Title: Does Size Count Incidence and Reporting of Occupational Disease by Size of Company
1Does Size Count? Incidence and Reporting of
Occupational Disease by Size of Company
- Tim Morse, Ph.D.
- ErgoCenter
- UConn Health Center
2Collaborators
- Charles Dillon, NHANES
- Joseph Weber, CT Labor Dept.
- Nick Warren, UCHC
- Heather Bruneau, UCHC
- Rongwei Fu, UCHC
3NIOSH/OSHA Report higher rates for larger
companies
4Reasons for Correlation?
- Increased risk vs. better reporting
- Increased risk?
- Biersner and Winn, 1998
- More repetition in larger companies?
- Connected to industry segment or other co-variate
such as worker age? - Better reporting?
- Oleinick, et al. 1995
- MSD is under-reported
- Occupational disease is primarily MSD
- Better recordkeeping?
- Less fear of reporting?
5Why do we care?
- How do you best target industries?
- Grants for small employer training
- Prioritize OSHA inspections
- Other policy issues
- Recordkeeping by small employers
- What is source of problem?
- Repetition, stress, other risk factors
- Need for and focus of internal training for
companies - Under-estimate of Occupational Disease if
under-reporting
6Under-reporting
- CUSP (CT Upper-Extremity Surveillance Project)
Data - 9.1 of population with likely work-related
prevalent MSD - 0.78 (95 CI 0.58-1.24) doctor-called incident
cases - 10.6-21.0 had filed workers compensation claims
7Correlates of under-reporting (CUSP)
- Severity of MSD
- Surgery (OR 3.5)
- Time off work (OR 4.5)
- Doctor diagnosis (OR 13.7)
- Psycho-social factors
- Management cares (OR 2.0)
- Fear of reporting
- Union (OR 4.1)
- Industry/Occupation
- Manufacturing, transport, trade higher
- Hourly wage workers (OR 2.8)
8Population-based telephone survey (CUSP)
- Random sample of 3,200 CT workers
- 78 interview response rate
- with likely work-related MSD
- of cases reported to workers comp
- Compare to BLS MSD figures by size of company
- Size of company coded by CT Labor Dept
additional coding by InfoUSA
9Statistical methods
- Data reduction of risk factors by factor analysis
- Tabular analysis of MSD by size of company
- Partial correlations and Logistic regression
10ConnOSHA/BLS Survey
- Connecticut, 1996
- Repetitive Trauma
- 61.6 of occupational illnesses
- 3.6 of all injuries and illnesses
- 3,711 cases of repetitive trauma
- 28.8 per 10,000 workers
11CT BLS Repetitive trauma rates also increase by
size of business
12Results Coding for Size
- Only 64 of respondents could be coded for size
- No major differences between coded and uncoded
for gender, age, and ethnicity - Minor differences in education
- 33 (uncoded) vs. 27 (coded) High school grad
- 13 vs 20 for post-graduate
- Differences in industry
- government (5.2 uncoded vs. 20.1 coded)
- service (60.2 vs. 50.7)
- construction (8.1 vs. 4.1)
13Demographic characteristics by company size
- No difference in gender distribution
- Higher education in larger companies
- chi-square110.3, siglt.001
- Blacks and Hispanics over-represented in larger
companies - chi-square39.6, sig.006
- Older workers in very large and very small
companies - chi-square72.7, siglt.001
14Risk Factors
- Factor analysis
- Physical risk factor (push/pull,reach above,
wrist bent, tool use) - Stress/computer factor (job stress, computer use)
- Correlations with business size
- physical risk factor (r -.14)
- stress/computer factor (.14)
15Partial correlations
- Controlling for gender, race, marriage, age, and
education. - Physical risk factor and Business size
- -.078 (p.001)
- Stress/computer risk factor and business size
- .120 correlation (plt.001)
16MSD Prevalence by Company Size, CUSP, CT, 1996
17MSD by Company Size, CUSP, CT, 1996Chi-square9.4
, sig.052
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23Physical risk by MSD prevalence, by firm size,
CUSP, CT, 1996
24Logistic Regression
- MSD case on Size
- OR0.91
- CI 0.83-1.00
- Doctor called MSD on Size
- OR0.88
- CI 0.78-0.99
25Logistic Regression
- Entered Company size, gender, age, industry,
occupation, married, race - Backward conditional regression
26Logistic regression
- MSD
- Stay in equation Gender, age, race, occupation
- Size marginally significant (OR0.90 0.81-1.00)
- Larger companies have lower rates
- Doctor called
- Stay in regression occupation, gender, race
- Size not significantly related to MSD
27Cautions and limitations
- Self-reported data
- Prevalence, not incidence
- Just MSD
- Only 64 could be coded for size
- Likely that sample under-represented smaller
companies - Demographics similar between coded and uncoded
- Not likely to systematically affect rate of MSD
by size
28Conclusions
- Business size is only weakly related to MSD, in
negative direction (in contrast to BLS reports) - Risk factors vary somewhat by size largest
companies have - Lowest physical risks,
- Highest stress and computer risks
29Under-reporting
- Strong positive correlation in BLS reports
between MSD and company size most likely due to
better reporting in larger companies - Appears to be large under-reporting for smaller
companies