Costs of productivity loss due to occupational cancer in Canada: estimation using claims data from Workers' Compensation Boards

Our plain-English summary of Costs of productivity loss due to occupational cancer in Canada: estimation using claims data from Workers' Compensation Boards, by W.D. Wranik, A. Muir, M. Hu (Health Economics Review, 2017).

The study

• Authors: W.D. Wranik, A. Muir, M. Hu
• Journal: Health Economics Review
• Published: 2017;7(1):9
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Introduction: Cancer is a leading cause of illness globally, yet our understanding of the financial implications of cancer caused by working conditions and environments is limited. The goal of this study is to estimate the costs of productivity losses due to occupational cancer in Canada, and to evaluate the factors associated with these costs.

Methods: Two sources of data are used: (i) Individual level administrative claims data from the Workers Compensation Board of Nova Scotia; and (ii) provincial aggregated cancer claims statistics from the Association of Workers Compensation Boards of Canada. Benefits paid to claimants are based on actuarial estimates of wage-loss, but do not include medical costs that are covered by the Canadian publicly funded healthcare system. Regional claims level data are used to estimate the total and average (per claim) cost of occupational cancer to the insurance system, and to assess which characteristics of the claim/claimant influence costs. Cost estimates from one region are weighted using regional multipliers to adjust for system differences between regions, and extrapolated to estimate national costs of occupational cancer.

Results/discussion: We estimate that the total cost of occupational cancer to the Workers' Compensation system in Canada between 1996 and 2013 was $1.2 billion. The average annual cost was $68 million. The cancer being identified as asbestos related were significantly positively associated with costs, whereas the age of the claimant was significantly negatively associated with costs. The industry type/region, injury type or part of body affected by cancer were not significant cost determinants.

Conclusion: Given the severity of the cancer burden, it is important to understand the financial implications of the disease on workers. Our study shows that productivity losses associated with cancer in the workplace are not negligible, particularly for workers exposed to asbestos.

In plain English

This study estimated what occupational cancer claims cost Canada's Workers' Compensation system, using benefit payments as a stand-in for lost wages (productivity loss). The authors analysed 304 accepted occupational cancer claims from the Workers' Compensation Board of Nova Scotia (298 men and six women, from records covering 1957 to 2015). They then used national claim counts and provincial adjustment factors to extend the cost estimate to all of Canada for 1996 to 2013. Total Nova Scotia costs ranged from $36.5 million to $44.0 million, depending on how inflation was handled. Claims classed as asbestos-related cost more than unspecified occupational cancer claims: 363% higher before adjustment and 556% higher in the authors' simpler adjusted model. In adjusted models, claims from people aged 65 or older at biopsy cost about 80% less than claims from people aged 50 or younger. Nationally, the authors estimated $1.2 billion in total, or $68 million a year. They concluded that these losses are not negligible, particularly for workers exposed to asbestos. They said their figures likely underestimate true costs, partly because the national records were incomplete and covered only time-loss claims.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Cost analysis of workers' compensation claims records. It had two parts: a regional (Nova Scotia) model that estimated costs and used regression to find what drives cost per claim, and a national model that extrapolated the Nova Scotia costs to Canada using provincial multipliers.
• Who was studied: There were 385 occupational cancer claims accepted by the Workers' Compensation Board of Nova Scotia (records from 1957 to 2015). Of these, 304 claims (298 men, six women) were analysed; claims with no cost recorded were dropped. The national model used aggregated time-loss claim counts from the Association of Workers' Compensation Boards of Canada for 1996 to 2013 (8261 claims in total).
• Exposure: Occupational cancer claims, grouped by cancer type (occupational/unspecified, asbestos, fire fighter, missing) and by injury type (including asbestosis and mesothelioma). Asbestos-related claims made up 26.97% of the Nova Scotia claims. No fiber types were specified.
• Main results:
  • In Nova Scotia, the total cost of all included cancer claims was estimated at between $36.5 million and $44.0 million, depending on the inflation assumptions used.
  • The average cost per Nova Scotia claim was estimated at between $120,182 and $145,807.
  • Asbestos-related cancer claims cost more than unspecified occupational cancer claims: 363% higher in the unadjusted model and 1309% higher in the full adjusted model (both p less than 0.01).
  • In the simpler (parsimonious) adjusted model, asbestos-related cancer claims cost 556% more than unspecified occupational cancer claims (p less than 0.01).
  • Claims from people aged 65 or older at biopsy cost less than claims from people aged 50 or younger: about 67% lower unadjusted (p less than 0.1), 82% lower in the full adjusted model (p less than 0.01) and 80% lower in the parsimonious model (p less than 0.01).
  • Industry type was statistically significant only in the unadjusted model. Cost did not depend on the body part affected.
  • The estimated total cost of occupational cancer to the Workers' Compensation system in Canada for 1996 to 2013 was $1.2 billion, an average of $68 million per year.
  • Ontario had the highest estimated cost, followed by Quebec, British Columbia and Alberta.
• The authors' conclusion: The authors concluded that productivity losses from occupational cancer are not negligible, particularly for workers exposed to asbestos.
• Limitations the authors state:
  • The Nova Scotia individual claims data covered a relatively small number of claims.
  • The national aggregate records appeared incomplete, especially for the Territories, Saskatchewan and Prince Edward Island.
  • The authors said their results likely underestimate the true costs.
  • The national data include only time-loss claims, so people who kept working while ill are left out.
  • Health care system costs incurred outside the workers' compensation claim are not counted.
  • The provincial multipliers were based on all claim types, not only cancer claims, which the authors said is likely to introduce bias.
  • Cost estimates may change, because some claims were still open and still accruing costs.
  • Costs by gender were not examined, because there were too few women in the sample.

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