Prevalence and Reporting of Occupational Illness by Company Size: Population Trends and Regulatory Implications

Tim Morse, Charles Dillon, Joseph Weber, Nick Warren, Heather Bruneau, Rongwei Fu

Research output: Contribution to journalReview articlepeer-review

36 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)361-370
Number of pages10
JournalAmerican Journal of Industrial Medicine
Issue number4
StatePublished - Apr 2004
Externally publishedYes


  • Business size
  • Ergonomics
  • MSD
  • Occupational illness
  • Surveillance

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


Dive into the research topics of 'Prevalence and Reporting of Occupational Illness by Company Size: Population Trends and Regulatory Implications'. Together they form a unique fingerprint.

Cite this