TY - JOUR
T1 - Prevalence and Reporting of Occupational Illness by Company Size
T2 - Population Trends and Regulatory Implications
AU - Morse, Tim
AU - Dillon, Charles
AU - Weber, Joseph
AU - Warren, Nick
AU - Bruneau, Heather
AU - Fu, Rongwei
PY - 2004/4
Y1 - 2004/4
N2 - Background: Reports of occupational disease using the Bureau of Labor Statistics (BLS)/OSHA survey have shown increasing rates with larger establishment size. The literature is divided on whether this pattern in an artifact of under-reporting in smaller businesses or is the result of differences in underlying risk-factors. Methods: A population-based survey [the Connecticut Upper-Extremity, Surveillance Project (CUSP)] assessing prevalence of likely work related musculoskeletal disorders (MSD) in CT, coded by establishment size, is compared to CT MSD incidence rates based on the BLS/OSHA survey. Results: When analyses were controlled for age, gender, physical risks, and occupation, there was a marginally significant association between business size and the rate of MSD [odds ratio (OR) = 0.91, CI 0.82-1.01], but in the opposite direction of the BLS/OSHA rates, with larger businesses having somewhat lower rates of MSD. Reported risk factors varied in a similar direction, though with mid-sized companies having the highest physical risks. Conclusions: The increased rates of occupational illness in larger businesses reported in the BLS/OSHA survey does not appear to be due to actual incidence or distribution of risk factors, but appears more likely to be due to under-reporting in smaller businesses. Estimates based on the assumption that the ORs based on size are actually similar to the CUSP population survey results suggest that MSD incidence is approximately 3.6-times the reported rates.
AB - Background: Reports of occupational disease using the Bureau of Labor Statistics (BLS)/OSHA survey have shown increasing rates with larger establishment size. The literature is divided on whether this pattern in an artifact of under-reporting in smaller businesses or is the result of differences in underlying risk-factors. Methods: A population-based survey [the Connecticut Upper-Extremity, Surveillance Project (CUSP)] assessing prevalence of likely work related musculoskeletal disorders (MSD) in CT, coded by establishment size, is compared to CT MSD incidence rates based on the BLS/OSHA survey. Results: When analyses were controlled for age, gender, physical risks, and occupation, there was a marginally significant association between business size and the rate of MSD [odds ratio (OR) = 0.91, CI 0.82-1.01], but in the opposite direction of the BLS/OSHA rates, with larger businesses having somewhat lower rates of MSD. Reported risk factors varied in a similar direction, though with mid-sized companies having the highest physical risks. Conclusions: The increased rates of occupational illness in larger businesses reported in the BLS/OSHA survey does not appear to be due to actual incidence or distribution of risk factors, but appears more likely to be due to under-reporting in smaller businesses. Estimates based on the assumption that the ORs based on size are actually similar to the CUSP population survey results suggest that MSD incidence is approximately 3.6-times the reported rates.
KW - Business size
KW - Ergonomics
KW - MSD
KW - Occupational illness
KW - Surveillance
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U2 - 10.1002/ajim.10354
DO - 10.1002/ajim.10354
M3 - Review article
C2 - 15029569
AN - SCOPUS:1842680264
SN - 0271-3586
VL - 45
SP - 361
EP - 370
JO - American Journal of Industrial Medicine
JF - American Journal of Industrial Medicine
IS - 4
ER -