Occupational Health Indicators in Colorado, 2001 – 2005

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Occupational Health Indicators in Colorado, 2001 – 2005 Mulloy KB 1,2, Stinson KS2, Boudreau Y3, Miller L4, Warner A4,Newman LS2 1 – Denver Health Center for Occupational Safety & Health, 2 – Mountain and Plains Education and Research Center, Colorado School of Public Health 3 - National Institute for Occupational Safety and Health, 4 - Colorado Department of Public Health and Environment Background Employment Demographic Profile Work-Related Pesticide Poisonings • More than 2.2 million civilian workers per year were employed in CO for the years 2001-2005 • Civilian workers in CO were primarily between the ages of 25 and 54 years; over half were male; over 90% White; and 16% were of Hispanic origin • The majority of workers were employed full time and worked a standard work week of 40 hours or greater • Approximately 8% of workers were self-employed • The unemployment rate in CO ranged from 2.7% in 2000 to 4.2% in 2006, with a rate as high as 6.0% in 2003 • Each year thousands of Colorado (CO) workers are affected by preventable work-related exposures, illnesses, and injuries • Occupational health surveillance plays a critical role in the identifying problems, targeting interventions and evaluating programs to reduce occupational injury and illness morbidity and mortality • Currently no comprehensive occupational health surveillance system exists in CO • A baseline health status evaluation of workers in CO is needed to determine a state-based plan for surveillance, intervention and prevention • The rate of work-related pesticide poisonings in CO has ranged from 1.6 to 2.6 per 100,000 workers per year for the years 2001 to 2005 • The rate of work-related pesticide poisonings reported to poison control centers has been higher in CO than the US for 4 out of the 5 years Work-Related Fatalities Methods • On average one worker in CO died from a work-related injury every 3 days • The average annual rate of fatal work-related injuries in CO was 5.2 per 100,000 workers compared to 4.1 for the US • Work-related injury fatality rates in CO were higher than overall US rates • Most fatal work-related injuries in CO and US were attributable to transportation incidents • 15% of workers in CO were employed in industries at high risk for occupational mortality • 10% of workers in CO were employed in occupations at high risk for occupational mortality • A working group from Denver Health Center for Occupational Safety and Health, Mountain and Plains Education and Research Center (MAP ERC), National Institute for Occupational Safety and Health Denver Regional Office, and Colorado Department of Public Health and Environment (CDPHE) was established • The Council of State and Territorial Epidemiologists (CSTE) Occupational Health Indicators: A Guide for Tracking Occupational Health Conditions and Their Determinants was used with the goals of defining areas of occupational morbidity and mortality and building capacity for occupational health surveillance in CO • Occupational Health Indicators describe worker demographics, measures of work-related health, and factors that influence worker health • Of the 19 indicators, 12 reveal injury and illness resulting from occupational hazards; 3 describe potential workplace health and safety hazards; 2 examine intervention activities; 1 measures harmful exposure in the workplace; and 1 describes the socio-economic impacts of work-related injuries and illnesses • A core set of data was abstracted from multiple existing state and national datasets for the years 2001-2005 to describe worker demographics, measures of work-related health and factors that influence worker health • For data presented in this abstract, we used the Occupational Health Indicators (OHI) and Data Sources as shown in Bold Conclusions • Work-related fatalities in CO are a significant problem and exceed the national rate • Transportation related injuries are a significant cause of work-related fatalities • The number of non-fatal work-related injury and illness claims remain stable, however the average workers’ compensation cost per worker has increased compared to the national average, which has remained stable • The rates of work-related pesticide poisonings in CO, on average, were higher compared to overall US rates which have remained stable • Occupational injury and illness is a significant problem in the state of CO and a state-based occupational injury and illness surveillance system would help to guide resources in the development of intervention, education, prevention strategies and regulatory efforts • Continued analysis of Occupational Heath Indicators including trend analysis is warranted Occupational Health Indicators Employment demographics and characteristics Non-fatal injuries and illnesses reported by employers Work-related hospitalizations Fatal work-related injuries Amputations reported by employers Amputations identified in state workers’ compensation systems Hospitalizations for work-related burns Musculoskeletal disorders reported by employers Carpal tunnel syndrome cases identified in state workers’ compensation systems Pneumoconiosis hospitalizations Pneumoconiosis mortality Acute work-related pesticide poisonings reported to poison control centers Incidence of malignant mesothelioma Elevated blood lead levels among adults Workers employed in industries with high risk for occupational morbidity Workers employed in occupations with high risk for occupational morbidity Workers in occupations and industries with high risk for occupational mortality Occupational health and safety professionals OSHA enforcement activities Workers’ compensation awards Limitations • Geographic profile data are based on the Current Population Survey, a monthly probability sample of households in the United States - Excluded from geographic profile are workers less than 16 years of age, active-duty military personnel, and inmates in correctional institutions • Deaths in the military are included in the number of fatalities but not the rates • Number of work related injuries and illnesses may be underestimated because not all individuals with work-related injuries and illnesses file for or are covered under workers’ compensation and only private industry is captured by BLS data • Federal employees and selected industries (i.e. agriculture) as well as independent contractors are exempt from filing workers’ compensation claims under state workers’ compensation laws and are not included in this calculation • Not all work-related pesticide exposures resulting in illness are reported to poison control centers Non-Fatal Work-Related Injuries and Illnesses Future Directions • Approximately 5% of the workforce in CO was employed in industries at high risk for occupational morbidity • An estimated 10% of workers in CO were employed in occupations at high risk for occupational morbidity • On average, 1.4% of workers in CO per year filed a work-related injury and illness claim with Workers’ Compensation • On average, 122 per 100,000 workers was hospitalized in CO for a work-related injury or illness. • Of workers’ compensation claims filed, over half involved more than 10 days of temporary disability benefits •  The average benefit paid per covered worker per year from 2001 to 2005 ranged from $270 to $419 in CO and $373 to $429 in the US • The CO OHI working group helped to develop a successful application to the CDC for a CDC fellow to be assigned to CDPHE to develop a CO Occupational Health Surveillance system – the fellow was assigned to CDPHE in September 2008 for 2 years • The CO OHI working group helped to organize and participated in the 1st and 2nd Western States Occupational Network (WestON) conferences bringing together 19 western states’ Departments of Public Health and/or Departments of Labor, NIOSH, and western NIOSH Agricultural Research Centers and ERCs to build capacity for occupational health surveillance in the western US- continued annual WestON meetings are planned • The CO OHI working group organized a CO occupational health surveillance capacity building meeting in October 2008 with representatives from CO Department of Labor and Employment, Workers’ Compensation, CDPHE divisions, Pinnacol Assurance, Colorado School of Public Health’s MAP ERC, Denver Health COSH, NIOSH Denver Regional Office, OSHA, CO School of Public Health, National Jewish, ALA of CO, Rocky Mountain Poison Control Center, CO Business Group on Health, Tri-County Health Department, and CSU High Plains Intermountain Center for Agricultural Health and Safety– this solidified a strong network of interested occupational experts within CO who continue to work closely with the CO OHI working group • The MAP ERC published a report “Occupational Health Indicators in Colorado: A baseline health assessment (2001-2005)” and the report was distributed to the major leaders in the CO house and senate, the Governor and Lt. Governor, and the CO congressional delegates • The newly created Occupational Health Surveillance office within CDPHE applied for NIOSH conference support grant to build state wide capacity for an occupational health surveillance system and applied for a State-based Occupational Health Surveillance grant from NIOSH in the summer 2009 to develop a comprehensive Occupational Health Surveillance Program in Colorado • CDPHE has gathered additional health indicator data that could not be collected in the initial OHI analysis and is continuing to perform trend analysis with more recent years of data • This project is supported by Grant 1T42OH009229-01 from CDC-NIOSH. Data Sources • Colorado Health Information Dataset • Colorado Hospital Association • Healthcare Cost and Utilization Project • National Academy of Social Insurance • OSHA • Rocky Mountain Poison Control Center • U.S. Bureau of the Census • Bureau of the Census County Business Patterns • BLS Geographic Profiles of Employment and Unemployment • BLS Covered Employees and Wages • BLS Current Population Survey • Census of Fatal Occupational Injuries • Colorado Central Cancer Registry • Colorado Department of Public Health and Environment • Colorado Division of Workers’ Compensation