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Towards worker-centered injury surveillance and prevention

Julia F. Costich, PhD, JD, Kentucky Injury Prevention & Research Center, University of Kentucky, 333 Waller Ave., Suite 202, Lexington, KY 40504, 859-257-4954, julia.costich@uky.edu

Official data on occupational injury do not cover small firms, much agricultural injury, the self-employed, and most government workers. Estimates of the burden of injury not accounted for in Bureau of Labor Statistics data range as high as two-thirds of all worker injuries. The proportion of worker injury lost to traditional surveillance is likely to grow as labor market restructuring pushes workers out of organized settings into independent contractor status and very small businesses. This growing sector has a disproportionate burden of injury, compounding the risk of misleading findings about the magnitude of occupational injury. The utility of workers' compensation data also declines in the decentralized work environment where the absence of an employment relationship leaves the worker without an accountable third party. We present preliminary findings from the use of worker-centered rather than workplace-centered surveillance in a population at high risk of occupational injury, Latino immigrants in central Kentucky. We found a large number of preventable injuries associated with overexertion or overuse, infection and other complications from lack of timely access to care, and occupational illnesses related to working conditions rather than exposure to harmful agents. Investigators learned of concealed work-related fatalities that were not included in occupational death data. The workers were hired primarily through labor contractors; no one was accountable for worker injury. We explore strategies to generalize findings from these surveillance techniques to other populations and conclude that accurate accounting of U.S. worker injury cannot be achieved without broader adoption of surveillance methods oriented towards workers.

Learning Objectives:

Keywords: Occupational Injury and Death, Vulnerable Populations

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Data Sources on Workplace Injuries and Illnesses: Workers' Compensation and Beyond

The 132nd Annual Meeting (November 6-10, 2004) of APHA