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NIOSH Center for Workers' Compensation Studies (CWCS)

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Current Projects

We are currently working on several projects which use workers’ compensation data to:

  • Prevent work-related injuries
  • Identify emerging health and safety concerns
  • Evaluate leading indicators (measures of hazards and controls that predict future injuries/ illnesses) in employer safety and health programs

  • Evaluate cost-shifting for work-related injuries and illnesses between workers’ compensation and other health and social insurance programs

Below are brief descriptions of several ongoing or recently completed NIOSH studies, many with an emphasis on economics, that involve the use of workers’ compensation data. Studies are organized in relation to the goals of the CWCS.

Projects that Support Strategic Goal 1

Use workers’ compensation data to identify and track work-related health conditions

Intermediate Goal 1.1

Understand the uses and limitations of workers’ compensation systems for research and surveillance of work-related health conditions

  • A primer is being written to describe data resources and some limitations, key workers’ compensation insurance industry organizations, and public health research and surveillance. Each of the 50 states has individual rules that govern claims reporting which affect data content, quality and access. Extramural partners are the National Council on Compensation Insurance (NCCI), Ohio Bureau of Workers’ Compensation (OBWC), Property Casualty Insurance Association of America (PCIAA), and State of California Division of Workers’ Compensation.

    Project Contact: David Utterback, Ph.D.; Division of Surveillance, Hazard Evaluations, and Field Studies; E-mail: dfu0@cdc.gov; NIOSH Project Members: Alysha Meyers, Ph.D., Steve Wurzelbacher, Ph.D., Project Period: 2012-2013.

  • NIOSH recently co-sponsored two workshops on the use of workers’ compensation for occupational safety and health. The proceedings have been assembled into two NIOSH publications.

    Project Contact: David Utterback, Ph.D; Division of Surveillance, Hazard Evaluations, and Field Studies; E-mail: dfu0@cdc.gov; Project Members: Theresa Schnorr, Ph.D.; Project Period: 2010-2013; Project Publications:

    Utterback, D, Schnorr T, eds. Use of Workers’ Compensation Data for Occupational Safety and Health: Proceedings from June 2012 Workshop. Cincinnati OH: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health. DHHS (NIOSH) Publication No. 2013-147, 2013 May; 1-235, 2013

    Utterback D, Schnorr T, eds., Use of workers’ compensation data for occupational injury & illness prevention. Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 2010-152, 2010 May; 1-185NIOSH 2010

Intermediate Goal 1.2

Analyze existing state-level workers’ compensation data and use results to identify research and intervention priorities

  • This study performed a trend analysis on fatal and nonfatal occupational injuries in small businesses, employing less than one hundred employees. It also estimated the economic burden of occupational fatal and nonfatal injuries in these small businesses for the past five years and will forecast the burden of these injuries and illnesses in small businesses. The study will also estimate the impact of forecasted injuries in small businesses on future national economic output, expressed as gross domestic product (GDP) and employment. It is a multi-phase study using multiple national level datasets from various sources, such as, workers’ compensation costs from NCCI, work-related fatalities from Bureau of Labor Statistics’ (BLS) Census of Fatal Occupational Injuries (CFOI) research files, work-related investigations on fatal and nonfatal injuries from Occupational Safety and Health Administration’s (OSHA) Integrated Management Information System (IMIS), employment, wages and salary related data from BLS, and U.S. Census Bureau, and others. All these data sources were merged with each other by industry sector, year of injury, gender, age groups and other variables to estimate rates and numbers of fatal and nonfatal injuries in small businesses. Direct and indirect costs of these injuries were estimated using workers’ compensation costs, wages, salaries, and other costs related variables following the literature. Multiple reports have been generated and will be published in peer reviewed journals.

    Project Contact: Anasua Bhattacharya, Ph.D; Division of Education and Information Dissemination; E-mail: fwa4@cdc.gov; Project Period: 2011-2014.

  • This study will generate multi-sector incidence rates for OBWC workers’ compensation outcomes (e.g. case incidence, lost time case incidence, cost per employee per year) from 2001–2009 and describe industry trends and high risk industry segments by 3 to 6 digit North American Industrial Classification Codes (NAICS), size of company, and claim causes. The purpose of the analysis is to produce information that can be used by OBWC-insured employers to benchmark their safety and health performance versus industry peers and develop data-driven plans for prevention. This data will also be used by OBWC and researchers to understand industry risk trends and tailor safety, health, and disability management services to efficiently allocate resources by OBWC service offices throughout the state. The overall goal is to reduce the frequency and cost of work-related injuries and illnesses in Ohio, especially for small businesses, which account for a majority of all workplaces.

    Project Contact: Steve Wurzelbacher, Ph.D., Division of Surveillance, Hazard Evaluations, and Field Studies; E-mail: srw3@cdc.gov; NIOSH Project Members: Alysha Meyers, Ph.D., Steve Bertke, Ph.D., Tim Bushnell, Ph.D., MPA; OBWC Project Members: Mike Lampl, M.S., Dave Robins, A.A.S., Abe Tarawneh, Ph.D. ; Project Period: 2011-2014.

Projects that Support Strategic Goal 2:

Understand and reduce risk factors for injuries/ illnesses through economic and intervention research.

Intermediate Goal 2.1

Characterize occupational injury and illness risk, severity, and cost using workers’ compensation data across states, industries, size of employers, and occupations

  • A white paper on the total burden of work-related injuries and illnesses, including the usefulness of workers’ compensation data for this burden’s estimation was co-authored for presentation and discussion at the second Workers’ Compensation Workshop that was co-sponsored by NIOSH and resulted in the creation of the NIOSH CWCS. The paper was a collaborative effort among economists from NIOSH, Boston University, University of British Columbia, and the Institute for Work and Health (IWH). We are now pursuing publication of a succinct version of the white paper in a peer-reviewed journal and publication of the white paper as a document co-branded by NIOSH and IWH.

    Project Contact: Rene Pana-Cryan, Ph.D.; Office of the Director; E-mail: rfp2@cdc.gov; NIOSH Project Members: Tim Bushnell, Ph.D., MPA; External Project Members: Les Boden, Ph.D., Boston University; Chris McLeod, Ph.D., University of British Columbia; Emile Tompa, Ph.D., Institute for Work and Health.

  • In 2007, NIOSH obtained access to several years of MarketScan data (from Thomson-Reuters) on medical claims and the health and productivity of workers at several large employers. Data on health-related costs for family members of these employees also are included. Data are being analyzed to better understand the relationship between workers’ compensation, group health, and short-term disability costs, and the associated health and productivity consequences for employees and their family members. In 2011, additional years and modules of data were purchased and a series of articles were published or continued to be drafted and are at different stages of review and clearance. In addition, through a partnership with the Social Security Administration (SSA), NIOSH, and Boston University, linkages between state-based workers’ compensation and long-term disability benefits data will be studied to better understand the long-term effects of work on health. The National Death Index will also be linked to SSA and state-based workers’ compensation data to assess long-term effects of work injury on mortality.

    Project Contact: Rene Pana-Cryan, Ph.D.; Office of the Director; E-mail: rfp2@cdc.gov; NIOSH Project Members: Abay Getahun, Ph.D., Frank Hearl, Ph.D.; Anasua Bhattacharya, Ph.D., Tim Bushnell, Ph.D., MPA.

  • This study examined if injured workers were more likely than non-injured workers to be treated for depression after an occupational injury and estimated the cost paid by group medical insurance. Nearly 367,900 injured and non-injured workers were drawn from the 2005 Thomson Reuters MarketScan data and we used descriptive, logistic, and two-part model regression analyses. The odds of injured workers being treated for depression within the study period were 45% higher than those of non-injured workers (95% confidence interval, 1.17–1.78). The unconditional average cost of outpatient depression treatment was 63% higher for injured workers than for non-injured workers. Conclusions: Injured workers were more likely than non-injured workers to suffer from depression during the study period. Consequently, additional costs are incurred for treating injured workers’ depression; these costs were not covered by the workers’ compensation system.

    Project Contact: Abay Asfaw, Ph.D.; Office of the Director; E-mail: hqp0@cdc.gov; Project Members: Kerry Souza, Ph.D. Project Publications: Asfaw A, Souza K. Incidence and cost of depression after occupational injury. J Occup Environ Med. 2012 Sep;54(9):1086-91.

  • Workers’ compensation programs were established as a social insurance against medical expenses and lost wages that result from occupational injuries and illnesses. Filing for workers’ compensation is a lengthy, complicated process and research suggests that workers under-file for workers’ compensation benefits. Previous research suggests that non-workers’ compensation insurance systems, such as group health insurance (GHI), Medicare, or Medicaid, at least partially cover work-related injury and illness costs. This project further examined GHI utilization and costs by comparing those outcomes immediately following specific injuries for which workers’ compensation claims either were accepted or denied. We focused on a narrow two-week time window between the occurrence of injury and GHI utilization to limit the influence of other factors not associated with a workers’ compensation claim.

    Project Contact: Abay Asfaw, Ph.D.; Office of the Director; E-mail: hqp0@cdc.gov; NIOSH Project Members: Roger Rosa, Ph.D.; and Rebecca Mao, Ph.D.

  • This project aims at examining whether workers with workers’ compensation claims also have elevated health care utilization costs associated with the same injury or illness event that appear in their medical insurance and disability compensation systems. This project will also investigate if work-related injury or illness has consequences on employment status, such as, early retirement, from full time status to part time status, and others.

    Project Contact: Anasua Bhattacharya, Ph.D; Division of Education and Information Dissemination; E-mail: fwa4@cdc.gov; Project Period: 2011-2014.

  • This study will estimate the direct and indirect costs of all occupational fatal and nonfatal injuries in the various sectors and sub-sectors of wholesale and retail trade.

    Project Contact: Anasua Bhattacharya, Ph.D; Division of Education and Information Dissemination; E-mail: fwa4@cdc.gov; Project Period: 2011-2014.

Intermediate Goal 2.2

Identify employer, carrier, and state policies, programs and characteristics that significantly impact injury and illness rates and costs among workers

  • This project encompasses several efforts to improve methods of evaluating the costs and benefits of health and safety improvements. One of the components of this project that addresses workers’ compensation costs focuses on the methods for estimating costs and benefits of health and safety improvements for the individual employer. Various methods used to estimate these costs and benefits are being compared and assessed in order to develop a comprehensive inventory of potentially relevant costs and benefits, and a summary of methods for estimating them. The results will be published as a journal article which can be used as a basis for guidance that can be used by both employers and researchers. Another component of this project supports another NIOSH project by contributing to publications on the relationship between injuries of workers’ compensation claimants and subsequent changes in health care claims of workers’ family members.

    Project Contact: Tim Bushnell, Ph.D., MPA; Division of Surveillance, Hazard Evaluations, and Field Studies; E-mail: plb4@cdc.gov; Project Period: 2011-2013.

  • OBWC offers over 15 programs and services to reduce workers’ compensation incidence, severity, and cost for clients. The purpose of this study is to determine the effectiveness and return-on-investment (ROI) of the OBWC sponsored programs for all industry sectors from 1999–2009. This will allow OBWC to focus on evidence based programs and allocate resources appropriately. Best practices will also be shared for all employers nationwide. The main program of interest is the Safety Intervention Grants (SIG) Program (where OBWC provided matching funds to implement engineering controls at hundreds of insured employers since 1999) but all programs will be researched. The current SIG analysis involves comparing employers before/ after intervention, controlling for the change in workers’ compensation rates that are independent of the interventions. A second analysis will be to evaluate the effectiveness and ROI of multiple OBWC programs, including onsite OBWC consultation services. The method will be to compare pre/ post workers’ compensation rates of participant companies versus non-participant companies, while controlling for industry type, company size, self-rated safety and health programs, prior loss history, and participation in other programs and loss control consultation frequency. Outputs will include peer reviewed journal manuscripts and a web-based intervention effectiveness summary.

    Project Contact: Steve Wurzelbacher, Ph.D.; Division of Surveillance, Hazard Evaluations, and Field Studies; E-mail: srw3@cdc.gov; NIOSH Project Members: Alysha Meyers, Ph.D., Steve Bertke, Ph.D., Tim Bushnell, Ph.D., MPA; OBWC Project Members: Mike Lampl, M.S., Carol Morrison, B.S., M.B.A., Dave Robins, A.A.S., Abe Tarawneh, Ph.D.; Project Period: 2011-2014.

  • NIOSH, the OBWC, and the University of Texas School of Public Health (UTSPH) will examine the association between survey-assessed I2P2 leading indicators (organizational policies, procedures, practices) and workers’ compensation outcomes in a large (~ 3,000 employers) stratified sample of OBWC-insured wholesale/ retail trade (WRT) firms from 2013–2014. Crucial I2P2 elements and practices with particularly high impact on workers’ compensation losses will be identified in this study and disseminated to the WRT sector. An evidence-based I2P2 evaluation tool will also be disseminated. Planned outputs include peer reviewed journal manuscripts and a web-based summary.

    Project Contact: Steve Wurzelbacher, Ph.D.; Division of Surveillance, Hazard Evaluations, and Field Studies; E-mail: srw3@cdc.gov; NIOSH Project Members: Alysha Meyers, Ph.D., Steve Bertke, Ph.D., Tim Bushnell, Ph.D., MPA; OBWC Project Members: Mike Lampl, M.S., Dave Robins, A.A.S., Abe Tarawneh, Ph.D.; UTSPH Project Members: Ben Amick, Ph.D., David Gimeno, Ph.D., Raven Cunningham, Ph.D.; Project Period: 2011-2015.

  • The purpose of this research project is to evaluate the efficacy of slip, trip, and fall (STF) prevention practices in the food services industry. A randomized controlled trial is being conducted to evaluate the effectiveness of slip-resistant shoes in reducing slips and falls injuries. The study involves the participation of approximately 4,000 employees wearing slip-resistant shoes and will continue through 2014. One of the largest food service companies in the US is collaborating in this NIOSH-led research by providing access to its workforce. It is anticipated that this research would impact worker safety by providing scientific evidence and business case support for a comprehensive STF prevention program to effectively reduce STF injuries among food service workers. By demonstrating the effectiveness of STF prevention measures, it is anticipated that food service companies initially hesitant to expend time and money on prevention programs with unknown effectiveness could use these research findings to help justify implementing prevention strategies.

    Project Contact: Jennifer L. Bell, Ph.D.; Division of Safety Research; E-mail: JBell@cdc.gov; Project Period: 2010-2014.

  • This project will work with small wood product manufacturing businesses to limit the number of contact incidents with stationary sawing machinery. Many small companies do not have the resources to have dedicated safety professionals to interpret the many different machine safety regulations and standards. This project will develop risk assessment templates based on machine safety regulations/standards to guide companies to minimize risk from stationary sawing machinery.

    Project Contact: Jim Harris, Ph.D., P.E.; Division of Safety Research; E-mail: jrh6@cdc.gov; Project Period: 2012–2015.

  • NIOSH and the OBWC are collaborating to determine the effectiveness and cost-benefit of MSD primary prevention approaches (material handling engineering controls) in a multi-site prospective study at OBWC-insured companies from 2012–2015, using a randomized control trial design. Interventions include a number of controls designed to improve material handling during delivery, installation, receiving, and/ or other processes such as stocking shelves. The costs of the interventions are being funded through existing OBWC Safety Intervention Grant (SIG) funds and participating employers. Main outcomes are affected employee-level low back/ shoulder pain (employee reported) and affected workgroup-level workers’ compensation claims, productivity, and quality (employer-reported). The return-on-investment (ROI) of the interventions will also be calculated from the employer, OBWC, and combined perspectives. The target is to recruit 40 employers with 400 affected employees. Best practices will be shared with employers nationwide and planned outputs include peer reviewed journal manuscripts and a web-based intervention effectiveness summary.

    Project Contact: Steve Wurzelbacher, Ph.D.; Division of Surveillance, Hazard Evaluations, and Field Studies; E-mail: srw3@cdc.gov; OBWC Project Members: Mike Lampl, M.S., Dave Robins, A.A.S., Abe Tarawneh, Ph. D.; Project Period: 2011-2014.

  • In 2012, the OBWC launched the Workplace Wellness Grant Program where an estimated 266 employers and 13,000 employees will be provided $4 million in funds over the next four years to implement wellness programs. NIOSH and OBWC researchers are conducting a study to:

    • Measure effectiveness of wellness programs by comparing data from pre- and post-implementation of a wellness program on the following outcomes: a) workers’ compensation claim, severity (days lost per claim), and cost rates, b) aggregate health metrics c) absenteeism rates, d) turnover rates, and e) healthcare cost per employee
    • Determine the relationship between workers’ compensation claim, severity, and cost rates and changes in yearly measures pre- and post-implementation for a) wellness program elements, b) occupational safety and health program elements, and c) wellness-occupational safety and health program integration measures
    • Determine the total costs, savings, and savings (benefits) to cost ratios associated with grant-supported wellness programs from the perspective of the OBWC and the participating employers.

    Best practices will be shared with employers nationwide and planned outputs include peer reviewed journal manuscripts and a web-based intervention effectiveness summary.

    Project Contact: Alysha Meyers, Ph.D.; Division of Surveillance, Hazard Evaluations, and Field Studies; E-mail: itm4@cdc.gov; NIOSH Project Members: Steve Wurzelbacher, Ph.D., Steve Bertke, Ph.D., Tim Bushnell, Ph.D., Kaori Fujishiro, Ph.D.; OBWC Project Members: Carol Morrison, B.S., M.B.A., Mike Rienerth, M.S., Abe Tarawneh, Ph.D.; Project Period: 2014-2018.

 
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  • Page last reviewed: September 16, 2013
  • Page last updated: September 16, 2013
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