The purpose of this compendium is to provide an overview of current research projects conducted or funded by NIOSH that focus on prevention and control of occupational injury and illness through economic analysis. The compendium includes 22 NIOSH intramural and 32 NIOSH-funded extramural economic projects or other research projects with a substantial economic component that were being conducted during 2002 and 2003.

Contents

Foreword

Occupational safety and health professionals in a variety of disciplines including epidemiology, occupational health nursing, industrial hygiene, safety engineering, occupational medicine, and related areas have worked tirelessly over the past 30 years to make the Nation’s workplaces safer, and their advocacy and contributions have been widely recognized. Less well known is the role of economists, policy analysts, prevention effectiveness specialists, and social scientists in determining the economic burden of work-related illness and injury and the economic effects of introducing prevention and intervention efforts into the workplace.

This compendium of NIOSH intramural and extramural economic research is an effort to illuminate the vital research being done by these professionals. Their work will help determine the impact of occupational illness and injury on the Nation’s workers, the commensurate burden upon our Nation’s resources, and the cost effectiveness of introducing measures into the workplace that can alleviate this health burden. This area of research provides an important dimension and context for the work of the occupational safety and health community.

John Howard, M.D.
Director, National Institute for Occupational Safety and Health
Centers for Disease Control and Prevention

Common Agency Acronyms Used In This Document

BLS Bureau of Labor Statistics
EPA Environmental Protection Agency
MSHA Mine Safety and Health Administration
NIOSH National Institute for Occupational Safety and Health
OSHA Occupational Safety and Health Administration

Background

Each year, millions of occupational injuries and illnesses occur in the United States. The Liberty Mutual insurance company estimated that in 2001, the direct cost of workplace injuries and illnesses was $45.8 billion, and the indirect costs ranged from $137.4 billion to $229 billion. Estimates generated by the National Safety Council for the cost of work injuries in 2002 were $1,060 per worker, a national total of $146.6 billion. Moreover, according to the National Academy of Social Insurance, between 1998 and 2002, employer costs for providing workers’ compensation rose from $52.8 billion to $72.9 billion. The costs of work-related illness and disability both in human and economic terms justify the allocation of substantial resources for the control of workplace hazards.

In addition to the direct costs of lost earnings and health care related to occupational injury and disease, there are numerous indirect economic costs. Employers sustain some of these, including additional hiring and training costs, disruption of work processes by workplace incidents, and the effects of workplace injuries or exposures on the productivity of coworkers who may feel at heightened risk. Other indirect costs are borne by the injured workers and their families—for example, loss of income, depletion of savings, and a reduced standard of living; increased expenditures for professional counseling and purchased caregiver services in the home; home modifications and equipment related to disability; and deferral or loss of education for family members. Other costs may fall on the community in the form of increased need for social service programs.

Understanding the total human and economic burdens of occupational injuries and illnesses is crucial to setting priorities and shaping other components of the occupational safety and health research agenda. Furthermore, determining the magnitude of these burdens is essential to the assessment of the economic effectiveness of safety and health interventions designed to reduce the number of occupational injuries and illnesses. Such evaluations provide decision makers in both the public and private sectors with necessary information to assess whether the outcomes of interventions justify the expenditures relative to other choices. Economic analysis is vital in preventing and controlling occupational injury and illness.

About the NIOSH Economics Interest Group

The National Institute for Occupational Safety and Health (NIOSH), established by the Occupational Safety and Health Act of 1970, has the primary responsibility of conducting research and making recommendations for the prevention of work-related disease and injury. NIOSH is committed to meeting its mission—to provide national and world leadership to prevent work-related illness, injury, and death by gathering information, conducting scientific research, and translating the knowledge gained into products and services.

In an effort to guide and coordinate research nationally, the National Occupational Research Agenda (NORA) was established in 1996. This agenda identified 21 research priorities, which included the social and economic consequences of workplace illness and injury. A partnership team, the Social and Economic Consequences of Workplace Illness and Injury (S/E Team) was formed to help develop, pursue, review, and disseminate research under this topic. An institute-wide workgroup, the Economics Interest Group (EIG), was formed under the auspices of the NORA S/E Team to address these tasks within NIOSH.

The EIG provides leadership for the advancement of economic research and evaluation at NIOSH with the further purpose of advancing science and informing decision makers. The EIG provides a forum for NIOSH researchers to discuss major issues in the fields of public health, economics, decision analysis, evaluation, and health services research as they apply to the practice of public health and safety research, and, more importantly, to provide a means to establish consensus on the best methods and practices available in these areas. This group assists other NIOSH researchers and encourages the use of economics in policy making, program development, and program evaluation. Current members include:

Elyce A. Biddle, Chair, Division of Safety Research
Laura Blanciforti, Health Effects Laboratory Division
Matt Bowyer, Division of Safety Research
Tim Bushnell, Division of Surveillance, Hazard Evaluations, and Field Studies
Thomas W. Camm, Spokane Research Laboratory
Barbara Fotta, Pittsburgh Research Laboratory
Dan Hartley, Division of Safety Research
Diana Hudson, Division of Safety Research
Ted Katz, Office of the Director
Paul R. Keane, Division of Safety Research
Rene Pana-Cryan, Office of the Director

Acknowledgments

The Economics Interest Group would like to thank Joyce Spiker and Herb Linn of the Division of Safety Research for their assistance with designing and assembling this document. We would also like to thank Janie Gittleman and Trish Quinn of the Center to Protect Workers’ Rights and Gwendolyn Cattledge of the NIOSH Office of Extramural Programs for their assistance in providing information about the current NIOSH-funded economics extramural projects.

About the Compendium

The purpose of this compendium is to provide an overview of current research projects conducted or funded by NIOSH that focus on prevention and control of occupational injury and illness through economic analysis. The compendium includes 22 NIOSH intramural and 32 NIOSH-funded extramural economic projects or other research projects with a substantial economic component that were being conducted during 2002 and 2003.

The principal investigator of each NIOSH intramural project was asked to describe the project in one page. The description for each extramural project was extracted from the project protocol submitted for funding consideration.

In addition to this document, the following compendia of NIOSH research can be accessed on the NIOSH Web site at www.cdc.gov/niosh. Interested readers are encouraged to examine each research compendium for safety and health projects.
• A Compendium of NIOSH Mining Research 2002 (DHHS NIOSH Publication No. 2002–110).
• A Compendium of NIOSH Construction Research 2002 (DHHS NIOSH Publication No. 2003–103).
• A Compendium of NIOSH Health Care Worker Research 2001 (DHHS NIOSH Publication No. 2003–108).

About NIOSH Extramural Research

NIOSH extramural projects are based on proposals submitted by academic and other researchers through the NIOSH Office of Extramural Programs. Applications for research grants, cooperative agreements, training grants, and conference grants are accepted throughout the year, and researchers interested in economics are encouraged to apply. Additional details are available on the NIOSH Web site at www.cdc.gov/niosh/oep/.

Some extramural projects are conducted through a cooperative agreement with the Center to Protect Workers’ Rights (CPWR), which is directed to encourage research on the following:
• Innovative pilot or feasibility studies to reduce injury and illness in construction
• Evaluations of interventions geared to developing and testing best practices
• Disseminating information and technology transfer
• Reviewing preventive systems (e.g., policies, procedures, organizational factors) that affect construction
• Ongoing surveillance
• Establishing and reviewing research priorities

CPWR supports an Economics Research Network that is dedicated to examining incentives and underlying economic determinants of safety and health outcomes in construction. Members include researchers from academia, private industry, labor organizations, government agencies, and other research organizations.

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