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The cost of fatal injuries to civilian workers in the United States, 1992-2001.
Morgantown, WV: 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. 2009-154, 2009 Aug; :1-119
The National Institute for Occupational Safety and Health (NIOSH), through the National Traumatic Occupational Fatalities (NTOF) surveillance system, collected death certificates from the 52 vital statistics reporting units in the 50 states, New York City, and the District of Columbia. Information was collected for workers aged 16 years or older who died as a result of a work-related injury from 1980 through 2001. Data gathered through this NIOSH program help describe the nature and magnitude of the occupational injury problem in the U.S. Counts of fatalities by demographic and employment groups and by injury characteristics help identify high-risk worker groups and potential injury-risk factors [NIOSH 1993; NIOSH 2001]. This promotes the effective use of resources aimed at preventing injuries in the workplace. Although important, typical measures of lives lost - frequency and rate - are not the only measures of the impact of occupational fatalities on the American public. Nor are they the only source of guidance for directing efforts to reduce the number of occupational incidents. Economic loss, or cost, is another perspective that can provide a more complete and meaningful outcome evaluation over time and can also assist in directing scarce research and prevention resources. This document presents the number of fatal occupational injuries and their total, mean, and median societal costs for each state and by worker and case characteristics for the U.S. for 1992-2001. The cost-of-illness method, which sums indirect and direct costs, was used to calculate the mean, median, and total societal costs for the fatalities reported in NTOF. Indirect costs are calculated for each incident by accounting for the probability of survival, median annual earnings at the time of death, home production costs, earnings growth rate adjustments, and real discount rate. These costs are then added to the direct cost of medical expenses to arrive at the societal cost of fatal injury. The addition of home production costs to this model represents an advancement in methodology over models which simply account for loss of income from wages and presents a point of departure from previous studies. Limitations of this study are varied and include lack of inclusion of some costs of insurance compensation, lack of comprehensiveness of data drawn from death certificates and pay equity. Major findings from this study are as follows: 1. From 1992-2001, there were 51,684 civilian workers who died from injuries sustained while working in the U.S., generating a total societal cost of just over $43 billion (Table 1). 2. Civilian occupational injury fatalities ranged from a high of 5,396 in 1994 to a low of 4,888 in 2001, while the total societal cost ranged from a low of $4.1 billion in 1998 to a high of just over $4.5 billion in the years 1993 and 1994 (Table 1). 3. For the years 1992-2001, the mean and median societal costs of a fatal occupational injury were $834,000 and $841,000, respectively. The mean societal costs ranged from $808,000 in 1998 to a high of $863,000 in 2001, with a similar range of median costs - $817,000 in 1998 to $869,000 in 1993 (Table 1). 4. By state, the greatest number and total societal cost of occupational injury fatalities occurred in California (5,173; $4.5 billion), Texas (4,438; $3.8 billion), Florida (3,287; $2.8 billion), New York (2,509; $2.0 billion), and Pennsylvania (2,165; $1.8 billion) (Table 2). 5. Five states had mean societal cost of a fatal occupational injury over $900,000 - Alaska ($1,005,000), Hawaii ($922,000), Louisiana ($911,000), Utah ($905,000), and Nevada ($903,000). The only mean societal cost below $750,000 occurred in South Dakota ($703,000), North Dakota ($716,000), and Nebraska ($725,000), with only one state below $700,000 - Iowa ($664,000) (Table 2). 6. The majority of the occupational injury fatalities involved males (93%). Males had about the same share of total societal costs. The mean societal cost of a fatal injury for males was slightly higher than the mean societal cost for females: $835,000 compared to $815,000 (Table 5). 7. One age group, 35-44 years of age, had the largest share of occupational fatalities and the largest share of the total societal cost of occupational injury fatalities (25%, 32%) closely followed by those who were 25-34 years of age (22%, 27%) and those who were 45-54 years (21%, 22%) (Table 5). 8. Two age groups, 35-44 years and 25-34 years, had the highest mean societal costs of $1.07 million and $1.05 million, respectively. These two age groups had the highest means in every occupation division, industry division, and year. Two age groups, 55-64 years and over 65 years, had the lowest overall mean societal costs, $468,000 and $75,000 respectively (Table 5). These two groups also had the lowest means in every occupation division, industry division, and year (Tables 7, 24, and 31). 9. Between 1992 and 1998, the leading International Classification of Diseases, 9th Revision, (ICD-9) external causes of occupational injury death in the U.S. were motor vehicle crashes (25%), homicides (16%), machine-related incidents (11%), and falls (10%). These four causes of death were not only the most common, they also had the highest total societal costs - $7.5 billion, $4.9 billion, $2.8 billion, and $2.9 billion, respectively (Table 10). 10. Between 1999 and 2001, the International Classification of Diseases, 10th Revision, (ICD-10) causes of death with the highest total societal costs were motor vehicle crashes ($3.8 billion with 87% involving motor vehicle traffic incidents), falls ($1.5 billion), homicides ($1.4 billion), and machine-related incidents ($1.0 billion). These four causes of occupational injury death also had the largest number of cases - motor vehicle incidents (4,589 with 84% being motor vehicle traffic incidents), falls (1,923), homicides (1,664), and machine-related incidents (1,227) (Table 11). 11. Regardless of sex, race, or age group of the decedent, motor vehicle incidents had the highest total cost of traumatic occupational fatalities during 1992-1998 (Table 10, 14, and 16). Motor vehicle traffic incidents also had the highest total cost regardless of sex, race, or age group for 1999-2001 (Tables 11, 15, and 17). 12. The industry divisions with the greatest number of deaths and the highest total societal costs from 1992 to 2001 were (1) Construction and (2) Transportation, Communication, and Public Utilities. Finance, Insurance, and Real Estate had the fewest number of deaths and the lowest total societal cost during this time period (Tables 18 and 19). 13. With two exceptions, 1995 and 1996, Public Administration had the highest mean and median costs for the years 1992 through 2001, averaging just over $1 million per fatality. Mining was the only other industry division to exceed $1 million per fatal occupational injury (Tables 18 and 19). 14. During 1992-1998, the highest total societal cost by external cause of death was dominated by three categories - motor vehicle incidents (highest for Transportation, Communication, and Public Utilities; Construction; and Services), machine-related incidents (highest for Manufacturing; Construction; and Agriculture, Forestry, and Fishing), and homicides (highest for Retail Trade; Services; and Public Administration). The only remaining total societal cost by external cause of death above $1 billion was falls within the Construction industry (Table 20). 15. During 1999-2001, motor vehicle incidents had the highest costs for all industry divisions except Retail Trade; Finance, Insurance, and Real Estate; and Construction. As in the previous time period, the highest total costs for Retail Trade and Finance, Insurance, and Real Estate were for homicides and the highest total costs for Construction were for falls (Tables 11 and 21). 16. Without exception, air transportation incidents had the highest mean costs for each industry division from 1992-1998 (Table 22). The same was true for 1999-2001 with the exception that poisoning had the highest mean cost in the Finance, Insurance, and Real Estate industry division (Table 23). During 1992-1998, machine-related deaths were recorded as the lowest mean cost for three of the ten industry divisions - Agriculture, Forestry and Fishing; Transportation, Communication and Public Utilties; and Public Administration. Struck by falling objects had the lowest mean costs for Manufacturing and Finance, Insurance, and Real Estate, while falls had the lowest mean costs in Retail Trade and Services. Nontraffic motor vehicle incidents recorded the lowest mean cost for five of the ten industry divisions during 1999-2001 (Tables 22 and 23). 17. Out of all the occupational divisions, Precision Production/Craft/Repair (Crafts) had the highest number of fatal occupational injuries and total societal costs for 1992-2001 - 10,423 and $9.5 billion, respectively (Table 25). Furthermore, Crafts had the highest number of fatalities and total costs for each year during this period (Table 26). Similarly, Technicians/Related Support Occupations (Tech/Support) exhibited the highest mean and median costs for each year, averaging $1.4 million and $1.3 million, respectively (Tables 25 and 26). 18. Homicides had the highest total societal costs by external cause of death for four of eleven occupation divisions - Executives/Administrators/Managers, Sales, Clerical, and Service occupations - during 1992-1998. Motor vehicle incidents also had the highest total societal costs by external cause of death for three of eleven occupation divisions during this time period - Professional Specialties, Transportation/Material Movers, and Handlers/Equipment Cleaners/Helpers/ Laborers (Table 27). 19. For five of eleven occupation divisions - Executives/Administrators/Managers, Professional Specialties, Clerical, Farming/Forestry/Fishing, and Transportation/Material Movers occupations - motor vehicle incidents had the highest total societal costs for 1999-2001. For the remaining occupation divisions, homicide (Sales and Service), falls (Precision Production/Craft/Repair and Handlers, Equipment Cleaners/Helpers/Laborers), machines (Machine Operators/Assemblers/Inspectors) and air transport (Technicians/Related Support) had the highest total societal costs (Table 28). 20. The mean cost of fatal occupational injury was highest for transportation incidents (air transport, water transport, and rail transport) over the entire study period for the majority of occupation divisions, ranging from $692,000 to $1.59 million. However, the highest mean cost in any occupation division for external cause of death was $1.61 million for explosions in Professional Specialties during 1999-2001 (Tables 29-30).
Injuries; Traumatic-injuries; Mortality-data; Mortality-rates; Mortality-surveys; Epidemiology; Statistical-analysis; Accident-statistics; Accidents; Accident-rates; Surveillance-programs
NTIS Accession No.
DHHS (NIOSH) Publication No. 2009-154
National Institute for Occupational Safety and Health
Page last reviewed: May 5, 2020
Content source: National Institute for Occupational Safety and Health Education and Information Division