Costs of occupational injuries and illnesses in California

Objectives. The purpose of this study was to estimate the annual incidence, the mortality, and the direct and indirect costs associated with occupatio nal injuries and illnesses in California in 1992. To achieve this, we perfo rmed aggregation and analysis of national and California data sets collecte d by the U,S, Bureau of Labor Statistics, California Workers' Compensation Insurance Rating Bureau, California Division of Industrial Relations, the N ational Center for Health Statistics, and the U.S. Health Care Financing Ad ministration. Methods, To assess incidence of and mortality from occupational injuries an d illnesses, we reviewed data from state and national surveys and applied a n attributable risk proportion method. To assess costs, we used the cost-of -illness, human capital, method that decomposes costs into direct categorie s such as medical expenses and insurance administration expenses as well as indirect categories such as lost earnings, lost home production, and lost fringe benefits. Some cost estimates were drawn from California data, where as others were drawn from a national study but were adjusted to reflect Cal ifornia's differences. Cost estimates for injuries were calculated by multi plying average costs by the number of injuries. For the majority of disease s, cost estimates relied on the attributable risk proportion method, Results. Approximately 660 job-related deaths from injury 1.645 million non fatal injuries, 7,079 deaths from diseases, and 0.133 million illnesses are estimated to occur annually in the civilian California workforce. The dire ct ($7.04 billion, 34%) plus indirect ($13.62 billion, 66%) costs were esti mated to be $20.7 billion, Injuries cost $17.8 billion (86%) and illnesses $2.9 billion (14%). These estimates are likely to be low because: (1) they ignore costs associated with pain and suffering, (2) they ignore home care provided by family members, and (3) the numbers of occupational injuries an d illnesses are likely to be undercounted, Conclusion. Occupational injuries and illnesses are a major contributor to the total cost of health care and lost productivity in California. These co sts are on a par with those of all cancers combined and only slightly less than the cost of heart disease and stroke in California. Workers' compensat ion covers less than one-half of the costs of occupational injury and illne ss, (C) 2001 American Health Foundation and Academic Press.