Occupational Injury and Illness Surveillance: Conceptual Filters Explain Underreporting
Lenore S. Azaroff, ScD,
Charles Levenstein, PhD, MOH and
David H. Wegman, MD, MPH
The authors are with the Department of Work Environment, University of Massachusetts, Lowell.
Correspondence: Requests for reprints should be sent to Lenore S. Azaroff, ScD, University of Massachusetts Lowell Work Environment Department, One University Ave, Lowell, MA 01854 (e-mail: lenore_azaroff{at}uml.edu).
Occupational health surveillance data are key to effective intervention.However, the US Bureau of Labor Statistics survey significantlyunderestimates the incidence of work-related injuries and illnesses.Researchers supplement these statistics with data from othersystems not designed for surveillance.
The authors apply the filter model of Webb et al. to underreportingby the Bureau of Labor Statistics, workers compensationwage-replacement documents, physician reporting systems, andmedical records of treatment charged to workers compensation.Mechanisms are described for the loss of cases at successivesteps of documentation. Empirical findings indicate that workersrepeatedly risk adverse consequences for attempting to completethese steps, while systems for ensuring their completion areweak or absent.
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