NIOSH
Economic Research Projects:
Intramural |
Comparative Analysis of Methods for Calculating Employer
Costs
of Workplace Illness and Injury
Investigator(s): Tim Bushnell
Affiliation: National Institute for Occupational Safety
and Health
Division of Surveillance, Hazard Evaluations, and Field Studies
(513) 841–4428
Partner(s): Larry Chapman
University of Wisconsin
Keywords: employer costs, cost accounting
Purpose:
This project will demonstrate the variety of methods and perspectives
used in the United States and other countries for calculating employer
costs of workplace illness and injury. The project is also intended to
show common difficulties and pitfalls in calculating costs, and to help
identify best practices for further development.
Research Summary:
Many attempts have been made to provide a general method or accounting
framework for employers to calculate the cost of workplace illnesses and
injuries. A number of them have been developed abroad or are otherwise
not widely known. Within these methods, there are many differences in
focus and emphasis. Many recommendations are conflicting and are questionable
from a practical or theoretical standpoint.
This project will identify and characterize several of these methods
used to provide guidance for employer cost calculations and systematically
compare them. The basis of comparison will be the presence and absence
of certain elements and the identification of points of agreement and
disagreement. When methods are different, practical and theoretical issues
raised by any disagreements will be identified and described. Examination
of all of these methods as a group will also provide a picture of the
common difficulties and key opportunities associated with employer efforts
to calculate cost savings from reducing workplace injury and illness.
Cost Effectiveness of Fall Prevention Interventions
for
Aerial Lifts in the Construction Industry
Investigator(s): Paul Keane, Chris Pan
Affiliation: National Institute for Occupational Safety
and Health
Division of Safety Research
(304) 285–5894
Partner(s): The Center to Protect Workers’ Rights
Keywords: economic consequences, economic theory, economic methods, risk
analysis
Purpose:
This study will focus on the economic component of a NIOSH Division of
Safety Research project entitled the Fall Prevention for Aerial Lifts
in the Construction Industry. This field and laboratory study will use
engineering tools and methods to redesign equipment and improve work practice
controls to reduce fatalities and injuries associated with aerial lifts.
Research Summary:
Falls are one of the leading causes of injury and death in the construction
industry. Occupational falls in construction are associated with high
rates of days away from work, as well as insurance and workers’
compensation costs. Aerial lifts are commonly used in construction. Newer
lifts can elevate workers to increasing heights and thus represent a serious
and emerging fall hazard. The Occupational Safety and Health Administration
research identified 35 deaths between 1986–1990 that were associated
with vehicle-mounted elevated work platforms. Approximately 40% of the
deaths involved falls, and one third of the incidents involved equipment
failures or were related to materials or facilities. When aerial lifts
overturn or collapse, there is a high potential for loss of life or serious
injury, as well as a high potential for destruction of large items of
capital equipment and disruption of construction activities. This project
will perform a risk assessment on the causes of occupational falls involving
aerial lift platforms in the construction industry and assess the costs
of an intervention in equipment design, redesign and retrofitting, as
well as costs of interventions to address work practices. The cost effectiveness
of each candidate intervention, which includes new designs and work practices,
will be evaluated based on its potential to reduce falls and overturns
in comparison with cost.
Cost Model for Traumatic Injuries in Mining
Investigator(s): H. Kenneth Sacks, Regina Pana-Cryan, Lynn Elinson, Audrey
Podlesny
Affiliation: National Institute for Occupational Safety and Health
Pittsburgh Research Laboratory
(412) 386–6601
Keywords: cost model, mining, fatalities, lost time injury
Purpose:
This project will develop a cost assessment tool and generate cost estimates
to help focus injury prevention research.
Research Summary:
The starting point for the cost model will be the Mine Safety and Health
Administration (MSHA) injury and illness database. The database provides
information about the injured worker’s age, occupation, degree of
injury, and time lost from work. The model will be based on a societal
perspective and will calculate lost earnings and non-market loss (also
known as home production). Lost workdays are used as a proxy for lost
production, and the model will also include medical costs. Earnings will
be derived from union contract data and commercial wage surveys. Future
earnings estimates will be adjusted by the employment cost index and life
cycle salary growth. Medical costs will be based on the days lost from
work and the degree of injury. Aggregated data from the National Council
on Compensation Insurance’s detailed claims information will be
analyzed. Prior analysis has shown that medical costs are linearly related
to days lost and benefit class.
Following the cost model development, it will be applied to each injury
in the MSHA database between 1997 and 1999. Using these data, the estimates
from this model will be used to compare societal costs (medical costs,
nonmarket loss, and lost earnings) of fatal and nonfatal lost-time injury
by mining commodity sector, work location, and employer type (e.g., mine
operator or contractor employer).
Economic and Social Consequences of Injury and Fatality
in the Mining Industry
Investigator(s): Thomas W. Camm, Shann R. Ferch, Jami G. Dwyer
Affiliation: National Institute for Occupational Safety and Health
Spokane Research Laboratory
(509) 354–8001
Keywords: economic cost, social consequences, injury, fatality, stress,
systems
Purpose:
This project will build on existing expertise at the Spokane Research
Laboratory of NIOSH to examine the economic and social consequences of
injuries and fatalities in the workplace with a focus on the mining industry.
Research Summary:
Millions of occupational injuries occur each year in the United States
in addition to thousands of occupational fatalities. The direct medical
costs of injury are often a small percentage of the total impact of occupational
injury and death. Little attention is given to the social costs or the
indirect and intangible costs associated with workplace injury and fatality.
Heightened stress levels associated with high-risk occupations or working
conditions, particularly in a setting where a serious injury or a fatality
has recently occurred, can have a significant impact on both the productivity
and long-term health of workers. The effects of low cognitive levels as
a result of high stress levels and unsafe or unhealthy working conditions
(whether real or perceived) can also adversely affect a worker’s
ability to pay attention to work, be aware of at-risk behavior, and work
productively.
Using a multidisciplinary approach and research methodologies from systems
engineering, the project will include the following interrelated tasks:
• Develop a cost-of-illness method for measuring economic impacts
of injury and fatality
• Measure the stress level of workers at mine sites using standardized
psychological tests for anger, anxiety, and depression
• Develop a measure for individual differentiation based on Bowen
Systems Theory to demonstrate the relation of differentiation to working
safely, attention to task, productivity, and personal health
• Apply grounded theory research design to identify why workers
put themselves at risk
This project will provide qualitative data to enhance knowledge of the
social consequences of occupational injury and fatality. Incorporating
this information into existing training programs has the potential for
increasing the effectiveness of those programs and reducing the number
of occupational injuries and fatalities.
Economic and Social Consequences of Injury at Sand and
Gravel Operations
Investigator(s): Thomas W. Camm, Shann R. Ferch
Affiliation: National Institute for Occupational Safety and Health
Spokane Research Laboratory
(509) 354–8001
Keywords: economics, cost of injury, social consequences, systems theory
Purpose:
This project will determine the economic and social costs of workplace
injuries at sand and gravel operations.
Research Summary:
A system safety model will be developed to demonstrate how to integrate
the safety factors of workers, equipment, and environment into a framework
that will assess the social and economic consequences of an occupational
injury. Economic costs will be measured based on the cost-of-illness method;
social impacts will be measured based on levels of anger, anxiety, and
depression as indicators of worker stress. The cost-of-illness approach
is the most commonly used method for valuing the cost of an occupational
injury. Based on this method, a list of indirect costs associated with
injuries at sand and gravel mines will be developed for the project. These
indirect costs will include lost earnings, lost fringe benefits, lost
home production (e.g. laundry, cleaning, yard maintenance, etc.), employer
costs of retraining and re-staffing, coworker costs of lost productivity,
and time delays.
Three standardized questionnaires will be used to measure levels of depression,
anger, and anxiety: the Beck Depression Inventory, the State-Trait Anger
Expression Inventory-2, and the State-Trait Anxiety Inventory (Form Y).
The three questionnaires typically take 20 minutes to administer and use
indicators of work stress as proxies for social impacts of injury on the
worksite. The systems methodology being used for the project, integrating
a multidisciplinary approach to measuring the economic and social consequences
of injury, will have potential applications for other economic projects
within NIOSH.
Economic Cost of Fatal Occupational Injuries in the
United States
Investigator(s): Elyce Biddle, Dan Hartley
Affiliation: National Institute for Occupational Safety and Health
Division of Safety Research
(304) 285–5894
Keywords: economic consequences, traumatic fatalities, socio-economic
Purpose:
This project will enhance a standardized method and an interactive desktop
computer program that calculates the societal cost of fatal injuries as
reported through the National Traumatic Occupational Fatalities (NTOF)
surveillance system. The calculated costs from this research can be used
in evaluation tools such as cost utility, cost effectiveness, cost benefit,
and decision analysis to help allocate limited resources for research
and prevention efforts more effectively.
Research Summary:
The NIOSH Division of Safety Research (DSR) recently developed a computerized
costing model that calculates societal costs of fatal occupational injuries
using the cost-of-illness method, which is based on human capital theory.
This project will refine and enhance the computerized costing model previously
developed by DSR. The study will focus on the following:
• Expanding the computerized costing model to calculate the cost
of occupational fatal injury using Census of Fatal Occupational Injuries
(CFOI) data and transferring the technology to each CFOI participating
State
• Improving the specificity of the computerized costing model by
estimating indirect costs using State-specific wage and benefit data
• Changing application coding from Power-Builder to SAS, which is
a more widely used and more standardized application
• Improving the operational utility of the computerized costing
model for end-users
In general, cost estimates provide additional information about how injuries
affect society. Furthermore, they can improve injury prevention and control
program planning, policy analysis, evaluation, and advocacy. With these
enhancements, the computerized costing model will provide more accurate
cost estimates and operate more efficiently.
Economic Impact Analysis for the Quality Assurance and
Administrative Module on 42 CFR 84
Investigator(s): Elyce Biddle, Matt Bowyer, Thomas Camm, Dan Hartley
Affiliation: National Institute for Occupational Safety and Health
Division of Safety Research
(304) 285–5894
Partner(s): John Dacquisto, Gonzaga University
Jim Simon, National Highway and Traffic Safety Administration
Bob Burt, Occupational Safety and Health Administration
Keywords: economic impact, respirator, respiratory protection, quality
assurance
Purpose:
This project will evaluate the economic impact of the proposed changes
in the quality assurance and administrative module of 42 CFR part 84,
Tests and Requirements for Certification and Approval of Respiratory Protective
Devices.
Research Summary:
Employers, both large and small, rely on respirators to protect their
employees from airborne toxic contaminants. As the last and sometimes
the only defense against some acute and chronic health hazards at work,
respirators must be reliable and perform in the expected manner. Respirator
purchasers and users rely on the NIOSH performance standards and certification
program to assure that respirators will perform with a specific efficiency
for a definite purpose.
The NIOSH proposed regulatory change would implement new quality assurance
requirements that parallel the certification requirements of the International
Organization for Standardization (ISO).
This project will develop the economic impact statement to accompany
the proposed regulatory changes in 42 CFR part 84. Economic considerations
include the impact of the following:
• An annual maintenance fee for maintaining records based on a flat
fee per approval
• An increased fee schedule for approval applications
• A quality-assurance fee based on the actual cost of audit
• Potential cost increases to manufacturers related to equipment/process
change requirements to achieve regulatory approval for new standards
• Potential cost increases to manufacturers for new or upgraded
test equipment to monitor respirators as required by the new regulations
• Potential indirect cost increases to manufacturers associated
with the new regulations
• Increased barriers of entry into the respirator manufacturing
market
Employers’ Workers’ Compensation Savings
from Prevention
Investigator(s): Tim Bushnell
Affiliation: National Institute for Occupational Safety and Health
Division of Surveillance, Hazard Evaluations, and Field Studies
(513) 841–4428
Keywords: workers’ compensation, experience rating, employer costs
Purpose:
This project will provide ways of estimating the impact of employer injury
and illness prevention efforts on workers’ compensation expenses.
Financial arguments for prevention can be very effective, and knowledge
of the overall magnitude and pattern of prevention incentives can help
to form strategies for promoting prevention.
Research Summary:
A large part of this project will be the analysis of experience rating
plans in many States. These plans consist of formulas that generate an
insurance premium adjustment for an employer based on the number and cost
of claims filed in the past by that employer’s workforce. The size
of the premium reduction resulting from a given reduction in workers’
compensation claims depends on the size of the employer, the State, and
the industry. This research will produce estimates of premium dollars
saved per dollar of claims avoided and show how this varies by employer
size, State, and industry.
Another part of this project will be to analyze data on premiums paid
and the cost and number of claims for a large set of (nonidentified) employers
in at least one State with a low level of rate regulation. The purpose
of this analysis is to learn the extent to which premiums may be affected
by claims experience other than through the experience rating mechanism.
Insurance carriers in most States have the freedom to adjust premiums
to meet competition or reflect their own assessment of employers’
risk profiles.
The project will also include the collection and synthesis of information
that is needed for estimating the premium savings available to any group
of employers for preventing any type of illness or injury. Examples of
needed information are costs of claims by claim type, proportion of workplace
illnesses and injuries resulting in claims, geographical and employer
size distribution of industries, and the relationship between industry
classification systems.
Estimated Costs of Injuries Caused by Falling Through
Roof Openings, Surfaces, and Skylights
Investigator(s): Thomas Bobick, Paul Keane, Elyce Biddle, James Spahr
Affiliation: National Institute for Occupational Safety and Health
Division of Safety Research
(304) 285–5894
Keywords: construction, falls through openings, costs
Purpose:
This research will assess the degree to which elevated costs can be associated
with falls in the construction industry, specifically falls to lower levels
through roof or floor openings or through skylights. These incidents are
associated with injuries involving high numbers of days away from work.
Research Summary:
Fall-related occupational injuries are serious problems in the U.S. construction
industry. An important subset of the fall-to-lower-level category involves
workers falling through existing roof or floor openings and through roof
or floor surfaces, including skylights. These fall-through injuries are
among the most severe cases for median number of days away from work.
Data analyses will be conducted for injuries during 1992–2000 using
the Survey of Occupational Injuries and Illnesses maintained by the BLS.
This survey is an estimate of values from a sample of approximately 200,000
private establishments.
To obtain an estimate of costs related to fall-through incidents, the
Liberty Mutual Workplace Safety Index will be used. This index used their
claims information, along with data from the BLS and the National Academy
of Social Insurance, to determine the total in wage and medical payments
paid in 1998.
The total cost of a serious injury is the summation of direct and indirect
costs. Generally, indirect costs are estimated to be 2 to 5 times the
magnitude of direct costs. For this analysis, however, a very conservative
estimate will be used that assumes direct and indirect costs are of equal
magnitude. The dissemination of cost estimates will provide employers
with the basis to conduct cost-effectiveness analyses for potential workplace
interventions, such as guardrail systems or protective skylight screens.
Evaluation of Injury Prevention Efforts in Nursing
Homes
Investigator(s): Tim Bushnell, Robert Park
Affiliation: National Institute for Occupational Safety and Health
Division of Surveillance, Hazard Evaluations, and Field Studies
(513) 841–4428
Keywords: workers’ compensation, musculoskeletal injuries, nursing
homes, intervention effectiveness, employer costs
Purpose:
This project will evaluate whether a set of services and programs offered
by the Ohio Bureau of Workers’ Compensation (BWC) to Ohio nursing
homes has succeeded in reducing musculoskeletal injuries among nursing
home employees involved with lifting and transferring residents. A component
of this project is the calculation of the workers’ compensation
premium savings that Ohio nursing homes may have realized as a result.
Research Summary:
In 2000 and 2001, the Ohio BWC made a special effort to increase the number
of nursing homes taking advantage of its programs for the prevention of
workplace injuries. Nursing homes with relatively high rates of injury
were especially targeted. The principal programs involved the following:
• A variety of short safety and health courses, primarily for managers
and supervisors
• Consulting services in the areas of ergonomics, safety and hygiene,
and safety program development
• A safety grants program subsidizing the cost of patient lifting
equipment
The principal data for this project will be provided by the Ohio BWC
as a part of their effort to better understand the effectiveness of their
injury prevention efforts. These data include the date, type, and amount
of services received by each nursing home, and data on workers’
compensation claims filed by nursing home employees both pre- and post-intervention
(with personal identifiers removed). Additional expertise and data relating
to Ohio nursing homes are being supplied by the Scripps Gerontology Institute.
Estimates will be made of reductions in the number of workers’
compensation claims and in total benefit costs and days away from work
due to increased BWC services to nursing homes. These estimates will be
combined with data on nursing home premiums and their method of calculation
to estimate the impact of Ohio BWC services on the workers’ compensation
expenses of nursing home employers.
Evaluation of the Effectiveness of a Logger Safety
Training Program
Investigator(s): Jennifer Bell
Affiliation: National Institute for Occupational Safety and Health
Division of Safety Research
(304) 285–5894
Keywords: logging, training, injury prevention, costs
Purpose:
This project will determine the effectiveness of a logger safety training
program in reducing logging-related injuries and injury costs. It will
also determine which types of injuries are most affected after training.
Research Summary:
With an estimated lifetime fatality risk of 62.7 per 1,000 full-time workers,
logging is one of the most hazardous occupations and industries. Of all
small business industries, logging has one of the highest risks for occupational
injuries and fatalities. Despite the widespread awareness of the occupational
dangers of logging, fatality rates remain high. Because of the high risk
for traumatic injuries, loggers have been identified by the National Occupational
Research Agenda (NORA) as a priority research group. The state of West
Virginia has one of the highest logging fatality rates in the nation based
on 1992–1997 BLS Census of Fatal Occupational Injuries data.
This study will evaluate the effectiveness of a new logger safety training
program started in West Virginia called the Loggers’ Safety Initiative.
Specialized training is provided for all members of the logging crew (fellers,
skidder/dozer operators, trucker/loader operators, owner/operators). The
results of this study will provide a definitive statement about the usefulness
of the training program in reducing logging injury rates and associated
injury costs based on workers’ compensation claims data. The results
will also identify the types of injuries most and least affected by the
training in terms of reducing injuries and costs. The injury experience
and associated injury costs of logging companies not in the training program
will also be examined. The results of this study will be disseminated
so that States and individual logging companies can use this information
to initiate or refine logging safety efforts.
Exposure Assessment and Control Technology for Hexavalent
Chromium
Investigator(s): Leo Blade, Marjorie Wallace, Jennifer Topmiller, Amir
Khan, James Bennett, Keith Crouch, Anthony Martinez
Affiliation: National Institute for Occupational Safety and Health
Division of Applied Research and Technology
(513) 533–8462
Partner(s): Office of Regulatory Analysis
Occupational Safety and Health Administration
Keywords: lung cancer, hexavalent chromium, Cr(VI), engineering controls,
control technology, economic feasibility
Purpose:
This study, funded under an interagency agreement between NIOSH and OSHA,
will provide a characterization of occupational exposures to hexavalent
chromium (Cr[VI]) and will document engineering exposure-control measures
and work practices affecting those exposures by conducting field surveys
in a variety of industries. OSHA will use the results of this study to
determine the technical and economic feasibility of a new standard for
occupational exposure to Cr(VI). NIOSH classifies Cr(VI) as a potential
occupational carcinogen on the basis of observed increases in the risk
of lung cancer among groups of exposed workers, and on other data.
Research Summary:
OSHA has requested assistance from NIOSH to obtain exposure and exposure-control
information useful to the rulemaking for Cr(VI), particularly for the
required technical and economic feasibility evaluation. The potential
for worker exposures to Cr(VI) had been identified in industrial sectors
represented by at least 46 different two-digit Standard Industrial Classification
(SIC) codes, and OSHA has indicated that inadequate exposure and control
information was available for many of these sectors. This study will conduct
field industrial hygiene and engineering surveys at 21 selected sites,
which represent a variety of industrial sectors, processes, and operations.
A principal objective of this study is to measure full-shift personal
breathing-zone exposures to particulate-borne Cr(VI) in air. Another principal
objective is to identify and describe the exposure-control technology
and work practices used in these operations, and to recommend additional
control measures when appropriate. In addition, extensive supplemental
information, including costs associated with the control measures, will
be collected from participating sites and is intended to represent, to
the extent feasible, typical conditions. OSHA will use the results of
this study to determine the technical and economic feasibility of a new
standard for occupational exposure to Cr(VI).
Exposure Assessment and Control Technology for Silica
Investigator(s): Alan Echt, Michael Gressel, Daniel Almaguer
Affiliation: National Institute for Occupational Safety and Health
Division of Applied Research and Technology
(513) 533–8462
Partner(s): Office of Regulatory Analysis
Occupational Safety and Health Administration
Keywords: silicosis, crystalline silica, engineering controls, control
technology, economic feasibility
Purpose:
This project will evaluate the technical feasibility of controlling occupational
exposure to crystalline silica. Information from this study about the
types and costs of engineering controls and the extent of exposure to
silica in various industries will be provided to OSHA for their use in
determining the technical and economic feasibility of the proposed standard
for occupational exposure to silica.
Research Summary:
Occupational exposures to respirable silica in the form of quartz or cristobalite
increase a worker’s risk for silicosis and lung cancer. An estimated
2 million American workers are at risk for silicosis, 73% of whom are
in manufacturing industries. OSHA has requested assistance from NIOSH
to obtain information about exposure and engineering controls to establish
the technical and economic feasibility of the proposed standard for silica.
In this study, NIOSH will conduct industrial hygiene sampling surveys
at more than 30 sites to assess worker exposures to crystalline silica
under a variety of conditions and control measures. The principal objectives
of these surveys are the following:
• Estimate full-shift respirable particulate exposures to crystalline
silica in various industries including a representative sample of both
small (fewer than 500 employees) and large employers in the United States
• Determine (or measure) the full-shift exposures associated with
various processes and associated control techniques
• Identify short, high-exposure tasks that are amenable to control
Facilities and workers selected for sampling will include the different
processes or jobs, exposures, and engineering controls commonly found
where crystalline silica is used.
Feasibility of Forecasting U.S. Occupational Injuries
and Illnesses:
A Pilot Project
Investigator(s): Laura Blanciforti
Affiliation: National Institute for Occupational Safety and Health
Health Effects Laboratory Division
(304) 285–6121
Keywords: economic consequences, injuries, illnesses
Purpose:
This pilot project will explore the feasibility of updating an existing
study using econometric techniques to predict the economic costs of occupational
injuries and illnesses. Its main goal is to improve the economic information
currently being used by NIOSH decision makers and other occupational researchers
to answer questions related to the economic burden of all occupational
injuries and illnesses.
Research Summary:
In the past, costs of occupational injuries and illnesses have been estimated
using the human capital method, a statistical accounting approach. This
method is understandable and straightforward, but it is a massive undertaking
when considering all occupational injuries and illnesses. Such estimates,
however, are important measures of overall cost and are useful when comparing
the dollar costs of other injuries and diseases. Data series used in earlier
cost estimation have since been revised and now provide additional information.
Also, many data series useful in calculating related regressions have
been revised or updated. For example, earnings, fringe benefits, medical
costs, and insurance have all undergone revision. Furthermore, characteristics
of the workforce have changed over the last 10 years.
This project has three tasks. The first will be the model-building segment
of cases of occupational injuries and illnesses. Here, econometric models
of occupational injuries and illnesses for the 1992 to 2000 time period
will be developed using characteristic information gathered by BLS, NIOSH,
and other government agencies, as well as regression and structural equation
techniques. These models will generate estimates using data from 1973
to 1992, and they will be used to predict the 1992 and beyond values.
This will provide data for a root mean square analysis comparing actual
and forecasted values from 1997 to 2000. The second phase of the study
will be the cost-generating segment and it will involve data collection
of wages, medical costs, and other variables for 1997–2000. If necessary,
price indexation methods and other common statistical procedures to link
old and new data will be used. The third phase will be the forecasting
segment which will combine both prior phases to develop total estimated
costs of occupational injuries and illnesses. Forecasts will then be made
over various time segments such as 1 to 3 years, 3 to 5 years, and 5 to
10 years.
Feasibility of Matching Administrative Database Records
from
Multiple Washington State Sources
Investigator(s): Elyce Biddle, Kristi Anderson
Affiliation: National Institute for Occupational Safety and Health
Division of Safety Research
(304) 285–5894
Keywords: intervention evaluation, economic evaluation, apprenticeship,
training programs
Purpose:
This project will determine the feasibility of collecting detailed administrative
data from the State of Washington that could be used to evaluate the safety,
health, and economic outcomes of apprenticeship and training programs
overseen by the Washington State Apprenticeship and Training Council.
Research Summary:
In 1999, there were 297 programs with more than 10,000 active apprentices
in Washington. On completion, the apprentice receives a State-issued certificate
that identifies his or her qualifications as a journey-level worker. In
1999, 1,044 apprentices received such certification in 92 occupations.
Occupations ranged from firefighters to dispensing opticians to watershed
restoration/resource workers. Nearly 75% of the class of 1999 were certified
in construction occupations.
Apprenticeship and training programs are usually developed with a primary
focus on developing a highly skilled and diverse workforce. Although these
programs may be evaluated for their ability to create such a workforce,
they are rarely evaluated for their impact on the safety and health of
the worker and the economic outcomes of the program.
The administrative information maintained in Washington include databases
of completed apprenticeships, occupational injury and illness experience,
and wages and hours. Matching individual worker records from each data
collection system should be possible because each identifies a worker
using a single common identifier.
Should the matching of data from multiple Washington administrative sources
prove feasible, this information would provide the ability to conduct
a training effectiveness evaluation using safety, health, and economic
outcome measures. Results from such an evaluation could provide valuable
information to similar programs in other States.
Followback Study of Assault Cases Reported to a Sample
of
Hospital Emergency Departments in the United States
Investigator(s): Dan Hartley, Lynn Jenkins, Kristi Anderson
Affiliation: National Institute for Occupational Safety and Health
Division of Safety Research
(304) 285–5894
Partner(s): Tom Schroeder, Phil Travers
Consumer Product Safety Commission
Keywords: assaults, workplace violence, occupational injury
Purpose:
This followback study will examine the risk factors, circumstances, and
economic outcomes of workplace violence incidents that resulted in treatment
at a participating National Electronic Injury Surveillance System (NEISS)
hospital emergency department. This project is a component of the Congressional
directive for NIOSH to develop a workplace violence prevention initiative.
Research Summary:
NEISS is a database of injuries treated in a nationally representative
sample of U.S. hospital emergency departments. This study uses narrative
data from NEISS to determine potential cases for a followback study related
to workplace assaults. For a 1-year period, the followback study will
use a telephone interview survey to collect information related to the
circumstances, risk factors, and outcome measures for workplace violence.
This information will help fill the gaps in workplace violence research
by describing the nature and magnitude of nonfatal injuries resulting
from workplace violence, examining the economic burden of workplace violence
to the injured worker, and identifying additional risk factors.
This study covers data collection for December 2002 through September
2003; approximately 1,000 interviews will be conducted. In addition to
an extended narrative description of the injury incident, the followback
interview will cover items such as general workplace organization, personal
worker characteristics, perpetrator characteristics, security measures,
prevention strategies, return to work, and bearers of the cost of the
injury. The data collected will provide critical information for understanding
the nature and impact of nonfatal workplace assault on a victim’s
ability to earn a living in his/her chosen profession, and will contribute
to preventing violence in the workplace.
Interaction Between Safety and Productivity:
A Case Study Using Lightweight Block
Investigator(s): Matt Bowyer, Elyce Biddle, Tom Bobick
Affiliation: National Institute for Occupational Safety and Health
Division of Safety Research
(304) 285–5894
Partner(s): Michael McCann and Laura Welch, Center to Protect Workers’
Rights
Dan Anton and John Rosecrance, University of Iowa
Keywords: safety, construction, economic consequences
Purpose:
This project will determine how the introduction of the new lightweight
block technology affects worker productivity in construction and, in turn,
how this productivity difference affects the safety of the workplace.
Research Summary:
The standard weight block is a plain-faced 8”x8”x16”
concrete block with a weight of approximately 35–38 pounds. Recent
production methods that use expanded shale lightweight aggregate or haydite
produce an 8”x8”x16” block that usually weights 26 lb
or less. This block, which is known as lightweight block, adheres to the
ASTM–C90–99A standard of 105 lb/cubic foot density, is fire
resistant and has good insulation capacity. The drawback to lightweight
block is a higher price compared with standard weight block.
The primary objective of this study is to elucidate the potential relationship
between new technologies, productivity, and safety using lightweight block
as a case study. To determine this relationship the project will do the
following:
• Determine differences in productivity between masonry workers
using lightweight block and standard weight block
• Determine differences in injury incidence, duration, and type
between workers using lightweight block and workers using standard weight
block
For the productivity evaluation, a case-control study will determine
productivity and injury differences between lightweight block and standard
weight block. On selected field study sites, time study analysis will
be used to determine the number of blocks laid during an 8-hour workday
for both workers using lightweight block (cases) and workers using standard
weight block (controls). Differences in rates and types of injury will
also be analyzed using company records, including workers’ compensation
data.
Measuring the Direct and Indirect Costs of Asthma
Investigator(s): Laura Blanciforti
Affiliation: National Institute for Occupational Safety and Health
Health Effects Laboratory Division
(304) 285–6121
Keywords: economic costs, asthma, workplace exacerbation
Purpose:
This project will examine the hypothesis that the cost of care for asthma
is greater for patients who report workplace exacerbation than others.
It will focus on the economic component of a NIOSH Division of Respiratory
Disease Studies project entitled Workplace Exacerbation of Asthma Study.
Research Summary:
This component of the Workplace Exacerbation of Asthma Study will look
at the subjects’ use of the health care system in the year before
being interviewed, as determined by a search of computerized databases
for outpatient care, inpatient care, and pharmacy dispensings. The study
will estimate the cost or charge for each item listed, which can then
be used to arrive at a total cost of asthma care for one year. The indirect
cost of care will be based on items in a study questionnaire. The cost
of care for those with workrelated exacerbation of asthma will be compared
with the costs for subjects without workrelated exacerbation. The statistical
significance of the difference in costs for those with and without workplace
exacerbation will be accomplished using the Student’s ttest. Also,
economic costs will be modeled to examine whether workplace exacerbation
and other factors (e.g., age, gender, etc.) are associated with cost.
Nursing Home Back Injury Intervention Study
Investigator(s): Jim Collins, Jennifer Bell
Affiliation: National Institute for Occupational Safety and Health
Division of Safety Research
(304) 285–5894
Partner(s): BJC HealthCare
Keywords: low-back pain, nursing homes, workers’ compensation,
economic consequences
Purpose:
This study will evaluate the impact of engineering controls (lifting equipment)
and medical management programs in reducing the incidence, severity, and
costs associated with injuries to nursing aides and orderlies that occur
during resident-transferring tasks in nursing homes.
Research Summary:
Nursing homes have the highest injury rate of all health services. Employees
in nursing and personal care homes suffer an estimated 200,000 work-related
injuries and illnesses a year. In addition, nursing aides, orderlies,
and attendants suffer the highest prevalence (18.8%) and report the most
annual cases of work-related back pain (n=269,000) among female workers
in the United States. BLS reported that musculoskeletal injury rates for
nursing homes are highest among all industries, surpassing even the construction
industry.
In nursing homes, many residents require round-the-clock assistance with
the basic activities of daily living. This study will evaluate the impact
of engineering controls (lifting equipment) and medical management programs
on reducing the incidence, severity, and costs associated with injuries
to nursing assistants that occur during resident-transferring tasks in
nursing homes. Workers’ compensation records, OSHA injury records,
nursing home demographic data, and nursing assistant demographic data
will be collected to describe the injury experience and injury-related
costs, pre- and post-intervention prevention programs, and risk factors.
The findings from this study will provide recommendations on reducing
the risk of back injury to nursing home workers.
Revision of the OSHA “$AFETY PAYS” E-Tool
for Employers
Investigator(s): Elyce Biddle, Dan Hartley
Affiliation: National Institute for Occupational Safety and Health
Division of Safety Research
(304) 285–5894
Partner(s): Robert Burt, Jens Svenson, and Edward Stern
Occupational Safety and Health Administration
Keywords: cost of injury, cost of illness, employer costs, economic consequences
Purpose:
This collaborative project will update and enhance the capabilities of
an existing electronic tool that provides employers with an economic measure
of the impact of occupational injuries and illnesses on their profitability.
Research Summary:
Introduced in the 1980s by OSHA, $AFETY PAYS is an interactive software
program that uses a company’s profit margin, the average costs of
an occupational injury or illness, and an indirect cost multiplier to
project the amount of sales a company would need to generate to cover
those costs. Since that time, substantial changes in levels of the average
and indirect costs indicate the need for revision of the underlying components
of the estimation process. Additional cost categories will be added to
the original OSHA program, and the computer program will be enhanced by
providing the ability to customize the program according to a firm’s
sophistication in capturing their costs. Firms that do not collect any
cost information will be provided default values for estimation purposes.
Project goals are to raise awareness of the cost of occupational injury
and illness and to increase the motivation for employers to adopt injury
and illness prevention efforts. To accomplish these goals, the computer
program will be widely disseminated to employers in the United States.
CDs will be provided to nearly 100,000 employers from OSHA and NIOSH distribution
lists and to OSHA staff for outreach and compliance efforts. This product
will be made available on the NIOSH and OSHA Web sites.
Technology Investment Agreement with Advanced Technology
Institute
Investigator(s): Stephen Hudock
Affiliation: National Institute for Occupational Safety and Health
Division of Applied Research and Technology
(513) 533–8462
Partner(s): Advanced Technology Institute
Keywords: shipyard, ergonomics, intervention evaluations, cost-effective
Purpose:
This project will systematically study a variety of construction, repair,
and recycling processes in the shipyard industries to assess job risk
factors and devise and implement cost-effective ergonomic controls.
Research Summary:
The domestic shipbuilding, ship repair, and ship recycling industries
have historically had injury and illness incidence rates 2–3 times
higher than those of general industry, manufacturing, or construction.
Approximately one-half of all shipyard injuries can be considered musculoskeletal
disorders.
Because of the number of multifaceted job tasks performed by the various
trades in the ship construction, repair, and recycling industries, fitting
the job to the worker may not be practical or applicable. Additionally,
ergonomic engineering controls employed in other industries are not unilaterally
employable because of the diverse job activities in the shipyard industries.
It is imperative that research be undertaken to better understand the
high rates of musculoskeletal disorders and associated job risk factors.
This study will be conducted in three phases. The first phase will include
conducting walk-through surveys of domestic shipyards to examine trade-
or department-specific injury and illness rates, conducting job risk factor
assessments of the various trades or job processes, and determining the
willingness of shipyards to cooperate in the collection of the data and
the implementation of pilot ergonomic interventions.
The second phase will quantify job risk factors by using exposure assessment
tools for selected job processes in selected shipyards, recommend unique
ergonomic engineering controls to reduce the exposure to the risk factors
associated with the specific job processes, and implement pilot ergonomic
interventions for the specific job processes.
The third phase will evaluate the cost-effectiveness of the ergonomic
interventions and disseminate the results of the study to the public.
The broader application of the developed ergonomic interventions will
be used to transfer the lessons learned to other shipyards and boatyards
and other industries such as manufacturing and construction.
Willingness-to-Pay for a Safer Work Environment in
Alaska: A Pilot Study
Investigator(s): Elyce Biddle, Diana Hudson
Affiliation: National Institute for Occupational Safety and Health,
Division of Safety Research
(304) 285–5894
Partner(s): Alaska Marine Safety Education Association (AMSEA)
Keywords: willingness-to-pay, traumatic injury, fisherman
Purpose:
This pilot study will do the following:
• Identify the most efficient or appropriate survey method to determine
willingness-to-pay for a safer work environment by commercial fishermen
in Alaska
• Derive baseline measurements of the economic impact of injuries
and deaths to commercial fishermen in Alaska, using contingent valuation
and conjoint analysis methods
Research Summary:
Commercial fishermen in Alaska have some of the most dangerous jobs in
the Nation. Commercial fishermen represented 217 (33%) of the 648 occupational
fatalities that occurred in Alaska during 1990–1999. The annual
fatality rate of 124 per 100,000 workers is 28 times the overall U.S.
occupational fatality rate.
This project will survey commercial fishermen in Alaska using three different
methods of survey administration—telephone, mail, and face-to-face
interviews. Each of the survey groups will be administered one of two
different survey instruments: either a closed-ended bid-type questionnaire,
or an open-ended questionnaire to make up a total of six survey groups.
The response rates for the survey and each survey item will be determined
to derive variance estimates for future studies and to determine the most
efficacious way to conduct a larger willingness-to-pay survey. Econometric
models will be developed that are capable of producing estimates of willingness-to-pay
by commercial fishermen should a more robust study be undertaken in the
future. Cost estimations from the econometric model could then be used
to compare Alaska commercial fishermen to other groups, both nationally
and internationally.
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