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Incidence, costs, and compensation of work-related injuries among sawmill workers in British Columbia Alamgir, Abul Hasanat Mohammad


Objectives: The primary objective of this study were to investigate the use of hospital discharge records as a tool for work-related serious injury surveillance, including analyses to compare injury reporting patterns using hospital records versus workers’ compensation records and the use of hospital records to investigate the epidemiology and the economic burden of serious work related injuries. Methods: The study population was working members of the sawmill industry in the Canadian province of British Columbia between 1989-1998. Hospital discharge records and workers’ compensation claims for a cohort of 5,876 actively employed workers were obtained. Hospitalization records were identified as work-related using ICD-9 external cause of injury codes (E-codes) that indicate place of occurrence, and the responsibility of payment schedule, which identifies workers’ compensation as being responsible for payment. Hospital records were linked and matched to compensation claims by injury diagnosis and available date variables. Claim cost information was collected from the provincial compensation agency. Results: Both the E-code and the payment schedule code available in hospital discharge records were useful in capturing work-related injuries requiring hospitalization. The study findings indicate that the compensation agency underreports serious and acute injuries by about 10%. This study documented that several vulnerable groups of workers, like, non-white people, and specific injury categories, like, overexertion and falls were related with greater under-reporting. For the cost analyses, the median non-health care costs were $16,559 and healthcare costs were $4,377 per sawmill injury (in 1995 Canadian dollars). By median costs, the category of fire, flame, natural & environmental was the most costly cause of injury category. About 9% of the total costs ($12 million) of hospitalized injuries were not compensated by the workers’ compensation system. Conclusions: Hospital data represent an alternative source of information for serious work-related injuries. Knowing the injuries and costs that remain unreported and/or uncompensated will be helpful to employers, compensation officials, unions, policy makers and other stakeholders to identify vulnerable worker groups and work processes, and subsequently target preventive measures within an industry.

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