Occupational Injury and Illness Surveillance: Conceptual Filters Explain Underreporting

TLDR

Occupational health surveillance data are essential for effective intervention, yet the US Bureau of Labor Statistics survey markedly underestimates work‑related injury and illness incidence, prompting researchers to supplement it with data from other non‑surveillance systems. The authors employ Webb et al.’s filter model to trace underreporting across the Bureau of Labor Statistics survey, workers’ compensation wage‑replacement documents, physician reporting systems, and medical records, describing how cases are lost at each successive documentation step. Empirical results show that workers repeatedly face adverse consequences when attempting to complete these documentation steps, while systems to ensure completion are weak or absent.

Abstract

Occupational health surveillance data are key to effective intervention. However, the US Bureau of Labor Statistics survey significantly underestimates the incidence of work-related injuries and illnesses. Researchers supplement these statistics with data from other systems not designed for surveillance. The authors apply the filter model of Webb et al. to underreporting by the Bureau of Labor Statistics, workers' compensation wage-replacement documents, physician reporting systems, and medical records of treatment charged to workers' compensation. Mechanisms are described for the loss of cases at successive steps of documentation. Empirical findings indicate that workers repeatedly risk adverse consequences for attempting to complete these steps, while systems for ensuring their completion are weak or absent.