Employer-based occupational injury and illness surveillance: Amputation injury as a framework for the survey of reporting practices, tools and outcomes

The United States currently has no comprehensive system for the surveillance of non-fatal occupational injuries and illnesses. Instead, the surveillance for these conditions is conducted separately from the public health infrastructure. Consequently, the annual national statistics for work-related injuries and illnesses, (Bureau of Labor Statistics Survey of Occupational Injuries and Illnesses – BLS SOII), rely on reports submitted by a selected sample of employers. Considering its role in generating these data, as well the employer’s access to critical information regarding both exposures and the population at risk, the quality of employer-based surveillance is of substantial import to the prevention of occupational injury and illness. There is substantial evidence, however, that work-related injury and illness cases are underreported to the BLS, with the literature commonly estimating that between 40% – 70% of such cases fail to be reported. Barriers to accurate reporting by employers have been identified, but their prevalence among employers has not been quantified nor have employer reporting practices been described. We developed a cross-sectional survey instrument that addressed employer reporting of work-related injuries and illnesses. The survey instrument asked participants to describe how work-related injury and illness cases were documented in their workplace and used a hypothetical work-related amputation injury case as a framework on which to base questions regarding the data elements routinely collected by employers. It also assessed the presence of potential barriers to employer reporting of work-related injury and illness cases among the respondents’ organizations. The web-based survey instrument was administered to the membership of the American Society of Safety Engineers (ASSE) Region III in November 2015. The study found that organization size was a significant factor in the availability of data in workplace records of injuries and illnesses. Overall, respondents from smaller organizations (250 full-time employees or less) have almost twice the odds of reporting having data elements available in their workplace records than larger organizations (1.83, 95% CI = 1.04, 3.23). This difference seems to be especially true for task-related risk factors. The study also found the highest prevalence of filters/barriers to employer reporting of work-related injuries and illnesses are the use of related metrics for other business applications. As the filters/barriers to reporting do not vary significantly by industry or average number of full time employees, generic interventions for improving employer-reporting of these cases could be effective. Further study of how smaller organizations are able to collect more risk factor data would be a worthwhile investigation, to see if larger organizations could adopt the same methodology or identify if there is some particular barrier preventing larger organizations from doing the same