data

Latex allergies among health care workers have garnered considerable attention from medical researchers and practitioners. However, the majority of research on natural rubber latex allergy has focused on clinical methodologies and emphasized the quantification of employee sensitization rates as opposed to actual incidents of reactivity. Workers' compensation data provide information on the number and impact of reactions to latex use. This article presents an analysis of health care workers' compensation data from North Dakota to estimate the prevalence, costs, and nature of claims associated with latex allergic reaction. The results show an annual average claim rate of 1.52 per 10,000 health care workers employed in the state, and annual costs averaging about $.08 per health care worker. Skin disorders were the most commonly reported condition. These findings are compared with previous studies of Minnesota and Rhode Island and demonstrate similar results.     

Use of a prevention index to identify industries at high risk for work-related musculoskeletal disorders of the neck, back, and upper extremity in Washington state, 1990-1998

BACKGROUND: The prevention of work-related musculoskeletal disorders such as carpal tunnel syndrome and low back disorders has been a focus of international prevention efforts including regulation. This study examines workers compensation claims in Washington State to provide baseline data from which to assess the need and the effects of prevention activities. METHODS: Washington State Fund workers compensation claims for general and selected specific hand/wrist, elbow, shoulder, and back disorders in 1990-1998 as well as general self-insured compensable (four or more lost workdays) claims data were examined. Payroll hours were used to calculate claims incidence rates per 10,000 full-time equivalent employees (FTEs). We created a prevention index (PI) to rank industries by averaging the ranks of their number of claims and their claims incidence rate. The focus was on non-traumatic soft tissue musculoskeletal disorders (NTST-MSDs). RESULTS: Between 1990-1998, there were 392,925 State Fund accepted claims for NTST-MSDs of the neck, back, and upper extremity resulting in $2.6 billion in direct costs and 20.5 million lost workdays. The average claims incidence rate (CIR) was 355 NTST-MSDs per 10,000 FTEs. The NTST-MSD CIR decreased significantly less than that for all other claims (P = 0.05) but the CIR for upper extremity NTST-MSDs did not significantly decrease over the study period. There were no significant changes in the CIRs for sciatica (4.9 per 10,000 FTEs) and rotator cuff syndrome (15.3 per 10,000 FTEs), whereas the CIR for epicondylitis (10.6 per 10,000 FTEs) increased and for carpal tunnel syndrome (24.5 per 10,000 FTEs) decreased significantly over the study period. Based on the prevention index, the top five industries for combined State Fund and Self-Insured Compensable NTST-MSDs were Trucking and Courier Services (SIC 421), Nursing Homes (SIC 805), Masonry (SIC 174), Air Transportation (SIC 451), and Residential Construction (SIC 152). Using Washington Industrial Classes (WIC), temporary workers in assembly and administrative services were also high on the prevention index. CONCLUSIONS: NTST-MSDs continue to be a large and costly problem in Washington State. While the incidence rates for some NTST-MSDs are decreasing, the overall rate is not decreasing as fast as the rate for all other claims. In some cases, the rate is stable (sciatica, rotator cuff syndrome) or increasing (epicondylitis). Heavy manual handling and repetitive work characterize the industries with the highest risk.     

Economic consequences of workplace injuries and illnesses: lost earnings and benefit adequacy.

BACKGROUND: This is the first study based on individual data to estimate earnings lost from virtually all reported workplace injuries and illnesses in a state. METHODS: We estimated lost earnings from workplace injuries and illnesses occurring in Wisconsin in 1989-90, using workers' compensation data and 6 years of unemployment insurance wage data. We used regression techniques to estimate losses relative to a comparison group. RESULTS: The average present value of losses projected 10 years past the observed period is over $8,000 per injury. Women lose a greater proportion of their preinjury earnings than do men. Replacement of after-tax projected losses averages 64% for men and 50% for women. CONCLUSIONS: Overall, workers with compensated injuries and illnesses experienced discounted pre-tax losses projected to total over $530,000,000 (1994 dollars), with about 60% of after-tax losses replaced by workers' compensation. Generally, groups losing over eight weeks' work received workers' compensation benefits covering less than 40% of their losses.