Capture-recapture estimation of unreported work-related musculoskeletal disorders in Connecticut

Background Estimates of the extent of musculoskeletal disorders (MSD) are u sually based upon workers' compensation reports, although recent reports in dicate that there may be widespread under-reporting of MSD. Methods An estimate of the incidence of ann and hand work-related MSD was m ade using capture-recapture analysis of the overlap between state workers' compensation reports and physician reports in Connecticut for 1995. The res ulting estimate was compared to a population-based survey of MSD. Results There was very small overlap between the two state injury reporting systems: 6.7% of 793 reported workers' compensation cases, or 8% of 661 ph ysician's reports. The estimate for MSD not captured by either system was 1 3,285 resulting in 14, 686 (95% CI: 9,733-18,453) total reported and non-re ported cases. This compares to an estimate of 13, 775 cases (95% CI: 8,800- 18,800) based on a phone survey. Conclusions This analysis points to substantial under-reporting of MSD in C onnecticut: estimates of unreported cases exceed those officially, reported by a factor of 11:1. The findings have an important bearing on injury prev ention programs and policy making. Am. J. Ind. Med. 39:636-642, 2001. (C) 2 001 Wiley-Liss, Inc.