Occupational illnesses within two national data sets

Our plain-English summary of Occupational illnesses within two national data sets, by J.P. Leigh, T.R. Miller (International Journal of Occupational and Environmental Health, 1998).

The study

• Authors: J.P. Leigh, T.R. Miller
• Journal: International Journal of Occupational and Environmental Health
• Published: 1998;4(2):99-113
• Cited by: 30 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

To describe occupational illness data in two large data sets, two national data sets were aggregated, and the numbers, percentages, and rates of cases of occupational illnesses were determined. Job-related illness data were from Bureau of Labor Statistics documents containing Annual Survey and Census of Fatal Occupational Injury data. A severity index was created to assess the overall burden of a disease. The index multiplies the number of cases times the median days lost. Circulatory disease accounted for 85% of the deaths in the Census and at least 80% in the Annual Survey. More fatal myocardial infarctions occurred on Monday than on any other day. Low-paying occupations had the most myocardial infarctions: operators, laborers, and truck drivers; high-paying occupations had the least: executives, administrators, and managers. Carpal tunnel syndrome and hearing loss accounted for more morbidity, measured by cases and days lost, than any other illness. Persons at great risk for carpal tunnel syndrome included dental hygienists, butchers, sewing machine operators, and dentists. Mental disorders generated more morbidity than is generally acknowledged. Neurotic reactions to stress were highest in the transportation and public utility industries, as well as in finance, insurance, and real estate. Manufacturing contributed far more cases than any other industry. Industries generating significant asbestos-related deaths included construction and boat building. Ninety-three percent of all illness fatalities were among men. Few African Americans died from coal-workers' pneumoconiosis. Illness cases increased much faster than injury cases in recent years. The two data sets provide insights into the incidences and prevalences of occupational illnesses, but underestimate the burden of job-related illnesses.

In plain English

This article described illness records in two U.S. Bureau of Labor Statistics data sets: the Census of Fatal Occupational Injuries (1991 to 1993) and the Annual Survey of Occupational Injuries and Illnesses, which excludes government workers, small firms and the self-employed. Of 3,926 illness deaths in the Census, 3,351 (85%) were from circulatory diseases. Men were 93% of those who died. Asbestosis accounted for 132 deaths (3.4%), and 67% of the asbestosis deaths were in people aged 65 or older. The authors called the Census pneumoconiosis figures a serious undercount, noting 285 asbestosis deaths among men in national statistics for 1992 alone. A government report they cited described 294 asbestos-related illness deaths, with high shares among craft and repair workers including mechanics, construction trades and the military. In the Annual Survey, reported illness cases rose from 136,800 in 1986 to 457,400 in 1992, and carpal tunnel syndrome ranked highest on the authors' severity index. The authors concluded the data sets cannot measure the overall burden of occupational disease but can provide insights.

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: Descriptive analysis of two existing national government data sets (Bureau of Labor Statistics), reporting counts, percentages and rates of occupational illnesses
• Who was studied: Census of Fatal Occupational Injuries illness deaths: 1,099 in 1991 (31 states), 1,361 in 1992 and 1,466 in 1993 (50 states and the District of Columbia), 3,926 in total. Annual Survey of Occupational Injuries and Illnesses (1986, 1992 and 1994 data), covering roughly 250,000 mainly private-sector firms in the United States
• Exposure: Work in U.S. occupations and industries in general. No specific asbestos fiber type was studied. Asbestos appears only as outcome categories: asbestosis, and asbestos-related diseases within the dust diseases of the lung category
• Main results:
  • In the Census, 1991 to 1993, circulatory system diseases caused 3,351 of the 3,926 illness deaths (85%)
  • In the Census, myocardial infarction (heart attack) accounted for 67% of all illness deaths
  • In the Census, men were 93% of illness deaths and women 7%
  • In the Census, pneumoconiosis deaths were: asbestosis 132 (3.4%), coal-workers' pneumoconiosis 65 (1.6%), silicosis 15 (0.4%)
  • Among those in the Census who died of asbestosis, 67% were aged 65 or older; for coal-workers' pneumoconiosis the figure was 88%
  • The authors judged the Census pneumoconiosis counts a serious undercount. By comparison, the National Center for Health Statistics counted 285 asbestosis deaths among men in 1992 alone
  • A Bureau of Labor Statistics report cited by the authors (not their own analysis) described 294 people who died of asbestos-related illnesses in the Census. Of these, 1% were under 45 and 63% were 65 or older. High and disproportionate shares of deaths were among precision production, craft and repair workers (including mechanics), the construction trades and the military
  • Monday had the highest percentage of fatal heart attacks in the Census
  • The authors compared each group's share of fatal heart attacks with its share of employment; a ratio over 1 means a disproportionately high number. Ratios were especially high for protective services (4.4) and truck drivers (7.0). They were low for white-collar groups, for example technical, sales and administrative support (0.37)
  • In the Annual Survey, reported illness cases rose from 136,800 in 1986 to 457,400 in 1992. Disorders associated with repeated trauma rose from 46,000 to 281,800
  • In the Annual Survey, the rate of dust diseases of the lung fell from 0.5 to 0.3 per 10,000 full-time workers between 1986 and 1992, a change of minus 40%
  • The authors built a severity index (cases multiplied by median days away from work). Using 1992 Annual Survey data, carpal tunnel syndrome had 33,042 cases, a median of 32 days and an index of 1,057,344. Pneumoconioses had 188 cases, a median of 153 days and an index of 28,764
  • In 1994 Annual Survey data, dental hygienists had the highest rate of carpal tunnel syndrome cases, at 2.76 per 1,000 employees
• The authors' conclusion: The authors concluded that the two data sets cannot be used to estimate the overall burden of all occupational diseases in the United States, but can provide a number of insights for more modest goals, such as comparing relative rankings, trends and groups
• Limitations the authors state:
  • The Census illness data rely heavily on workers' compensation records
  • Illnesses among retirees, such as pneumoconioses with long latency, are largely missed in the Census
  • The Annual Survey excludes government employees, workers in small firms and the self-employed
  • Firms have economic incentives to underreport, and some may do so deliberately
  • Annual Survey days-lost data are limited to one year, so long absences are underestimated
  • Physicians often fail to recognize illnesses as occupational, which affects both data sets

Topics

Medical terms in this study, explained in our Lexicon: Pneumoconiosis.

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