Fatal illness

"The human and economic losses attributable to nonfatal occupational illness are difficult to fully assess. For many illnesses, there is a long latency between exposure and the development of disease, and the association of disease with occupation is not readily apparent. The failure of some health care professionals to routinely obtain patients' work histories and report work-related illnesses contributes to the lack of data. Even so, occupational health data systems have helped identify new and emerging problems and trends such as occupational musculoskeletal disorders and asthma. The Bureau of Labor Statistics (BLS) records information about nonfatal occupational illness in the Survey of Occupational Injuries and Illnesses (SOII) using data from logs maintained by employers. Nearly 430,000 nonfatal occupational illnesses were recorded in SOII in 1997. About 60% of those illnesses occurred in the manufacturing sector. The illness incidence rate for 1997 was 49.8 cases per 10,000 full-time workers. Illness incidence rates varied by industry, with the highest rate occurring in manufacturing. The rates in private industry increased with establishment size, with the highest rate occurring in establishments employing 1,000 or more workers. Disorders related to repeated trauma (including carpal tunnel syndrome [CTS], tendinitis, and noise-induced hearing loss) accounted for 64% of the occupational illnesses recorded in SOII in 1997. CTS accounted for more than 29,000 cases with days away from work in 1997. Half of the CTS cases required 25 or more days away from work. Most noise-induced hearing loss cases with days away from work occurred in manufacturing. Skin diseases or disorders represented 13% (approximately 58,000 cases) of work-related illnesses recorded in SOII in 1997. Dermatitis, a subcategory of skin diseases or disorders, resulted in more than 6,500 cases with time away from work. Half of these cases required 3 or more days away from work. Illnesses reported to SOII are those most easily and directly related to workplace activity (e.g., contact dermatitis). Diseases that develop over a long period (e.g., cancers) or that have workplace associations that are not immediately obvious are overwhelmingly underrecorded in SOII. Consequently, other approaches and data sources have been developed to track occupational illnesses in a more active way. For example, the Sentinel Event Notification System for Occupational Risks (SENSOR) establishes a variety of simultaneous data sources to increase the chances of identifying a work-related illness in State surveillance systems. The California SENSOR program has specifically targeted surveillance of occupational CTS. Of the CTS cases identified in that program through physician first reports filed with the State compensation system in 1998, 30% occurred in the services industry and 17% occurred in manufacturing. Currently, the Michigan SENSOR program monitors noise-induced hearing loss. Manufacturing accounted for 51% of the noise-induced hearing loss cases reported by clinicians in 1998. Seven States have had active SENSOR programs for silicosis surveillance. From 1993 to 1995, 75% of silicosis cases occurred in manufacturing. In addition, four States have had active SENSOR programs for occupational asthma surveillance. The industry divisions accounting for the most cases from 1993 to 1995 were manufacturing (42%) and services (31%). Other public and private programs describe toxic exposures, pesticide poisonings, X-rays of working underground coal miners, infections in health care workers, and self-reported respiratory diseases among nonsmokers by industry. For example, the Adult Blood Lead Epidemiology and Surveillance Program (ABLES) monitors elevated blood lead levels (BLLs) in persons aged 16 and older. In 1998, a total of 10,501 adults in 25 States had BLLs of 25 microg/dL or greater." - NIOSHTIC-2Editors: Roger R. Rosa, et al.Includes bibliographical references (p. 48-50).Originally published as chapter 5 of: Worker health chartbook