A Healthier Future for West Virginia - Healthy People 2010

20 - Occupational Safety and Health

Objectives | References

Background

Statistics presented in the national publication of Healthy People 2010 show the magnitude of work-related injuries and illnesses. Every 5 seconds a worker is injured. Every 10 seconds a worker is temporarily or permanently disabled. Each day, on average, 137 people die from work-related diseases, and an additional 17 die from work-place injuries on the job. Each year 70 youths less than 18 years of age die from injuries at work and 70,000 require treatment in a hospital emergency room. In 1996, an estimated 11,000 workers were disabled each day because of work-related injuries. In 1996, the National Safety Council estimated that on the job injuries alone cost the country $121 billion, including lost wages, productivity, administrative expenses, health care, and other costs. A 1997 study published in the Archives of Internal Medicine reported that the 1992 combined U.S. economic burden for occupational injuries and illnesses was estimated at $171 billion.

West Virginia, in general, has higher rates of occupational fatalities, injuries, and illnesses than the nation as a whole. The state is home to a number of industries that are inherently risky: coal mining, chemical manufacturing, steel manufacturing, and timbering. In 1998, there were 61,090 workers' compensation claims filed. A total of $630,279,423 in medical, wage replacement, and survivors benefits were paid out in all existing claims in that year. When West Virginia is compared to the nation from 1985 through 1995 (the latest year for which statistics are available), it ranks between first and fourth among 46 jurisdictions in cost of benefits per 100,000 workers with West Virginia's total benefit payment ranging between 161% and 269% of the U.S. average. In 1995, the total benefit payment was 210% of the national average, with West Virginia ranking first.

The occupational safety and health chapter in the national publication had a total of 14 objectives. From those 14, the occupational health and safety focus group selected 5 for West Virginia to seek to accomplish. The baseline data for reducing work-related injuries is from 1996 since it was the last year used in the national objective. The baseline data for the other 4 objectives related to work-place fatalities, hearing loss, and occupational dermatitis are slightly more recent. By definition there are no baseline data for the developmental objective to improve injury surveillance.

One objective that at first seemed a "natural" for West Virginia was not adopted because of the lack of a method to establish reliable baseline data. That objective would have called for a reduction in mortality and morbidity from occupational pneumoconiosis. An incidence rate is difficult to construct because of the long-term development of the disease and because of multiple exposures to any single worker that may occur in different years and different industries. A good point prevalence rate could not be established because of declining employment in the major industries where occupational pneumoconiosis occurs: glass manufacturing and mining. However, the group recognizes that the disease is still a significant problem in West Virginia and encourages all prevention efforts to reduce its occurrence.

The West Virginia Outlook, a 1999 publication issued by the Bureau of Business and Economic Research at West Virginia University (WVU) reports that, while job growth is projected to continue from 2000 to 2003, the growth will be at a slower pace than it was throughout the 1990s. Mining will continue to register job losses; construction job growth will decelerate; transportation, communication, and public utilities employment will stabilize. Only manufacturing job growth will remain upward because of growth in durable manufacturing, wood products, and transportation equipment. The unemployment rate should stabilize at 6.7%, the lowest since the late 1970s. These statistics would indicate that the baseline data will provide good benchmarks.

The Objectives

OBJECTIVE 20.1. Reduce deaths from work-related injuries to no more than 5.6 per 100,000 workers. (Baseline: during 1994-98, 8.0 per 100,000)
20.1a. Reduce deaths in the coal mining industry to no more than 33.2 per 100,000 workers. (Baseline: during 1994-98, 47.4 per 100,000)
20.1b. Reduce deaths in the transportation industry to no more than 23.1 per 100,000 workers. (Baseline: during 1994-98, 33.0 per 100,000)
20.1c. Reduce deaths in the construction industry to no more than 20.5 per 100,000 workers. (Baseline: during 1994-98, 29.3 per 100,000)
20.1d. Reduce deaths in logging industry to no more than 40.9 per 100,000 workers. (Baseline: during 1994-98, 58.4 per 100,000)

Data Sources: Census of Fatal Occupational Injuries (CFOI), U.S. Bureau of Labor Statistics; WV Bureau of Employment Programs (WVBEP), WV Fatality Assessment and Control Evaluation Program

Deaths from work-related injuries have dropped significantly from an average of 74 per year for the 14-year period 1980 through 1993 to 58 per year for the most recent five-year period, 1994 through 1998. Still, these injuries remain a major public health problem for the state, with an overall rate higher than the national baseline of 5.1 in 1996. Work-related deaths are preventable, and public health efforts and resources should be targeted towards prevention efforts, especially in industries and worker populations at greatest risk. High-risk industries include construction, coal mining, motor freight transportation, and logging, all with rates nearly or more than double national rates.

The reduction of occupational incidents that result in death will require focused efforts embracing the principles of the public health model coupled with a thorough understanding of the interaction of agent, environment, and victim during the pre-incident, incident, and post-incident phases. This model is designed to identify, quantify, and prioritize risk factors, identify existing or develop new prevention strategies, implement the most effective injury control strategies, and monitor and evaluate results of intervention efforts. This comprehensive and continuous process will require the combined efforts of many groups and agencies encompassing educational and outreach efforts, the application of engineering controls, and the enforcement of work-place safety regulations.

OBJECTIVE 20.2. Reduce work-related injuries resulting in medical treatment, lost time from work or restricted work activity to no more than 6.3 cases per 100 full-time equivalent workers. (Baseline: in 1996, 9.0 per 100 full-time equivalent workers)
20.2a. Reduce work-related injuries in the construction industry to no more than 8.4 cases per 100 full-time equivalent workers. (Baseline: in 1996, 12.0 per 100 full-time workers)
20.2b. Reduce work-related injuries in the health services industry to no more than 6.7 per 100 full-time equivalent workers. (Baseline: in 1996, 9.6 per 100 full-time workers)
20.2c. Reduce work-related injuries in the agriculture/forestry/fisheries industry to no more than 13.2 per 100 full-time equivalent workers. (Baseline: in 1996, 18.9 per full-time workers)
20.2d. Reduce work-related injuries in the transportation and public utility sector no more than 3.0 per 100 full-time equivalent workers. (Baseline: in 1996, 4.3 per 100 full-time workers)
20.2e. Reduce work-related injuries in the mining industry to no more than 7.5 per 100 full-time equivalent workers. (Baseline: in 1996, 10.7 per full-time workers)
20.2f. Reduce work-related injuries in adolescent workers to no more than 4.9 full-time equivalent workers. (Baseline: in 1996, 7.0 per full-time workers)
20.2g. Reduce work-related injuries in older workers (age 55 and above) to no more than 3.6 per full-time equivalent workers. (Baseline: in 1996, 5.1 per full-time workers)

Data Sources: West Virginia Workers Compensation Information System (WVWCIS); WVBEP, Employment and Wages Division

A large number of workers are injured each year in West Virginia. According to West Virginia Workers' Compensation Division claims data, 53,265 and 51,033 occupational injury and illness claims occurred in calendar years 1995 and 1996, respectively, that resulted in medical treatment, lost time from work, or restricted work activity. The overall incidence rates per 100 full-time equivalent workers (FTEs) were 9.2 and 9.0, respectively. Therefore, West Virginia baseline rates were higher than the national average of 7.4 per 100 FTEs in 1996. If a 30% decrease, consistent with the national objective, is projected over a 14-year period, the expected incidence rate would be 6.3 per 100 FTEs, higher than the projected national average of 5.2 per FTEs in the year 2010. In both the agriculture/forestry/fishery and the mining industries, West Virginia baselines are well above the national baselines of 8.7 per 100 FTEs and 5.4 per 100 FTEs, respectively.

OBJECTIVE 20.3. (Developmental) Improve statewide work-place injury and illness surveillance by increasing the frequency and quality of the coding for work-relatedness in:
a. Cancer registries
b. Trauma registries
c. Risk factor surveys
d. Injury and illness medical encounter data (emergency department visits, clinic visits, hospital discharge records, death certificates)

Data Sources: a through d above

This objective will begin to address some of the significant gaps in statewide occupational injury and illness surveillance. It will provide a means to address the oversight of morbidity and mortality from occupational pneumoconiosis, a work-related illness particularly prevalent in West Virginia. Broad-based medical data are critical to assess occupational injury and illness trends in West Virginia as well as for targeting prevention programs to where they will do the most good.

The improved recording of work-relatedness of injuries and illnesses will require education and training efforts in the state's medical community to raise the importance and usefulness of this information. The development of a consensus definition of work-relatedness that encompasses all kinds of injury, illness, and death will be required to ensure consistency, standardization, and accuracy of reported events. Improvements will also require the modification and integration of several existing but largely distinct data systems (including Workers' Compensation and trauma registries). Existing systems should be modified only to the extent that they complement other systems to improve the quality of work-related injury and illness information. Better quality data will ultimately contribute to a clearer understanding of the etiology of occupational injury and illness and facilitate the development of prevention strategies that will lessen the likelihood of future similar events and, in turn, reduce their burden on families, employers, and the state.

OBJECTIVE 20.4. (Developmental) Improve by 25% the number of employers with more than 50 employees who have a hearing conservation program.

Data Source: WVBEP, Research, Information and Analysis Division

The Research, Information and Analysis Division of the Bureau of Employment Programs will survey all employers in West Virginia with more than 50 employees in 2000, 2005, and again in 2010 to measure their compliance with Occupational Safety and Health Administration standards for a comprehensive hearing conservation program.

Hearing loss is a significant cause of morbidity in working West Virginians, the majority of which is easily preventable. Simple but consistent efforts from employers who have comprehensive hearing conservation programs can be expected to reduce the number of employees exposed to harmful noise levels and prevent hearing impairment. The National Institute for Occupational Safety and Health (NIOSH) estimates that almost 30 million American workers are exposed to noise levels at work at or above 85 dBA, intense enough to cause a hearing impairment over a working life. The standard is for all employers to monitor noise levels and implement hearing conservation measures in areas with exposure levels greater than 85 dBA.

OBJECTIVE 20.5. Reduce occupational dermatitis claims to an incidence of no more than 60 per 100,000 full-time workers. (Baseline: during 1995-98, 67.3 per 100,000 workers)

Data Sources: WVWCIS; WVBEP, Employment and Wages Division

Occupational skin diseases (OSDs) or disorders are not unique to West Virginia but do affect a large part of the work force and are very common, with a rate approximately on par with the national 1996 rate of 69 per 100,000 workers. In West Virginia, as throughout the nation, OSDs are preventable. Strategies in the prevention of OSDs include identifying allergens and irritants; substituting chemicals that are less irritating/allergenic; establishing engineering controls to reduce exposure; utilizing personal protective equipment such as gloves and special clothing; emphasizing personal and occupational hygiene and establishing educational programs to increase awareness in the work place.

Primary prevention programs that include providing advice on personal protective equipment and educating the work force about skin care can successfully be directed toward workers in high-risk industries. Increased awareness by health care personnel, early detection, and proper diagnosis and treatment are also important tools for achieving the objective. Over half a century ago, J.G. Downing, a Boston dermatologist, noted: "Prevention and early detection are much cheaper than indifference and neglect. Every outbreak should be thoroughly investigated, for the hypersensitive person may constitute the warning signal of a whole series of reactions, and careful study of his condition may be the means of preventing similar eruptions." Continuing medical education programs for health care personnel would play an important role in increasing awareness and lead to early and proper diagnosis and correct treatment. Allergens for skin patch tests are important tools for the proper diagnoses of occupational allergic contact dermatitis.

Meeting the Objectives

Health Promotion Channels for Achieving Objectives:

• Worksites
• Schools
• Public Health Programs
• Networks
• Health Care System
• Higher Education

The lead agency in preparing this chapter has been the Bureau of Employment Programs, Research, Information and Analysis Division.

In the past decade the state has acquired new resources to bring to bear on occupational safety and health. In 1989 the National Institute for Occupational Safety and Health provided the initial funding for the Institute of Occupational and Environmental Health at WVU. The Institute has grown as a residency program and faculty members have participated in site visits to small business to assess their safety needs and offer advice. In 1997 the BEP's Workers' Compensation Division established a Safety and Loss Control Program that allows the Division to address injury prevention as well as addressing the medical and financial needs of injured workers. Again, small and mid-sized employers are most effectively helped as large employers often have their own risk management programs. The Division also offers employers premium discounts for maintaining safety programs. The Bureau's Research, Information and Analysis Division, especially its Office of Workers' Compensation Research, will be involved with any employer surveys on occupational safety and health such as the one identified in developmental Objective 5. The Division's Office of Labor Statistics has employer survey data on occupational injuries and illnesses from the U.S. Department of Labor's Occupational Safety and Health Administration, which will allow interstate comparisons and comparison with similar data related to claims reported to the BEP's Workers' Compensation Division.

Other agency and organizational resources include the state Department of Labor, the Office of Miners' Health, Safety and Training, the WVU Center for Rural Emergency Medicine, the Institute for Labor Studies and Research at WVU, and the West Virginia Safety Council.

It will take all the above resources, as well as the participation of worksites, employers, and the continued special efforts of concerned individuals throughout the state who have an interest in occupational safety and health, to make a difference.

Work Group Members

Judith Greenwood, PhD, MPH, Work Group Leader, Assistant Director, Research, Information and Analysis Division, Workers Compensation Research, BEP
Marsha Bailey, MD, MPH, Director of Occupational Medicine, Corporate Health Services.
Chuck Boggs, MA, Safety Director, Workers' Compensation Division, BEP
Jennifer Burgess, Director, Safety Section, Department of Labor
Doug Conaway, Administrator of Enforcement and Safety, Office of Miners' Health, Safety and Training
Alan Ducatman, MD, MS, Professor of Community Medicine and Chairman, Department of Community Medicine, WVU
Tammy Gunnoe, Director, West Virginia Safety Council
Jim Helmkamp, PhD, Director of Research, Center for Rural Emergency Medicine, WVU
Richard Humphreys, Professor Emeritus, Industrial and Labor Relations, WVU, Compensation Programs Performance Council, BEP
Cheryl Johnson, MS, PhD, CPS, Extension Assistant Professor, Institute for Labor Studies and Relations, WVU
Syed Islam, MD, MPH, MSPH, DrPH, Research Director, Institute of Occupational and Environmental Health, WVU
Pat Posey, MA, RN, LPC, Nurse Coordinator, U.S. Postal Service
Roy Smith, Secretary/Treasurer, West Virginia State Building and Construction Trades
Emily Spieler, JD, Professor of Law, WVU Law School

References/Resources

Bonnie RJ, Fulco CE, Liverman CT, eds. Reducing the Burden of Injury-Advancing Prevention and Treatment. Washington, DC: Institute of Medicine, National Academy Press, 1999.

Christoffel T, Gallagher S. Injury Prevention and Public Health. Gaithersburg MD: Aspen Publishers, 1999.

Division of Research, Information and Analysis. Economic Summary. Charleston, WV: Bureau of Employment Programs, July 1999.

Helmkamp JC, Lundstrom WJ. "Work-related deaths in West Virginia from July 1996 through December 1999." J Occupational and Environmental Medicine 42(2): 156-162.

National Center for Injury Control and Prevention. Data Elements for Emergency Department Systems, Release 1.0. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, 1997.

National Center for Injury Prevention and Control. Fact Book and State Injury Profile for West Virgina. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, 2000.

Occupational Safety and Health Administration. Code of Federal Regulation 1910.95. Washington, DC: Occupational Noise Standard, 1974.

Robertson, LS. Injury Epidemiology - Research and Control Strategies. 2nd ed. New York: Oxford University Press, 1998.

State and Territorial Injury Prevention Director's Association. Consensus Recommendations for Injury Surveillance in State Health Departments. September 1999.

U.S. Department of Health and Human Services. Healthy People 2010 Objectives: Draft for Public Comment - Occupational Safety and Health Draft Objectives 8 and 11. Washington, DC: 1998.

United States Bureau of Labor. Census of Fatal Occupational Injuries, 1994-1998.

For More Information

Research, Information and Analysis Division
Worker's Compensation Research
4700 MacCorkle Avenue
Phone: (304) 558-4998; Fax: (304) 558-5004

This page was last updated June 28, 2001.
For additional information about HP2010, contact Chuck Thayer at (304) 558-0644 or Chuck.E.Thayer@wv.gov