Online Program

Medical management of occupational injuries and illnesses: Ethics, underreporting and workers' health

Tuesday, November 3, 2015 : 2:50 p.m. - 3:10 p.m.

Kathleen Fagan, MD, Office of Occupational Medicine, Occupational Safety and Health Administration, Washington, DC
A 2009 Government Accounting Office (GAO) report “Enhancing OSHA’s Records Audit Process Could Improve the Accuracy of Worker Injury and Illness Data”, along with several published studies, have documented that many worker injuries go unrecorded on the OSHA 300 logs and consequently are underreported in Bureau of Labor Statistics (BLS) reports.  In addition to employer incentive and absentee programs that discourage underreporting, along with workers’ fear of retaliation, medical management of workers’ injuries and illnesses play a part in underreporting.   OSHA inspections have uncovered medical management practices that not only result in undercounting of work-related injuries and illnesses but also are likely to have resulted in adverse effects on workers' health.   Further, these practices raise eithical concerns.   Case studies in poultry processing, meat packing and other industries will illustrate these issues.  The role of health care providers in provision of occupational health services and approaches to overcome these ethical and regulatory challenges will be discussed.

Learning Areas:

Ethics, professional and legal requirements
Occupational health and safety
Public health or related laws, regulations, standards, or guidelines
Public health or related nursing
Public health or related public policy

Learning Objectives:
Describe medical management practices identified in OSHA investigations. Analyze the effects of these practices on OSHA recordkeeping, underreporting and undercounts of occupational injuries and illnesses. Discuss the ethical and worker health issues arising from these medical management practices.

Keyword(s): Occupational Health and Safety, Ethics

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been an OSHA medical officer for 6 1/2 years and involved in an number of OSHA investigations. I have reviewed medical management policies and medical records in these investigations. I have conducted interviews of health care providers in these settings. I have evaluated the effects of these policies and practices on recordkeeping, worker health and ethical conduct. Previously, I practiced clinical occupational medicine for 25 years.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.