20 - Occupational Safety and Health
Objectives | References
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
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
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
Top of Page
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
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
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
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:
- Public Health Programs
- 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,
Top of Page
Marsha Bailey, MD, MPH, Director of Occupational Medicine, Corporate
Chuck Boggs, MA, Safety Director, Workers' Compensation Division,
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
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
Emily Spieler, JD, Professor of Law, WVU Law School
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.
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,
For More Information
Research, Information and Analysis Division
Worker's Compensation Research
4700 MacCorkle Avenue
Phone: (304) 558-4998; Fax: (304) 558-5004