Objective: The purpose of this study was to understand federal workplace injury/illness trends. Methods: Over 1.5 million federal and Postal Service employee workers' compensation (WC) claims from 2007 to 2022 were linked to employment data and analyzed. Results: From 2007 to 2019, Falls, Slips, Trips represented the highest proportion of claims (30.7%), followed by Overexertion and Bodily Reaction (24.4%), Unclassified (16.4%), Contact with Objects and Equipment (13.1%), Violence and Other Injuries by Persons or Animals (8.8%), Transportation Incidents (4.0%), Exposure to Harmful Substances or Environments (2.5%), and Fires and Explosions (0.24%). From 2020 to 2022, COVID-19 drove a major shift to Exposure to Harmful Substances or Environments representing the highest proportion of claims (44.3%). Conclusions: Claims data represent a potentially rich data source that employing agencies can use to focus prevention and treatment of injury/illness.

Background: This study examined age-group differences in the rate, severity, and cost of injuries among construction workers to support evidence-based worker safety and health interventions in the construction industry. Methods: Ohio workers' compensation claims for construction workers were used to estimate claim rates and costs by age group. We analyzed claims data auto-coded into five event/exposure categories: transportation incidents; slips, trips, and falls (STFs); exposure to harmful substances and environments (EHS); contact with objects and equipment (COB); and overexertion and bodily reaction. American Community Survey data were used to determine the proportion of workers by age group. Results: From 2007-2017, among 72,416 accepted injury claims for 166,000 construction full-time equivalent (FTE) per year, nearly half were caused by COB, followed by STFs (20%) and overexertion (20%). Claim rates related to COB and EHS were highest among those 18-24 years old, with claim rates of 313.5 and 25.9 per 10,000 FTE, respectively. STFs increased with age, with the highest claim rates for those 55-64 years old (94.2 claims per 10,000 FTE). Overexertion claim rates increased and then declined with age, with the highest claim rate for those 35-44 years old (87.3 per 10,000 FTE). While younger workers had higher injury rates, older workers had higher proportions of lost-time claims and costs per claim. The total cost per FTE was highest for those 45-54 years old ($1,122 per FTE). Conclusion: The variation in rates of injury types by age suggests age-specific prevention strategies may be useful.

This study estimated the average annual number of U.S. workers' compensation (WC) claims for occupational hearing loss (OHL) and their associated cost and identified the industry/occupation classifications with the highest numbers of OHL claims. The most recent U.S. cost estimate ($242 million) was based on data from one state in 1 year (1991). WC data from the National Council on Compensation Insurance, Inc. (35 states) and two additional individual states were examined, incorporating data from 37 states and the District of Columbia. Costs and numbers of claims were estimated for the 13 missing states to develop estimates for the United States. Sensitivity analyses were also performed to develop ranges for the point estimates. The estimated U.S. average annual OHL claim cost fell within the range of $49 to $67 million during 2009-2013, with a point estimate of $60 million (2013 dollars). The estimated average annual number of OHL claims ranged from 4,114 to 5,986, with a point estimate of 4,965 claims. Based on data available from 36 states and DC, 18 of the 40 industry/occupation classifications with ≥50 OHL claims were in the manufacturing sector. WC data underestimate the true burden of OHL. Most OHL cases are not compensated. WC laws, industry composition and other factors vary widely by state, so estimates must employ data for many states. This study incorporated data from most states and utilized sensitivity and comparative analyses to obtain estimates. Workers in a wide range of industry/occupation classifications need special attention to prevent OHL. © 2023. Thieme. All rights reserved. Thieme Medical Publishers, Inc.

Measuring the ultimate impact of research on health and economic well-being has presented challenges that have rarely been surmounted, and research on preventing occupational injuries and illnesses is no exception. Nevertheless, there is an increasing need to demonstrate the value of publicly funded research. The National Institute for Occupational Safety and Health (NIOSH) recently contracted with the RAND Corporation to conduct six in-depth case studies that aimed to quantify the benefits of key NIOSH research efforts using economic metrics. These case studies focused on silica exposure in asphalt pavement milling, firefighter cancer risks, a multi-industry matching-grant program for purchase of safety equipment, personal coal dust monitors for coal miners, re-design of ambulance patient compartments for safety, and workplace amputation surveillance. In this article, we summarize what we learned about how measurement of research benefits may be pursued. We summarize the benefit measurement methods that were used and the results of these research efforts in terms of costs saved, injuries and illnesses prevented, and the statistical value of reductions in risk of death or illness. We then distill some observations about the characteristics of research efforts that make measurement of research benefits feasible and suggest steps that could make it feasible to apply the same methods more widely. We also outline key NIOSH activities that appear not to be amenable to benefit measurement but suggest potentials for progress toward at least partial or qualitative benefit assessment. Finally, we discuss implications of the benefit measurement case studies for strategic research planning.

OBJECTIVE: This study evaluated the impact of a state workers' compensation (WC) insurer's onsite risk control (RC) services on insured employers' WC claim frequency and cost. METHODS: We used two methods to model 2004-2017 claims data from 4,606 employers that received RC visits over time and compare this claims experience to matching employers that did not receive RC services. RESULTS: Relative total WC claim rates increased slightly after RC services, while relative lost-time claims rates either remained similar or decreased and WC cost rates decreased. The impact of RC services on reducing WC costs was cumulative up to the fourth visit but diminished thereafter. CONCLUSIONS: The insurer RC consultation program was effective in reducing WC cost rates for serviced employers. This is consistent with other research conducted on insurer RC services and related regulatory visits.

Introduction: This study analyzed workers compensation (WC) claims among private employers insured by the Ohio state-based WC carrier to identify high-risk industries by detailed cause of injury. Methods: A machine learning algorithm was used to code each claim by U.S. Bureau of Labor Statistics (BLS) event/exposure. The codes assigned to lost-time (LT) claims with lower algorithm probabilities of accurate classification or those LT claims with high costs were manually reviewed. WC data were linked with the state's unemployment insurance (UI) data to identify the employer's industry and number of employees. BLS data on hours worked per employee were used to estimate full-time equivalents (FTE) and calculate rates of WC claims per 100 FTE. Results: 140,780 LT claims and 633,373 medical-only claims were analyzed. Although counts and rates of LT WC claims declined from 2007 to 2017, the shares of leading LT injury event/exposures remained largely unchanged. LT claims due to Overexertion and Bodily Reaction (33.0%) were most common, followed by Falls, Slips, and Trips (31.4%), Contact with Objects and Equipment (22.5%), Transportation Incidents (7.0%), Exposure to Harmful Substances or Environments (2.8%), Violence and Other Injuries by Persons or Animals (2.5%), and Fires and Explosions (0.4%). These findings are consistent with other reported data. The proportions of injury event/exposures varied by industry, and high-risk industries were identified. Conclusions: Injuries have been reduced, but prevention challenges remain in certain industries. Available evidence on intervention effectiveness was summarized and mapped to the analysis results to demonstrate how the results can guide prevention efforts. Practical Applications: Employers, safety/health practitioners, researchers, WC insurers, and bureaus can use these data and machine learning methods to understand industry differences in the level and mix of risks, as well as industry trends, and to tailor safety, health, and disability prevention services and research. 2021

Overexertion is a leading cause of work-related musculoskeletal disorders (WMSDs) among construction workers. Nearly 90% of construction jobs require manual handling of materials for approximately one half of the worker's time (1). In 2015, overexertion from lifting and lowering materials caused 30% of WMSDs among construction workers; overexertion involving pushing, pulling, holding, carrying, and catching materials caused an additional 37% of WMSDs (1). This study examined the rate and cost of WMSD claims from overexertion among Ohio construction workers during 2007-2017. Workers' compensation claims related to overexertion that were submitted to the Ohio Bureau of Worker's Compensation (OHBWC) by workers in the construction industry for injuries and illnesses occurring during 2007-2017 were analyzed. Rates and costs of allowed claims were measured by age group. Workers aged 35-44 years experienced the highest claim rate: 63 per 10,000 full-time employees (FTEs) for WMSDs from overexertion. However, claims by workers aged 45-54 years and 55-64 years were more costly on average and resulted in more days away from work. Ergonomic design improvements and interventions are needed to ensure that the majority of construction workers can safely perform jobs throughout their careers. Age-specific WMSD prevention and risk communication efforts also might be helpful.

OBJECTIVE: The aim of this study was to describe levels of integration between occupational safety and health (OSH) and workplace wellness programs/practices/policies ("programs") among participants in an insurer-sponsored wellness grant program. METHODS: We analyzed survey responses about year 1 of an insurer-sponsored grant to start a wellness program from 220 small- and medium-sized employers. Responses yielded 25 indicators of OSH-wellness integration, and 10 additional indicators to summarize multiple responses. RESULTS: At least half of the employers (N = 220) reported some level of integration within five of seven categories of OSH-wellness integration. Employers sometimes considered ergonomics, safety, or substance exposure hazards while designing their wellness program (15%) or reduced such hazards to support their wellness program (24%). Few meaningful differences were observed by employer size. CONCLUSION: Although high levels of integration were unusual, some degree of integration was common for most indicator categories.

BACKGROUND: Ambulance service workers frequently transfer and transport patients. These tasks involve occupational injury risks such as heavy lifting, awkward postures, and frequent motor vehicle travel. METHODS: We examined Ohio workers' compensation injury claims among state-insured ambulance service workers working for private employers from 2001 to 2011. Injury claim counts and rates are presented by claim types, diagnoses, and injury events; only counts are available by worker characteristics. RESULTS: We analyzed a total of 5882 claims. The majority were medical-only (<8 days away from work). The overall injury claim rate for medical-only and lost-time cases was 12.1 per 100 full-time equivalents. Sprains and strains accounted for 60% of all injury claims. Overexertion from patient handling was the leading injury event, followed by motor vehicle roadway incidents. CONCLUSIONS: Study results can guide the development or improvement of injury prevention strategies. Focused efforts related to patient handling and vehicle incidents are needed.

OBJECTIVE: This study leveraged a state workers' compensation claims database and machine learning techniques to target prevention efforts by injury causation and industry. METHODS: Injury causation auto-coding methods were developed to code more than 1.2 million Ohio Bureau of Workers' Compensation claims for this study. Industry groups were ranked for soft-tissue musculoskeletal claims that may have been preventable with biomechanical ergonomic (ERGO) or slip/trip/fall (STF) interventions. RESULTS: On the basis of the average of claim count and rate ranks for more than 200 industry groups, Skilled Nursing Facilities (ERGO) and General Freight Trucking (STF) were the highest risk for lost-time claims (>7 days). CONCLUSION: This study created a third, major causation-specific U.S. occupational injury surveillance system. These findings are being used to focus prevention resources on specific occupational injury types in specific industry groups, especially in Ohio. Other state bureaus or insurers may use similar methods.

BACKGROUND: Workers' compensation (WC) claims data may be useful for identifying high-risk industries and developing prevention strategies. METHODS: WC claims data from private-industry employers insured by the Ohio state-based workers' compensation carrier from 2001 to 2011 were linked with the state's unemployment insurance (UI) data on the employer's industry and number of employees. National Labor Productivity and Costs survey data were used to adjust UI data and estimate full-time equivalents (FTE). Rates of WC claims per 100 FTE were computed and Poisson regression was used to evaluate differences in rates. RESULTS: Most industries showed substantial claim count and rate reductions from 2001 to 2008, followed by a leveling or slight increase in claim count and rate from 2009 to 2011. Despite reductions, there were industry groups that had consistently higher rates. CONCLUSION: WC claims data linked to employment data could be used to prioritize industries for injury research and prevention activities among State-insured private employers.

Hearing loss is the third most common chronic physical condition in the United States, and is more prevalent than diabetes or cancer (1). Occupational hearing loss, primarily caused by high noise exposure, is the most common U.S. work-related illness (2). Approximately 22 million U.S. workers are exposed to hazardous occupational noise (3). CDC compared the prevalence of hearing impairment within nine U.S. industry sectors using 1,413,789 noise-exposed worker audiograms from CDC's National Institute for Occupational Safety and Health (NIOSH) Occupational Hearing Loss Surveillance Project (4). CDC estimated the prevalence at six hearing impairment levels, measured in the better ear, and the impact on quality of life expressed as annual disability-adjusted life years (DALYs), as defined by the 2013 Global Burden of Disease (GBD) Study (5). The mining sector had the highest prevalence of workers with any hearing impairment, and with moderate or worse impairment, followed by the construction and manufacturing sectors. Hearing loss prevention, and early detection and intervention to avoid additional hearing loss, are critical to preserve worker quality of life.

BACKGROUND: This study evaluated the effectiveness of a program in which a workers' compensation (WC) insurer provided matching funds to insured employers to implement safety/health engineering controls. METHODS: Pre- and post-intervention WC metrics were compiled for the employees designated as affected by the interventions within 468 employers for interventions occurring from 2003 to 2009. Poisson, two-part, and linear regression models with repeated measures were used to evaluate differences in pre- and post-data, controlling for time trends independent of the interventions. RESULTS: For affected employees, total WC claim frequency rates (both medical-only and lost-time claims) decreased 66%, lost-time WC claim frequency rates decreased 78%, WC paid cost per employee decreased 81%, and WC geometric mean paid claim cost decreased 30% post-intervention. Reductions varied by employer size, specific industry, and intervention type. CONCLUSIONS: The insurer-supported safety/health engineering control program was effective in reducing WC claims and costs for affected employees.

BACKGROUND: The consequences of occupational injuries for the health of family members have rarely been studied. We hypothesized that non-fatal occupational injury would increase the incidence and costs of hospitalization among workers' families, and that family members of severely injured workers would be likely to experience greater increases in hospitalizations than family members of non-severely injured workers. DATA AND METHODS: We used the MarketScan databases from Thomson Reuters for 2002-2005, which include workers' compensation and inpatient medical care claims data for injured workers' families. We used a before-after analysis to compare the odds and costs of family hospitalization 3 months before and after the index occupational injury among 18,411 families. Severe injuries were defined by receipt of indemnity payments and at least 7 days of lost work. Family hospitalizations were measured by the incidence of hospitalization of at least one family member. RESULTS: Among families of all injured workers, the odds of at least one family member being hospitalized were 31% higher [95% confidence intervals (CI) = 1.11-1.55] in the 3 months following occupational injury than in the 3 months preceding injury. Among the families of severely injured workers, the odds of hospitalization were 56% higher [95% CI = 1.05-2.34] in the 3 months following injury. Hospitalization costs were found to rise by approximately the same percentage as hospitalization incidence. CONCLUSION: The impact of occupational injury may extend beyond the workplace and adversely affect the health and inpatient medical care use of family members. (Am. J. Ind. Med. 55:1028-1036, 2012. (c) 2012 Wiley Periodicals, Inc.)

OBJECTIVE: To help address underrecognition of occupational illnesses and support planning of workplace health initiatives. METHODS: Data from Highmark Inc., a health care insurer headquartered in Pittsburgh and Camp Hill, Pennsylvania, was used to calculate age and gender-adjusted rates of 15 diseases by industry and broad industry sector. RESULTS: Significant industry differences in disease rates were observed, some corresponding to known differences in workplace risk factors. CONCLUSION: Group medical claims offer timely, relatively low cost, longitudinal data on rates of physician-diagnosed cases and costs of many diseases for large populations. Limitations of medical claims data include inaccuracies in industry coding, lack of occupation codes, and lack of key variables that affect health. Yet, some elevated industry rates suggest potential new targets for wellness programs and evaluation of possible workplace health risks.

There is evidence that work schedules may influence rates of unhealthy behaviors, suggesting that addressing work schedule challenges may improve health. Health Risk Assessment (HRA) survey responses were collected during 2000-2008 in a multinational chemical and coatings manufacturer. Responses of 26,442 were sufficiently complete for analysis. Rates of smoking, lack of exercise, moderate to high alcohol use, obesity (BMI >= 30), and short sleep duration were compared by work schedule type (day, night, or rotating shift) and daily work hours (8, 10, or 12 h). Prevalence rate ratios (RRs) were calculated, adjusting for age group, sex, marital/living status, job tenure, and occupational group. The reference group was 8-h day shift employees. Overall prevalence rates were: sleep duration of 6 h or less per night 47%, smoking 17.3%, no exercise 22.0%, BMI >= 30 28.3%, and moderate to heavy alcohol consumption 22.2%. Statistically significant RRs include the following: Short sleep duration: 10 h rotating shift (RR=1.6), 12 h day and 12 h rotating shifts (RR=1.3); Smoking: 12 It day and rotating shifts (RR=1.6), 10 and 12 h night and 8 h rotating shift (RR=1.4); No exercise: 8, 10, and 12 h rotating shifts (RR=1.2 to 1.3), 12 h day schedules (RR=1.3). Obesity (BMI >= 30): 8 and 10 h night shifts (RR=1.3 and 1.4, respectively).

BACKGROUND: Working while under stress due to a family health event may result in injuries of greater severity. Work leave might mitigate such consequences. DATA AND METHODS: Workers' compensation data for 33,817 injured workers and inpatient medical data for 76,077 members of their families were extracted from the 2002-2005 Thomson Reuters Medstat MarketScan Health and Productivity Management (HPM) and Commercial Claims and Encounter (CCE) datasets. Using a probit model, the impact of family hospitalization on the probability that a subsequent injury would be severe (above average indemnity costs) was estimated, adjusting for age, sex, hourly versus salaried status, industry sector, state, and family size. RESULTS: Family hospitalization within 15 days before injury increased the likelihood that the injury would be severe (from 12.5% to 21.5%) and was associated with 40% higher indemnity costs and 50% higher medical costs. Hospitalizations over 30 days before injury had no impact. CONCLUSION: The observed higher severity of work injuries following family hospitalizations suggests additional analyses may find higher injury rates as well, and that timely family leaves might help prevent severe workplace injuries. Am. J. Ind. Med. (c) 2010 Wiley-Liss, Inc.

BACKGROUND: The rate of lost-time sprains and strains in private nursing homes is over three times the national average, and for back injuries, almost four times the national average. The Ohio Bureau of Workers' Compensation (BWC) has sponsored interventions that were preferentially promoted to nursing homes in 2000-2001, including training, consultation, and grants up to $40,000 for equipment purchases. METHODS: This study evaluated the impact of BWC interventions on back injury claim rates using BWC data on claims, interventions, and employer payroll for all Ohio nursing homes during 1995-2004 using Poisson regression. A subset of nursing homes was analyzed with more detailed data that allowed estimation of the impact of staffing levels and resident acuity on claim rates. Costs of interventions were compared to the associated savings in claim costs. RESULTS: A $500 equipment purchase per nursing home worker was associated with a 21% reduction in back injury rate. Assuming an equipment life of 10 years, this translates to an estimated $768 reduction in claim costs per worker, a present value of $495 with a 5% discount rate applied. Results for training courses were equivocal. Only those receiving below-median hours had a significant 19% reduction in claim rates. Injury rates did not generally decline with consultation independent of equipment purchases, although possible confounding, misclassification, and bias due to non-random management participation clouds interpretation. In nursing homes with available data, resident acuity was modestly associated with back injury risk, and the injury rate increased with resident-to-staff ratio (acting through three terms: RR = 1.50 for each additional resident per staff member; for the ratio alone, RR = 1.32, 95% CI = 1.18-1.48). In these NHs, an expenditure of $908 per resident care worker (equivalent to $500 per employee in the other model) was also associated with a 21% reduction in injury rate. However, with a resident-to-staff ratio greater than 2.0, the same expenditure was associated with a $1,643 reduction in back claim costs over 10 years per employee, a present value of $1,062 with 5% discount rate. CONCLUSIONS: Expenditures for ergonomic equipment in nursing homes by the Ohio BWC were associated with fewer worker injuries and reductions in claim costs that were similar in magnitude to expenditures. Un-estimated benefits and costs also need to be considered in assessing full health and financial impacts. Am. J. Ind. Med. 52:683-697, 2009. (c) 2009 Wiley-Liss, Inc.