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Discussion of: the total burden of work-related injuries and illnesses: a draft white paper developed for the workshop on the use of workers' compensation data.

Pana-Cryan-R; Bushnell-TP; Tompa-E; Boden-LI; Leigh-JP; McLeod-C;
Use of workers' compensation data for occupational safety and health: proceedings from June 2012 workshop. Utterback DF, Schnorr TM, eds. 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; :187-189
The total burden of work-related injuries and illness is their broad impact on society. This impact extends beyond the number of reported work-related injuries and illnesses and the cost of workers' compensation claims for medical treatment and wage replacement. To operationalize this definition, we would need to assess the total burden accurately but currently there is no one preferred and standardized burden estimation approach. Estimates of burdens inform decisions that aim to reduce these burdens by comparing them to each other and to strategies to prevent them. It is increasingly important to improve our understanding of the total burden of work-related injuries and illnesses because the pressure continues to build for providing evidence that it pays -at any level, worker's, employer's, or society's- to invest in the safety and health of workers. To articulate this evidence, we need to understand the true magnitude and distribution of the total burden, and as a result, by how much and for whom prevention efforts may reduce it. Currently available burden estimates are being used to make decisions that affect everyone's health-related and economic wellbeing; improved information is likely to lead to improved decisions. Despite past efforts to accurately assess the total burden of work-related injuries and illnesses, some of which we mention throughout the paper, gaps remain both at the conceptual and the application levels. Understanding if and how two different burden estimation approaches complement each other is an example of addressing a conceptual gap. Consistently following standardized methods is an example of addressing an application gap. The primary goal of this paper is to help researchers and consumers of research improve their understanding of the total burden of work-related injuries and illnesses. First, we mention examples of notable studies and present some conceptual relationships among broad estimation approaches and categories of the burden. Then, we elaborate on the difficulties in developing burden estimates that are common in multiple approaches, present criteria for the assessment of the quality of burden estimates derived by different approaches, and briefly describe these approaches, their limitations, and if and how they can utilize workers' compensation data. Finally, we provide recommendations for improving our understanding of the total burden.
Workers; Work-environment; Injuries; Accidents; Risk-factors; Hazards; Health-protection; Surveillance-programs; Preventive-medicine; Traumatic-injuries; Humans; Men; Women; Health-care; Risk-factors; Epidemiology; Analytical-processes
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Utterback-DF; Schnorr-TM
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Use of workers' compensation data for occupational safety and health: proceedings from June 2012 workshop