There were 6,837 occupational disease (OD) reports submitted to the Michigan Department of Energy, Labor and Economic Growth (MDELEG) in calendar year 2009 as required under the Michigan Occupational Disease Reporting Law. Only occupational diseases, not injuries are included in this report. These reports were submitted by company medical departments or clinics under contract to companies to provide occupational health services to their employees, as well as health care practitioners not providing services to companies. The percentage of reports received that were submitted from company medical departments or clinics under contract has decreased from 84-91% in the early 1990s to approximately 53-70% in the last eight years. The most frequent reports were repetitive trauma (26%), toxic effects of substances (26%), and respiratory diseases (10%). The reports submitted in 2009 are much lower than the number of reports received from 1994-2001. Since 1999, there has been a downward trend of reporting; 21,538 reports were received in 1999 versus 6,837 reports received in 2009. Some of this decline is probably secondary to the development of fewer occupational illnesses particularly in recent years relating to the closure of manufacturing facilities in Michigan from the economic recession. Some component of the reduction may also be from poorer compliance with the reporting law. To address reporting compliance, MIOSHA enforcement of the Occupational Disease Reporting Law began in April 2009. Site visits to 10 non-reporting clinics were conducted in 2009 to enforce the requirement to report. Additional clinic audits are planned for 2011. Company-associated health care practitioners report different types of illnesses than non-company associated health care practitioners. For example, there were 1,739 (56%) reports from non-company providers for toxic effects of substances (poisonings) while only 43 (1%) such reports were received from employer-associated providers. In contrast, company-related providers reported 1,771 (48%) cases of repetitive trauma compared to 10 (<1%) of non-company provider reported cases. The average age of individuals reported was 44 years, ranging from 13 to 95. Sixty-nine percent of individuals reported were between the ages of 25 and 54, and 66% were for male workers. There were differences in the types of reports received through the OD reporting system compared to illnesses identified through either the Bureau of Labor Statistics' Annual Survey of a sample of employers or the Michigan Workers' Compensation Agency. The OD reporting system had much higher percentages of illnesses from poisonings and dust diseases of the lung than the other two reporting systems. Reliance on multiple reporting systems presents a more complete picture of the spectrum of work-related illnesses in our state. Beginning in 1997, Michigan laboratories were required to report blood lead levels; beginning in 2005, the labs were also required to report blood and urine levels of arsenic, cadmium and mercury, as well as plasma and red cell cholinesterase levels. In 2002, Michigan's two Poison Control Centers began to submit work-related reports; there is now only one center based in Detroit that covers the whole state. In 2009, there were 961 reports received from this Center. Given the complementary nature of all the existing programs, we are able to combine data across systems to better characterize the extent and distribution of individuals who become sick and injured at work. This is an essential first step in reducing the burden of these preventable injuries and illnesses in our state. A previous publication of ours highlighted the potential incompleteness of the official national statistics on occupational injuries and illnesses. The official statistics are based solely on reporting from employers. Our study indicated that the true occurrence of occupational injuries and illnesses may be undercounted by as much as two-thirds.1 More recent work on amputations in the state found that in 2007 the BLS only identified 22% and in 2008 only 59% of the work-related amputations identified through our multi-source surveillance system (see Amputation Annual Reports at http://www.oem.msu.edu
). For 2009, the most recent year available, the Bureau of Labor and Statistics (BLS) survey reported 127,600 occupational injuries and illnesses in Michigan. If this represents only one-third of the true number of occurrences, then one would estimate almost 400,000 occupational injuries and illnesses in Michigan in 2009.