Chapter 1 • Characteristics of U.S. Workers
Introduction
Background
The health status of U.S. workers continues to improve with time. As illustrated in this 2004 edition of the National Institute for Occupational Safety and Health (NIOSH) Worker Health Chartbook, the rates of fatal occupational injuries and nonfatal occupational injuries and illnesses have declined significantly, and Americans are living longer, healthier lives [Arias 2004; Molla et al. 2003].
Despite these positive statistics, occupational safety and health surveillance faces significant challenges. The data presented here attest to the depth of current surveillance programs, but a comprehensive and integrated surveillance program remains a long-term goal [NIOSH 2001]. Current surveys and surveillance programs do not adequately track occupational illnesses because of problems in recognition, recording, and reporting. These limitations hinder a complete and accurate assessment of the Nation’s occupational injury and illness burden.
The U.S. population is becoming increasingly diverse. The labor force is constantly evolving and being affected by new technology, services, and types of work and work organization. With so many changes, it is difficult to assure that the designs and contents of our household and establishment surveys capture this dynamic labor force. Many segments of the labor force (e.g., self-employed public-sector workers, workers in small-scale businesses, migrant workers, and youths under age 16) are beyond the scope of the only ongoing establishment survey of nonfatal occupational injuries and illnesses. Other segments of the labor force (part-time, temporary, disabled, and immigrant workers) are not a focus of ongoing surveillance or research programs. These priority populations are important segments of the labor force. Better tracking would (1) advance our understanding of health disparities and the needs of priority populations, (2) help us focus research, intervention, and communication efforts to prevent injuries and illnesses, and (3) promote the safety and health of these groups.
NIOSH compiled the first Worker Health Chartbook in 2000 to provide a variety of occupational health surveillance data and information in a single volume [NIOSH 2000]. In January 2001, NIOSH published its strategic plan for surveillance to provide a guide within NIOSH and a framework for occupational safety and health surveillance [NIOSH 2001]. Central to this vision is the concept of public health surveillance, “the ongoing systematic collection, analysis, and interpretation of health data essential to the planning, implementation, and evaluation of public health practices, closely integrated with the timely dissemination of these data to those who need to know” [NIOSH 2001]. This 2004 edition of the Worker Health Chartbook exemplifies these strategic goals for ongoing surveillance and periodic dissemination of data that track occupational injuries and illnesses.
Scope
This edition of the Worker Health Chartbook describes the magnitude of the Nation’s occupational health problem by providing a view of the distribution and trends for occupational injuries, illnesses, fatalities, and other measures of health status. The document presents national and State data to the extent possible. Data are presented from the U.S. Department of Labor (DOL) Bureau of Labor Statistics (BLS) on labor force demographics [BLS 2001] and employment projections [BLS 2002a]. Health status measures are described by age, race/ethnicity, severity of injury or illness, occupation, and industry of the affected workers [BLS 2003b,c]. The breadth of the data sources precludes a thorough discussion of them or of their methods and limitations. The following comments highlight the limits of the employment data and demographic variables used.
The Worker Health Chartbook makes extensive references to the BLS Current Population Survey (CPS) [BLS 2001], which is a household sample survey of the civilian noninstitutionalized population that requests information about the employment status of each household member aged 15 or older. The CPS provides estimates of employment, unemployment, and other characteristics of the labor force, the population as a whole, and various other population subgroups. These employment statistics are available for various demographic characteristics, including age, sex, race, occupation, industry, and class of worker. The lack of labor force data for youths aged 15 and younger (Chapter 5) limits occupational surveillance of working youths.
Employment-based fatality rates measure the incidence of fatal occupational injury for all workers in a group (usually an industry) regardless of exposure time. These rates do not reflect the movement of persons into and out of the labor force, the length of their work week (i.e., variation in hours worked) or work year, or the effect of multiple jobholders. The use of employment-based fatality rates has been shown to underestimate fatality risk for workers aged 20 and younger and for workers aged 65 and older [Ruser 1998].
Information about age, sex, and race/ethnicity are typical variables used for epidemiologic and statistical comparisons. The race/ethnicity categories used in the Chartbook are taken from the original data sources. In contrast to household surveys (in which respondents are likely to be more familiar with the race/ethnicity of a household member), workplace fatality, injury, or illness data may not be supplied by persons with such knowledge. For the Census of Fatal Occupational Injuries (CFOI) [BLS 2003a] and the annual Survey of Occupational Injuries and Illnesses (SOII) [BLS 2003b,c], these categories follow the guidance in the October 30, 1997 Federal Register Notice entitled Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity, issued by the Office of Management and Budget (OMB). These categories permit respondents to be classified as multiracial or multiethnic, which is important for improved description of Hispanic workers. Chapter 1 contains data from Census 2000 to permit comparisons between the general population and the occupational health data presented here.
Chapter 1 Overview
The Worker Health Chartbook 2004 focuses on worker health and the injury and illness statistics that measure the work-related health status of workers in the United States. The magnitude and patterns of injury and illness are influenced by labor force trends that may reflect general population changes. Such changes are illustrated in the charts presented here.
This chapter provides charts that illustrate the status of worker health as measured by occupational fatalities, injuries, illnesses, and disorders. Included are illustrations and discussions of (1) the demographic characteristics of the labor force (age, sex, race/ethnicity, occupation, and industry), (2) the work-related health status of workers (fatal and nonfatal injury and illness rates), and (3) the characteristics of injured and ill workers, their injuries, and their illnesses. Both national and State data are presented when they are available.
Since 1992, improved data collection by the BLS permits better descriptions of the injured or ill workers’ demographics (age, sex, race/ethnicity, occupation, and industry) as well as their work-related injuries and illnesses. This document illustrates the extensive statistical resources available for describing work-related injuries and illnesses.
