The law and incomplete database information as confounders in epidemiologic research on occupational injuries and illnesses

Oleinick, Arthur; Zaidman, Brian

doi:10.1002/ajim.20763

Cited by 21 publications

(25 citation statements)

References 25 publications

(44 reference statements)

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“…It has been estimated that aggregate national expenditures in the 2002 MEPS were about 13.8% below summary national expenditures from the National Health Expenditure Accounts [42]. Lastly, workers’ compensation programs are jointly managed by the federal and state governments, and research has suggested that the proportions of occupational injuries covered by workers’ compensation program differ significantly among the states [43-45]. …”

Section: Discussionmentioning

confidence: 99%

Medical expenditures associated with nonfatal occupational injuries among immigrant and U.S.-born workers

et al. 2012

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BackgroundNo national study has investigated whether immigrant workers are less likely than U.S.-workers to seek medical treatment after occupational injuries and whether the payment source differs between two groups.MethodsUsing the 2004–2009 Medical Expenditure Panel Survey (MEPS) data, we estimated the annual incidence rate of nonfatal occupational injuries per 100 workers. Logistic regression models were fitted to test whether injured immigrant workers were less likely than U.S.-born workers to seek professional medical treatment after occupational injuries. We also estimated the average mean medical expenditures per injured worker during the 2 year MEPS reference period using linear regression analysis, adjusting for gender, age, race, marital status, education, poverty level, and insurance. Types of service and sources of payment were compared between U.S.-born and immigrant workers.ResultsA total of 1,909 injured U.S.-born workers reported 2,176 occupational injury events and 508 injured immigrant workers reported 560 occupational injury events. The annual nonfatal incidence rate per 100 workers was 4.0% (95% CI: 3.8%-4.3%) for U.S.-born workers and 3.0% (95% CI: 2.6%-3.3%) for immigrant workers. Medical treatment was sought after 77.3% (95% CI: 75.1%-79.4%) of the occupational injuries suffered by U.S.-born workers and 75.6% (95% CI: 69.8%-80.7%) of the occupational injuries suffered by immigrant workers. The average medical expenditure per injured worker in the 2 year MEPS reference period was $2357 for the U.S.-born workers and $2,351 for immigrant workers (in 2009 U.S. dollars, P = 0.99). Workers’ compensation paid 57.0% (95% CI: 49.4%-63.6%) of the total expenditures for U.S.-born workers and 43.2% (95% CI: 33.0%-53.7%) for immigrant workers. U.S.-born workers paid 6.7% (95% CI: 5.5%-8.3%) and immigrant workers paid 7.1% (95% CI: 5.2%-9.6%) out-of-pocket.ConclusionsImmigrant workers had a statistically significant lower incidence rate of nonfatal occupational injuries than U.S.-born workers. There was no significant difference in seeking medical treatment and in the mean expenditures per injured worker between the two groups. The proportion of total expenditures paid by workers’ compensation was smaller (marginally significant) for immigrant workers than for U.S.-born workers.

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Section: Discussionmentioning

confidence: 99%

Medical expenditures associated with nonfatal occupational injuries among immigrant and U.S.-born workers

et al. 2012

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“…Taken together, these factors will prevent the case from being included in epidemiological data, thus resulting in an underestimation or miscount of the true number of cases of a specific occupational disease [30]. …”

Section: Discussionmentioning

confidence: 99%

“…It will also allow physicians to gain a better understanding of occupational events and workplace illnesses through self-education involving case-by-case evaluation of occupational diseases. In addition we hope that by educating PCPs in this way their failure rate in detecting occupational disease will be reduced and thereby increase the surveillance of specific diseases by a resultant increase in the reporting by PCPs to regulatory agencies and, in part, to the epidemiological literature [30]. …”

Section: Discussionmentioning

confidence: 99%

The Primary Care Practitioner and the diagnosis of occupational diseases

Cegolon

Lange²,

Mastrangelo

2010

BMC Public Health

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BackgroundRather than a clinical diagnosis, in occupational medicine the critical point is the etiological diagnosis. The first is useful for the therapy, the latter for preventive, epidemiological, regulatory, and insurance measures.DiscussionAs with causality criteria which are employed in population studies, the answering of four easy questions allows a Primary Care Practitioner to establish a causal link between the work activities and a potential disease that a specific patient may present.After determining the clinical diagnosis and the actual pathology of an occupational disease, the identity, duration, and intensity of the exposure have to be detected for establishing a close-causal effect. The judgment on the occupational origin of the disease requires an integrated approach using multiple sources of information, and goes beyond the clinical diagnosis. This may require consultation with a specialist in occupational medicine.SummaryIt is important that the Primary Care Practitioner takes an accurate medical history since this may be the only chance a patient has to have their occupational disease recognised and properly detected/identified. Proper identification of the causative nature of such diseases is important for establishing preventive measures in eliminating and controlling future cases against exposure, epidemiological reporting and studies (particularly in identifying the rates of disease), regulatory reporting requirements and insurance compensation.

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“…Data inaccuracies, different definitions of data elements, and disparate criteria for inclusion all require researchers to make choices about how to assemble and analyze the data. All of these issues are present in the data used by Oleinick and Zaidman [2009] in this issue and in the earlier studies by Rosenman et al [2006] and by Boden and Ozonoff [2008]. These data shortcomings and researchers' responses to them may have important implications for research results.…”

Section: Introductionmentioning

confidence: 90%

Researcher judgment and study design: Challenges of using administrative data

Boden

Ozonoff

2009

American J Industrial Med

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Studies linking administrative data from different sources require substantial judgment in constructing research datasets and choosing analytic methods. Moreover, different sample construction rules lead to different results. This suggests that sensitivity analysis should be carried out when alternatives cannot be ruled out. In this case, sensitivity analysis supports the hypothesis of substantial underreporting.

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The law and incomplete database information as confounders in epidemiologic research on occupational injuries and illnesses

Abstract: More precisely targeted information is needed before decisions regarding redesign of the BLS survey are made or before legislative or administrative changes in the WC are contemplated.

Cited by 21 publications

References 25 publications

Medical expenditures associated with nonfatal occupational injuries among immigrant and U.S.-born workers

Medical expenditures associated with nonfatal occupational injuries among immigrant and U.S.-born workers

The Primary Care Practitioner and the diagnosis of occupational diseases

Researcher judgment and study design: Challenges of using administrative data

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