I. Occupational Hazards and Diseases
Counting Occupational Diseases: the Tip of an Iceberg
National statistics show that occupational diseases are reported infrequently
relative to the number of traumatic fatalities and musculoskeletal injuries. An
occupational illness (or disease) is defined by OSHA as, "any abnormal condition or
disorder, other than one resulting from an occupational injury, caused by exposure to
factors associated with employment." For several reasons, occupational diseases, as opposed
to occupational injuries, are difficult to recognize. Occupational diseases are the
"icebergs" that challenge occupational health and safety professionals. Beneath
the surface are hidden a large number of occupational diseases that are not recognized or
not reported. The number of cases of occupational illness reported for statistical surveys
are just the tip of the iceberg.
Like collisions with icebergs, occupational hazards must be recognized before they can
be prevented. The graphs below are based on statistics from the Bureau of Labor Statistics
(BLS). They depict what we know about recognized and reported occupational fatalities,
injuries and illnesses in the population of 126 million working
Americans.
II. Reported Fatal Injuries and Illnesses
Average Annual Number of Fatal Occupational Injuries
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Reference from BLS: Fatal
occupational injuries by event or exposure, 1992-97
The previous graph showed that of the 6331 work-related fatalities/year in the United
States, 596 are caused by exposure to harmful substances or environments. The next graph
details the fatalities caused by these exposures.
Fatalities from Exposure to Harmful Substances or
Environments
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|
Of the 327 electrocutions, 128
were caused by contact with overhead power lines; |
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Of the 42 deaths from
temperature extremes, 30 were due to heatstroke and 8 to burns from hot water or steam; |
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Of the 105 fatalities from
oxygen deficiency, 81 were caused by drowning and 10 by methane gas emitted from sewer
pits or sewers. |
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Of the 121 deaths from
exposure to caustic, noxious or allergenic substance, 4 workers per year died after bee
stings and 35 succumbed after inhalation of a substance (10 after inhalation of carbon
monoxide); |
Some of the details above were found in "Perils in the
Workplace" from the BLS site.
III. Reported Nonfatal Injuries and Illnesses
Among the 123,190 systemic diseases involving days away from work reported
in 1996 are the following specific conditions:
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Diseases of the blood and
blood forming organs--16 |
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Inflammatory diseases of the
central nervous system-- 54 |
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Carpal tunnel syndrome--
29,937 |
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Toxic polyneuropathy-- 240 |
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Welder's flash--5,109 |
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Allergic rhinitis--51 |
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Pneumonia-- 46 |
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Legionnaires' disease--17 |
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Extrinsic asthma-- 403 |
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Pneumoconiosis-- 45 |
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Dermatitis-- 6,884 |
There were 5.8 million injuries and illnesses that resulted in either lost
work time, medical treatment other than first aid, loss of consciousness, restriction of
work or motion or transfer to another job.
Of the 5.8 Million Cases Reported in 1996,
439,002 Were Illnesses:
-
-
- 281,128
disorders associated with repeated trauma (29,937 cases of carpal tunnel syndrome)
- 53,018 all other
occupational illnesses
- 58,099 skin diseases or
disorders
- 3,473 dust diseases of the
lungs
- 21,724 respiratory
conditions due to toxic agents
- 4,785 poisonings
- 16,776 disorders due to
physical agents
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IV. Estimating the Size of the Iceberg
Difficulty Counting Work-Related Cancers and Other Long-Term Latent Illnesses
The BLS workplace fatality statistics are obtained by "cross-referencing source
documents, such as death certificates, workers' compensation records, and reports to
federal and state agencies. This method assures counts are as complete as possible."
For work-related illness cases, "Some conditions, e.g., long-term latent illnesses
caused by exposure to carcinogens, often are difficult to relate to the workplace and are
not adequately recognized and reported. These long-term latent illnesses are believed to
be understated in the survey's illness measures."
An Effort to Estimate these Illnesses and Account for other Deficiencies of the BLS
System
The following table summarizes the methods and results a scientific paper entitled
"Occupational Injury and Illness in the United States: Estimates of Costs, Morbidity,
and Mortality." The authors reviewed the national statistics from available sources
and applied an attributable risk proportion method in which a certain percentage of the
total number of fatalities and illnesses in the U.S. is attributed to occupation based on
a "best guess." The assumption made in attributing proportion to cardiovascular
(angina and heart attack) and cerebrovascular (stroke) is particularly interesting:
"The estimate of 5% to 10% of cardiovascular and cerebrovascular disease is based on
a number of studies showing that job strain or psychosocial stress causes excess morbidity
and mortality and that selected common chemical exposures, such as lead, carbon monoxide,
and solvents, adversely affect the heart."
Occupational Injury and Illness in the United States:
Estimates of Costs, Morbidity, and Mortality
Leigh JP et al. Arch Intern Med. Vol 157, July 28, 1997, p.
1557-1568
|
|
BLS |
Leigh, et al. |
Method Used to Adjust Annual Incidence |
Job-Related Deaths |
6331 |
6500 |
|
Deaths from Disease |
|
60,300 |
Used these proportions of deaths attributable to occupation:
6% to 10 % of cancer; 5% to 10 % of cardiovascular and cerebrovascular disease; 10% of
chronic respiratory disease; 100% of pneumoconioses; and 1% to 3% of nervous system
disorders and renal disorders; |
Nonfatal Injuries |
6.2 million |
13.2 million |
Included government employees; assumed an undercounting in the BLS Annual Survey due
to economic incentive; |
Illnesses |
439,002 |
862,200 |
Included illnesses from the BLS Annual Survey (457,400 in 1992) + government employees
(92,010) + these proportions of incident cases attributable to occupation: 6% to 10% of
cancer, 5% to 10% of coronary heart disease, 5% to 10% of cerebrovascular disease and 10%
of chronic obstructive pulmonary disease; |
See PubMed abstracts
on injury and illness statistics.
Revised May 30, 2018
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