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A6.1 Common Performance Measures for Canada's Occupational Safety and Health Agencies-Warrack BJ
While governments are continuously monitoring their financial performance, they are also looking at new ways to assess the effectiveness of the regulatory frameworks in which they operate. For many years, a variety of output measures have been used by occupational safety and health (OSH) agencies in Canada as a surrogate for non-existent outcome measures, i.e. the counting and reporting of numbers of activities such as inspections, investigations and the like. More recently, Canadian jurisdictions have looked at other types of program efficiency and effectiveness measures.
The concept of assessing performance in OSH agencies has many dimensions, from measuring client service to measuring the impact of effectiveness of safety regulatory performance across industry sectors. OSH performance has long been measured in many differing ways across jurisdictions. There is some similarity in the types of measures being used, but in the past, there has not existed a national system of comparative safety and health indicators.
This paper will outline some cooperative work that has been undertaken at a national level in Canada to develop such a series of indicators. A national system of performance measures will enable OSH regulators to identify areas of common shortcoming, allowing them to develop co-operative safety activities at the national level to target areas of common concern. Standardised measures would assess and benchmark national safety and health system performance. These measures would also allow for the benchmarking of performance across jurisdictions.
This presentation will look at the work that has been taking place to develop this national system for the measurement of safety and health performance for Canada's safety and health regulatory agencies and will discuss some of the problems of common data collection, coding systems etc. that affect the development of national performance measurement systems.
A6.2 Earnings Loss From Occupational Injury: A Comparison of Six States-Biddle J, Boden L, Reville RT, Imbens G
This presentation reports results to date in the second year of a three-year study of the consequences for workers of workplace injuries (funded by NIOSH, California and New Mexico). We estimate the earnings losses associated with workplace injuries using data from six states: California, Washington, Oregon, Wisconsin, Florida and New Mexico. In each state, we have longitudinal data on earnings before and after injury for a large sample of injured workers. Using identical methods for each state, we estimate losses and also calculate the fraction of losses replaced by workers' compensation benefits. We also compare estimates using several alternative methods. In this presentation, we will report the earnings loss and wage replacement estimates for each of the six states. We will also outline our hypotheses about the causes of differences across states, to be investigated during the final year of the study.
A6.3 Cost Effectiveness Methodologies Used to Evaluate the Impact of an Intervention Reducing Injuries in Fire Service-Fabricant RA, Johnson L, Beaton R
Nationwide 43.1% of U.S. firefighters sustained line-of-duty injuries in 19997 (IAFF, 1997). In that same year, these on-the-job injuries resulted in 6,285 lost work hours per 100 firefighters. Furthermore, in 1997 nearly one-quarter (23.7%) of all firefighter retirements were due to line-of-duty injury "early" retirements. The purpose of this paper is to describe methods used to estimate the actual economic costs of line-of-duty injuries in the fire service and the potential cost-effectiveness of interventions or programs intended to reduce the incidence of such duty-related injuries using a single urban fire department as a case exemplar.
Methods: Departmental on-the-job injury and absenteeism data from a single large metropolitan fire department were available for a three year pre-intervention baseline as well as for the initial year following the implementation of a multi-component leadership intervention. These objective departmental data included the type of injury sustained, a brief description of their injuries, as well as the locale and shift on which they occurred. From this documentation, all injuries were categorized and coded using the ICD-9, and a magnitude estimate of the severity was assigned to each injury by a trained coder.
Findings: Using a range of both direct and indirect costs, along with reasonable assumptions and decision-rules, the fiscal and economic impact of duty-related injuries in an urban fire department were calculated for a three year baseline. These costs to the Fire Department and to their public sector funding agencies need to be considered in evaluating the potential benefits of an intervention (also with fixed costs) which reduces on-the-job injuries in the fire service. The strengths and weaknesses of these cost effectiveness methods and related models will be considered.
A6.4 The Incidence and Costs of Acute Injuries From a Validated Injury Surveillance System at a U.S. Manufacturing Company-Fogleman M, Reeve G, Rynard S
In allocating resources for the prevention of occupational injuries and illnesses, it is important to realize the impact of acute injuries and the associated costs. The purpose of this project was to determine acute injury rates from a validated occupational safety and health data system and to compare the occupational acute rates and costs with those for cumulative trauma disorders. All first time occupational visits (FTOVs) for 55 manufacturing facilities in a U.S. company were reviewed for the calendar year 1998. This review focused on the occupational injury and illness experiences of more than 100,000 hourly employees.
Metrics included in the analysis were the FTOV rate, the OSHA case rate, the number of cases that resulted in days away from work, the total number of days away from work, and estimated costs associated with days away from work. These metrics (other than costs) were standardized to rates expressed as units per 200,000 hours worked. The results indicated that acute trauma accounted for 68% of all FTOVs with a rate of 73.5 for acute versus 33.5 for cumulative trauma. The OSHA case rate and the lost day case rate were similar for both acute injuries and cumulative trauma. Acute injuries accounted for 43% of all days away from work with a rate of 73.4 days away per 200,000 hours worked. This implies that there should be renewed attention to the issue of acute injuries.
A6.5 Where is it Safest to Work: Ranking States by Occupational Injury and Illness Costs Per Capita- Waehrer GM, Miller TR, Leigh JP, Sheppard M
This paper ranks states by per capita cost of occupational injury/illness and by severity of nonfatal days away from work (DAFW) cases. It uses 1993 Census of Fatal Occupational Injuries and Bureau of Labor Statistics DAFW survey data. For each victim, we modeled medical payments, the dollar value of wage and household work losses, and the dollar amount that an informed jury would award to compensate pain, suffering, and lost quality of life if a trial were appropriate and the victim's negligence did not contribute to the injury/illness. Analyses of national and state health care data sets yielded spending per victim by diagnosis (illness or nature of injury and body part injured). The work loss analysis modeled the duration of work-related disability for victims who had not returned to work by BLS report data and accounted for permanent disability. Wage losses were modeled with Current Population Survey data. The jury verdict analysis examined almost 2,000 occupational injury verdicts (typically awards against third parties) and adjusted for bias in who decides to sue.
The most dangerous states to work (those with the highest occupational injury and illness costs per capita), are Alaska (highest), West Virginia, and Wyoming. The safest "states" to work are the District of Columbia (lowest), New Hampshire, and Massachusetts. These ranks account for event frequency and severity but not for state medical care price differentials or earnings differences for comparable jobs. Ranking by cost per DAFW case (i.e., by severity), in order, West Virginia, New Jersey, Texas, the District of Columbia, and Wyoming rank highest. New Hampshire, Florida, Hawaii, Idaho, and South Dakota rank lowest. Climate and the nature of available jobs bound health and safety levels. Controllable factors - employer attitudes toward worker protection, reporting enforcement, government occupational safety and health efforts - also are influential.
A6.6 Years of Potential Life Lost in the National Traumatic Occupational Fatality Database-Gilbert SJ, Bailer AJ, Stayner LT
Years of potential life lost (YPLL) may be a more meaningful and intuitive measure of the impact of occupational fatalities than traditional measure such as SMRs and rate ratios. We examine the YPLL for different industries, occupations, and causes of death over the years 1980 to 1995 using the National Traumatic Occupational Fatality Database (NTOF). The number of deaths, total YPLL, and average YPLL are calculated for different combinations of industry, occupation, and cause of death. The industries of Public Administration, Mining, and Construction have the highest average YPLL per death among those classified, with Public Administration and Mining losing a potential of at least 39 years per fatal injury. Construction makes the largest contribution to the total YPLL accounting for over 18 percent of the total YPLL for all industries. We also compare YPLLs over time for other causes of death such as suicide, motor vehicles, falls, and those struck by falling objects. A comparison of YPLL by cause of death may help target intervention strategies designed to prevent occupational fatal injuries in different industries.
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