LAUSR

Work-related injuries and illnesses account for an estimated $250 billion annually in medical expenses and indirect costs, such as lost earnings and benefits, and reduced productivity at home; these costs are 12% more than the cost of all cancers and 30% more than costs for diabetes (1). Traditional state-wide surveillance systems often rely on employer-reported data to describe work-related injury and illness, which underestimate the magnitude. Studies estimate that the Bureau of Labor Statistics’ Survey of Occupational Injuries and Illnesses (BLS SOII) undercount 20%–70% of cases compared with workers’ compensation, which has also been shown to underestimate cases (2,3). These surveillance systems also lack information on potential individual-level risk factors, such as health status and risk behaviors. Data were analyzed from the Washington State Behavioral Risk Factor Surveillance System (WA BRFSS) to demonstrate an opportunity to enhance current occupational health surveillance systems. During 2011–2014, 6.4% of Washington workers reported work-related injuries or illnesses during the previous year. Work-related injuries or illnesses were significantly associated with industry and occupation, male gender, lower socioeconomic status, chronic health conditions, and substance use. Because BRFSS does not rely on employer report and contains information on workers not available in traditional occupational health surveillance systems, it is a useful tool for identifying and examining work-related injury and illness. BRFSS is a CDC-sponsored, statewide telephone survey conducted annually to collect information on health outcomes and behaviors. The sample includes adults aged ≥18 years in a private residence or college housing. Since 1995, the WA BRFSS has added questions* to collect information on industry and occupation. Trained coders assign industry and occupation codes to verbatim responses through automated and manual coding processes. During 2011–2014, WA BRFSS also collected work-related injury or illness information on working adults with a state-added question.† The response rates in Washington during this period ranged from 31% to 44%. Among the 51,335 respondents to the 2011–2014 WA BRFSS, 25,493 (50.0%) were eligible to answer the workrelated injury or illness question, including those currently employed for wages (20,028, 78.5%), self-employed (4,059, 15.9%), and out of work for <1 year (1,406, 5.5%). Among all eligible respondents, 24,650 (96.7%) participated in the optional work-related injury or illness module. Associations between work-related injury or illness and select demographics, health conditions,§ and risk behaviors¶ were examined. Results were weighted to the adult population in Washington. Statistical significance was determined using Rao-Scott chi-square tests, at a=0.05. During 2011–2014, an estimated 6.4% (190,076 annually) of employed Washington residents reported having a workrelated injury or illness during the previous year (Table 1). The percentage of workers with work-related injuries or illnesses varied significantly by respondent’s reported industry and occupation, with the highest prevalences reported among workers in the Transportation and Warehousing (9.2%), and Construction industries (8.9%), and the Installation, Repair, and Maintenance (11.1%), Service (9.7%), and Transportation and Material Moving (9.6%) occupations (Table 1). The percentage of workers reporting work-related injury or illness was lowest among females (5.7%), married persons (5.4%), persons with ≥4 years of college (4.1%); and persons with an annual household income ≥$75,000 (4.4%) (Table 2).