The Pump Handle

Cost of work-related injury and disease higher than cost for heart disease, cancer

Money talks, as the saying goes, and a recently published paper on the annual cost of work-related injuries and illnesses should get policymakers to listen up. The number is staggering: $250 Billion, and it’s a figure on par with health conditions like cancer, coronary heart disease, and diabetes that attract much more attention and research funding.

The author, J. Paul Leigh, PhD, a professor of health economics at University of California Davis, assembled data from more than a dozen sources to estimate the annual economic burden of occupational injuries and illnesses. Using data from 2007, his estimate includes direct and indirect costs for fatal and nonfatal injuries, as well as numerous diseases associated with exposures in the work environment. Cost components included spending on hospitals, physicians, pharmaceuticals, etc., as well as current and future lost earnings, fringe benefits, and home production. It’s been nearly 15 years since an analysis of this type and complexity has been published on the occupational injury and disease.

Leigh used data assembled by the US Bureau of Labor Statistics for fatality, injury and illnesses cases, and adjusted it to account for subsets of excluded workers, and used evidence-based rates to account for underreporting of cases. Other data sources included the National Council on Compensation Insurance and the Agency for Healthcare Research and Quality’s Healthcare Cost Utilization Project. Leight updated estimates published originally by Steenland et al (2003) to derive an attributable fraction of selected diseases that can be occupationally-related. All cases of coal workers’ pneumoconiosis are work-related, for example, while only some portion of bladder cancer (i.e., 5.6% – 19.0%) or non-malignant renal disease (i.e., 8.2%-14.5%) are attributed [epidemiologically] to work. In total, Leigh’s analysis suggests there were 516,149 fatal and non-fatal work-related disease cases in 2007. Leigh’s case estimates for 2007 also include the following:

*8.5 million occupational injuries, with 2.5 million of them requiring time away from work;

*More than 1 million workers suffered a temporary, total disability;

*More than 500,000 workers suffered an injury that caused a permanent disability; and

*More than 53,400 disease deaths from work-related causes, including an estimated 18,400 from chronic obstructive pulmonary disease (COPD), 15,000 from lung cancer, 9,800 from coronary heart disease, and 2,200 from mesothelioma.

His cost-specific estimates for 2007 include:

*An average of $680,000 in medical care for each of the 8,200 cases of a permanent, total disabling injury;

*About $5.7 billion in medical care costs for 6 million injury cases in which workers did not even miss any time away from work;

*Total medical cost for fatal and non-fatal injuries of $46.26 billion;

*Total medical costs for fatal and non-fatal occupational disease of $20.83 billion, including $6 billion for circulatory diseases, $4 billion for cancers, $3.9 billion for COPD, and $1 billion for renal diseases; and

*Lost earnings and fringe benefits totaled $139 billion.

Leigh’s $250 billion estimate of the economic burden in 2007 of occupational injury and disease compares to estimates for other major diseases. He notes methodological similarities of his estimate for work-related harm, to those prepared on the cost of cardiovascular disease ($431.8 billion), cancer ($219 billion), diabetes ($174 billion), coronary heart disease ($151.6 billion) and stroke ($62.7). The relevance of the $250 billion estimate is put in perspective when Leigh reminds us that about 153 million people in the U.S. were working in 2007. He adds:

“Most Americans between the ages of 22 to 65 spend 40 to 50% of their waking hours at work. Some of these costs are borne directly by employers through workers’ compensation premiums. But because workers’ compensation benefits cover less than 25 percent of these costs, all members of society must share them. Taxpayers pay through Medicare and Social Security Disability Insurance. Employers and individuals pay through high premiums for non-workers’ compensation insurance carriers, which absorb some of the excess medical costs. Injured workers and their families pay through out-of-pocket medical costs as well as lost wages, fringe benefits, and home production.”

With lawmakers focused on skyrocketing healthcare costs, including in the Medicare program, will any of them see an opportunity to reduce costs by PREVENTING work-related injuries and illnesses?