DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Institute for Occupational Safety and Health
 This document is in the public domain and may be freely copied or reprinted.

Disclaimer
Mention of any company or product does not constitute endorsement by the National
Institute for Occupational Safety and Health (NIOSH). In addition, citations to Web
sites external to NIOSH do not constitute NIOSH endorsement of the sponsoring
organizations or their programs or products. Furthermore, NIOSH is not responsible
for the content of these Web sites.

Ordering Information
To receive documents or other information about occupational safety and health
topics, contact NIOSH at

NIOSH
Publications Dissemination
4676 Columbia Parkway
Cincinnati, OH 452261998

Telephone: 180035NIOSH (18003564674)

Fax: 5135338573
E-mail: pubstaft@cdc.gov

or visit the NIOSH Web site at www.cdc.gov/niosh

DHHS (NIOSH) Publication No. 2004146

September 2004

ii
Foreword
The National Institute for Occupational Safety and Health (NIOSH) is the Federal agency respon-
sible for occupational safety and health research. As such, NIOSH is committed to the periodic
dissemination of data describing the magnitude of the Nations occupational injuries, illnesses,
and fatalities. NIOSH has prepared the Worker Health Chartbook, 2004 as a resource for agencies,
organizations, employers, researchers, workers, and others who need to know about occupational
injuries and illnesses. This concise, chart-based document consolidates information from the
network of tracking systems that forms the cornerstone of injury and illness surveillance in the
United States. The Chartbook is intended to fulfill the NIOSH strategic goals for preventing occu-
pational injury and illness and to guide research and prevention efforts.

This 2004 edition of the Worker Health Chartbook builds on the foundation established in the first
edition of this document, which was published in 2000. We have made the Chartbook accessible to
technical and nontechnical audiences through traditional printed publications as well as a variety
of electronic media.

The Chartbook was developed with support and contributions from Federal and State agencies.
Such continuing cooperation and partnerships strengthen the NIOSH framework for coordinat-
ing our surveillance programs with others in the Centers for Disease Control and Prevention
(CDC), the Bureau of Labor Statistics (BLS), and the States. We look forward to continuing our
work with public-sector partners who have similar interests in preventing work-related injuries and
illnesses.

John Howard, M.D.

Director
National Institute for Occupational Safety
and Health
Centers for Disease Control and Prevention

iii
 Preface
During the past 32 years, major advances have been made in recog-
nizing, evaluating, and preventing occupational injuries, illnesses,
and deaths. All have declined significantly. Despite these changes,
unnecessary morbidity and mortality from occupational health haz-
ards remain a significant burden to our workers, their families, and
employers. The costs to our national health care system and the
economy are substantial.
More than 146.5 million people make up the civilian labor force,
and more than 137.7 million of them were employed in 2003
according to the U.S. Department of Labor. About 7.3 million of
these workers held more than one job. The U.S. labor force is
becoming older and more diverse, and the supply of labor and jobs
is shifting from goods-producing industries to services. Use of tem-
porary, contract, and contingent laborers has increased along with
alternative work arrangements such as job sharing and part-time
work. These changes in the labor force and the nature of work pres-
ent new challenges to assuring the safety and health of Americans
in the workplace.
This 2004 edition of the Worker Health Chartbook builds on the
foundation established in the first edition, published in 2000. The
Chartbook is intended as a resource for technical and nontechnical
audiences, including agencies, organizations, employers, research-
ers, workers, and others with a need to know about occupational
injury, illness, and death.
The Chartbook includes more than 400 figures and tables focusing
on worker health and the injury and illness statistics that measure
the health of workers. Contributors include Federal and State agen-
cies as well as nonprofit organizations; they have provided data from
iv
national and State surveys and program data sources. Contributing
data sources and organizations include the following:
U.S. Department of Agriculture, National Agricultural
Statistics Service
U.S. Department of Labor: Office of the Assistant Secretary
for Policy (OASP), Bureau of Labor Statistics (BLS), and
the Mine Safety and Health Administration (MSHA)
State health and labor departments under the NIOSH
Sentinel Event Notification System for Occupational Risk
(SENSOR) Program
Surveillance and prevention centers from the Centers for
Disease Control and Prevention (CDC), including the
National Center for Health Statistics (NCHS), the National
Center for Infectious Diseases (NCID), and the National
Center for HIV, STD, and TB Prevention (NCHSTB)
U.S. Bureau of the Census
Consumer Product Safety Commission (CPSC)
The Center to Protect Workers Rights (CPWR)
The Chartbook is organized around five chapters, three appendices,
a glossary, and an index. Chapter 1 includes an introduction and
provides information about the demographic characteristics of U.S.
workers, worker health status, and characteristics of injured and ill
workers. Data from BLS are used in this chapter and extensively
throughout the Chartbook for tables and figures. Chapter 2 focuses
on more than 30 health outcomes (fatal and nonfatal injuries as well
as selected illnesses and conditions) and provides data describing
the magnitude, distribution, and major demographic characteristics
of cases. Chapter 3 focuses on agriculture and presents data on this
sectors fatal and nonfatal injuries among adults and children as The Chartbook also is available on CDROM [DHHS (NIOSH) Pub-
well as selected data on farm workers. Chapter 4 focuses on high-risk lication No. 2004146C] in a stand-alone HTML version and a PDF
industries and occupations; it reflects NIOSH research priorities in version. The CDROM also includes the EPS and Excel files and
the areas of mining and construction. Chapter 5 addresses special
the bibliographic references. To obtain individual copies of the
populations by exploring occupational injury and illness data on
young workers, older workers, and Hispanic workers. All figures CDROM, contact NIOSH at
and tables were prepared from public statistical or surveillance pro-
gram data sources and refer the reader to the appropriate data and NIOSHPublications Dissemination
sources of analysis. 4676 Columbia Parkway
Cincinnati, Ohio 452261998
Appendix A provides information about the 21 survey and sur-
veillance programs used by the contributors. In addition to brief Telephone: 1800NIOSH (18003564674)
descriptions of these programs, this appendix provides program Fax: (513) 5338573
contacts and reference citations to enable user follow-up. Appen- E-mail: pubstaft@cdc.gov
dix B provides information about data and analysis methods. This
appendix discusses data limitations and reinforces the cautionary For answers to questions about the Chartbook, please contact
guides that accompany the dissemination of selected source data.
These limits are often overlooked by casual users, especially in the John P. Sestito
context of reviewing extensive summary tables or reports. Appen- National Institute for Occupational Safety and Health
dix C is a bibliography containing a variety of reference materials 4676 Columbia Parkway, R12
from the public domain, including data tables, report forms and Cincinnati, Ohio 452261998
documentation, government news releases, and research articles.
The glossary briefly discusses basic definitions for many terms used Telephone: (513) 8414208
throughout the Chartbook. E-mail: JSestito@cdc.gov

The reference character of the Chartbook is enhanced by a compre- or

hensive index, which includes key words and phrases that permit
R. Alan Lunsford
users to locate data readily in the many figures and tables.
National Institute for Occupational Safety and Health
The Chartbook is available in HTML and PDF formats on the Web at 4676 Columbia Parkway, R7
www.cdc.gov/niosh/docs/chartbook/. Chartbook figures and tables Cincinnati, Ohio 452261998
are available as EPS (Encapsulated Postscript) graphic files and
Excel spreadsheet files. Full-text bibliographic references are pro- Telephone: (513) 8414253
vided. A searchable index facilitates cross-referencing of data. E-mail: RLunsford@cdc.gov

v
 Abstract
The Worker Health Chartbook, 2004 is a descriptive epidemiologic ref-
erence on occupational morbidity and mortality in the United States.
The Chartbook includes more than 400 figures and tables describing
the magnitude, distribution, and trends of the Nations occupational
injuries, illnesses, and fatalities. This 2004 edition of the Worker Health
Chartbook builds on the foundation established in the first edition,
published in 2000. The Chartbook is intended as a resource for tech-
nical and nontechnical audiences, including agencies, organizations,
employers, researchers, workers, and others who need to know about
occupational injury and illness. This concise, chart-based document
consolidates information from the network of monitoring systems
that forms the cornerstone of injury and illness surveillance in the
United States. The document is intended to fulfill the NIOSH strate-
gic goals for preventing occupational injury and illness and to guide
research and prevention efforts.
The Worker Health Chartbook, 2004 contains five chapters and three
appendices. Chapter 1 describes the U.S. labor force and the
health status of workers. Chapter 2 focuses on the demographic
characteristics of workers (age, sex, occupation, industry, and case
severity) and 33 types of occupational injuries and illnesses that
affect them: amputations; anxiety, stress, and neurotic disorders;
asbestosis; asthma; back, including spine and spinal cord; blood-
borne infections and percutaneous exposures; bruises and con-
tusions; byssinosis; carpal tunnel syndrome (CTS); coal workers
pneumoconiosis (CWP); cuts and lacerations; dermatitis; disorders
due to physical agents; disorders associated with repeated trauma;
vi
dust diseases of the lungs; fatal injuries; fractures; hearing loss; heat
burns and scalds; hypersensitivity pneumonitis; lead toxicity; meso-
thelioma; musculoskeletal disorders; nonfatal injury; pneumoco-
nioses; poisoning; respiratory diseases; respiratory conditions due
to toxic agents; silicosis; skin diseases and disorders; sprains, strains,
and tears; tendonitis; and tuberculosis. Chapter 2 also examines
the magnitude, trends, and geographic distribution of these con-
ditions. Chapter 3 focuses exclusively on agriculture, presenting
data on fatal and nonfatal injuries among adults and children in
agriculture and examining selected health conditions of farm work-
ers. Chapter 4 concentrates on high-risk industries and occupations
and reflects NIOSH research priorities in mining and construction.
Chapter 5 addresses special populations, exploring available occu-
pational injury and illness data on young workers, older workers,
and Hispanic workers.
The three appendices complement the chapters with details about
source data and programs. Appendix A describes the 21 survey and
surveillance programs used by the contributors; it includes program
contacts and reference citations for follow-up by users. Appendix B
examines various aspects of data collection, analysis methods, and
dissemination practices that limit the uses and inferences of data.
Appendix C provides a bibliography of reference materials from
the public domain, including data tables, report forms and docu-
mentation, government news releases, and research articles.
Contents
Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iii Characteristics of Injured and Ill Workers . . . . . . . . . . . . 23
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iv Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Abstract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vi Sex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xvi Race/Ethnicity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xviii Occupation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxii Industry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Severity of Injuries and Illnesses . . . . . . . . . . . . . . . . 26
Length of Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Chapter 1 Characteristics of U.S. Workers . . . . 1 Characteristics of the Injury or Illness . . . . . . . . . . . . . . . 27
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Nature of Injury or Illness . . . . . . . . . . . . . . . . . . . . . 27
Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Body Part Affected . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Scope . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Source of Injury or Illness . . . . . . . . . . . . . . . . . . . . . 29
Chapter 1 Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Event or Exposure . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Worker Demographics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Sex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Race/Ethnicity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Chapter 2 Fatal and Nonfatal Injuries, and Selected
Occupation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Illnesses and Conditions . . . . . . . . . . . . . . . . . . . 33
Industry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Anxiety, Stress, and Neurotic Disorders . . . . . . . . . . . . . . . . 34
Fastest Growing Occupations . . . . . . . . . . . . . . . . . . . . . . 10 Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Worker Health Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Fatal Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Sex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Injuries and Illnesses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Race/Ethnicity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . . . 14 Severity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Industry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Occupation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Rates among States . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Industry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Illnesses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Bloodborne Infections and Percutaneous Exposures . . . . . 40
Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . . . 19
Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
Numbers and Rates among States . . . . . . . . . . . . . . . 21
Occupation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
Characteristics of Injured and Ill Workers and Medical Devices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
Their Injuries and Illnesses . . . . . . . . . . . . . . . . . . . . . . . . 22 Hollow-Bore Needles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43

vii
 Fatal Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 Severity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 Occupation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
Numbers and Rates among States . . . . . . . . . . . . . . . . . . . 46 Industry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 Case-Based Reporting of CTS (California SENSOR) 70
Sex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 Occupation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
Race/Ethnicity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 Job Activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
Causes of Death . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 Disorders Associated with Repeated Trauma . . . . . . . . . . 72
Occupation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . . . 73
Industry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50 Numbers and Rates among States . . . . . . . . . . . . . . . 74
Event or Exposure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50 Tendonitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . . . 76
Hearing Loss . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Reporting Sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Sex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Race/Ethnicity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78
Industry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
Severity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78
Lead Toxicity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 Occupation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56 Industry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
Rates among States . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Nonfatal Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
Musculoskeletal Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . 58 Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
Numbers by State . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60 Sex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
Rates among States . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60 Race/Ethnicity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84
Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61 Industry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
Sex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61 Nonfatal Injuries Involving Days Away from Work . . . . . . 87
Race/Ethnicity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 Amputations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
Severity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . 88
Occupation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63 Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
Industry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63 Sex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90
Carpal Tunnel Syndrome (CTS) . . . . . . . . . . . . . . . . . . . . 64 Race/Ethnicity . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
Annual Survey of Employers Reports for CTS (BLS) 64 Severity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . 65 Occupation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66 Industry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
Sex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66 Back, Including Spine and Spinal Cord . . . . . . . . . . 94
Race/Ethnicity . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . 95

viii
 Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96 Severity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
Sex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96 Occupation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124
Race/Ethnicity . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97 Industry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124
Severity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97 Sprains, Strains, and Tears . . . . . . . . . . . . . . . . . . . . . 126
Occupation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98 Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . 127
Industry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98 Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128
Bruises and Contusions . . . . . . . . . . . . . . . . . . . . . . . 100 Sex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128
Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . 101 Race/Ethnicity . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102 Severity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
Sex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102 Occupation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130
Race/Ethnicity . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103 Industry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130
Severity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
Occupation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104 Disorders Due to Physical Agents . . . . . . . . . . . . . . . . . . . . . 132
Industry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104 Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
Heat Burns and Scalds . . . . . . . . . . . . . . . . . . . . . . . . 106 Numbers and Rates among States . . . . . . . . . . . . . . . . . . . 134
Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . 107 Poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135
Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108 Annual Survey of Employers: Reports of
Sex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109 Occupational Poisonings (BLS) . . . . . . . . . . . . . . . . . . 135
Race/Ethnicity . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110 Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . . . 136
Severity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110 Numbers and Rates among States . . . . . . . . . . . . . . . 137
Occupation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111 Case-Based Reporting of Pesticide-Related Illness
Industry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111 and Injury (SENSOR) . . . . . . . . . . . . . . . . . . . . . . . . . . 138
Cuts and Lacerations . . . . . . . . . . . . . . . . . . . . . . . . . 113 Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139
Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . 114 Sex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139
Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115 Occupation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140
Sex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115 Industry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140
Race/Ethnicity . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116 Agent or Exposure . . . . . . . . . . . . . . . . . . . . . . . . . . . 141
Severity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116
Occupation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117 Respiratory Diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 142
Industry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117 Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 142
Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119 Reporting Sources . . . . . . . . . . . . . . . . . . . . . . . . . . . 143
Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . 120 Occupation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143
Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121 Industry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144
Sex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122 Agent or Exposure . . . . . . . . . . . . . . . . . . . . . . . . . . . 144
Race/Ethnicity . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123 Hypersensitivity Pneumonitis . . . . . . . . . . . . . . . . . . . . . . 145

ix
 Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . . . 146 Rates among States . . . . . . . . . . . . . . . . . . . . . . 170
Rates among States . . . . . . . . . . . . . . . . . . . . . . . . . . . 146 Occupation and industry . . . . . . . . . . . . . . . . . . 171
Sex and Race . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147 Dust Diseases of the Lungs . . . . . . . . . . . . . . . . . . . . . . . . 172
Mesothelioma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 148 Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . . . 173
Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . . . 149 Numbers and Rates among States . . . . . . . . . . . . . . . 174
Rates among States . . . . . . . . . . . . . . . . . . . . . . . . . . . 149 Respiratory Conditions Due to Toxic Agents . . . . . . . . . . 175
Sex and Race . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150 Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . . . 176
Occupation and Industry . . . . . . . . . . . . . . . . . . . . . . 150 Numbers and Rates among States . . . . . . . . . . . . . . . 177
Pneumoconioses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151 Tuberculosis (TB) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178
Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . . . 152 Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . . . 179
Sex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152
Skin Diseases and Disorders . . . . . . . . . . . . . . . . . . . . . . . . . 180
Race/Ethnicity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153
Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181
Asbestosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 154
Numbers and Rates among States . . . . . . . . . . . . . . . . . . . 182
Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . 155
Dermatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 183
Rates among States . . . . . . . . . . . . . . . . . . . . . . . . . 155
Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . . . 184
Occupation and Industry . . . . . . . . . . . . . . . . . . . . 156
Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185
Byssinosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157
Sex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185
Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . 158
Race/Ethnicity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 186
Rates among States . . . . . . . . . . . . . . . . . . . . . . . . . 158
Severity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 186
Occupation and Industry . . . . . . . . . . . . . . . . . . . . 159
Occupation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187
Coal Workers Pneumoconiosis (CWP) . . . . . . . . . . 160
Industry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187
Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . 161
Rates among States . . . . . . . . . . . . . . . . . . . . . . . . . 162 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189
Occupation and Industry . . . . . . . . . . . . . . . . . . . . 163
Pneumoconiosis, Other or Unspecified . . . . . . . . . . 164 Chapter 3 Focus on Agriculture . . . . . . . . . . . . . 193
Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . 165 Fatal Agricultural Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . 193
Rates among States . . . . . . . . . . . . . . . . . . . . . . . . . 165 Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195
Occupation and Industry . . . . . . . . . . . . . . . . . . . . 166 Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 196
Silicosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167 Race/Ethnicity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 196
Silicosis Prevalence . . . . . . . . . . . . . . . . . . . . . . . . . 168 Sources and Causes of Death . . . . . . . . . . . . . . . . . . . . . . 197
Source of reports . . . . . . . . . . . . . . . . . . . . . . . . 168 Numbers and Rates among States . . . . . . . . . . . . . . . . . . . 198
Occupation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 168 Youths . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 199
Industry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169 Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 199
Silicosis Mortality . . . . . . . . . . . . . . . . . . . . . . . . . . 169 Causes of Death . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 200
Magnitude and trend . . . . . . . . . . . . . . . . . . . . . 169 Numbers among States . . . . . . . . . . . . . . . . . . . . . . . 200

x
 Nonfatal Agricultural Injuries . . . . . . . . . . . . . . . . . . . . . . . . 201 Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . . . 231
Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . . . . . . . 202 Type of Employer and Commodity . . . . . . . . . . . . . . 232
Numbers and Rates among States . . . . . . . . . . . . . . . . . . . 203 Surface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 232
Type of Farm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204 Underground . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 232
Source of Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205 Work Location and Type of Incident . . . . . . . . . . . . 233
Youths on Farms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205 Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 233
Youths on Minority Farms . . . . . . . . . . . . . . . . . . . . . . . . . 207 Sex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 234
Youths on Hispanic Farms . . . . . . . . . . . . . . . . . . . . . . . . . 210 Severity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 234
Experience . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 235
Farm Workers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 212 Metal/Nonmetal Mines . . . . . . . . . . . . . . . . . . . . . 236
Migrant Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 213 Coal Mines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 237
Years in Farm Work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 213 Hearing Loss . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 238
Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 214 Fatal Illnesses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 239
Sex and Hispanic Ethnicity . . . . . . . . . . . . . . . . . . . . . . . . 214 Coal Workers Pneumoconiosis . . . . . . . . . . . . . . . . 239
Nonfatal Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 215
Health Conditions or Symptoms . . . . . . . . . . . . . . . . . . . . 216 Construction Trades . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 240
Joint or Muscle Pain . . . . . . . . . . . . . . . . . . . . . . . . . . 216 Distribution of Construction Workers by Trade . . . . . . . 242
Dermatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 217 Fatal Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 242
Wheezing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 218 Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 242
Race/Ethnicity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 243
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 220 Occupation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 243
Establishment Size . . . . . . . . . . . . . . . . . . . . . . . . . . . 244
Chapter 4 High-Risk Industries and Event or Exposure . . . . . . . . . . . . . . . . . . . . . . . . . . . 244
Occupations . . . . . . . . . . . . . . . . . . . . . . . . . . 223 Nonfatal Injuries and Illnesses . . . . . . . . . . . . . . . . . . . . . 245
Mining . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 225 Occupation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 245
Employment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 226 Event or Exposure . . . . . . . . . . . . . . . . . . . . . . . . . . . 246
Surface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 226 Brickmasons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 247
Underground . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 226 Fatal Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 247
Fatal Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 227 Nonfatal Injuries and Illnesses . . . . . . . . . . . . . . . . . 247
Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . . . 227 Carpenters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 248
Type of Employer and Commodity . . . . . . . . . . . . . . 228 Fatal Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 248
Work Location . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 229 Nonfatal Injuries and Illnesses . . . . . . . . . . . . . . . . . 248
Type of Incident . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 230 Drywall Installers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 249
Size of Operation (Employment) . . . . . . . . . . . . . . . 230 Fatal Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 249
Nonfatal Injuries and Illnesses . . . . . . . . . . . . . . . . . . . . . 231 Nonfatal Injuries and Illnesses . . . . . . . . . . . . . . . . . 249

xi
 Electricians . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 250
Fatal Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 250
Nonfatal Injuries and Illnesses . . . . . . . . . . . . . . . . . 250
Ironworkers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 251
Fatal Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 251
Nonfatal Injuries and Illnesses . . . . . . . . . . . . . . . . . 251
Construction Laborers . . . . . . . . . . . . . . . . . . . . . . . . . . . . 252
Fatal Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 252
Nonfatal Injuries and Illnesses . . . . . . . . . . . . . . . . . 252
Operating Engineers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 253
Fatal Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 253
Nonfatal Injuries and Illnesses . . . . . . . . . . . . . . . . . 253
Painters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 254
Fatal Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 254
Nonfatal Injuries and Illnesses . . . . . . . . . . . . . . . . . 254
Plumbers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255
Fatal Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255
Nonfatal Injuries and Illnesses . . . . . . . . . . . . . . . . . 255
Roofers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 256
Fatal Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 256
Nonfatal Injuries and Illnesses . . . . . . . . . . . . . . . . . 256
Truck Drivers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 257
Fatal Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 257
Nonfatal Injuries and Illnesses . . . . . . . . . . . . . . . . . 257
Welders and Cutters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 258
Fatal Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 258
Nonfatal Injuries and Illnesses . . . . . . . . . . . . . . . . . 258
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 259
Chapter 5 Special Populations . . . . . . . . . . . . 261
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 261
Employment and Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . 263
Fatal Injuries and Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . 264
Nonfatal Injuries and Illnesses . . . . . . . . . . . . . . . . . . . . . 264
xii
Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 264
Severity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 265
Young Workers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 266
Fatal Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 267
Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . . . 267
Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 267
Sex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 268
Race/Ethnicity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 268
Occupation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 269
Industry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 269
Event or Exposure . . . . . . . . . . . . . . . . . . . . . . . . . . . 270
Nonfatal Injuries and Illnesses . . . . . . . . . . . . . . . . . . . . . 270
Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . . . 270
Severity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 272
Occupation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 272
Industry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 273
Case-Based Reporting of Work-Related Injuries to
Adolescents in Massachusetts (SENSOR) . . . . . . . . . . . 274
Data Sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 275
Age and Sex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 275
Type of Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 276
Industry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 276
Older Workers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 277
Fatal Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 278
Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . . . 278
Sex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 278
Race/Ethnicity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 279
Occupation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 279
Industry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 280
Event or Exposure . . . . . . . . . . . . . . . . . . . . . . . . . . . 280
Nonfatal Injuries and Illnesses . . . . . . . . . . . . . . . . . . . . . 281
Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . . . 281
Severity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 281
Occupation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 282
 Industry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 282
Hispanic Workers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 283
Fatal Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 284
Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . . . 284
Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 285
Sex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 285
Occupation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 286
Industry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 286
Event or Exposure . . . . . . . . . . . . . . . . . . . . . . . . . . . 287
Nonfatal Injuries and Illnesses . . . . . . . . . . . . . . . . . . . . . 287
Magnitude and Trend . . . . . . . . . . . . . . . . . . . . . . . . 287
Severity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 288
Occupation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 289
Industry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 289
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 290
Appendix A Survey and Surveillance
Program Descriptions . . . . . . . . . . . . . . . . . . . 291
Adult Blood Lead Epidemiology and Surveillance
(ABLES) Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 291
Census of Fatal Occupational Injuries (CFOI) . . . . . . . . . . 292
The Center to Protect Workers Rights (CPWR) . . . . . . . . . 292
1998 Childhood Agricultural Injury Survey (CAIS) . . . . . . 293
Coal Workers X-Ray Surveillance Program (CWXSP) . . . . 294
Current Population Survey (CPS) . . . . . . . . . . . . . . . . . . . . 295
Mine Safety and Health Research at NIOSH . . . . . . . . . . . . 295
2000 Minority Farm Operator Childhood
Agricultural Injury Survey (M-CAIS) . . . . . . . . . . . . . . . . . 297
Multiple-Cause-of-Death Data . . . . . . . . . . . . . . . . . . . . . . . . 298
National Agricultural Workers Survey (NAWS) . . . . . . . . . . 299
National Electronic Injury Surveillance
System (NEISS) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 300
National Notifiable Diseases Surveillance
System (NNDSS) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 301
National Occupational Respiratory Mortality
System (NORMS) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 302
National Surveillance System for Health Care
Workers (NaSH) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 303
National Surveillance System for Pneumoconiosis
Mortality (NSSPM) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 304
National Traumatic Occupational Fatality
(NTOF) Surveillance System . . . . . . . . . . . . . . . . . . . . . . . 305
Sentinel Event Notification System for
Occupational Risk (SENSOR) . . . . . . . . . . . . . . . . . . . . . . 306
Surveillance of Health Care Workers with AIDS . . . . . . . . . 307
Surveillance for Tuberculosis (TB) Infection
in Health Care Workers . . . . . . . . . . . . . . . . . . . . . . . . . . . . 308
Survey of Occupational Injuries and Illnesses (SOII) . . . . . 308
Traumatic Injury Surveillance of Farmers
(TISF) Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 310
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 310
Appendix B Data and Analysis Methods . . . . . 313
Census of Fatal Occupational Injuries (CFOI) . . . . . . . . . . 313
xiii
 Census Measures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 313 Selected Data Elements . . . . . . . . . . . . . . . . . . . . . . . . . . 320
Fatality Rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 313 Sex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 320
Uses and Limitations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 313 Age group . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 320
Publication Guidelines . . . . . . . . . . . . . . . . . . . . . . . . . . . . 314 Race/Ethnicity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 320
Data Objectives and Limitations . . . . . . . . . . . . . . . . . . . . 320
The Center to Protect Workers Rights (CPWR) . . . . . . . . 314
Fatal Injury Rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 314 Occupational Respiratory Disease . . . . . . . . . . . . . . . . . . . . 321
Nonfatal Injury and Illness Rates . . . . . . . . . . . . . . . . . . . 315 Number of Deaths . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 321
Hispanic Construction Workers . . . . . . . . . . . . . . . . . . . . 315 Industry and Occupation Codes and Titles . . . . . . . . . . . 321
Establishments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 315 Age-Adjusted Mortality Rates . . . . . . . . . . . . . . . . . . . . . . . 321
Mine Safety and Health Research Data Proportionate Mortality Ratio (PMR) . . . . . . . . . . . . . . . . 322
Analysis Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 315
Survey of Occupational Injuries and Illnesses (SOII) . . . . . 322
Commodity Differences for Type of Employer
Survey Measures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 322
(Mine Operators versus Independent
Incidence Rate Calculation . . . . . . . . . . . . . . . . . . . . . . . . 323
Contractors) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 315
Work Location . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 316 State Participation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 324
Selection Criteria for Fatalities . . . . . . . . . . . . . . . . . . . . . 316 Publication Guidelines . . . . . . . . . . . . . . . . . . . . . . . . . . . . 324
Employment Size of Mining Operations . . . . . . . . . . . . . 316 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 325
Selection Criteria for Lost-Workday Cases . . . . . . . . . . . . 316
Calculation of Rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 316
Appendix C Bibliography . . . . . . . . . . . . . . . . . 327
Injury/Illness and Mining Experience Data
Inclusion Criteria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 316 Adult Blood Lead Epidemiology and Surveillance
Determining the Type of Incident Associated (ABLES) Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 327
with the Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 317
Bureau of the Census (CENSUS) . . . . . . . . . . . . . . . . . . . . . 327
National Electronic Injury Surveillance System
(NEISS) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 317 Census of Fatal Occupational Injuries (CFOI) . . . . . . . . . . 327
Case Definition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 317 Center to Protect Workers Rights (CPWR) . . . . . . . . . . . . . 328
Case Exclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 318
Case Identification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 318 Current Population Survey (CPS) . . . . . . . . . . . . . . . . . . . . 328
Injury and Illness Estimates . . . . . . . . . . . . . . . . . . . . . . . . 318
Injury and Illness Estimate Confidence Bounds . . . . . . . 318 Mine Safety and Health Administration (MSHA) . . . . . . . . 328
Worker Population . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 319 National Agricultural Workers Survey (NAWS) . . . . . . . . . . 329
Injury and Illness Rate Estimates . . . . . . . . . . . . . . . . . . . 319
Minimum Reporting Requirements . . . . . . . . . . . . . . . . . 319 NIOSH Reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 329

xiv
Sentinel Event Notification System for News Releases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 330
Occupational Risk (SENSOR) . . . . . . . . . . . . . . . . . . . . . . 330 Selected Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 331
Survey of Occupational Injuries and Illnesses (SOII) . . . . . 330
Documentation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 330 Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 335

xv
 Abbreviations
ABLES...........Adult Blood Lead Epidemiology and Surveillance
Program
AIDS..............acquired immune deficiency syndrome
BLL ...............blood lead level
BLS................Bureau of Labor Statistics
CAIS ..............Childhood Agricultural Injury Survey
CATI..............computer-assisted telephone interview
CDC ..............Centers for Disease Control and Prevention
CFOI .............Census of Fatal Occupational Injuries
CFR ..............Code of Federal Regulations
CPS................Current Population Survey
CPWR............The Center to Protect Workers Rights
CSTE .............Council of State and Territorial Epidemiologists
CTS ...............carpal tunnel syndrome
CWP ..............coal workers pneumoconiosis
CWXSP .........Coal Workers X-Ray Surveillance Program
dL..................deciliter(s)
DHHS ...........U.S. Department of Health and Human Services
DOL ..............U.S. Department of Labor
EPA................U.S. Environmental Protection Agency
EPO...............Epidemiology Program Office
FTE ...............full-time equivalent worker
HARS ............HIV/AIDS Reporting System
HIV ...............human immunodeficiency virus
ICD8............International Classification of Diseases, Eighth
Revision (World Health Organization)
ICD9............International Classification of Diseases, Ninth
xvi
Revision (World Health Organization)
ICD10..........International Classification of Diseases, Tenth
Revision (World Health Organization)
ILO................International Labour Office
MCAIS.........Minority Farm Operation, Childhood Agricultural
Injury Survey
MMWR..........Morbidity and Mortality Weekly Report
MSHA ...........Mine Safety and Health Administration
MSD ..............musculoskeletal disorder
NaSH.............National Surveillance System for Health Care
Workers
NASS .............National Agricultural Statistics Service
NAWS ............National Agricultural Workers Survey
NCHS............National Center for Health Statistics
NCHSTP .......National Center for HIV, STD, and TB Prevention
NCID.............National Center for Infectious Diseases
n.e.c. .............not elsewhere classified
NEISS............National Electronic Injury Surveillance System
NIOSH..........National Institute for Occupational Safety and Health
NNDSS..........National Notifiable Diseases Surveillance System
NNIS .............National Nosocomial Infections Surveillance System
NORMS ........National Occupational Respiratory Mortality System
NORA ...........National Occupational Research Agenda
n.o.s...............not otherwise specified
NTOF............National Traumatic Occupational Fatalities
Surveillance System
NSSPM ..........National Surveillance System for Pneumoconiosis
Mortality
OASP.............Office of the Assistant Secretary for Policy
OMB .............Office of Management and Budget
OSHA............Occupational Safety and Health Administration
PMR ..............proportionate mortality ratio
SENSOR .......Sentinel Event Notification System for Occupational
Risk
SIC.................standard industrial classification
SOII...............Survey of Occupational Injuries and Illnesses
STD ...............sexually transmitted disease
TB .................tuberculosis
TISF...............Traumatic Injury Surveillance of Farmers
TST ...............tuberculin skin test
USDA ............U.S. Department of Agriculture
WHO.............World Health Organization
Work-RISQS..Work-Related Injury Statistics Query System
WoRLD .........work-related lung disease
WRA ..............work-related asthma
g ..................microgram(s)
xvii
 Glossary
Centers for Disease Control and Prevention (CDC): The Cen-
ters for Disease Control and Prevention (CDC) is headquartered
in Atlanta, Georgia, and is an agency of the U.S. Department of
Health and Human Services. CDC is recognized as the lead Fed-
eral agency for protecting the safety and health of people at home
and abroad. CDC provides credible information to enhance health
decisions and promote health through strong partnerships with
other public and nongovernment organizations. CDC serves as the
national focus for developing and applying disease prevention and
control, occupational and environmental health, and health pro-
motion and education activities designed to improve the health of
the people of the United States.
Civilian labor force: The civilian labor force comprises all civilians
classified as employed and unemployed.
Employed persons: Employed persons are all persons who fit into
one of the following categories during the reference week of the
U.S. Census Bureaus Current Population Survey: (1) persons who
did any work at all as paid employees, worked in their own business
or profession or on their own farm, or worked 15 or more hours
as unpaid workers in a family-operated enterprise; and (2) all per-
sons who did not work but had jobs or businesses from which they
were temporarily absent because of illness, bad weather, vacation,
child-care problems, labor disputes, maternity or paternity leave,
or other family or personal obligationswhether or not they were
paid by their employers for the time off and whether or not they
were seeking other jobs.
Fatal occupational injury rate: Fatal occupational injury rates are
determined by combining the number of fatal occupational inju-
ries identified by the Census of Fatal Occupational Injuries (CFOI)
xviii
with the average annual number of employed workers from the
Current Population Survey (CPS). These rates depict the risk that
certain workers (such as those in a given occupation or industry)
have of incurring a fatal injury. The formula for calculating a fatal
occupational injury rate is
Fatal injury = (N/W) 100,000
where N = the number of fatally injured workers aged 16 and older
and W = the number of employed workers aged 16 and older.
For example, in computing the fatal occupational injury rate for 1994,
N = 6,588 25 workers under age 16
= 6,563 (from 1994 CFOI)
and
W = 124,469,000
(from Current Population Survey 1994 annual average plus resi-
dent military figures derived from Census Bureau data). Thus
Fatality rate = (6,563/124,469,000) 100,000
= 5 deaths per 100,000 workers
Because neither hours nor employment figures are collected in
the Bureau of Labor Statistics (BLS) census (CFOI), fatality rates
are calculated using annual average employment estimates from
the Current Population Survey, conducted for BLS by the Census
Bureau. Employment-based fatality rates measure the incidence of
a fatal injury for all workers in the group regardless of exposure
time. Such measures do not reflect the movement of persons into
and out of the labor force, the length of their workweek or work
year, or the effect of multiple jobholders.
Hispanic workers: Hispanic workers are those who trace their ori-
gins to a Spanish-speaking country or culture. Origins may include
the heritage, nationality group, ancestry, or country of birth of the
person or persons parents or ancestors. People who identify their
origin as Hispanic may be of any race.
Incidence rate for nonfatal injury or illness: Incidence rates for
nonfatal injury or illness are calculated using the total obtained
through the weighting and benchmarking procedures. The adjust-
ed estimates for a particular characteristic (for example, for injury
and illness cases involving days away from work) are aggregated
to the appropriate level of industry detail. The total is multiplied
by 200,000 (the base of hours worked by 100 full-time workers for
1 year). The product is then divided by the weighted and bench-
marked estimate of hours worked as reported in the survey for a
particular industry segment.
The formula for calculating the incidence rate at the lowest level of
industry detail is
(Sum of characteristic reported) 200,000
Incidence rate =
(Sum of the number of hours worked)
Incidence rates for higher levels of industry detail are produced
using aggregated, weighted and benchmarked totals. Rates may be
computed by industry, employment size, geographic area, extent
or outcome of case, and case characteristic category. Rates for ill-
nesses and rates for case characteristic categories are published
per 10,000 full-time employees using 20 million hours instead of
200,000 hours in the above formula. Rates per 10,000 workers can
be converted to rates per 100 workers by moving the decimal point
two places to the left and rounding the resulting rate to the nearest
tenth.
Industry: An industry consists of a group of establishments primar-
ily engaged in producing or handling the same product or group
of products or in rendering the same service or services. For more
than 60 years, the Standard Industrial Classification (SIC) system
has served as the structure for the collecting, aggregating, present-
ing, and analyzing data on the U.S. economy. Industry definitions
used in BLS programs come from the 1987 Standard Industrial Clas-
sification (SIC) Manual of the Office of Management and Budget.
Because the SIC is used by many other Federal government statisti-
cal programs, it is possible for users to assemble a comprehensive
statistical picture of an industry.
Lost-workday cases: Lost-workday cases are cases of nonfatal injury
or illness that involve days away from work, or days of restricted
work activity, or both.
Lost-workday cases involving days away from work: Lost-workday
cases are cases that result in days away from work or a combination
of days away from work and days of restricted work activity.
Lost-workday cases involving restricted work activity: Lost-workday
cases involving restricted work activity are those cases that result in
restricted work activity only.
Median: A median is a measure of central tendency: it constitutes
the middle value in a distribution. The simplest division of a set of
measurements is into two partsthe lower and the upper half. The
point on the scale that divides the group in this way is the median.
Median days away from work is the measure used in many Chartbook
xix
 figures to summarize the varying lengths of absences from work
among the cases with days away from work.
Noise-induced hearing loss: Noise-induced hearing loss refers to
a sensorineural hearing loss caused by repeated exposure to high-
intensity sound levels. Noise-induced hearing loss is characterized
by irreversible damage to the sensory hair cells located in the inner
ear. The condition is usually preventable by limiting noise expo-
sures or by using personal hearing protection devices.
Occupation: Occupation is a set of activities or tasks that workers
are paid to perform. Workers that perform essentially the same
tasks are in the same occupation whether or not they are in the
same industry. Some occupations are concentrated in a few indus-
tries, and others may be found in the majority of industries.
Current, recent, or usual job activity information is collected by
many agencies to help characterize an occupation. Questions are
used to obtain information about the kind of work and the most
important activities or duties. This information, in conjunction with
industry or employer and class of worker (e.g., private or public
sector, nonprofit, self-employed), is used to classify jobs by occupa-
tional class. BLS data on the occupation of the injured or ill worker
was coded from job titles supplied by the employer, supplemented
at times by employer descriptions of how the incident occurred.
The 1990 Occupational Classification System developed by the
Census Bureau was used to classify thousands of job titles supplied
by employers into several hundred individual occupations such as
registered nurse, licensed practical nurse, or nursing aide or order-
ly. Each occupation is tied to one of six major occupational groups:
(1) managerial and professional specialty, (2) technical, sales, and
administrative support, (3) service occupations, (4) farming, for-
estry, and fishing, (5) precision production, craft, and repair; and
(3) operators, fabricators, and laborers.
xx
Occupational injury: An occupational injury is any injury such as
a cut, fracture, sprain, amputation, etc. that results from a work-
related event or from a single instantaneous exposure in the work
environment.
Occupational illness: An occupational illness is any abnormal con-
dition or disorder (other than one resulting from an occupational
injury) caused by exposure to factors associated with employment.
Occupational illness includes acute and chronic illnesses and dis-
eases that may be caused by inhalation, absorption, ingestion, or
direct contact.
Proportionate mortality ratio (PMR): The proportionate mortality
ratio (PMR) is defined as the observed number of deaths with the
condition of interest (mentioned as either underlying or contrib-
uting) in an industry/occupation from selected States and years,
divided by the expected number of deaths with that condition. The
expected number of deaths is the total number of deaths in the
industry or occupation classification of interest multiplied by a pro-
portion. This proportion is defined as the number of cause-specific
deaths for the condition of interest in all industries/occupations
divided by the total number of deaths in all industries/occupations.
The PMRs in this report have been internally adjusted by 5-year age
groups (i.e., 1519, 2024, . . . , 110114, and 115 years and over),
sex, and race (i.e., white, black, and all other). Confidence intervals
were calculated assuming Poisson distribution of the data. A PMR
greater than 1.0 indicates that more deaths were associated with
the condition in an occupation or industry than expected. This
report includes only those industries/occupations with 5 or more
decedents with the condition and a lower 95% confidence limit
exceeding 1.0.
Race: Race refers to a human population distinguished as a group by
certain physical characteristics. However, the concept of race involves
self-identification. Racial categories are sociopolitical constructs and
should not be interpreted as being scientific or anthropological.
Racial categories include both racial and national-origin groups.
The racial classifications used by most Federal agencies since 1997
follow the standards set forth in the October 30, 1997, Federal Reg-
ister Notice entitled Revisions to the Standard Classification of Federal
Data on Race and Ethnicity. The Office of Management and Budget
(OMB) requires five minimum categories for race: white; black or
African American; American Indian or Alaska Native; Asian; and
Native Hawaiian or other Pacific Islander. OMB also states that
respondents should be offered the option to select one or more
races.
Reader: Reader is a designation granted by NIOSH to physicians
who demonstrate proficiency in classifying chest X-rays for the
pneumoconioses using the International Labour Office (ILO)
Classification system. NIOSH has established a two-tier system for
designating readers: A Readers have completed a training course
or have otherwise demonstrated competence in the use of the ILO
Classification; B Readers have successfully completed a certification
examination and must be recertified every 4 years. A final determi-
nation about the classification of each X-ray requires agreement
between at least two Readers, one of whom must be a B Reader.
Rates: See incidence rates or fatal occupational injury rates.
Sentinel Event Notification System for Occupational Risk (SEN-
SOR): The Sensor program is a NIOSH cooperative agreement
program with State health departments or other State agencies
that develops generalizable, condition-specific strategies for State-
based surveillance of occupational diseases and injuries. Efforts
have focused on standardization of variables collected by the State
programs, creation of software to facilitate adoption of the surveil-
lance systems by additional States, comparison of SENSOR findings
to other surveillance data sources, collaboration with the Council
of State and Territorial Epidemiologists (CSTE) on building infra-
structure for State-based surveillance, further development of
State-based hazard surveillance, and publication and dissemination
of SENSOR reports.
Severity: Severity of an injury or illness is estimated by using infor-
mation provided by employers about the number of days away from
work to recuperate from each disabling condition. If, as a result of
injury or illness, the worker did not return to work by the end of the
survey year, the employer reports an approximate return date that,
in conjunction with the date of injury or illness, yields an estimated
number of days away from work for that case. Two basic measures
of severity are used with the characteristics of days-away-from-work
cases: (1) median days away from work (the point at which half of
the days-away-from-work cases have a longer duration and half have
a shorter duration; and (2) the distribution of days-away-from-work
cases involving various lengths of absences from work, ranging
from 1 or 2 days to 31 days or longer.
Surveillance: Surveillance is the systematic, ongoing collection or
acquisition of information about occupational diseases, injuries,
and hazards. Surveillance includes the analysis and interpreta-
tion of surveillance data, the dissemination of data or information
derived from surveillance to appropriate audiences for prevention
and control, and the development of surveillance methodology.
xxi
 Acknowledgments
This document was prepared by the staff of the National Institute Janice Windau, M.S., Bureau of Labor Statistics
for Occupational Safety and Health (NIOSH). All contributors are R. Alan Lunsford, Ph.D.
affiliated with NIOSH unless otherwise indicated.
Chapter 2. Fatal and Nonfatal Injuries, and Selected
The Worker Health Chartbook, 2004 includes a substantial amount of
information based on data and other contributions from the Office
Illnesses and Conditions
of Safety, Health, and Working Conditions, Bureau of Labor Statis- Amputations; fractures; and heat burns and scalds
tics. We extend a special note of appreciation to the following mem-
John P. Sestito, J.D., M.S.
bers of their staff for their cooperation and support throughout the
Larry L. Jackson, Ph.D.
development and review of the Chartbook: William Weber (retired),
Roger R. Rosa, Ph.D.
Katharine Newman, Janice Windau, William M. McCarthy, Linda
Garris, and Mark Zak.
Anxiety, stress, and neurotic disorders; dermatitis;
The nature and extent of the content of the Chartbook provided tendonitis
a significant challenge to our technical reviewers. We extend our
thanks for their time, constructive comments, and suggestions. Angela Booth-Jones, Ph.D.
John P. Sestito, J.D., M.S.
Toni Alterman, Ph.D., M.P.H.

Editors
Asbestosis; byssinosis; coal workers pneumoconiosis
John P. Sestito, J.D., M.S. (CWP); hypersensitivity pneumonitis; mesothelioma;
R. Alan Lunsford, Ph.D.
pneumoconioses; silicosis
Anne C. Hamilton
Roger R. Rosa, Ph.D. Cathy Rotunda, Ed.D.
Girija Syamlal, M.B.B.S., M.P.H.
Margaret Filios, Sc.M., R.N.
Contributors Ki Moon Bang, Ph.D., M.P.H.
Chapter 1. Characteristics of U.S. Workers Ricki Althouse, M.S.

John Sestito, J.D., M.S.

Asthma
William Weber, Bureau of Labor Statistics (retired)
Katharine Newman, Bureau of Labor Statistics Margaret Filios, Sc.M., R.N.

xxii
Back, including spine and spinal cord; bruises and Hearing loss
contusions; cuts and lacerations; and sprains, strains, Kenneth D. Rosenman, M.D., Michigan State University
and tears Amy Sims, Michigan State University
John P. Sestito, J.D., M.S.
Roger R. Rosa, Ph.D. Lead toxicity
Robert Roscoe, M.S.
Bloodborne infections and percutaneous exposures
Winnie Boal, M.P.H. Musculoskeletal disorders
John P. Sestito, J.D., M.S.
Carpal tunnel syndrome (CTS) R. Alan Lunsford, Ph.D.
Angela Booth-Jones, Ph.D. Linda Garris, Bureau of Labor Statistics
John P. Sestito, J.D., M.S. William D. McCarthy, Bureau of Labor Statistics
Toni Alterman, Ph.D., M.P.H.
Robert Harrison, M.D., M.P.H., California Department of Health
Nonfatal injury
Services
Jennifer Flattery, M.P.H., California Department of Health John P. Sestito, J.D., M.S.
Services Larry L. Jackson, Ph.D.
Roger R. Rosa, Ph.D.
Disorders due to physical agents; disorders associated
with repeated trauma; dust diseases of the lungs; Poisoning
respiratory conditions due to toxic agents; and skin Geoffrey Calvert, M.D., M.P.H.
diseases and disorders John P. Sestito, J.D., M.S.
John P. Sestito, J.D., M.S. R. Alan Lunsford, Ph.D.
R. Alan Lunsford, Ph.D.
Respiratory diseases
Fatal injuries Cathy Rotunda, Ed.D.
Suzanne M. Marsh Girija Syamlal, M.B.B.S, M.P.H.
Janice Windau, M.S., Bureau of Labor Statistics Margaret Filios, Sc.M., R.N.
Katharine Newman, Bureau of Labor Statistics Ki Moon Bang, Ph.D., M.P.H.
Mark Zak, Bureau of Labor Statistics Ricki Althouse, M.S.

xxiii
 Tuberculosis Haihong Hu, M.P.H., Center to Protect Workers Rights
Jitendra Chauhan, M.P.H., Center to Protect Workers Rights
Ki Moon Bang, Ph.D.

Chapter 3. Focus on Agriculture

Chapter 5. Special Populations
Fatal agricultural injuries Young workers
John P. Sestito, J.D., M.S.
John Myers, M.S.
Suzanne M. Marsh
Janice Windau, M.S., Bureau of Labor Statistics
Nonfatal agricultural injuries R. Alan Lunsford, Ph.D.
John Myers, M.S. Letitia Davis, Sc.D., Massachusetts Department of Public Health

Farm workers Older workers

Andrea Steege, M.S. John P. Sestito, J.D., M.S.
John Myers, M.S. Suzanne M. Marsh
Janice Windau, M.S., Bureau of Labor Statistics
R. Alan Lunsford, Ph.D.
Chapter 4. High-Risk Industries and Occupations
Mining Hispanic workers
Lynn I. Elinson, Ph.D. John P. Sestito, J.D., M.S.
Patrick Coleman, Ph.D. Suzanne M. Marsh
Barbara Fotta, M.S. Janice Windau, M.S., Bureau of Labor Statistics
Deborah D. Landen, M.D., Ph.D. R. Alan Lunsford, Ph.D.
Linda J. McWilliams, M.S.
Audrey Podlesny Technical Reviewers
James M. Wallingford, Mine Safety and Health Administration
Heinz Ahlers, J.D.
Construction trades Michael Attfield, Ph.D.
Robert Castellan, M.D., M.P.H.
Risana T. Choudhury, M.S., Center to Protect Workers Rights Dawn N. Castillo, M.P.H.
Xiuwen Dong, M.S., Center to Protect Workers Rights Letitia Davis, Sc.D., Massachusetts Department of Public Health
Janie Gittleman, Ph.D., M.R.P., Center to Protect Workers Rights Stephen J. Ganocy
Rose Men, M.S., Center to Protect Workers Rights Janie Gittleman, Ph.D., M.R.P., Center to Protect Workers Rights

xxiv
Joseph Hurrell, Ph.D. Editorial Review and Assistance
Max Lum, Ph.D.
Susan E. Afanuh
Kenneth Linch, M.S.
Timothy Morse, Ph.D., University of Connecticut Health Center Jane Weber, M.Ed.
Katharine Newman, Bureau of Labor Statistics Andre Allen, M.T.S.C.
Bonnie Rogers, Dr.P.H., COHN-S, The University of North Melissa R. Van Orman, M.A.
Carolina at Chapel Hill
Lynn L. Rethi Document Design and Desktop Publishing
Kenneth D. Rosenman, M.D., Michigan State University
Patricia L. Schlieff, M.S. Vanessa Becks
Rosemary Sokas, M.D., M.O.H., University of Illinois at Chicago Donna Pfirman

Web Development
Editorial and Production Support
Jihong Chen, M.S.
Graphics Development and Editing Stephen Leonard
R. Alan Lunsford, Ph.D. Christopher Storms
Sally Toles
Pamela Schumacher
John P. Sestito, J.D., M.S. Printing
Brenda Jones Penelope Arthur

xxv
Introduction
Background
T
he health status of U.S. workers continues to improve with
time. As illustrated in this 2004 edition of the National Insti-
tute for Occupational Safety and Health (NIOSH) Worker Health
Chartbook, the rates of fatal occupational injuries and nonfatal
occupational injuries and illnesses have declined significantly, and
Americans are living longer, healthier lives [Arias 2004; Molla et al.
2003].
Despite these positive statistics, occupational safety and health
surveillance faces significant challenges. The data presented here
attest to the depth of current surveillance programs, but a compre-
hensive and integrated surveillance program remains a long-term
goal [NIOSH 2001]. Current surveys and surveillance programs do
not adequately track occupational illnesses because of problems in
recognition, recording, and reporting. These limitations hinder
a complete and accurate assessment of the Nations occupational
injury and illness burden.
The U.S. population is becoming increasingly diverse. The labor
force is constantly evolving and being affected by new technology,
services, and types of work and work organization. With so many
changes, it is difficult to assure that the designs and contents of our
household and establishment surveys capture this dynamic labor
force. Many segments of the labor force (e.g., self-employed pub-
lic-sector workers, workers in small-scale businesses, migrant work-
ers, and youths under age 16) are beyond the scope of the only
ongoing establishment survey of nonfatal occupational injuries
and illnesses. Other segments of the labor force (part-time, tempo-
rary, disabled, and immigrant workers) are not a focus of ongoing
surveillance or research programs. These priority populations are
important segments of the labor force. Better tracking would (1)
advance our understanding of health disparities and the needs of
priority populations, (2) help us focus research, intervention, and
communication efforts to prevent injuries and illnesses, and (3)
promote the safety and health of these groups.
NIOSH compiled the first Worker Health Chartbook in 2000 to
provide a variety of occupational health surveillance data and
information in a single volume [NIOSH 2000]. In January 2001,
NIOSH published its strategic plan for surveillance to provide
a guide within NIOSH and a framework for occupational safety
and health surveillance [NIOSH 2001]. Central to this vision is
the concept of public health surveillance, the ongoing systematic
collection, analysis, and interpretation of health data essential to
the planning, implementation, and evaluation of public health
practices, closely integrated with the timely dissemination of these
data to those who need to know [NIOSH 2001]. This 2004 edition
of the Worker Health Chartbook exemplifies these strategic goals for
1
Chapter 1 Characteristics of U.S. Workers
ongoing surveillance and periodic dissemination of data that track
occupational injuries and illnesses.
Scope
This edition of the Worker Health Chartbook describes the magnitude
of the Nations occupational health problem by providing a view
of the distribution and trends for occupational injuries, illnesses,
fatalities, and other measures of health status. The document
presents national and State data to the extent possible. Data are
presented from the U.S. Department of Labor (DOL) Bureau of
Labor Statistics (BLS) on labor force demographics [BLS 2001]
and employment projections [BLS 2002a]. Health status measures
are described by age, race/ethnicity, severity of injury or illness,
occupation, and industry of the affected workers [BLS 2003b,c].
The breadth of the data sources precludes a thorough discussion of
them or of their methods and limitations. The following comments
highlight the limits of the employment data and demographic vari-
ables used.
The Worker Health Chartbook makes extensive references to the BLS
Current Population Survey (CPS) [BLS 2001], which is a house-
hold sample survey of the civilian noninstitutionalized population
that requests information about the employment status of each
household member aged 15 or older. The CPS provides estimates
of employment, unemployment, and other characteristics of the
labor force, the population as a whole, and various other popula-
tion subgroups. These employment statistics are available for vari-
ous demographic characteristics, including age, sex, race, occupa-
tion, industry, and class of worker. The lack of labor force data for
youths aged 15 and younger (Chapter 5) limits occupational sur-
veillance of working youths.
2
Employment-based fatality rates measure the incidence of fatal
occupational injury for all workers in a group (usually an industry)
regardless of exposure time. These rates do not reflect the move-
ment of persons into and out of the labor force, the length of their
work week (i.e., variation in hours worked) or work year, or the
effect of multiple jobholders. The use of employment-based fatality
rates has been shown to underestimate fatality risk for workers aged
20 and younger and for workers aged 65 and older [Ruser 1998].
Information about age, sex, and race/ethnicity are typical vari-
ables used for epidemiologic and statistical comparisons. The
race/ethnicity categories used in the Chartbook are taken from the
original data sources. In contrast to household surveys (in which
respondents are likely to be more familiar with the race/ethnicity
of a household member), workplace fatality, injury, or illness data
may not be supplied by persons with such knowledge. For the
Census of Fatal Occupational Injuries (CFOI) [BLS 2003a] and
the annual Survey of Occupational Injuries and Illnesses (SOII)
[BLS 2003b,c], these categories follow the guidance in the Octo-
ber 30, 1997 Federal Register Notice entitled Revisions to the Standards
for the Classification of Federal Data on Race and Ethnicity, issued by
the Office of Management and Budget (OMB). These categories
permit respondents to be classified as multiracial or multiethnic,
which is important for improved description of Hispanic workers.
Chapter 1 contains data from Census 2000 to permit comparisons
between the general population and the occupational health data
presented here.
Chapter 1 Overview
The Worker Health Chartbook, 2004 focuses on worker health and
the injury and illness statistics that measure the work-related health
status of workers in the United States. The magnitude and patterns
of injury and illness are influenced by labor force trends that may

reflect general population changes. Such changes are illustrated in
the charts presented here.
This chapter provides charts that illustrate the status of worker
health as measured by occupational fatalities, injuries, illnesses,
and disorders. Included are illustrations and discussions of (1) the
demographic characteristics of the labor force (age, sex, race/
ethnicity, occupation, and industry), (2) the work-related health
status of workers (fatal and nonfatal injury and illness rates), and
(3) the characteristics of injured and ill workers, their injuries, and
their illnesses. Both national and State data are presented when
they are available.
Since 1992, improved data collection by the BLS permits better
descriptions of the injured or ill workers demographics (age, sex,
race/ethnicity, occupation, and industry) as well as their work-relat-
ed injuries and illnesses. This document illustrates the extensive
statistical resources available for describing work-related injuries
and illnesses.
Worker Demographics
Throughout the Chartbook, work-related injury, illness, and fatality
data for U.S. workers are presented relative to their age, sex, race/
ethnicity, occupation, and industry. To provide some perspective
on the employed population, these demographic data are included
for employed persons from the 2001 CPS [BLS 2001].
In 2001, most U.S. workers (nearly 71.4%) fell within the prime
working ages of 25 to 54; 15% were younger than 25, and 13.6%
were 55 or older (Table 11). By 2010, the baby boom generation
will reach the ages of 4564, and middle and older age groups in
the labor force will outnumber younger workers (Figure 11).
Chapter 1 Characteristics of U.S. Workers
Male workers represented more than half (53.4%) of the working
population in 2001: white male workers accounted for 54.2% of all
white workers, and Hispanic male workers represented 58.1% of
all Hispanic workers (Table 12). Black male workers accounted
for slightly fewer than half of all black workers (46.7%). Though
male workers accounted for a larger share of jobs in 2001, their
distribution in the labor force is projected to decrease to 52.1% in
2010. With corresponding increases for female workers, women are
projected to account for 47.9% of the labor force in 2010 (Figure
12).
In 2001, white workers accounted for 83.8% of the civilian labor
force, black workers for 11.3%, and Hispanic workers for 10.9%
[BLS 2001]. As the number of white workers decreases, BLS proj-
ects corresponding job growth for minority groups: black workers
are projected to account for 12.7% of the labor force and Asian
and other workers for 6.1% by 2010 (Figure 13). The percentage
of Hispanic workers is projected to more than double during this
period, increasing from 5.7% in 1980 to 13.3% in 2010 (Figure
14).
Data for 2001 indicate that two major occupational groups (mana-
gerial and professional specialty; and technical, sales, and adminis-
trative support) account for more than 60% of employed persons in
the United States (Table 13). The percentage of female workers is
smallest in precision production, craft, and repair jobs (8.7%) and
greatest in technical, sales, and administrative support (63.7%).
The percentage of black workers is smallest in farming, forestry,
and fishing (5.0%) and greatest in public administration (16.2%).
The percentage of Hispanic workers is smallest in the managerial
and professional specialty group (5.1%) and greatest in farming,
forestry, and fishing (21.5%). BLS projects employment to increase
by 22 million workers by 2010, with the largest numbers of work-
ers employed in professional and related occupations and service
(Figure 15).
3
Chapter 1 Characteristics of U.S. Workers
Among industry sectors, services employed the most workers in
2001 (37.4% of the labor force, or 50.5 million workers), followed
by retail trade (16.7%) and manufacturing (14.0%) (Table 14).
BLS estimates that these industrial sectors will have the greatest
growth between 2000 and 2010: employment will increase to 52.2
million for services and to 34.2 million for wholesale and retail
trade (Figure 16). As shown in Table 14, the high-risk industries
of agriculture, mining, and construction accounted for only 9.8% of
employed workers. Construction and mining contained the small-
est percentages of female workers (9.7% and 14.6%, respectively),
and the services sector contained the largest (62.1%). Forestry and
fisheries contained the smallest percentage of black workers (1.7%),
and public administration contained the largest (16.2%). Forestry
4
and fisheries also contained the smallest percentage of Hispanic
workers (5.1%), and agriculture contained the largest (20.3%).
The BLS estimated that the labor force consisted of 135 million
employed workers in 2001, a figure projected to increase by 17 mil-
lion during the next decade [BLS 2002a]. How the characteristics of
the labor force will affect future rates of fatal and nonfatal injuries
and illnesses is unclear. However, a review of these characteristics is
useful for understanding changes in the demographic composition
of at-risk populations and for predicting occupations and industries
that will experience future job growth. The data presented here are
based on annual estimates and projections produced by the CPS of
the BLS [BLS 2001].
 Chapter 1 Characteristics of U.S. Workers

Age
How did employed U.S. workers differ by age in 2001? Age Number Distribution
(years) (thousands) (%)
Table 11. Number and distribution of employed U.S. workers 1619 6,889 5.1
by age, 2001. U.S. workers aged 2554 accounted for 96.5 mil-
2024 13,361 9.9
lion workers in 2001, or 71.5% of all employed U.S. workers.
(Source: BLS [2001].) 2534 29,697 22.0
3544 36,226 26.8
4554 30,592 22.6
5564 14,133 10.5
65 and older 4,174 3.1

How did the labor force differ by age? 30

1980 1990 2000 2010

Figure 11. Distribution of the civilian labor force by age,

19802000 and projected to 2010. Since 1980, the age distribu- 25
tion of the labor force has shifted. By 2010, middle and older
age groups in the labor force will outnumber younger workers.
(Sources: BLS [2002a]; Fullerton and Toossi [2001].) 20
Distribution (%)

15

10

0
1624 2534 3544 4554 5564 >64
Age range

5
 Chapter 1 Characteristics of U.S. Workers

Total White workers Black workers Hispanic workers Sex

Number Distri- Number Distri- Number Distri- Number Distri- How did the labor force differ by sex of
(thou- bution (thou- bution (thou- bution (thou- bution worker?
Sex of worker sands) (%) sands) (%) sands) (%) sands) (%)
Table 12. Number and distribution of em-
Male workers 72,080 53.4 61,411 54.2 7,127 46.7 8,556 58.1 ployed white, black, and Hispanic workers
Female workers 62,992 46.6 51,810 45.8 8,143 53.3 6,159 41.9 by sex, 2001. Overall, more male workers
Totals 135,073 100.0 113,220 100.0 15,270 100.0 14,714 100.0 (53.4%) than female workers (46.6%) were
Source: BLS [2001]. employed in 2001, though 53.3% of all em-
*Totals may not add up because of rounding. ployed black workers were female; 41.9% of
all employed Hispanic workers were female.
(Source: BLS [2001].)

1980 1990 2000 2010 Figure 12. Distribution of the civilian labor force by sex,
60 57.5 19802000 and projected to 2010. The labor force participa-
54.8
53.4 tion of male workers is projected to decrease from 57% in
52.1
1980 to 52% in 2010. Corresponding increases are shown for
50 46.6 47.9
45.2
female workers, who are projected to account for 48% of the
42.5 labor force in 2010. (Sources: BLS [2002a]; Fullerton and Toossi
40 [2001].)
Distribution (%)

30

20

10

0
Male Female

6
 Chapter 1 Characteristics of U.S. Workers

Race/Ethnicity 1980 1990 2000 2010

90 87.5 85.4
83.5
How did the labor force differ by race/ethnicity during 81.2
19802000 and what is the projection for 2010? 80

Figure 13. Distribution of the civilian labor force by race, 70

19802000 and projected to 2010. The labor force participa-
60
tion of black workers and Asian and other workers has in-

Distribution (%)
creased since 1980, with black workers projected to account for
50
12.7% of the labor force and Asian and other workers for 6.1%
by 2010. Corresponding decreases are shown for white workers, 40
whose labor force participation is projected to decline to 81.2%
by 2010. (Sources: BLS [2002a]; Fullerton and Toossi [2001].) 30

20
10.2 10.9 11.8 12.7
10 4.7 6.1
2.3 3.7
0
Asian and other Black White

How did the labor force differ by Hispanic and non- 1980 1990 2000 2010
100
Hispanic ethnicity during 19802000 and what is the 94.3
91.5
projection for 2010? 89.1 86.7
81.9
Figure 14. Distribution of the civilian labor force by Hispanic 80 77.7
and non-Hispanic ethnicity, 19802000 and projected to 2010. 73.1
69.2
The percentage of Hispanic workers is projected to more than
double during this period, increasing from 5.7% in 1980 to
Distribution (%)

60
13.3% in 2010. Corresponding decreases are shown for non-
Hispanic white workers and other than Hispanic workers.
(Sources: BLS [2002a]; Fullerton and Toossi [2001].)
40

20
10.9 13.3
8.5
5.7

0
Hispanic White, non-Hispanic Other than Hispanic

7
 Chapter 1 Characteristics of U.S. Workers

Distribution (%) Occupation

Number
Occupation (thousands) Women Black Hispanic Which occupational groups employed the most workers in
All 135,073 46.6 11.3 10.9 2001?
Managerial and professional specialty 41,894 50.0 8.3 5.1 Table 13. Number of employed workers by major occupa-
Technical, sales, and administrative support 39,044 63.7 11.4 9.1 tional group and percentage of female, black, and Hispanic
Service occupations 18,359 60.4 17.9 16.3 workers, 2001. Two occupational groups (managerial and
Precision production, craft, and repair 14,833 8.7 7.8 14.7 professional specialty; and technical, sales, and administrative
support) employed 60% of all workers (or 80.9 million work-
Operators, fabricators, and laborers 17,698 23.3 15.8 17.7
ers). Female workers accounted for nearly half (46.6%) of all
Farming, forestry, and fishing 3,245 20.8 5.0 21.5 employed workers and more than half of workers in techni-
cal, sales, and administrative support (63.7%) and in service
occupations (60.4%). Black workers accounted for 11.3% of
all workers, and service occupations had the greatest propor-
tion of black workers (17.9%). Hispanic workers accounted for
10.3% of all workers, and farming, forestry, and fishing had the
greatest proportion of Hispanic workers (21.5%). (Source: BLS
[2001].)

35 Professional and What changes are expected during 20012010?

related occupations
Service Figure 15. Employment by major occupational group, 2000
30 and projected to 2010. BLS projects employment to increase
Office and
administrative support
Employment (millions of workers)

by 22 million workers (to a total of 167.7 million) over the

25 Management, period 2000 to 2010. The largest numbers of workers will be
business, and financial employed in professional and related occupations and service.
Sales and related BLS estimates that these occupational groups will experience
20 occupations
the greatest growth between 2000 and 2010, with employment
Production
increasing to 33.7 million for professional and related occu-
Transportation and pations and 31.2 million for service occupations. (Source: BLS
15 material moving
[2002a].)
Construction and
extraction
10
Installation,
maintenance, and repair
5 Farming, fishing,
and forestry

0
2000 2010

8
 Chapter 1 Characteristics of U.S. Workers

Industry Distribution (%)

Number
Which industries employed the most workers in 2001? Industry (thousands) Women Black Hispanic
All 135,073 46.6 11.3 10.9
Table 14. Number of employed workers by major industry
Agriculture 3,144 27.6 3.6 20.3
sector and percentage of female, black, and Hispanic workers,
Forestry and fisheries 133 23.5 1.7 5.1
2001. Most workers (71.9%, or 97.1 million) were employed
by the services, wholesale and retail trade, and manufacturing Mining 567 14.6 4.2 7.6
sectors. Female workers accounted for nearly half of all work- Construction 9,581 9.7 6.4 15.8
ers (46.6%) and for more than half the workers in services; Manufacturing 18,970 31.8 10.1 12.3
finance, insurance, and real estate; and retail trade. Black work- Durable goods 11,588 27.3 9.0 10.6
ers accounted for 11.3% of all workers, but public administra- Nondurable goods 7,381 38.8 11.8 15.1
tion and transportation and public utilities had the greatest Transportation, communications, and other
proportions of black workers (16.2% and 15.8%, respectively). public utilities 9,738 29.2 15.8 9.6
Hispanic workers accounted for 10.9% of all workers, but Wholesale and retail trade 27,672 47.0 10.0 12.4
agriculture and construction had the greatest proportions of Wholesale trade 5,102 30.1 7.5 11.1
Hispanic workers (20.3% and 15.8%, respectively). (Source: Retail trade 22,571 50.8 10.6 12.7
BLS [2001].) Finance, insurance, and real estate 8,797 58.3 10.8 7.2
Services 50,478 62.1 12.6 9.3
Public administration 6,126 45.1 16.2 8.0

What changes are expected during 20002010? 60 Services

Wholesale and
Figure 16. Employment by major industry division, 1990, retail trade
2000, and projected to 2010. BLS projects employment to in- Employment (millions of workers) 50 Public administration
crease by 22 million workers (to a total of 167.7 million) during Manufacturing
20002010. The largest numbers of workers will be employed durable goods
in the services and wholesale and retail trade sectors. BLS esti- 40 Transportation and
mates that these industrial sectors will have the greatest growth public utilities
between 2000 and 2010, with employment increasing to 52.2 Finance, insurance,
30 and real estate
million for services and 34.2 million for wholesale and retail
trade. (Source: BLS [2002a].) Construction
Manufacturing
20 nondurable goods
Agriculture, forestry,
and fishing
Mining
10

0
1990 2000 2010

9
Chapter 1 Characteristics of U.S. Workers

Computer software engineers,

applications 100 Fastest Growing Occupations
Computer support specialists 97
Which occupations will have the most rapid growth during
Computer software engineers,
systems software 90 20002010?
Network and computer systems
82
administrators Figure 17. Occupations projected to have the most rapid
Network systems and data
communication analysts 77 growth during the period 20002010. The fastest growing oc-
Desktop publishers 67 cupations are computer- and health-care-related jobs. The
numbers of computer software engineers and support special-
Database administrators 66 ists are expected to increase 100% and 97%, respectively. The
Personal and home care aides 62 numbers of medical and physician assistants are expected to
Computer systems analysts 60
increase 57% and 53%, respectively. (Sources: BLS [2002a];
Hecker [2001].)
Medical assistants 57
Social and human service
assistants 54
Physician assistants 53

0 20 40 60 80 100
% increase

Food preparation and Which occupations are expected to add the most jobs
673
serving workers during 20002010?
Customer service 631
representatives Figure 18. Occupations expected to add the most jobs during
Registered nurses 561 20002010. Service- and computer-related jobs are expected
to predominate during 20002010. These include food prepa-
Retail sales representatives 510
ration workers, customer service representatives, registered
Computer support 490 nurses, and retail sales representatives. (Sources: BLS [2002a];
specialists Hecker [2001].)
Cashiers, except gaming 474

Office clerks, general 430

Security guards 391

Computer software engineers, 380
applications
Waiters and waitresses 364

0 100 200 300 400 500 600 700

Jobs added (thousands)

10

Worker Health Status
The responsibility for collecting statistics on occupational injuries
and illnesses is delegated to the BLS, which has reported annu-
ally since 1972 on the number and frequency of fatal and nonfatal
occupational injuries and illnesses in private industry. Before the
1992 SOII [BLS 1995], BLS statistics counted injuries and illnesses
that included fatalities. Since 1992, BLS has been able to count
fatal injuries more effectively through the use of a separate cen-
susCFOI. And beginning with the 1992 SOII [BLS 1995], BLS
has collected additional statistics from private industry regarding
worker and case characteristics for seriously injured or ill workers
(i.e., those requiring recuperation away from work beyond the day
of the incident).
Data for Figures 19 through 126 come from CFOI and SOII.
CFOI provides the most complete count of fatal occupational inju-
ries available. BLS uses diverse State and Federal data sources to
identify, verify, and profile fatal occupational injuries. The overall
fatal occupational injury count for 2002 (5,524) was 6.4% lower
than the count for 2001 (Figure 19). The fatal occupational injury
rate for 2002 was 4.0 per 100,000 employed workers. The trend
in rates reflects a decline beginning in 1993. Rates varied among
States from 1.4 to 14.1 per 100,000 employed workers. Fatal occu-
pational injuries exceeded 10 per 100,000 employed workers in
Alaska, Wyoming, and Montana (Figure 110).
SOII measures the number of new occupational illness cases that
are recognized, diagnosed, and reported each year. Some condi-
tions (for example, chronic or latent illnesses caused by exposure
to carcinogens) are difficult to identify as work-related and are
not adequately recognized and reported. These chronic or latent
illnesses are believed to be understated in the surveys illness mea-
sures. The overwhelming majority of the reported new illnesses
Chapter 1 Characteristics of U.S. Workers
are those that are easier to relate directly to workplace activity (for
example, contact dermatitis or carpal tunnel syndrome).
Private industry reported 5.2 million nonfatal occupational inju-
ries and illnesses in 2001, resulting in an overall incidence rate of
5.7 cases per 100 full-time workers (Figure 111). The number of
injuries and illnesses resulting in time away from work (1.54 mil-
lion cases in 2001) represents a decrease of 34% since 1992 (Figure
112). Nonfatal occupational injury and illness rates varied by State
from 2.3 to 8.7 per 100 full-time workers. Lower rates are reported
for States in the South, southern coastal States, and the Southwest
(Figure 118).
Durable goods manufacturing accounted for the highest rate of
nonfatal occupational injuries and illnesses reported in 2001 (8.8
per 100 workers), followed by construction (7.9), and agriculture,
forestry, and fishing (7.3). The Services industry reported approxi-
mately 1.3 million cases, or 25% of all nonfatal occupational inju-
ries and illnesses in 2001 (Figure 114). Eight industries, each
reporting at least 100,000 injuries, accounted for about 1.4 million
injuries or 29% of the 4.9 million total (Figure 115). Injury rates
were higher for mid-size establishments (those employing 50 to 249
workers) than for smaller or larger establishments (Figure 116).
About 333,800 new cases of occupational illness were reported in
private industry in 2001 (Figure 121). From 1972 to 1982, the
number of illness cases declined gradually from 210,500 to 105,600.
This number increased and peaked sharply in 1994 at 514,700 cases
(Figure 122). Disorders associated with repeated trauma (such as
carpal tunnel syndrome and noise-induced hearing loss) affected
216,400 workers or 4% of the 5.2 million occupational injuries
and illnesses and 64.8% of the 333,800 illness cases in 2001. These
11
Chapter 1 Characteristics of U.S. Workers

disorders declined for 7 consecutive years dating from 1995 (Figure Maine. Higher rates were reported in the Midwest. Lower rates
123). Occupational illness rates varied widely among the States, were reported for States in the South and in the southern coastal
from 8.8 per 10,000 full-time workers in New Mexico to 142.6 in and western mountain States (Figure 126).

12
 Chapter 1 Characteristics of U.S. Workers

Fatal Injuries 7,000

Number Rate
6
6,632
How did the numbers and rates of fatal occupational 6,217 6,331 6,275 6,202 6,238
6,055 6,053 5,915
injuries change during 19922002? 6,000 5,900
5

5.3
5,524

5.2

5.2

5.0
Figure 19. Numbers and rates of fatal occupational injuries,

4.8

Rate per 100,000 workers

4.7
5,000

Number of fatal injuries

4.5
4.5
19922002. The fatal occupational injury rate has varied from 4

4.3

4.3
5.3 per 100,000 workers in 1994 (6,632 fatal injuries) to 4.0

4.0
in 2002 (5,524 fatal injuries). Since 1993, the trend in rates 4,000
reflects a steady decline. (Note: Charts using data for calendar 3
year from the CFOI exclude deaths from the September 11 ter- 3,000
rorist attacks.) (Source: BLS [2003a].)
2
2,000

1
1,000

0 0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

How did the rates of fatal occupational injuries differ by

State in 2002?

Figure 110. Fatal occupational injury rates by State, 2002.

Fatal occupational injury rates varied by State from 1.4 to
14.1 per 100,000 employed workers. (The U.S. rate was 4.0
per 100,000 employed workers in 2002.) Fatal occupational
injuries exceeded 10 per 100,000 employed workers in Alaska,
Wyoming, and Montana. (Sources: BLS [2003a]; BLS [2003b].)
Rate per 100,000
workers
6.614.1
4.86.5
4.14.7
3.24.0
1.43.1

13
 Chapter 1 Characteristics of U.S. Workers

12
11.0
Total cases Injuries and Illnesses
Cases without lost workdays
Lost-workday cases Magnitude and Trend
10
How frequently did occupational injuries and illnesses
occur during 19732001?
Rate per 100 workers

8 7.5
Figure 111. Incidence rates of occupational injuries and ill-
5.7 nesses in private industry by case type, 19732001. The private-
6 industry sector reported 5.2 million nonfatal occupational inju-
ries and illnesses during 2001, corresponding with an overall rate
of 5.7 cases per 100 full-time workers. Approximately 2.6 million
4 3.4 4.3 were lost-workday cases requiring recuperation away from work
2.9
or restricted duties at work. The total occupational injury and
2.8 illness incidence rate continues to decline. This trend is reflect-
2
ed in the private-sector data reported to BLS since 1973. (Note:
Lost-workday cases include cases with days away from work and
cases with restricted work activity onlythat is, cases in which
0
1973 1975 1977 1979 1981 1983 1985 1987 1989 1991 1993 1995 1997 1999 2001 workers report to their jobs for limited duty. See Appendix B for
details about case types.) (Source: BLS [2002b].)

2.5 Private industry Service producing Goods producing Figure 112. Number of nonfatal occupational injury and
illness cases with days away from work in private industry,
19922001. The number of injuries and illnesses resulting in
time away from work continues to decline. The 1.54 million
2.0
cases in 2001 represent a decrease of 34% since 1992. Over the
Number of cases (millions)

same period, the goods-producing segment of private industry

experienced a 38.7% decrease, which is notably greater than
1.5 the 31.1% decrease recorded for the service-producing seg-
ment of the private sector. (Source: BLS [2002b].)

1.0

0.5

0.0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

14
 Chapter 1 Characteristics of U.S. Workers

How did the rate of lost-workday injuries and illnesses 5 Lost-workday cases
change during 19732001? Cases with days away from work
4.3
Cases with restricted work activity
Figure 113. Incidence rates for lost-workday cases of nonfa-
4
tal occupational injuries and illnesses in private industry, 1973
4.0
2001. Since 1973, the incidence rate for lost-workday cases has 3.4

Rate per 100 workers

varied from 4.3 per 100 full-time workers in 1979 to 2.8 cases
per 100 full-time workers in 2001. Lost-workday case rates have 3 3.2 2.8
been declining since 1990, with a strong contribution from
decreases in cases with days away from work. The decline is
offset by increases in restricted work activity cases, which have
increased steadily since 1987. These cases include those with 2 1.7
shortened workdays, temporary job changes, or temporary re-
strictions of job duties. (Source: BLS [2002b].) 1.1
1

0.1
0
1973 1975 1977 1979 1981 1983 1985 1987 1989 1991 1993 1995 1997 1999 2001

Industry Agriculture, forestry, 109,300 7.3

and fishing
How were nonfatal occupational injuries and illnesses Mining 24,000 4.0
distributed by major private-sector industry groups in
2001? Construction 481,400 7.9
Manufacturing 922,900 8.8
Figure 114. Number and rate of nonfatal occupational inju- durable
ries and illnesses in private industry by industry, 2001. Durable Manufacturing 468,100 6.8
nondurable
goods manufacturing accounted for the highest rate of nonfa-
Transportation and 456,100 6.9
tal occupational injuries and illnesses (8.8 per 100 workers) re- public utilities
ported in 2001, followed by construction (7.9) and agriculture,
Wholesale trade 340,100 5.3
forestry and fishing (7.3). Services reported approximately 1.3
million cases, or 25% of all nonfatal occupational injuries and Retail trade 986,800 5.7
illnesses in 2001. (Note: Numbers of nonfatal injuries and ill- Finance, insurance,
nesses are inside the bars.) (Source: BLS [2002b].) 122,100 1.8 Rate for all private
and real estate industry = 5.7
Services 1,304,900 4.6

0 1 2 3 4 5 6 7 8 9
Rate per 100 full-time workers

15
 Chapter 1 Characteristics of U.S. Workers

Air transportation, Which industry sectors accounted for the most nonfatal
116,300 13.6 injury cases in 2001?
scheduled
Nursing and personal
care facilities
192,900 13.0 Figure 115. Number and rate of total nonfatal occupational
injuries in private-industry sectors with at least 100,000 cases,
Motor vehicles and 102,700 10.9 2001. Each of these eight industry sectors (ranked by occupa-
equipment
tional injury rate) reported more than 100,000 injuries in 2001.
Trucking and courier 134,900 8.3 Air transportation reported the highest rate in the group (13.6
services, except air
per 100 workers), followed by nursing and personal care facili-
Hospitals 265,700 8.2 ties (13.0). Together, these eight industry sectors accounted for
about 1.4 million nonfatal injuries, or 29% of the 4.9 million
Grocery stores 175,100 7.8 total. (Source: BLS [2002b].)

Department stores 145,300 7.7

Eating and drinking 283,700 5.2

places

0 2 4 6 8 10 12 14
Rate per 100 workers

8 How did nonfatal injury rates vary by establishment size in

Rate for all establishments = 5.4 2001?
7.1
7
6.2 Figure 116. Incidence rates for nonfatal occupational injuries
6 in private industry by establishment size, 2001. By establish-
5.4 ment size, nonfatal occupational injury rates varied from 7.1 to
Rate per 100 workers

5 2.0 per 100 full-time workers. Incidence rates were higher for
4.5 establishments employing 50249 workers than for smaller or
4 larger establishments. This pattern did not hold for all indus-
tries. (Source: BLS [2002b].)
3
2.0
2

0
110 1149 50249 250999 >999
Number of workers per establishment

16
 Chapter 1 Characteristics of U.S. Workers

How did the trends in nonfatal injuries and illnesses Manufacturingdurable goods Manufacturingnondurable goods
change within industries during 19922001? Construction Transportation and public utilities
14 Agriculture, forestry, and fishing Mining
Figure 117. Incidence rates of injuries and illnesses in six
major industry sectors, 19922001. Overall, incidence rates
declined for each of the selected industry sectors during 1992 12
2001. The highest rates occurred within durable goods manu-
10

Rate per 100 workers

facturing, construction, and nondurable goods manufacturing.
(Source: BLS [2002b].)
8

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

Rates among States

How did the rates of nonfatal injuries and illnesses differ
by State in 2001?

Figure 118. Incidence rates of nonfatal occupational injuries

and illnesses in private industry by State, 2001. Nonfatal oc-
cupational injury and illness rates varied by State from 2.3 to
8.7 per 100 full-time workers. (The U.S. rate was 5.7 per 100
full-time workers.) Lower rates were reported for States in the
South, southern coastal States, and the Southwest. (Source: BLS Rate per 100
[2003d].) workers
5.98.7
5.55.8
3.65.4
No data

17
Chapter 1 Characteristics of U.S. Workers

How did the rate of lost-workday cases differ by State in

2001?

Figure 119. Incidence rates for lost-workday cases of nonfa-

tal occupational injury and illness in private industry by State,
2001. Rates of lost-workday cases of nonfatal occupational in-
jury and illness varied among the States from 1.9 to 5.0 per 100
full-time workers, with an overall U.S. rate of 2.8. Lower rates
were reported for the South, southern coastal States, and the
Southwest. (Source: BLS [2003d].)
Rate per 100
workers
2.95.0
2.72.8
1.92.6
No data

How did the rates of nonfatal injuries and illnesses

involving days away from work differ by State in 2001?

Figure 120. Incidence rates for nonfatal occupational injury

and illness cases involving days away from work in private in-
dustry by State, 2001. Rates of nonfatal occupational injury and
illness cases with days away from work varied among the States
from 1.2 to 3.5 per 100 full-time workers. (The U.S. rate was 1.7
per 100 full-time workers.) Lower rates were reported for the
South, southern coastal States, Mississippi Delta, and western
Rate per 100 mountain States. (Source: BLS [2003d].)
workers
1.83.5
1.7
1.21.6
No data

18
 Chapter 1 Characteristics of U.S. Workers

Illnesses All other

occupational
illnesses
How many occupational illnesses occurred in 2001? What Skin diseases
percentage of total occupational injuries and illnesses did or disorders
they account for that year? Illnesses 78,500
Injuries 6.4%
Figure 121. Injuries and illnesses in private industry, 2001. 93.6% 4,881,400
333,800 38,900
Of the 5.2 million nonfatal occupational injuries and illnesses
reported in 2001, 4.9 million or 93.6% were injuries. The re-
mainder (333,800 cases or 6.4%) were work-related illnesses.
Sixty-five percent (216,400 cases) of the nonfatal occupational 216,400
illnesses were disorders associated with repeated trauma.
(Source: BLS [2002b].)
Disorders
associated with
repeated trauma

Magnitude and Trend 600 All other occupational illnesses

Disorders associated with repeated trauma
How did the numbers and types of occupational illness Disorders due to physical agents
cases change between 1972 and 2001? Number of cases (thousands) 500 Poisoning
Respiratory conditions due to toxic agents
Figure 122. Number of illness cases in private industry by
Dust diseases of the lungs
type of illness, 19722001. Since 1972, BLS data illustrate sig- 400
Skin diseases or disorders
nificant variation in the number of reported illness cases. From
1972 to 1982, the number of illness cases declined gradually
from 210,500 to 105,600. This number increased and peaked 300
sharply in 1994 at 514,700 cases. The number of cases declined
steadily to 333,800 in 2001. Disorders associated with repeated
trauma declined for 7 consecutive years dating from 1995. 200
About 216,400 cases were reported in 2001, compared with a
high of 332,100 cases in 1994. (Source: BLS [2002b].)
100

0
1972 1976 1980 1984 1988 1992 1996 2000

19
 Chapter 1 Characteristics of U.S. Workers

Total cases of disease
Skin diseases or disorders
Disorders associated with
repeated trauma
70 All other occupational illnesses
60
Rate per 10,000 workers
Respiratory conditions
due to toxic agents
Disorders due to physical agents
Poisoning
Dust diseases of the lungs
How did the rates and types of occupational illnesses
change between 1983 and 2000?
Figure 123. Incidence rates of occupational illness in private
industry by illness category, 19842001. Since first reporting ill-
ness category rates in 1984, BLS has tracked the steep increase
in overall illness rates that began in the mid-1980s and peaked
in 1994. The overall pattern reflects the trends for disorders as-

50 sociated with repeated trauma. (Source: BLS [2002b].)

40

30

20

10

0
1984 1986 1988 1990 1992 1994 1996 1998 2000

Skin diseases or disorders Disorders due to physical agents How did the rates of selected occupational illnesses
All other occupational illnesses Poisoning change between 1984 and 2001?
9 Respiratory conditions due to Dust diseases of the lungs
toxic agents Figure 124. Incidence rates of occupational illness in private
8
industry by illness category other than disorders associated
7 with repeated trauma, 19842001. Rates for other categories of
illness were smaller than for disorders associated with repeated
Rate per 10,000 workers

6 trauma. These diseases and disorders represent approximately

one-third of all reported occupational illnesses. Skin diseases
5 or disorders have consistently accounted for 12%14% of all
occupational illness cases, with rates ranging from 8.2 to 4.3
4 per 10,000 full-time workers between 1992 and 2001. (Source:
BLS [2002b].)
3

0
1984 1986 1988 1990 1992 1994 1996 1998 2000

20
 Chapter 1 Characteristics of U.S. Workers

Numbers and Rates among States

How did the number of occupational illness cases differ
by State in 2001?

Figure 125. Number of occupational illness cases in private

industry by State, 2001. The number of new cases among re-
porting States ranged from 400 to 41,700. States with the high-
est numbers included California (41,700), Michigan (30,200),
Texas (17,200), and Illinois (14,500). (Source: BLS [2003d].)
Number of
illnesses
10,00041,700
5,0009,900
4004,900
No data

How did occupational illness rates differ by State in

2001?

Figure 126. Incidence rates for occupational illness in private

industry by State, 2001. Occupational illness rates varied widely
among the States, from 8.8 per 10,000 full-time workers in New
Mexico to 142.6 in Maine. (The U.S. rate was 36.7 per 10,000
full-time workers.) Higher rates were reported in the Midwest.
Lower rates were reported for States in the South and in the
southern coastal and western mountain States. (Source: BLS
[2003d].) Rate per 10,000
workers
38.0142.6
35.037.9
8.834.9
No data

21
Chapter 1 Characteristics of U.S. Workers
Characteristics of Injured and Ill Workers and
Their Injuries and Illnesses
BLS began collecting additional information from employers about
seriously injured or ill workers (i.e., injuries or illnesses requiring
recuperation away from work beyond the day of the incident) in
1992. Employers answer several questions about these cases, includ-
ing questions about the demographic characteristics of the injured
or ill worker (for example, age, sex, and race/ethnicity), the work-
ers occupation, length of service with the employer at the time of
the incident, the nature of the disabling condition, and the event
and source producing the condition.
BLS reported 1.5 million cases involving days away from work in
2001 [BLS 2003c]. Most cases were aged 2044 (65%) (Figure 1
27), male (66.1%) (Figure 129), and white, non-Hispanic (68.2%)
[Figure 130]. Operators, fabricators, and laborers accounted for
nearly 40% of all occupational injuries and illnesses (Figure 131).
Between 1993 and 2001, truck drivers experienced the most injuries
and illnesses involving days away from work (Figure 132). Services
industries accounted for 24% of the cases in each case category
(injury cases and injury plus illness cases) (Figure 133). Among
the occupations with at least 0.5% of the total cases involving days
away from work, bus drivers had a median of 11 days. Truck drivers;
plumbers, pipefitters, and steamfitters; and industrial machinery
repairers each had a median of 10 days. For all occupations, the
median was 6 days (Figure 134). Workers with 1 or more years of
service with their employer accounted for 57.9% of all injuries and
illnesses involving days away from work (Figure 135).
22
Case characteristics help describe each event leading to an injury or
illness involving 1 or more days away from work. These character-
istics include (1) the physical characteristics of the disabling injury
or illness (nature); (2) the body part affected; (3) what directly pro-
duced or inflicted the condition (source); and (4) the way in which
the incident occurred (event or exposure).
Sprains and strains were the leading type of nonfatal occupational
injury/illness in 2001, accounting for more than 669,889 casesor
nearly 43.6% of all nonfatal occupational injuries and illnesses (Fig-
ure 136). Among injuries and illnesses, median days away from
work were highest for carpal tunnel syndrome (25 days), fractures
(21 days), and amputations (18 days) (Figure 137). The back
was the body part most frequently affected in cases involving days
away from work (Figure 138). Four sources accounted for more
than half of all nonfatal occupational injuries and illnesses with
days away from work: floors, walkways, ground surfaces (17.2%);
worker motion or position (16%); containers (13.6%); and parts
and materials (10.6%) (Figure 140). Bodily reaction and exer-
tion, contact with objects and equipment, and falls were the lead-
ing events or exposures, accounting for nearly 90% of cases (Figure
141). Repetitive motion injuries (with a median of 18 days away
from work) resulted in the longest absences from work among the
leading events and exposures (Figure 142).
 Chapter 1 Characteristics of U.S. Workers

Characteristics of Injured and Ill Workers 30

Hours worked Injuries and illnesses
28.2 28.5
Age
25.3
25 24.2
How did nonfatally injured and ill workers differ by age in
21.9
2001? 20.6
20

Distribution (%)
Figure 127. Distribution of hours worked and occupational
injury and illness cases with days away from work in private
industry by age of worker, 2001. For workers aged 2044, the 15
percentage of total injuries and illnesses was greater than the
10.5 11.2
percentage of total hours worked. Together, these workers ac- 10 9.3 8.8
counted for the majority of injured or ill workers. (Source: BLS
[2001]; BLS [2003c].)
5 3.9
2.9
2.0 1.6

0
1619 2024 2534 3544 4554 5564 >64
Age range

How did the severity of the nonfatal injury or illness vary

1415 2
by age in 2001?

Figure 128. Median days away from work due to occupational 1619 4
injuries and illnesses in private industry by age of worker, 2001.
Median for
The median number of days away from work due to nonfatal 2024 4
all ages = 6
occupational injuries and illnesses increased as the age of the
Age range

worker increased. The median number of days away from work 2534 5
was 6 for all cases in 2001. (Source: BLS [2003c].)
3544 7

4554 8

5564 10

>64 14

0 2 4 6 8 10 12 14
Median days away from work

23
Chapter 1 Characteristics of U.S. Workers

Sex
Female
33.9% How did nonfatal injuries and illnesses differ by sex of
Female
41.3%
worker in 2001?

Figure 129. Distribution of hours worked and occupational

injury and illness cases with days away from work in private
Male industry by sex, 2001. Nearly two-thirds (66.1%) of the injured
58.7% or ill workers were male. (Sources: BLS [2001]; BLS [2003c].)
Male
66.1%

Hours worked Injuries and illnesses

68.2
Race/Ethnicity
White, non-Hispanic
74.1
How did the distribution of employed U.S. workers in 2000
17.1 compare with the distribution of nonfatally injured or ill
Hispanic workers by race/ethnicity in 2001?
10.2

11.9 Figure 130. Distribution of employed U.S. workers in 2000

Black, non-Hispanic and nonfatal occupational injury and illness cases with days
9.8 Injuries and illnesses
away from work in private industry in 2001 by race/ethnicity.
Employment
Asian or Pacific 2.3 Hispanic workers accounted for 10.2% of employed U.S. work-
Islander 3.8 ers in 2000 but 17.1% of all nonfatal injury and illness cases in
2001. White, non-Hispanic workers accounted for 74.1% of em-
American Indian or 0.5 ployed U.S. workers in 2000 but 68.2% of nonfatal injury and
Alaska Native 0.6
illness cases with days away from work in 2001. (Sources: Census
[2003]; BLS [2003c].)
0.0
Other
1.6

0 10 20 30 40 50 60 70 80
Distribution (%)

24
 Chapter 1 Characteristics of U.S. Workers

Occupation Managerial and 6.4

professional
specialty 27.9
How did the distribution of nonfatal injuries and illnesses
differ by occupational group in 2001? Technical, sales, and 15.5
administrative
support 30.7
Figure 131. Distribution of employed workers and injury and
illness cases with days away from work in private industry by oc- 17.4
Service
cupation, 2001. Operators, fabricators, and laborers accounted 12.5 Injuries and illnesses
for nearly 40% of all occupational injuries and illnesses, well
Employment
above the percentage of employed workers they represent Farming, forestry, 2.9
(15.4%). (Sources: BLS [2001]; BLS [2003c].) and fishing 1.7

Precision production, 18.3

craft, and repair 11.7

Operators, fabricators, 39.5

and laborers 15.4

0 5 10 15 20 25 30 35 40
Distribution (%)

Which occupations had the most nonfatal injuries and 180

illnesses during 19922001? Truck drivers Nonconstruction
160 laborers
Figure 132. Number of occupational injuries and illnesses Injuries and Illnesses (thousands)
with days away from work in private industry for selected oc- 140
cupations, 19922001. In 1992, nonconstruction laborers suf- Nursing aides,
120 orderlies
fered more injuries than any other occupational group. From
1993 to 2001, truck drivers suffered the most injuries involving
100
time away from work. (Source: BLS [2003c].)
80 Janitors,
Construction cleaners
60 laborers

40

20

0
01

01

01

01

01
95
98

95
98

95
98

95
98

95
98
92

92

92

92

92
20

20

20

20

20
19
19
19

19
19
19

19
19
19

19
19
19

19
19
19
25
Chapter 1 Characteristics of U.S. Workers

Agriculture, forestry, 2.7 Injuries Industry

and fishing 2.6 Injuries plus illnesses
Mining 0.7 How did the distribution of nonfatal injuries compare
0.7
12.5 with the distribution of nonfatal injuries plus illnesses by
Construction 12.1 industry sector in 2001?
Manufacturing 12.7
durable 13.5 Figure 133. Distribution of nonfatal injury cases with days
Manufacturing 6.9 away from work and nonfatal injury plus illness cases by pri-
nondurable 7.2
vate industry sector, 2001. For most private industry sectors in
Transportation and 13.2
public utilities 13.0 2001, distribution of the 1.47 million nonfatal injury cases was
7.4 comparable with that of the 1.54 million nonfatal injury plus ill-
Wholesale trade 7.3 ness cases. Services accounted for 24% of the cases in each case
Retail trade 17.6 category. Manufacturing accounted for 19.6% of injury cases
17.3
and 20.7% of injury plus illness cases. The difference was great-
Finance, insurance, 2.3
and real estate 2.5 est for durable manufacturing, which accounted for 12.7% of
24.0 injury cases and 13.5% of injury plus illness cases. (Source: BLS
Services 24.0 [2003c].)
0 5 10 15 20 25
Distribution (%)

Bus drivers 11 Severity of Injuries and Illnesses

Truck drivers 10 Which occupations experienced the most severe work loss
in 2001?
Plumbers, pipefitters, steamfitters 10
Figure 134. Occupations with the highest median days away
Industrial machinery repairers 10
from work due to occupational injuries or illnesses in private
Public transportation attendants 9 industry, 2001. Among the occupations with at least 0.5% of
the total cases involving days away from work, bus drivers had
Carpenters 8 a median of 11 days. Truck drivers; plumbers, pipefitters, and
steamfitters; and industrial machinery repairers each had a me-
Farm workers 8
dian of 10 days. The median number of days away from work
Construction laborers 7 was 6 for all cases in 2001. (Source: BLS [2003c].)

Assemblers 7
Median for all
occupations = 6
Electricians 7

0 2 4 6 8 10 12
Median days away from work

26
 Chapter 1 Characteristics of U.S. Workers

Length of Service Not reported

11.8%
<3 months
11.8%
How did nonfatal injuries and illnesses vary by the
workers length of service in 2001?

Figure 135. Distribution of occupational injury and illness

cases with days away from work in private industry by length 311 months
of service, 2001. Most injuries and illnesses (63.6%) occurred 18.5%
within the first 5 years of service with an employer. (Source: BLS >5 years
[2003c].) 24.6%

1 5 years
33.3%

Characteristics of the Injury or Illness Sprains, strains 43.6

Nature of Injury or Illness Bruises, contusions 8.9

Cuts, lacerations 7.5

How were nonfatal injuries and illnesses distributed by
nature of injury or illness in 2001? Fractures 7.0

Figure 136. Distribution of occupational injury and illness Multiple injuries 3.5
cases with days away from work in private industry by nature of
injury or illness, 2001. Sprains and strains accounted for more Carpal tunnel syndrome 1.7
than 669,889or nearly 43.6% of all nonfatal occupational in- Heat burns 1.6
juries and illnesses. (Source: BLS [2003c].)
Tendonitis 0.9

Chemical burns 0.6

Amputations 0.6

0 10 20 30 40 50
Distribution (%)

27
Chapter 1 Characteristics of U.S. Workers

Which injuries and illnesses accounted for the most

Carpal tunnel syndrome 25
severe work loss in 2001?
Fractures 21
Figure 137. Median days away from work due to occupational
Amputations 18 injuries or illnesses in private industry by nature of injury or
illness, 2001. Among major disabling injuries and illnesses,
Tendonitis 10 median days away from work were highest for carpal tunnel
Multiple injuries 8 syndrome (25 days), fractures (21 days), and amputations (18
days). The median number of days away from work was 6 for all
Sprains, strains 6 cases in 2001. (Source: BLS [2003c].)
Heat burns 5

Cuts, lacerations 3
Median for all
natures = 6
Bruises, contusions 3

Chemical burns 2

0 5 10 15 20 25
Median days away from work

Back 24.2 Body Part Affected

Upper extremities 23.1 How were nonfatal injuries and illnesses distributed by
body part affected in 2001?
Lower extremities 21.0

12.3
Figure 138. Distribution of occupational injury and illness
Trunk, except back
cases with days away from work in private industry by body
Multiple parts 9.1 part affected, 2001. The back was involved in nearly a fourth
of all occupational injuries and illnesses. Conditions involving
Head, except eye 3.6 the upper and lower extremities each accounted for more than
Eye 2.9 one-fifth of the cases. (Source: BLS [2003c].)

Neck 1.8

Body systems 1.4

Other 0.6

0 5 10 15 20 25
Distribution (%)

28
 Chapter 1 Characteristics of U.S. Workers

How did the body part affected relate to days away from Abdomen 17
work in 2001? Wrist 13
Shoulder 12
Figure 139. Median days away from work due to occupational Knee 11
injuries or illnesses in private industry by body part affected, Leg 10
2001. Workers with injuries and illnesses to the abdomen and Multiple parts 8
to the wrist had the highest median number of days away from Arm 7
work17 and 13 days, respectively. The median number of Foot, except toe 6
days away from work was 6 for all cases in 2001. (Source: BLS Back 6
[2003c].) Toe 5
Finger 5
Neck 5
Chest 4
Median for all body
Body systems 4 parts affected = 6
Hand, except finger 4
Eye 2
Head 2
0 2 4 6 8 10 12 14 16 18
Median days away from work

Source of Injury or Illness Floors, walkways, ground surfaces 17.2

How were nonfatal injuries and illnesses distributed by Worker motion or position 16.0
source of injury or illness in 2001? Containers 13.6

Figure 140. Distribution of occupational injury and illness Other 12.1

cases with days away from work in private industry by source
Parts and materials 10.6
of injury or illness, 2001. Together, four sources accounted
for more than half of all nonfatal occupational injuries and Vehicles 8.4
illnesses with days away from work: floors, walkways, ground
Machinery 6.3
surfaces (17.2%); worker motion or position (16%); contain-
ers (13.6%); and parts and materials (10.6%). (Source: BLS Tools, instruments, and equipment 6.3
[2003c].)
Health care patient 4.4
Furniture and fixtures 3.5

Chemicals and chemical products 1.6

0 3 6 9 12 15 18
Distribution (%)

29
Chapter 1 Characteristics of U.S. Workers

Event or Exposure
Bodily reaction and exertion 43.5
How were nonfatal injuries and illnesses distributed by
Contact with objects and equipment 26.0 event or exposure in 2001?

Falls 18.8 Figure 141. Distribution of occupational injury and illness

Exposure to harmful substances
Transportation accidents
Assaults and violent acts
cases with days away from work in private industry by event
4.4 or exposure, 2001. Bodily reaction and exertion, contact with
objects and equipment, and falls accounted for nearly 90% of
4.3 nonfatal injuries and illnesses that resulted in days away from
work in 2001. (Source: BLS [2003c].)
1.5

Other 1.2

Fires and explosions 0.2

0 5 10 15 20 25 30 35 40 45
Distribution (%)

Repetitive motion 18 How did event or exposure differ by median days away
from work in 2001?
Fall to lower level 11
Transportation accidents 10 Figure 142. Median days away from work due to occupational
Overexertion in lifting 7 injuries or illnesses in private industry by event or exposure,
2001. Repetitive motion injuries (with a median of 18 days away
Overexertion 7
from work) resulted in the longest absences from work among
Fall to same level 7 the leading events and exposures in 2001. Falls to a lower level
Slips, trips, loss of balance 6 and transportation accidents both resulted in median days
Caught in equipment or object 6 away that were well above the overall median of 6 days. (Source:
BLS [2003c].)
Assaults and violent acts 5
Fires and explosions 5
Struck against object 4 Median for all events
Struck by object 4 or exposures = 6

Exposure to harmful substances 3

0 2 4 6 8 10 12 14 16 18
Median days away from work

30

References
Arias E [2004]. United States life tables, 2001. Natl Vital Stat Rep 52(14).
BLS [1995]. Occupational injuries and illnesses: counts, rates, and
characteristics, 1992. Washington, DC: U.S. Department of Labor,
Bureau of Labor Statistics, Safety and Health Statistics Program.
Bulletin 2455. [www.bls.gov/iif/oshcdnew.htm]
BLS [2001]. Current population survey. Washington, DC: U.S.
Department of Labor, Bureau of Labor Statistics. [www.bls.gov/
cps/] and [www.bls.census.gov/cps]
BLS [2002a]. Current population survey. BLS releases new 2000
2010 employment projections. Washington, DC: U.S. Department
of Labor, Bureau of Labor Statistics, Office of Occupational Statis-
tics and Employment Projections. [www.bls.gov/emp/]
BLS [2002b]. Survey of occupational injuries and illnesses. Nonfa-
tal (OSHA recordable) injuries and illnesses. Industry incidence
rates and counts. Washington, DC: U.S. Department of Labor,
Bureau of Labor Statistics, Safety and Health Statistics Program.
[www.bls.gov/iif/]
BLS [2003a]. Census of fatal occupational injuries. Fatal injuries.
Washington, DC: U.S. Department of Labor, Bureau of Labor
Statistics, Safety and Health Statistics Program. [www.bls.gov/iif/
oshcfoi1.htm]
BLS [2003b]. Current population survey. State and regional unem-
ployment, 2002 annual averages. Washington, DC: U.S. Depart-
ment of Labor, Bureau of Labor Statistics. [www.bls.gov/lau/
srgune.pdf]
Chapter 1 Characteristics of U.S. Workers
BLS [2003c]. Survey of occupational injuries and illnesses. Nonfa-
tal (OSHA recordable) injuries and illnesses. Case and demograph-
ic characteristics. Washington, DC: U.S. Department of Labor,
Bureau of Labor Statistics, Safety and Health Statistics Program.
[www.bls.gov/iif/oshcdnew.htm]
BLS [2003d]. Occupational injuries and illnesses in the United
States: profiles data 19922001, version 9.0, CDROM. Washington,
DC: U.S. Department of Labor, Bureau of Labor Statistics, Safety
and Health Statistics Program. [www.bls.gov/iif]
BLS [2003e]. Current population survey. Employment status of
the civilian noninstitutionalized population by age, sex, and race.
Washington, DC: Department of Labor, Bureau of Labor Statistics.
[www.bls.gov/cps/], [www.bls.census.gov/cps], and [www.bls.gov/
cps/cpsaat3.pdf]
Census [2003]. Census 2000 special equal employment opportunity
(EEO) tabulation. Washington, DC: U.S. Census Bureau, Housing
and Household Economic Statistics Division. [www.census.gov/
hhes/www/eeoindex.html]
Fullerton FN, Toossi M [2001]. Labor force projections to 2010:
steady growth and changing composition. Mon Labor Rev 124(11):
2138.
Hecker DE [2001]. Occupational employment projections to 2010.
Mon Labor Rev 124(11):5784.
Molla MT, Madans JH, Wagener DK, Crimmins EM [2003]. Summary
measures of population health: report of findings on methodologic
and data issues. Hyattsville, MD: National Center for Health Statistics.
31
Chapter 1 Characteristics of U.S. Workers
NIOSH [2000]. Worker health chartbook, 2000. Cincinnati, OH:
U.S. Department of Health and Human Services, Public Health
Service, Centers for Disease Control and Prevention, National Insti-
tute for Occupational Safety and Health. DHHS (NIOSH) Publica-
tion No. 2000127. [www.cdc.gov/niosh/00-127pd.html]
NIOSH [2001]. Tracking occupational injuries, illnesses, and haz-
ards: the NIOSH Surveillance Strategic Plan. Cincinnati, OH: U.S.
32
Department of Health and Human Services, Public Health Service,
Centers for Disease Control and Prevention, National Institute for
Occupational Safety and Health. DHHS (NIOSH) Publication No.
2001118. [www.cdc.gov/niosh/2001-118.html]
Ruser J [1998]. Denominator choice in the calculation of work-
place fatality rates. Am J Ind Med 33(2):151156.
T his chapter provides data describing the magnitude, distri-
bution, and major demographic characteristics of fatal and
nonfatal occupational injuries and selected occupational illnesses
partners under the Sentinel Event Notification System for Occupa-
tional Risks (SENSOR) program, and NIOSH.

and conditions. The data and figures are presented in the following CDC provided case data reported from State and local health
11 sections, which correspond with surveillance and research areas authorities and from collaborating health care institutions on
within the National Institute for Occupational Safety and Health occupational hepatitis B, occupational human immunodeficiency
(NIOSH): virus/acquired immune deficiency syndrome (HIV/AIDS), percu-
taneous injuries, and occupational tuberculosis (TB).
Anxiety, stress, and neurotic disorders
Bloodborne infections and percutaneous exposures BLS provided data from their Census of Fatal Occupational Inju-
ries (CFOI) and Survey of Occupational Injuries and Illnesses
Fatal injuries (SOII). CFOI provides the most complete count of fatal occupa-
Hearing loss tional injuries available. BLS uses diverse State and Federal data
Lead toxicity sources to identify, verify, and profile fatal occupational injuries.
SOII measures the number, demographic, and case characteristics
Musculoskeletal disorders
of new occupational illness cases that are recognized, diagnosed,
Nonfatal injury and reported.
Disorders due to physical agents
Poisoning NIOSH supports State-based occupational injury surveillance activ-
Respiratory diseases ities through the SENSOR program to develop model surveillance
and related outreach activities for preventing occupational illness
Skin diseases and disorders and injury. Our State-based partners contributed data on carpal
tunnel syndrome, adult lead poisoning, hearing loss, pesticide
Data for the figures came from epidemiologic surveillance pro- poisoning, occupational asthma, and silicosis. Case data from these
grams in the Centers for Disease Control and Prevention (CDC), programs provided a unique perspective from our State-based part-
the Bureau of Labor Statistics (BLS), our State-based surveillance ners.

33
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions
NIOSH contributions included analyses from the many CDC data
sources, the BLS CFOI and SOII data sources, surveys of hospital
emergency departments, and fatal injuries and disease mortality
from State and national vital statistics programs.
Anxiety, Stress, and Neurotic
Disorders
Anxiety, stress, and neurotic disorders are associated with acute and
chronic post-traumatic anxiety, reaction to stress, panic disorders,
and other neurotic disorders not elsewhere classified. These dis-
orders are more severe than the average injury or illness. Affected
workers experience a much greater work loss than those with all
nonfatal injuries or illnesses25 days away from work compared
with 6 in 2001 (Figure 26).
34
BLS reported 5,659 anxiety, stress, and neurotic disorder cases
involving days away from work in 2001 (Figure 21). Rates declined
25% between 1992 and 2001, from 0.8 per 10,000 full-time workers
in 1992 to 0.6 in 2001 (Figure 22). In 2001, most cases involved
workers who were aged 2554 (78.3%) (Figure 23), female (Fig-
ure 24), and white, non-Hispanic (64.8%) (Figure 25). Two
occupational groups accounted for more than 63% of all anxiety,
stress, and neurotic disorder cases in 2001: technical, sales, and
administrative support (39.9% or 2,250 cases) and managerial and
professional specialty occupations (23.6% or 1,331 cases) (Figure
27). Incidence rates for anxiety, stress, and neurotic disorders
exceeding the private-sector rate were reported in 2001 for finance,
insurance, and real estate (1.1 per 10,000 full-time workers), trans-
portation and public utilities (1.1), and services (0.7) (Figure
28). Finance, insurance, and real estate had consistently higher
incidence rates than other industry sectors during 19922001 and
experienced a 42.1% reduction over this period (Figure 29).
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Magnitude and Trend 8,000 7,603

How did the number of anxiety, stress, and neurotic 7,000 6,658
disorders change during 19922001? 6,189
6,000 5,871
5,561 5,659
Figure 21. Number of anxiety, stress, and neurotic disorder 5,286
cases involving days away from work in private industry, 1992 4,949

Number of cases
5,000 4,704
2001. During 19922001, the annual number of anxiety, stress, 4,409
and neurotic disorder cases involving days away from work
ranged from a high of 7,603 cases in 1993 to a low of 4,409 in 4,000
1998. Numbers declined 8.6% between 1992 and 2001from
6,189 to 5,659 cases. (Sources: BLS [2003a,b].) 3,000

2,000

1,000

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

How did the rates of anxiety, stress, and neurotic 1.0

1.0
disorders change during 19922001?

Figure 22. Annual rates of anxiety, stress, and neurotic dis-

0.8 0.8
order cases involving days away from work in private industry, 0.8
19922001. The annual rate of anxiety, stress, and neurotic 0.7 0.7
Rate per 10,000 workers

disorder cases involving days away from work declined 25%

between 1992 and 2001from 0.8 to 0.6 per 10,000 full-time 0.6 0.6 0.6
0.6
workers. (Sources: BLS [2003a,b].)
0.5 0.5

0.4

0.2

0.0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

35
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

30
28.2% Age
25.5% 1,576
24.6% How did anxiety, stress, and neurotic disorders differ by
25 1,426
1,373 age of worker in 2001?

20 Figure 23. Distribution and number of anxiety, stress, and

Distribution (%)

neurotic disorder cases involving days away from work in pri-

vate industry by age, 2001. Age data are available for 5,589 of
15 14.1% the 5,659 BLS-estimated anxiety, stress, and neurotic disorder
790 cases involving days away from work in 2001. Younger age
groups accounted for the majority of cases. Workers aged
10 2534 accounted for 1,426 or 25.5% of cases, and workers aged
7.6%
3544 accounted for 1,576 or 28.2% of cases. (Sources: BLS
424 [2003a,b]; Booth-Jones et al. [2003a].)
5

0
<25 2534 3544 4554 >54
Age range

80 Male Female Sex

71.2

70.7
66.9

64.9
How did anxiety, stress, and neurotic disorders differ by
63.6

63.3

61.7
60.6
59.9

sex of worker during 19922001?

58.4

60
Figure 24. Distribution of anxiety, stress, and neurotic dis-
order cases involving days away from work in private industry
Distribution (%)

by sex, 19922001. Female workers accounted for the majority

41.6

40.1

39.4

38.3

of anxiety, stress, and neurotic disorder cases during 1992

36.7
36.4

35.1
40 2001from a low of 58.4% in 1992 to a high of 71.2% in 1995.
33.1

29.3

(Sources: BLS [2003a,b]; Booth-Jones et al. [2003a].)

28.8

20

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

36
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Race/Ethnicity Black, non-Hispanic

9.6%

How did anxiety, stress, and neurotic disorders differ by

race/ethnicity in 2001?
377
Figure 25. Distribution and number of anxiety, stress, and
neurotic disorder cases involving days away from work in pri-
vate industry by race/ethnicity, 2001. Race/ethnicity data are
available for 3,930 of the 5,659 BLS-estimated anxiety, stress, White, non-Hispanic 2,546 814 Hispanic
and neurotic disorder cases involving days away from work in 64.8% 20.7%
2001. White, non-Hispanic workers accounted for the major-
ity of cases (64.8%). Black, non-Hispanic and Hispanic work-
ers accounted for 9.6% and 20.7% of the cases, respectively. 193
(Sources: BLS [2003a,b]; Booth-Jones et al. [2003a].) Asian or Pacific Islander
4.9%
American Indian or Alaska Native
0.0%
()

Severity 50 Anxiety, stress, neurotic disorders All nonfatal injuries and illnesses

How did anxiety, stress, and neurotic disorders compare 42.1

with all nonfatal injury and illness cases when measured 40
by days away from work in 2001?
Distribution (%)

Figure 26. Distribution of anxiety, stress, and neurotic dis- 30

order cases and all nonfatal injury and illness cases involving
days away from work in private industry by days away from
22.0
work, 2001. Compared with all nonfatal injury and illness cases 19.8
in 2001, anxiety, stress, and neurotic disorder cases tended 20
15.4
to involve higher percentages of long-term work loss (1120, 13.1
12.7 12.4 12.6 12.8
2130, and 31 or more days away from work). In 2001, 42.1% 11.0 11.1
of these cases involved 31 or more days away from work. The 10
6.3
median number of days away from work was 25 for anxiety, 5.0
3.4
stress, and neurotic disorderssubstantially greater than the
median of 6 for all nonfatal injury and illness cases. (Sources: 0
BLS [2003a]; Booth-Jones et al. [2003a].) 1 2 35 610 1120 2130 >30
Days away from work

37
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Managerial and
professional 1,331 23.6%
Occupation
specialty
How were anxiety, stress, and neurotic disorders
Technical, sales, and distributed by occupation in 2001?
administrative 2,250 39.9%
support
Figure 27. Distribution and number of anxiety, stress, and
neurotic disorder cases involving days away from work in
Service 793 14.1%
private industry by occupation, 2001. Technical, sales, and
administrative support along with managerial and professional
Farming, forestry, () specialty occupations constituted 63.5% of anxiety, stress, and
and fishing neurotic disorder cases in 2001. (Sources: BLS [2003a,b]; Booth-
Jones et al. [2003a].)
Precision production, 557 9.9%
craft and repair

Operators, fabricators, 706 12.5%

and laborers

0 10 20 30 40
Distribution (%)

Agriculture, forestry, ()
Industry
and fishing
Mining () Rate for all private How did rates of anxiety, stress, and neurotic disorders
sector workers = 0.6 differ by private industry sector in 2001?
Construction ()
Figure 28. Incidence rate of anxiety, stress, and neurotic dis-
Manufacturing 0.5 order cases by private industry sector, 2001. For anxiety, stress,
and neurotic disorders, private industry reported an overall
Transportation and 1.1 incidence rate of 0.6 per 10,000 full-time workers in 2001.
public utilities
Higher rates were reported for transportation and public utili-
Wholesale trade 0.3 ties (1.1), finance, insurance, and real estate (1.1), and services
(0.7) (Note: A dash in parentheses indicates that no data were
Retail trade 0.6 reported or that data do not meet BLS publication criteria).
Finance, insurance, (Source: BLS [2003a].)
and real estate 1.1

Services 0.7

0.0 0.2 0.4 0.6 0.8 1.0 1.2

Rate per 10,000 workers

38
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

How did the rates of anxiety, stress, and neurotic 3.5 Finance, insurance, and real estate
disorders change by private industry sector during 1992 Transportation and public utilities
2001? Services
3.0
Wholesale trade
Figure 29. Annual rates of anxiety, stress, and neurotic dis-
Manufacturing
order cases involving days away from work by private industry 2.5

Rate per 10,000 workers

Retail trade
sector, 19922001. The annual rate for these disorders declined
25% in the private sector during 19922001, and rates declined Construction
for each industry sector except retail trade. Finance, insurance, 2.0 Mining
and real estate had consistently higher rates than other indus- Agriculture, forestry, and fishing
try sectors during the 10-year period and experienced a 42.1% 1.5
rate reduction. (Sources: BLS [2003a,b].)

1.0

0.5

0.0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

39
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Bloodborne Infections and

Percutaneous Exposures
This section provides information from the CDC about two of the
major occupational bloodborne infectionshepatitis B and HIV,
the virus that causes AIDS. Both infections are potentially fatal.
Most occupational exposures to these bloodborne illnesses occur
among health care workers.
More than 8 million U.S. health care workers in hospitals may be
exposed to blood or other body fluids through the following types of
contact:
Percutaneous injuries (injuries through the skin) with contam-
inated sharp instruments such as needles and scalpels (82%)
Contact with mucous membranes of the eyes, nose, or mouth
(14%)
Exposure of broken or abraded skin (3%)
Human bites (1%)
Up to 800,000 percutaneous injuries may occur annually among all
U.S. health care workers (both hospital-based workers and those in
other health care settings). After percutaneous injury with a con-
taminated sharp instrument, the average risk of infection is 0.3%
for HIV and ranges from 6% to 30% for hepatitis B.

40
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Magnitude and Trend

10,721
12,000

9,843
9,575
How many health care workers were infected with
hepatitis B during 19831999? 10,000

8,661
Figure 210. Estimated number of occupational hepatitis

7,310
B infections among U.S. health care workers, 19831999. 8,000

Number of cases

6,238

6,198
Hepatitis B infections include symptomatic and asymptomatic
cases. The National Notifiable Diseases Surveillance System
(NNDSS) indicates a 96% decline in hepatitis B viral infections 6,000
among health care workers over a 17-year periodfrom nearly
11,000 cases in 1983 to fewer than 400 in 1999. (Note: In the
mid-1980s, health care facilities began adopting recommended 4,000

1,944
universal precautions against exposure to body fluids. These

1,665

1,372
were followed in 1992 with the OSHA Bloodborne Pathogens
2,000
Standard [29 CFR* 1910.1030], which required employers to

849

734

486

461

384
364

346
offer hepatitis B vaccinations to exposed workers.) (Source:
CDC [2002a].) 0
1983 1985 1987 1989 1991 1993 1995 1997 1999

What were the rates of hepatitis B infection among U.S. 25

health care workers during 19931999?

Figure 211. Incidence rates of hepatitis B infection per Incidence rate per 100,000 workers 20.5
100,000 U.S. health care workers, 19931999. The incidence 20
rate (rate of new infections) of hepatitis B infections gener- 17.3
ally declined about 60% from 1993 to 1999 among U.S. health
care workers. These infections include both symptomatic and 15
asymptomatic cases. (Source: CDC [2002a].)
11.2
10.0
10
8.2 8.2
7.6

0
*Code of Federal Regulations. See CFR in references. 1993 1994 1995 1996 1997 1998 1999

41
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Nurses
42.1% Occupation
Which health care workers acquired HIV/AIDS at work
during 19812002?
24 Other
7.0% Figure 212. Distribution and number of documented cases of
occupational transmission of HIV among health care workers
4
Surgical technicians by occupation, 19812002. Among the cases of occupational
2 3.5% HIV transmission reported to the HIV/AIDS Reporting System
2 Housekeeping and (HARS) from 1981 through December 2002, 57 cases were
maintenance documented and 139 cases were possible. Most documented
3.5% cases of occupational HIV transmission occurred among
6
nurses (24 cases or 42.1%) and laboratory workers (19 cases or
19
33.3%). Among the documented cases of HIV following occu-
Physicians pational exposure, 84% resulted from percutaneous exposure.
10.5%
(Source: CDC [2003].)

Lab workers
33.3%

Hypodermic
needle Medical Devices
29%
What medical devices were associated with percutaneous
injuries during 19952000?
Other
14% Figure 213. Distribution of 10,378 reported percutaneous
injuries among hospital workers by medical device associ-
ated with the injury, 19952000. The devices most associated
with percutaneous injuries among hospital workers during
Glass 19952000 were hypodermic needles (29% of injuries), suture
2%
Suture needle needles (17%), winged steel needles (12%), and scalpels (7%).
17% Other hollow-bore needles together accounted for 19% of
Scalpel
7% injuries, glass items for 2%, and other items for 14%. (Source:
CDC [2002b].)

Winged steel Other

needle hollow-bore needle
12% 19%

42
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Hollow-Bore Needles Injection

22% Venipuncture
25%
What medical procedures involving hollow-bore needles
were associated with percutaneous injuries during 1995
2000?

Figure 214. Distribution of 6,212 reported percutaneous

injuries involving hollow-bore needles in hospital workers by
associated medical procedure, 19952000. Drawing blood from
a vein (venipuncture) was responsible for 25% of percutaneous
Access IV line Unknown
injuries involving hollow-bore needles during 19952000, and 8%
14%
injections were responsible for 22%. (Source: CDC [2002b].)

Insert IV line Other

12% 19%

43
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions
Fatal Injuries
Data for the figures come from two sources: (1) the NIOSH Nation-
al Traumatic Occupational Fatalities (NTOF) Surveillance System,
which is a death-certificate-based census of occupational deaths
for U.S. workers aged 16 or older, and (2) the BLS Census of Fatal
Occupational Injuries (CFOI) Surveillance System.
BLS reported 5,524 fatal occupational injuries in 2002. Rates of
these injuries declined 23.1% during 19922002, from 5.2 per
100,000 full-time workers in 1992 to 4.0 in 2002 (Figure 216).
During 19802000, the States with the highest rates of occupa-
tional injury death were Alaska, Wyoming, Montana, Idaho, West
Virginia, and Mississippi (Figure 217). Most fatal injuries occurred
among workers who were aged 2554 (66.6%) (Figure 219), male
44
(92.0%) (Figure 220), and white, non-Hispanic (71.0%) (Fig-
ure 222). The majority of fatal injuries (55.2% or 2,999 cases)
occurred among two occupational groups: operators, fabricators,
and laborers (34.9% or 1,895 cases) and precision production,
craft, and repair workers (20.3% or 1,104 cases) (Figure 224). Two
industry sectors accounted for more than 40% of fatal occupational
injuries: construction (22.6% or 1,121 cases) and transportation
and public utilities (18.3% or 910 cases) (Figure 225). Deaths due
to motor vehicle incidents had the highest rates from 1980 through
1998 (Figure 223). During 19922000, the number of fatal occu-
pational injuries associated with highway incidents increased 18.5%
(Figure 228).
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Magnitude and Trend Number Rate

7,343
8,000

7,061
How many workers were fatally injured during 19802000

6,378
7,000

6,192
6,113
8

7.39
and what was the fatality rate each year?

5,813
5,784

5,710
5,679
5,624
7.02

5,406
5,384

5,322
5,314
5,286

5,285
6,000

5,219
Figure 215. Numbers and rates of traumatic occupational 7

5,030

4,976
4,956
4,928
6.39
Number of fatal injuries
fatalities, 19802000. (All data for 19802000 exclude New

Rate per 100,000 workers

6

5.81
5,000

5.77
York City.) The numbers of traumatic occupational fatalities

5.72
decreased 33% during 19802000, from 7,343 fatalities in 1980

5.17
5

5.13

4.97
to 4,956 in 2000. During this period, the average annual rate 4,000

4.84
4.53
for traumatic occupational fatalities decreased 50%from 7.4

4.43

4.39
4.39
4

4.25
4.24

4.20
4.08
per 100,000 civilian workers in 1980 to 3.7 in 2000. (Source: 3,000

3.72
3.73

3.66
NIOSH [2003].) 3
2,000
2
1,000 1

0 0
1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000

How did the numbers and rates of fatal occupational Number Rate
injuries change during 19922002? 7,000 6,632 6
6,217 6,331 6,275 6,202 6,238
6,055 6,054 5,920
Figure 216. Numbers and rates of fatal occupational injuries, 6,000 5,915
5,524 5

5.3
19922002. A total of 5,524 fatal occupational injuries were

5.2

5.2

5.0
recorded in 2002. During 19922002, fatality rates declined

4.8

Rate per 100,000 workers

4.7
Number of fatal injuries

from 5.2 per 100,000 workers to 4.0. (Source: BLS [2003c].) 5,000

4.5
4.5
4

4.3
4.3

4.0
4,000
3
3,000

2
2,000

1
1,000

0 0
1992 1994 1996 1998 2000 2002

45
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Numbers and Rates among States

How did the rate of fatal occupational injuries differ by
State during 19802000?

Figure 217. Average annual rate of fatal occupational injuries

per 100,000 workers by State of death, 19802000. (All data for
19802000 exclude New York City.) The States with the highest
fatality rates for occupational injury during 19802000 include
Rate per 100,000 Alaska (20.9 per 100,000 workers), Wyoming (14.9), Montana
workers (11.1), Idaho (9.7), Mississippi (9.6), and West Virginia (9.6).
9.220.9 The greatest numbers of fatal occupational injuries occurred
7.19.1 in California (12,221), Texas (11,635), Florida (7,252), Illinois
4.97.0 (5,145), and Pennsylvania (4,420). (Source: NIOSH [2003].)
2.84.8
1.82.7

How did the number of fatal occupational injuries differ

by State in 2002?

Figure 218. Number of fatal occupational injuries by State,

2002. BLS reported a low of 8 fatal occupational injuries in
Rhode Island and a high of 478 in California for 2002. High
fatality counts were also reported for Texas (417), Florida
(354), New York (238), and Ohio (202). (Source: BLS [2003c].)

Number of fatal
injuries
146478
101145
80100
4079
839

46
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Age 30

25.4
How did fatal occupational injuries differ by age of worker
25
in 2002? 22.7

Figure 219. Distribution of fatal occupational injuries by 20 18.5

Distribution (%)
age of worker, 2002. In 2002, two-thirds of all fatally injured
workers were aged 2554. The highest percentage and number
of fatalities (25.4% or 1,402 cases) were reported for workers 15 14.2
aged 3544. (Source: BLS [2003c].)

10 9.0
7.9

5
1.7
0.3 0.5
0
<16 1617 1819 2024 2534 3544 4554 5564 >64
Age range

Sex Female
46.3%
Female
8.0%
How did fatal occupational injuries differ by sex of worker
63,761 441
in 2002?

Figure 220. Employment and fatality profiles by sex, 2002.

Male workers held 53.7% of the estimated 137.7 million jobs
for employed workers in 2002, and they incurred 92.0% of the
5,524 fatal occupational injuries. (Source: BLS [2003c].) 73,939 5,083

Male Male
53.7% 92.0%

Employment Fatal injuries

(thousands of workers)

47
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Black,
non-Hispanic
Race/Ethnicity
8.9%
How did fatal occupational injuries differ by race/ethnicity
in 2002?
491 Figure 221. Distribution and number of fatal occupational
Hispanic
15.2% injuries by race/ethnicity, 2002. The 3,917 fatal injuries among
white, non-Hispanic workers represented 71.0% of all fatal
840
occupational injuries in 2002. Hispanic workers accounted
for 840 cases or 15.2% of fatal occupational injuries in 2002.
140 Asian or (Source: BLS [2003c].)
Pacific Islander
3,917 2.5%
White, American Indian or
non-Hispanic Alaska Native
71.0% 0.7%
40
Other or unspecified
1.7%
92

10 Black How did annual rates of fatal occupational injuries

White change by race during 19802000?
9
Other
Figure 222. Annual rates of fatal occupational injuries by
8
race/ethnicity, 19802000. (All data for 19802000 exclude
New York City.) In general, fatal occupational injury rates
Rate per 100,000 workers

7
decreased for all races during 19802000. From 1991 through
6 1994, the rates for other races increased because of changes in
methods for coding race/ethnicity information. Before 1998,
5 black workers had slightly higher fatal occupational injury rates
than white workers. But after 1998, the rates for white workers
4 were slightly higher than those for black workers and for work-
ers of all other races. (Source: NIOSH [2003].)
3

0
1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000

48
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Causes of Death 2.0 Motor vehicles Falls

Machines Electrocutions
How did annual rates of fatal occupational injuries differ Homicides Struck by falling objects
by cause of death during 19801998?
1.5

Rate per 100,000 workers

Figure 223. Annual rates of fatal occupational injuries by
leading cause, 19801998. (All data for 1998 exclude New
York State.) During 19801998, fatal occupational injury rates
declined for the six leading causes of death, though not always
consistently. During this period, deaths due to motor vehicle 1.0
incidents had the highest rates. Deaths due to machines had
the second highest rate until 1990, when they were surpassed
by deaths due to homicides. For 1998, the rates of death for
homicides and falls were second highest, followed closely by 0.5
the rate for machine-related deaths. (Source: NIOSH [2001].)

0.0
1980 1982 1984 1986 1988 1990 1992 1994 1996 1998

Occupation Managerial and

professional specialty
Operators, fabricators, 9.4%
How were fatal injuries distributed by occupation in and laborers
34.9%
2002?
Technical, sales, and
Figure 224. Distribution and number of fatal occupational 513 administrative support
1,895
injuries by occupation, 2002. In 2002, the majority of fatal inju- 11.0%
ries (55.2% or 2,999 cases) occurred among two occupational
595
groups: operators, fabricators, and laborers (34.9% or 1,895
cases) and precision production, craft, and repair workers
(20.3% or 1,104 cases). (Source: BLS [2003c].)
483
Service
8.9%
1,104 840

Precision production,
craft, and repair Farming, forestry,
20.3% and fishing
15.5%

49
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Agriculture, forestry, 789 15.9%

Industry
and fishing
Mining 121 2.4% How were fatal injuries distributed by private industry
sector in 2002?
Construction 1,121 22.6%
Figure 225. Distribution and number of fatal occupational
Manufacturing 563 11.3% injuries by private industry sector, 2002. In 2002, two industry
sectors accounted for more than 40% of fatal occupational
Transportation and 910 18.3%
public utilities injuries: construction (22.6% or 1,121 cases) and transporta-
tion and public utilities (18.3% or 910 cases). (Source: BLS
Wholesale trade 205 4.1% [2003c].)
Retail trade 487 9.8%
Finance, insurance, 87 1.8%
and real estate
Services 680 13.7%

0 5 10 15 20 25
Distribution (%)

Assaults and
violent acts
Event or Exposure
Fires and 15.2%
explosions How did fatal occupational injuries differ by event or
3.0% Nonhighway exposure in 2002?
165 Transportation (farm, industrial
incidents premises)
840 43.1% Figure 226. Distribution and number of fatal occupational
Falls injuries by event or exposure, 2002. Transportation-related
12.9%
714 322 incidents caused 43.1% of the fatal occupational injuries in
Aircraft 2002, including 1,372 highway fatalities (which accounted for
Other
0.2% 2,381 192 24.9% of all occupational fatalities). (Source: BLS [2003c].)
Railway
13 538 1,372 64

Highway 356 Other

873 4
Exposure to
harmful Water
environments vehicle
9.7% 71
Contact with objects Worker struck by
and equipment vehicle, mobile
15.8% equipment

50
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

How did fatal occupational injuries differ by sex of worker

and event or exposure in 2002? 46.7
Transportation incidents
42.8
Figure 227. Distribution of fatal occupational injuries by sex
33.8
of worker and event or exposure, 2002. Fatal injuries to male Assaults and violent acts
13.6
and female workers were not distributed consistently by type of
event or exposure in 2002 because of differences in the types of Contact with objects 5.2
jobs held by men and women. Fatal injuries in female workers and equipment 16.7
were most frequently associated with transportation incidents
(46.7%) and assaults and violent acts (33.8%). Transportation 9.3 Female
Falls
incidents also accounted for the most fatalities in male workers 13.2 Male
(42.8%), and contact with objects and equipment accounted
for an additional 16.7% of male fatalities. (Note: A dash in Exposure to harmful 4.1
environments 10.2
parentheses indicates that no data were reported or that data
do not meet BLS publication criteria.) (Source: BLS [2003c].)
()
Fires and explosions
3.2

0 10 20 30 40 50
Distribution (%)

How did the numbers of fatal occupational injuries from Highway incidents Homicides Falls
highway incidents, homicides, and falls change during 1,600 1,496
1,442
19922002? 1,393 1,409 1,372
1,343 1,346 1,346 1,365
1,400
Figure 228. Numbers of fatal occupational injuries associ- 1,242
ated with the three most frequent fatal occupational events, 1,200 1,158
1,080
Number of fatal injuries

19922002. In 2002, fatal occupational highway injuries 1,036

declined slightly from 2001 (2.6% or 37 cases), accounting 1,000 1,044 1,074 927
for 1,372 fatal injuries. Falls showed the greatest decline from 860 810
2001 (11.9% or 96 cases). Fatal occupational highway injuries 800 714 721 734 714
and fatal falls increased 19% during 19922002. Job-related
homicides decreased 42% during the same period. (Source: 691 716 706
600 665 651 651 677
BLS [2003c].) 600 618 643 609
400

200

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

51
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions
Hearing Loss
Repeated exposures to loud noise can lead to permanent, incur-
able hearing loss or tinnitus [NIOSH 2002a]. Approximately 30
million workers are exposed to hazardous noise on the job, and
an additional 9 million are at risk for hearing loss from other
agents such as solvents and metals [NIOSH 2002b]. From 1992
to 2000 (and beginning again in 2002), NIOSH provided techni-
cal and financial support through the SENSOR program to the
State of Michigan for a noise-induced hearing loss surveillance
and prevention program. The Michigan SENSOR program is a
partnership between the Michigan Department of Labor and
52
Economic Growth and the Michigan State University [Rosenman
et al. 2002].
Data for the figures come from Michigans surveillance reports,
including reports from audiologists, otolaryngologists, and com-
panies. A worker is considered to have occupational noise-induced
hearing loss if a health professional determines the worker to have
(a) audiometric findings consistent with noise-induced hearing loss,
and (b) a history of exposures to sufficient noise at work to cause
hearing loss. In 2000, Michigan reported more than 2,200 new hear-
ing loss cases known or suspected to be caused by noise at work.
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Reporting Sources Bureau of Workers'

Compensation
0.3%
Who reported occupational noise-induced hearing loss 52
during 19912000?

Figure 229. Distribution and number of noise-induced hear-

ing loss cases in Michigan by source of reports, 19912000.
During 19912000, 17,683 noise-induced hearing loss cases Companies 13,710 3,802 Clinicians
77.5% 21.5%
were reported in Michigan. Companies with hearing conser-
vation programs reported the largest number of workers with
occupational noise-induced hearing loss. Typically, companies
reported standard threshold shifts, whereas the other three
sources reported fixed losses of at least 25 dB. (Source: Rosen-
man and Reilly [2002].) Hospitals
0.7%
119

Age 40 Company reports Noncompany reports

36.0
How old were workers who developed occupational noise- 35 33.8 33.6
induced hearing loss in 2000?
30
Figure 230. Distribution of noise-induced hearing loss cases 26.8
Distribution (%)

in Michigan by age of patient and type of report (company or 25

noncompany), 2000. Company reports indicated that workers
aged 4049 and 5059 had the highest percentages of noise- 20
induced hearing loss cases (36% and 33.8%, respectively) in 15.5
2000. Noncompany and company reports indicated nearly 15 14.0
12.7
equal percentages of cases among workers aged 5059. Age was
10.0
unknown for 11 workers reported by company medical depart- 10
ments and for 40 workers reported by noncompany hearing 6.0
health professionals. The hearing loss reports from companies 4.8
5 3.4
involve a younger working age population enrolled in a hearing 1.6 1.4
0.0 0.2 0.1
conservation program. (Source: Rosenman and Reilly [2002].) 0
1519 2029 3039 4049 5059 6069 7079 >79
Age range

53
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Public administration
4.6% Services
Industry
7.9%
Where were workers with occupational noise-induced
hearing loss exposed to the noise that caused their
48 Transportation hearing loss?
82 9.7%
Figure 231. Distribution and number of permanent hear-
101 ing loss cases reported by clinicians in Michigan, by industry,
2000. Manufacturing accounted for 50.9% of permanent hear-
Manufacturing 529 ing loss cases reported in Michigan in 2000, and construction
50.9%
124 industry sectors accounted for 15.0%. (Source: Rosenman and
Other Reilly [2002].)
11.9%

156

Construction
15.0%

Agricultural production In which industries were companies most likely to test for
9.3
and services, forestry hearing loss as part of a hearing conservation program?
Mining 50.0
Figure 232. Percentage of companies in Michigan in major
Construction 7.9
industry divisions that tested for hearing loss as part of a hear-
ing conservation program (when worker was most recently
Manufacturing 55.1 exposed to noise), as reported by patient interviews, 1992
2000. Companies were most likely to have tested for hearing
Transportation 56.5 loss as part of a hearing conservation program (when worker
was most recently exposed to noise) in the transportation,
Wholesale and 10.4
retail trade manufacturing, and mining industries. (Source: Rosenman and
Reilly [2002].)
Finance and insurance 0.0

Services 30.8

Public administration 30.8

0 10 20 30 40 50 60
Fraction (%)

54
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions
Lead Toxicity
The Adult Blood Lead Epidemiology and Surveillance (ABLES)
program is a State-based surveillance program of laboratory-report-
ed blood lead levels (BLLs) in adults. The public health objec-
tive of the ABLES program (objective 20.7 in Healthy People 2010
[DHHS 2000]) is to reduce the number of adults with BLLs of 25
g/dL or greater. Among the 25 States reporting to ABLES during
19982001, rates of elevated BLLs (25 g/dL or greater) ranged
from 2.6 to 40.9 per 100,000 employed workers (Figure 234).
Since 2001, ABLES program enhancements have (1) allowed for
an increase to 37 States (adding Alaska, Florida, Georgia, Hawaii,
Illinois, Indiana, Kansas, Kentucky, Maine, Missouri, Montana, and
New Mexico), and (2) increased data requirements to include indi-
vidual data on industry, age, and sex. During 19942001, declines
occurred in the mean annual State prevalence rates for adults with
elevated BLLs (Figure 233). For the most current listing of ABLES
data and ABLES States, visit [www.cdc.gov/niosh/ables.html].
55
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

18
25 g/dL 40 g/dL Magnitude and Trend
16.8
16 15.7 What were the average State rates of elevated BLLs
15.0 14.7
14.3 reported by ABLES States during 19942001?
13.8
14
12.9 Figure 233. Average State prevalence rates for adults aged
12.5
Rate per 100,000 workers

12 16 and older with elevated BLLs, ABLES States, 19942001.

For 19942001, ABLES States reported declines in the mean
10 annual State prevalence rates for adults with BLLs of 25 g/dL
or greater and 40 g/dL or greater. For 19982001, the 4-year
8 mean State prevalence rate for adults with BLLs of 25 g/dL
or greater was 13.4 per 100,000 employed workersa decline
6 from the rate of 15.2 per 100,000 employed workers reported
4.3 4.3 for 19941997. For adults with BLLs of 40 g/dL or greater,
3.5 3.8
4 3.3 the 4-year mean State prevalence rate for 19982001 was
2.9 2.8
2.5
2.9 per 100,000 employed workersa decline from 3.9 per
2 100,000 employed for 19941997. (Sources: NIOSH [2002c];
CDC [2002d].)
0
1994 1995 1996 1997 1998 1999 2000 2001

56
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

A. BLLs 25g/dL or greater

Rates among States
How did the rates of elevated BLLs differ by State?

Figure 234. Average State rates of elevated BLLs per 100,000

employed workers, 19982001: (A) 25 g/dL or greater, and
(B) 40 g/dL or greater. During 19982001, the mean State
rates for adults with BLLs of 25 g/dL or greater ranged from
2.6 to 40.9 per 100,000 employed workers. Among the report-
ing States, those with the highest rates included Pennsylvania
(40.9), New Hampshire (28.4), and Alabama (27.5). The low-
Rate per 100,000
est rate was reported by Arizona (2.6). State rates may truly workers
reflect the magnitude of the lead exposure problem, but they >19
may be biased because of varying degrees of completeness of
1019
blood lead testing carried out by employers among the States.
<10
(Sources: NIOSH [2002c]; CDC [2002d].)
No report

During 19982001, the mean State rates for adults with BLLs
of 40 g/dL or greater ranged from 0.4 to 8.8 per 100,000
employed workers. Among the reporting States, those with the
highest rates included Alabama (8.8), New Hampshire (7.5),
B. BLLs 40g/dL or greater
and North Carolina (7.0). The lowest rate was reported by Ari-
zona (0.4). (Note: Nebraska provided 2 years of data, and South
Carolina provided 3 years. All other States provided 4 years of
data for this figure.) (Sources: NIOSH [2002c]; CDC [2002d].)

Rate per 100,000

workers
>2.9
1.52.9
<1.5
No reports

57
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions
Musculoskeletal Disorders
Musculoskeletal disorders (MSDs) are injuries or disorders of the
muscles, nerves, tendons, joints, cartilage, and spinal discs. MSDs
do not include disorders caused by slips, trips, falls, or motor or
similar incidents. Through annual news releases and publications,
the BLS defines MSDs to include sprains, strains, tears; back pain,
hurt back; soreness, pain, hurt, except back; carpal tunnel syn-
drome (CTS); hernia; and musculoskeletal system and connective
tissue diseases and disorders when the event or exposure leading to
the case is bodily reaction (bending, climbing, crawling, reaching,
twisting), overexertion, or repetitive motion.
MSD cases are more severe than the average nonfatal injury or illness
58
case (Figure 242). In 2001, they involved a median of 8 days away
from work compared with 6 days for all nonfatal injury and illness
cases [BLS 2003a]. MSD cases declined from 784,145 cases in 1992
to 522,528 cases in 2001 (Figure 235). Three age groups (2534,
3544, and 4554) accounted for 78.9% of cases (Figure 239). More
male than female workers were affected (Figure 240), as were more
white, non-Hispanic workers (Figure 241). Operators, fabricators,
and laborers and persons in technical, sales, and administrative sup-
port occupations accounted for 58.1% of the MSD cases (Figure
243). The manufacturing and services industry sectors together
accounted for about half of all MSD cases (Figure 244).
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Magnitude and Trend All nonfatal injuries and illnesses

2.331
MSDs

2.253
2.5

2.237

2.041
How did the number of MSD cases compare with all
nonfatal injury and illness cases during 19922001?

1.881

1.833
2.0

1.740

1.702

1.664
Figure 235. Number of MSD cases and all nonfatal injury and

Number of cases (millions)

1.538
illness cases involving days away from work in private industry,
19922001. The number of MSD cases declined from 784,145 1.5
in 1992 to 522,528 in 2001. As a percentage of all nonfatal
injury and illness cases, MSD cases remained relatively stable
between 1992 and 2001, ranging from a low of 33.6% in 1992

33.6% 0.784

33.9% 0.763

33.8% 0.756
to a high of 34.0% in 2001. (Source: BLS [2003c].) 1.0

34.1% 0.696

0.647

34.2% 0.626

34.1% 0.593

34.2% 0.582

34.7% 0.578

34.0% 0.523
34.4%
0.5

0.0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

How were MSDs distributed by nature of injury or illness

in 2001? Sprains, strains 399,722 76.5%

Figure 236. Distribution and number of MSD cases involving 26,522 5.1%
Carpal tunnel syndrome
days away from work in private industry by nature of injury or
illness, 2001. Sprains and strains accounted for 399,772 cases Musculoskeletal system and
or 76.5% of the 522,528 musculoskeletal disorders involving connective tissue diseases 11,470 2.2%
and disorders
days away from work in 2001. (Source: BLS [2003d].)
Tendonitis 12,131 2.3%

Soreness, pain (except 22,346 4.3%

back pain)

Back pain 27,894 5.3%

Hernia 22,443 4.3%

0 20 40 60 80
Distribution (%)

59
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Numbers by State
How did the number of MSD cases differ by State in 2001?

Figure 237. Number of MSD cases involving days away from

work in private industry by State, 2001. The number of new
MSD cases within reporting States ranged from 1,589 to 52,136
in 2001. The States with the highest numbers of cases included
California (52,136), New York (33,773), and Texas (32,838).
(Source: BLS [2003d].)
Number of cases
>19,999
15,00019,999
10,00014,999
1,5899,999
No data

Rates among States

How did the rates of MSD cases differ by State in 2001?

Figure 238. Rates of MSD cases involving days away from

work in private industry by State, 2001. The rate of new MSD
cases within reporting States ranged from 35.0 to 141.5 per
10,000 full-time workers in 2001. The States with the highest
rates include West Virginia (141.5), Alaska (123.5), and Wash-
Rate per 10,000 ington (112.1). BLS reported an overall rate of 57.5 per 10,000
workers full-time workers for the United States in 2001. (Source: BLS
>89.6 [2003d].)
59.089.6
50.058.9
35.049.9
No data

60
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Age 40 MSDs All nonfatal injuries and illnesses

How did MSD cases compare with all nonfatal injury and
illness cases by age of worker in 2001? 31.2
30 28.8
Figure 239. Distribution of MSD cases and all nonfatal injury 25.9 25.6

Distribution (%)
and illness cases involving days away from work in private
industry by age, 2001. Age data are available for 518,397 of 21.8
20.8
the 522,528 BLS-estimated MSD cases involving days away from 20
work in 2001. Overall, three age groups (2534, 3544, and
4554) accounted for 78.9% of cases, slightly greater than the 14.3
75.2% reported for all nonfatal injury and illness cases. (Source: 11.8
10.5
BLS [2003d].) 10 9.3

0
<25 2534 3544 4554 >54
Age range

Sex 70
MSDs All nonfatal injuries and illnesses
66.1
How did MSD cases compare with all nonfatal injury and 62.5
illness cases by sex of worker in 2001? 60

Figure 240. Distribution of MSD cases and all nonfatal injury

50
and illness cases involving days away from work in private
industry by sex, 2001. Male workers accounted for a lower
Distribution (%)

percentage of MSD cases in 2001 than nonfatal injury and 40 37.5

illness cases (62.5% versus 66.1%). However, female workers 33.9
accounted for a higher percentage of MSD cases (37.5% versus 30
33.9%). (Source: BLS [2003d].)

20

10

0
Male Female

61
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

80 MSDs All nonfatal injuries and illnesses Race/Ethnicity

71.6
68.2 How did MSD cases compare with all nonfatal injury and
illness cases by race/ethnicity in 2001?
60
Figure 241. Distribution of MSD cases and all nonfatal
injury and illness cases involving days away from work in pri-
Distribution (%)

vate industry by race/ethnicity, 2001. Race/ethnicity data are

40 available for 373,710 of the 522,528 BLS-estimated MSD cases
involving days away from work in 2001. White, non-Hispanic
workers accounted for 71.6% of MSD cases and 68.2% of all
nonfatal injury and illness cases. Black, non-Hispanic workers
and Hispanic workers accounted for 12.1% and 13.7% of MSD
20 17.1
13.7 cases, respectively. (Source: BLS [2003d].)
12.1 11.9

2.5 2.8
0
White, non- Black, non- Hispanic Other
Hispanic Hispanic

25 MSDs All nonfatal injuries and illnesses 23.9 Severity

22.0
How did MSD cases compare with all nonfatal injury and
19.9 19.8
20 illness cases when measured by days away from work in
2001?
15.4
Distribution (%)

15
Figure 242. Distribution of MSD cases and all nonfatal injury
13.5 and illness cases involving days away from work in private
12.7 12.6 12.3
12.0 11.5 industry by days away from work, 2001. Compared with all
11.1
nonfatal injuries and illnesses in 2001, MSD cases tended to
10 involve higher percentages of long-term work loss (610, 11
6.9 20, 2130, and 31 or more days away from work). Thirty-one
6.3
or more days away from work were reported for 23.9% of MSD
5 cases. A median of 8 days away from work was reported for
MSD cases in 2001slightly greater than the median of 6 days
for all nonfatal injuries and illnesses. (Source: BLS [2003d].)
0
1 2 35 610 1120 2130 >30
Days away from work

62
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Occupation Managerial and 5.9

MSDs
professional All nonfatal injuries and illnesses
specialty 6.4
How did MSD cases compare with all nonfatal injury and
illness cases by occupation in 2001? Technical, sales, and 17.3
administrative
support 15.5
Figure 243. Distribution of MSD cases and all nonfatal
injury and illness cases involving days away from work in pri- 17.7
Service
vate industry by occupation, 2001. Operators, fabricators, and 17.4
laborers accounted for 40.8% of all MSD cases involving days
away from work in 2001. Comparisons between MSD cases and Farming, forestry, 1.9
nonfatal injuries and illnesses by occupational groups indicate and fishing 2.9
only small differences. (Source: BLS [2003d].)
Precision production, 16.5
craft, and repair 18.3

Operators, fabricators, 40.8

and laborers 39.5

0 5 10 15 20 25 30 35 40 45
Distribution (%)

Industry Agriculture, forestry, 1.7 MSDs

and fishing 2.6 All nonfatal injuries and illnesses
How did MSD cases compare with all nonfatal injury and 0.6
Mining
illnesses cases by private industry sector in 2001? 0.7
9.4
Construction
Figure 244. Distribution of MSD cases and all nonfatal 12.1
injury and illness cases involving days away from work in pri- 22.9
Manufacturing
20.6
vate industry by industry, 2001. Manufacturing (22.9%) and
Transportation and 13.3
services (25.8%) accounted for about half of all MSD cases in public utilities 13.0
2001. Distributions of MSD cases are notably different from 8.0
distributions of all nonfatal injuries and illnesses by industry Wholesale trade
7.3
sector, with the greatest differences in services, construction, 16.0
manufacturing, and retail trade. (Source: BLS [2003d].) Retail trade
17.3
Finance, insurance, 2.4
and real estate 2.5
25.8
Services
24.0
0 5 10 15 20 25 30
Distribution (%)

63
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions
Carpal Tunnel Syndrome (CTS)
The U.S. Department of Labor defines CTS as a disorder associated
with the peripheral nervous system, which includes nerves and gan-
glia located outside the spinal cord and brain. Carpal tunnel syn-
drome is the compression of the median nerve at the wrist, which
may result in numbness, tingling, weakness, or muscle atrophy in
the hand and fingers. The carpal tunnel receives its name from the
eight bones in the wrist (called carpals), which form a tunnel-like
structure. The tunnel is filled with flexor tendons, which control
finger movement. The carpal tunnel also provides a pathway for
the median nerve to reach sensory cells in the hand. Repetitive
flexing and extension of the wrist may cause a thickening of the
protective sheaths that surround each of the tendons. The swollen
tendon sheaths apply increased pressure on the median nerve and
produce CTS.
Two sources of data describe the magnitude and distribution of
these adverse health conditions: the SOII and the case-based SEN-
SOR program.
64
Annual Survey of Employers Reports for CTS (BLS)
CTS is more severe than the average nonfatal injury or illness case
(Figure 250). In 2001, CTS cases involved a median of 25 days
away from work compared with 6 days for all nonfatal injury and
illness cases [BLS 2003a]. BLS reported 26,794 CTS cases involv-
ing days away from work in 2001 (Figure 245). During 19922001,
annual rates declined 30.2% to a rate of 3.0 per 10,000 full-time
workers in 2001 (Figure 246). Most cases involved workers who
were aged 2554 (83.6%) (Figure 247), female (Figure 248),
and white, non-Hispanic (75.4%) (Figure 249). Two occupational
groups accounted for more than 70% of all CTS cases in 2001:
operators, fabricators, and laborers (36.7% or 9,808 cases) and
technical, sales, and administrative support (34.2% or 9,144 cases)
(Figure 251). Incidence rates exceeding the private-sector rate
were reported for manufacturing (6.5 per 10,000 full-time work-
ers) and finance, insurance, and real estate (3.2) (Figure 252).
Manufacturing had consistently higher rates than other industry
sectors during 19922001 and experienced a 33% rate reduction
(Figure 253).
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Magnitude and Trend 45,000

41,019
How did the number of CTS cases in private industry 40,000 38,337
change during 19922001?
35,000 33,042
Figure 245. Number of CTS cases involving days away from 31,457
29,937 29,244
work in private industry, 19922001. The annual number of 30,000 27,922 27,697
CTS cases involving days away from work declined 18.9% dur- 26,266 26,794

Number of cases
ing this periodfrom 33,042 cases in 1992 to 26,794 cases in 25,000
2001. CTS cases reached a high of 41,019 cases in 1993. (Sourc-
es: BLS [2003a,b].) 20,000

15,000

10,000

5,000

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

How did the annual rate of CTS cases change during 6.0
19922001?
5.2
Figure 246. Annual rates of CTS cases involving days away 5.0 4.8
from work in private industry, 19922001. The annual rate of
4.3
CTS cases involving days away from work declined 30.2% dur-
Rate per 10,000 workers

ing this periodfrom 4.3 per 10,000 full-time workers in 1992 4.0 3.9
3.6
to 3.0 in 2001. (Sources: BLS [2003a,b].) 3.4
3.0 3.1 3.0 3.0
3.0

2.0

1.0

0.0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

65
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

40 Age
34.0% How did the number of CTS cases differ by age of worker
9,041 30.4% in 2001?
30
8,077 Figure 247. Distribution and number of CTS cases involving
days away from work in private industry by age, 2001. Age data
Distribution (%)

are available for 26,581 of the 26,794 BLS-estimated CTS cases

20 19.2% involving days away from work in 2001. Workers aged 2554
5,095 accounted for 22,213 cases or 83.6%. Workers aged 3544
accounted for 34.0% and those aged 4554 accounted for
13.1%
30.4%. (Sources: BLS [2003a,b]; Booth-Jones et al. [2003b].)
3,494
10

3.3%
874
0
<25 2534 3544 4554 >54
Age range

Male Female Sex

80
71.6

71.4
71.0

70.8
69.5

69.3
69.0

67.9
How did the distribution of CTS cases differ by sex of

67.7
67.0
worker during 19922001?

60 Figure 248. Distribution of CTS cases involving days away

from work in private industry by sex, 19922001. Female work-
ers accounted for nearly 70% of CTS cases during 19922001,
Distribution (%)

ranging from 67.0% to 71.6%, with a slightly decreasing trend.

40 (Sources: BLS [2003a,b]; Booth-Jones et al. [2003b].)
33.0

32.3
32.1
31.0

30.7
30.5

29.2
29.0

28.6
28.4

20

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

66
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Race/Ethnicity Black, non-Hispanic

13.3%
How did CTS cases differ by race/ethnicity in 2001?

Figure 249. Distribution and number of CTS cases involv- 2,704

ing days away from work in private industry by race/ethnicity, Hispanic
2001. Race/ethnicity data are available for 20,327 of the 26,794 8.8%
BLS-estimated CTS cases involving days away from work in 1,794
2001. White, non-Hispanic workers accounted for the major- Asian or
ity of cases (15,335 or 75.4%). Black, non-Hispanic workers 445 Pacific Islander
2.2%
accounted for 2,704 cases or 13.3%, and Hispanic workers
accounted for 1,794 cases or 8.8%. (Sources: BLS [2003a,b]; American Indian or
15,335 Alaska Native
Booth-Jones et al. [2003b].) 0.2%
49

White, non-Hispanic
75.4%

Severity 50 CTS All nonfatal injuries and illnesses

44.5
How did CTS cases compare with all nonfatal injury and
illness cases when measured by days away from work in 40
2001?

Figure 250. Distribution of CTS cases and all nonfatal injury

Distribution (%)

and illness cases involving days away from work in private indus- 30
try by days away from work, 2001. Compared with all nonfatal
injury and illness cases, CTS cases tended to involve higher per- 22.0
19.8
centages of long-term work loss (1120, 2130, and 31 or more 20
days away from work) in 2001. Cases involving 31 or more days 15.4 15.6
away from work accounted for 44.5% of CTS cases and 22% of 12.7 12.6
11.1 11.1 11.5
all fatal injuries and illnesses. CTS cases involved a median of 10 8.9
25 days away from work in 2001substantially greater than the 6.3
4.3 4.1
median of 6 days for all nonfatal injuries and illnesses. (Sources:
BLS [2003a,b]; Booth-Jones et al. [2003b].
0
1 2 35 610 1120 2130 >30
Days away from work

67
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Managerial and Occupation

professional 1,547 5.8%
specialty How did CTS cases differ by occupation in 2001?
Technical, sales, and
administrative 9,144 34.2% Figure 251. Distribution and number of CTS cases involving
support days away from work in private industry by occupation, 2001.
In 2001, the majority of CTS cases requiring days away from
Service 1,827 6.8% work (18,952 cases or 70.9%) occurred among two occupation-
al groups: operators, fabricators, and laborers and technical,
Farming, forestry, sales, and administrative support workers. Precision produc-
251 0.9%
and fishing tion, craft, and repair workers constituted 15.6% (4,172) of
the overall CTS cases. (Sources: BLS [2003a,b]; Booth-Jones et al.
Precision production, [2003b].)
4,172 15.6%
craft, and repair

Operators, fabricators,
9,808 36.7%
and laborers

0 10 20 30 40
Distribution (%)

Agriculture, forestry, 1.1

Industry
and fishing
Mining 1.0
Rate for all private How did CTS rates differ by private industry sector in
sector workers = 3.0 2001?
Construction 2.0
Figure 252. Incidence rate of CTS cases by private industry
Manufacturing 6.5 sector, 2001. Private industry reported a CTS incidence rate of
3.0 per 10,000 full-time workers in 2001. The rates for manu-
Transportation and 2.5 facturing (6.5 or 11,240 cases) and for finance, insurance, and
public utilities
real estate (3.2 or 2,204 cases) both exceeded the private-sector
Wholesale trade 2.6 rate. (Sources: BLS [2003a,b]; Booth-Jones et al. [2003b].)

Retail trade 2.0

Finance, insurance, 3.2

and real estate
Services 1.8

0 1 2 3 4 5 6 7
Rate per 10,000 workers

68
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

How did the annual rates of CTS change by private 12 Manufacturing Transportation and public utilities
industry sector during 19922001? Finance, insurance, and real estate Construction
Retail trade
Figure 253. Annual rates of CTS cases involving days away 10 Services
from work by private industry sector, 19922001. The private-
Wholesale trade
sector annual rate declined 30.2% during 19922001. Rates

Rate per 10,000 workers

Agriculture, forestry, and fishing
declined for each industry sector except wholesale trade. Dur- 8
ing this 10-year period, manufacturing had consistently higher Mining
rates than other industry sectors and experienced a 33% rate
reduction. (Sources: BLS [2003a,b]; Booth-Jones et al. [2003b].) 6

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

69
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Case-Based Reporting of CTS (California SENSOR)

Through the SENSOR program, NIOSH provides technical and
financial support to the California Department of Health Services
for case-based surveillance of CTS. The California SENSOR pro-
gram evaluated 3,358 CTS cases during 19982000. Technical, sales,
and administrative support occupations consistently accounted for
a disproportionate number of CTS cases in California for each of
the 3 yearsnearly three times the number of cases in other occu-
pational categories (Figure 254). Computing (data entry) activi-
ties consistently accounted for nearly half of CTS cases in California
for each of the 3 years (Figure 255).

70
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Occupation Managerial and 250

professional 251
How did the number of CTS cases change in California by specialty 304
occupation during 19982000? Technical, sales, and 753
administrative 651
support 740
Figure 254. Number of CTS cases in California by occupa- 163
tion, 19982000. For each year during this period, technical, Service 143
142
sales, and administrative support occupations consistently 1998
Farming, forestry, 29
accounted for a disproportionately large number of CTS cases 22 1999
in Californianearly three times the number accounted for by and fishing 17
2000
other occupations. The number of CTS cases decreased during Precision production, 136
137
this period for four of the seven occupational groups. (Source: craft, and repair 144
Harrison and Flattery [2002a].) 247
Operators, fabricators, 220
and laborers 224
166
Other and nonclassifiable 143
176

0 100 200 300 400 500 600 700 800

Number of cases

Job Activity Computing (data 507

503
entry) 510
How did the prevalence of CTS change in California by 85
type of job activity? Reaching, twisting 123
146
98
Figure 255. Number of CTS cases in California by type of Loading, lifting 107
97
job activity, 19982000. Among the cases sampled, computing
Computing (customer 78
(data entry) activities consistently accounted for nearly half 50 1998
service) 111
of all CTS cases in California for each of the 3 years during 1999
65
19982000. Cases involved with reaching and twisting, comput- Fine motor tasks 38 2000
ing (customer service), and handwriting increased from 1998 64
44
to 2000. (Source: Harrison and Flattery [2002a].) Handwriting 39
56
62
Checking, cashiering 29
24
269
Other 171
159
0 100 200 300 400 500 600
Number of cases

71
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions
Disorders Associated with Repeated Trauma
Occupational disorders associated with repeated trauma include
conditions resulting from repeated motion, vibration, or pressure.
These disorders are one class of illness tracked by BLS. Examples
of repeated trauma disorders include CTS, noise-induced hearing
loss, Raynauds phenomenon, synovitis, tenosynovitis, and bursitis.
During 19722001, repeated trauma disorders ranged from a low of
20,200 cases in 1978 to a high of approximately 332,100 cases in 1994
(Figure 256). In 2001, BLS reported 216,400 cases of repeated
trauma disordernearly 65% of all nonfatal occupational illness
72
cases in 2001, and a decrease of 42% from the 1994 rate (Figure
256). Rates varied during 19842001 from a low of 5.1 per 10,000
full-time workers in 1984 to a high of 41.1 in 1994. BLS reported
a rate of 23.8 per 10,000 full-time workers in 2001 (Figure 257).
Within reporting States, the number of repeated trauma disorders
ranged from 100 to 26,700 cases in 2001 (Figure 258). In 2001,
incidence rates varied by State from a low of 2.9 per 10,000 full-time
workers in New Mexico to a high of 120.1 in Maine. The U.S. rate
was 23.8 per 10,000 full-time workers (Figure 259).
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Magnitude and Trend

332.1
350

306.2
302.4
How did the number of repeated trauma disorders change

281.8

281.1
276.6
during 19722001? 300

253.3
246.7
241.8
Number of cases (thousands)
Figure 256. Number of disorders associated with repeated

223.6

216.4
trauma in private industry, 19722001. Repeated trauma dis- 250
orders ranged from a low of 20,200 cases in 1978 to a high of

185.4
approximately 332,100 cases in 1994. In 2001, BLS reported 200
216,400 repeated trauma disorder casesnearly 65% of all

146.9
nonfatal occupational illness cases in 2001, and a decrease of

115.4
150
42% from the 1994 rate. (Source: BLS [2002].)

72.9
100

45.5
37.0
34.7
26.7
24.6
23.8

23.7
23.6

23.4

23.2
23.0

23.0
22.6
21.9
50

20.2
0
1972 1976 1980 1984 1988 1992 1996 2000

How did the rate of repeated trauma disorders change 45

during 19842001? 41.1
40 38.3 37.8
Figure 257. Incidence rates of disorders associated with 36.8
repeated trauma in private industry, 19842001. BLS reported 35 33.5
32.0
increasing rates for repeated trauma disordersfrom 5.1 per
Rate per 10,000 workers

29.7
10,000 full-time workers in 1984 to 41.1 in 1994. BLS reported 30 28.5
27.3 26.3
a rate of 23.8 per 10,000 full-time workers in 2001. (Source: BLS
[2002].) 25 24.1 23.8

20 19.2
15.4
15
10.0
10
6.4
5.1 5.3
5

0
1984 1986 1988 1990 1992 1994 1996 1998 2000

73
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Numbers and Rates among States

How did the number of repeated trauma disorders differ
by State in 2001?

Figure 258. Number of disorders associated with repeated

trauma in private industry by State, 2001. Within reporting
States, the number of repeated trauma disorders ranged from
100 to 26,700 cases in 2001. States with the highest num-
bers included California (26,700), Michigan (22,700), Texas
Number of cases (11,600), and Illinois (9,500). (Source: BLS [2002].)
>4,999
1,0004,999
<1,000
No data

How did the rates of repeated trauma disorders differ by

State in 2001?

Figure 259. Incidence rates for disorders associated with

repeated trauma in private industry by State, 2001. Incidence
rates for disorders associated with repeated trauma varied by
State in 2001, from a low of 2.9 per 10,000 full-time workers
in New Mexico to a high of 120.1 in Maine. The U.S. rate was
23.8 per 10,000 full-time workers. Lower rates were reported
for States in the West, the Southwest, and the South. (Source:
Rate per 10,000 BLS [2002].)
workers
>24.7
22.024.7
<22.0
No data

74
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions
Tendonitis
Tendonitis is an inflammation or irritation of a tendon, the thick
fibrous cord that attaches muscle tissue to bone. Tendonitis cases
are more severe than the average nonfatal injury or illness case
(Figure 265). In 2001, these cases involved a median of 10 days
away from work compared with 6 days for all nonfatal injury and
illness cases [BLS 2003a].
BLS reported 14,124 tendonitis cases involving days away from
work in 2001 (Figure 260). Rates declined 51.5% during 1992
2001, from 3.3 per 10,000 full-time workers in 1992 to 1.6 in 2001
(Figure 261). Most cases involved workers who were aged 2554
(82.1%) (Figure 262), female (Figure 263), and white, non-His-
panic (71.3%) (Figure 264). Two occupational groups accounted
for more than 67% of all tendonitis cases in 2001: operators, fab-
ricators, and laborers (47.1% or 6,627 cases) and technical, sales,
and administrative support workers (20.8% or 2,925 cases) (Fig-
ure 266). Incidence rates exceeding the private-sector rate were
reported for manufacturing (3.2 per 10,000 full-time workers),
construction (2.0), and transportation and public utilities (1.7)
(Figure 267). Manufacturing had consistently higher rates than
other industry sectors during 19922001 and experienced a 59%
rate reduction (Figure 268).
75
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

30,000 Magnitude and Trend

25,353 25,026 25,187 How did the number of tendonitis cases change during
25,000 19922001?
22,072
Figure 260. Number of tendonitis cases involving days away
20,000 from work in private industry, 19922001. The annual number
Number of cases

17,416 17,961 16,900 of tendonitis cases involving days away from work declined
16,582
44.3% during this period, from 25,353 cases in 1992 to 14,124
15,000 14,445 14,124
cases in 2001. (Sources: BLS [2003a,b].)

10,000

5,000

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

3.5
3.3 How did the annual rate of tendonitis cases change
3.2 during 19922001?
3.1
3.0 Figure 261. Annual rate of tendonitis cases involving days
2.7
away from work in private industry, 19922001. The annual
2.5 rate of private-sector tendonitis cases involving days away
Rate per 10,000 workers

from work declined 51.5% during this periodfrom 3.3 per

2.1 2.1
10,000 full-time workers in 1992 to 1.6 in 2001. (Sources: BLS
2.0 1.9
1.8 [2003a,b].)
1.6 1.6
1.5

1.0

0.5

0.0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

76
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Age 40

How did the number of tendonitis cases differ by age of 33.5%

worker in 2001? 4,686
30
Figure 262. Distribution and number of tendonitis cases
25.1%
involving days away from work in private industry by age, 2001.

Distribution (%)
23.5%
Age data are available for 13,990 of the 14,124 BLS-estimated 3,514
3,284
tendonitis cases involving days away from work in 2001. Work- 20
ers aged 3544 accounted for 4,686 or 33.5% of cases. (Sources:
BLS [2003a,b]; Booth-Jones et al. [2003c].)
10.2%
10 7.7%
1,423
1,083

0
<25 2534 3544 4554 >54
Age range

Sex 70 Male Female

62.3
61.7

61.3
61.2
60.9
60.3

58.4
57.6

57.3
How did the distribution of tendonitis cases differ by sex

54.8
60
of worker?

Figure 263. Distribution of tendonitis cases involving days

45.2
50

42.7
42.4

41.6
away from work in private industry by sex, 19922001. Female
39.7

39.1

38.8

38.7
Distribution (%)

38.3

37.7
workers accounted for the majority of tendonitis cases during
40
19922001. Over the decade, women represented 54.8% to
62.3% of the cases. (Sources: BLS [2003a,b]; Booth-Jones et al.
[2003c].) 30

20

10

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

77
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Race/Ethnicity
Hispanic How did tendonitis cases differ by race/ethnicity in 2001?
13.6%
Figure 264. Distribution and number of tendonitis cases
1,400 involving days away from work in private industry by race/
Asian or ethnicity, 2001. Race/ethnicity data are available for 10,268 of
Pacific Islander
White, non-Hispanic 7,325 190 1.9% the 14,124 BLS-estimated tendonitis cases involving days away
71.3% from work in 2001. White, non-Hispanic workers accounted for
American Indian or
Alaska Native the majority of cases (71.3% or 7,325 cases) in 2001. Hispanic
1,302
0.5% workers accounted for 13.6% or 1,400 cases of tendonitis, and
51 black, non-Hispanic workers accounted for 12.7% or 1,302
Black, non-Hispanic cases. (Sources: BLS [2003a,b]; Booth-Jones et al. [2003c].)
12.7%

30
Tendonitis All nonfatal injuries and illnesses 29.7 Severity
How did tendonitis cases compare with all nonfatal injury
and illness cases when measured by days away from work
22.0 in 2001?
19.8
20 Figure 265. Distribution of tendonitis cases and all nonfatal
18.2
Distribution (%)

injury and illness cases involving days away from work in pri-
15.4
vate industry by days away from work, 2001. Tendonitis cases in
12.7 13.2 2001 tended to involve higher percentages of long-term work
12.6 12.5
11.3 11.1 loss (610, 1120, 2130, and 31 or more days away from work).
10 8.7 For example, 29.7% of tendonitis cases involved 31 or more
6.4 6.3 days away from work compared with only 22.0% of all nonfatal
injuries and illnesses. Tendonitis cases required a median of
10 days away from work in 2001, whereas all nonfatal injuries
and illnesses required 6. (Sources: BLS [2003a,b]; Booth-Jones et
0 al. [2003c].)
1 2 35 610 1120 2130 >30
Days away from work

78
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Occupation Managerial and

professional 623 4.4%
How did tendonitis cases differ by occupation in 2001? specialty
Technical, sales, and
Figure 266. Distribution and number of tendonitis cases administrative 2,925 20.8%
support
involving days away from work in private industry by occupa-
tion, 2001. Operators, fabricators, and laborers represented
Service 1,178 8.4%
47.1% of tendonitis cases in 2001. Two other occupations
accounted for nearly 39% of the cases: technical, sales, and
administrative support (20.8%); and precision production, Farming, forestry, 186 1.3%
craft, and repair (18.0%). (Sources: BLS [2003a,b]; Booth-Jones and fishing
et al. [2003c].)
Precision production, 2,537 18.0%
craft, and repair

Operators, fabricators, 6,627 47.1%

and laborers

0 10 20 30 40 50
Distribution (%)

Industry Agriculture, forestry,

1.3
and fishing
How did the rate of tendonitis cases differ by private Mining 0.4
industry sector in 2001?
Construction 2.0
Figure 267. Incidence rate of tendonitis cases involving days
away from work by private industry sector, 2001. Private indus- Manufacturing 3.2
try reported a tendonitis incidence rate of 1.6 per 10,000 full-
Transportation and
time workers in 2001. Three sectors reported rates exceeding 1.7
public utilities
the private-sector rate: manufacturing (3.2 per 10,000 full-time
workers or 5,567 cases), construction (2.0 per 10,000 full-time Wholesale trade 1.5
workers or 1,230 cases), and transportation and public utilities Rate for all private
(1.7 per 10,000 full-time workers or 1,128 cases). (Source: BLS Retail trade 1.2 sector workers = 1.6
[2003a].) Finance, insurance,
0.9
and real estate
Services 0.9

0.0 0.5 1.0 1.5 2.0 2.5 3.0 3.5

Rate per 10,000 workers

79
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Manufacturing Construction How did the rates of tendonitis change by private industry
8 Agriculture, forestry, and fishing Services sector during 19922001?
Wholesale trade
Retail trade
Figure 268. Annual rates of tendonitis cases involving days
7
away from work by private industry sector, 19922001. The
Transportation and public utilities
annual rate of tendonitis cases declined 51.5% in the private
6 Finance, insurance, and real estate
sector during 19922001. Rates declined among most industry
Rate per 10,000 workers

Mining sectors except for mining and transportation and public utili-
5 ties. Manufacturing had consistently higher rates of tendonitis
than other industry sectors and experienced a 59% rate reduc-
4 tion during this 10-year period. (Source: BLS [2003a].)

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

80
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions
Nonfatal Injuries
BLS estimates that total recordable occupational injuries (which
include fatalities before 1992) reached a high of 6.4 million cases in
1990 then declined to a low of 4.9 million injuries in 2001 (Figure
269). Nonfatal injuries represented 93.6% of the 5.2 million non-
fatal injuries and illnesses reported in 2001. Injury incidence rates
(which include fatalities before 1992) declined 39% during 1976
2001, from 8.9 cases per 100 full-time workers in 1976 to 5.4 cases
in 2001 (Figure 270). This decline is reflected in cases without lost
workdays (19.6% reduction) and in cases involving days away from
work (19.5% reduction). The increasing number and rate of injury
cases with restricted work activity continued: the number of cases
increased 8.7-fold and the rates increased 4-fold.
NIOSH, in collaboration with the U.S. Consumer Product Safety
Commission, collects information about nonfatal occupational
injuries and illnesses treated in hospital emergency departments.
In 1999, an estimated 3.9 million occupational injuries and illnesses
were treated in hospital emergency departments among all industry
and occupation groups for workers aged 15 and older. The highest
rates of these occupational injuries and illnesses occurred among
workers aged 1524 (Figure 271). Male workers aged 15 and older
accounted for two-thirds or 2.7 million of all occupational injuries
and illnesses treated in U.S. hospital emergency departments (Fig-
ure 272). Among the treated workers for whom race/ethnicity was
known, 2.46 million or 78.3% were white, non-Hispanic; 459,000 or
14.6% were black, non-Hispanic; and 225,000 or 7.1% were Hispan-
ic. Race/ethnicity was unknown for a large portion of the workers
treated in hospital emergency departments (Figure 273).
By private industry sector in 2001, incidence rates for nonfatal
occupational injuries ranged from a low of 1.5 per 100 full-time
workers in finance, insurance, and real estate to a high of 7.8 in
construction (Figure 274). Other industry sectors exceeding the
private-sector rate included manufacturing (7.0, or 1.2 million
cases), agriculture, forestry, and fishing (7.0, or 104,400 cases),
transportation and public utilities (6.6, or 436,900 cases), and retail
trade (5.5, or 964,200 cases). During 19762001, construction and
manufacturing reported higher rates of total cases than other pri-
vate industry sectors (Figure 275), and construction had higher
rates for lost-workday cases (Figure 276); manufacturing reported
more cases of restricted work activity only (Figure 277).
81
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

7
6.421 Magnitude and Trend
Total cases
6 How many workers suffered injuries during 19762001?

Figure 269. Number of occupational injury cases by type

Number of cases (millions)

5 of case in private industry, 19762001. The number of total

4.996 4.882 recordable occupational injuries reached a high of 6.4 million
4.748
cases in 1990 then declined to a low of 4.9 million in 2001.
4 3.566 Injury cases with restricted work activity only increased steadily
Cases without lost workdays
3.074 after 1976, reaching a high of 944,100 cases in 2001. (Note: Data
3 2.547 before 1992 include fatalities.) (Source: BLS [2002].)
2.472

1.821
2
Cases with days away from work 1.465
1.003
1
Cases with restricted work activity only 0.944
0.097
0
1976 1980 1984 1988 1992 1996 2000

10 How did the rates of occupational injuries change during

Total cases
19762001?
9
9.2
8.9 Figure 270. Incidence rates of injury cases by type of case
8 in private industry, 19762001. The incidence rate for total
7
recordable occupational injuries reached a high of 9.2 cases
Rate per 100 workers

per 100 full-time workers in 1979 then declined to a low of 5.4

6 5.5 per 100 full-time workers in 2001. Injury rates for cases with
Cases without lost workdays 5.4
restricted work activity only increased steadily from a rate of
5 0.2 per 100 full-time workers in 1976 to 1.0 in 2001. (Note: Data
3.9 before 1992 include fatalities.) (Source: BLS [2002].)
4
3.2
3 2.7
Cases with days away from work
2 1.6

1 Cases with restricted work activity only

0.2 1.1 1.0
0
1976 1980 1984 1988 1992 1996 2000

82
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Age Number Rate 7

1,200 1,165
6.0
How did nonfatal occupational injuries and illnesses 6
1,027
treated in hospital emergency departments differ by age 1,000 5.2 5.1

Number of cases (thousands)

of worker in 1999? 5

Rate per 100 workers

Figure 271. Number and rate of nonfatal occupational inju- 800
ries and illnesses treated in hospital emergency departments, 3.7 4
by age of worker, 1999. An estimated 3.9 million occupational 609 583
600
injuries and illnesses were treated in hospital emergency 2.7 3
departments among all industry and occupation groups for
400 2.0
workers aged 15 and older. The highest numbers of these 1.7 2
1.5
injuries and illnesses occurred among workers aged 2544, and
198 225
the highest rates were among workers aged 1524. The overall 200 1
rate was 3.0 per 100 full-time workers. (Sources: NEISS [2003]; 80
44
Jackson [2003].)
0 0
1517 1819 2024 2534 3544 4554 5564 >64
Age group

Sex 3,000 Number Rate

2,713 4
How did nonfatal occupational injuries and illnesses 3.5
treated in hospital emergency departments differ by sex 2,500
of worker in 1999?
Number of cases (thousands)

3
Figure 272. Number and rate of nonfatal occupational inju- 2,000

Rate per 100 workers

ries and illnesses treated in U.S. hospital emergency depart-
ments, by sex of worker, 1999. Two-thirds (or 2.7 million) of 2.2
all occupational injuries and illnesses treated in hospital emer- 1,500
2
gency departments occurred among male workers aged 15 and 1,217
older. However, the disparity between male and female workers
was not as great when comparing incidence rates (2.2 versus 1,000
3.5 per 100 full-time workers). (Sources: NEISS [2003]; Jackson 1
[2003].)
500

0 0
Male Female

83
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

2,500 2,464
Race/Ethnicity
How did nonfatal occupational injuries and illnesses
2,000 treated in hospital emergency departments differ by race/
Number of cases (thousands)

ethnicity in 1999?

Figure 273. Number of nonfatal occupational injuries and

1,500 illnesses treated in hospital emergency departments, by race/
ethnicity, 1999. Among workers of known race/ethnicity treat-
ed in hospital emergency departments, 2,464,000 or 78.3%
1,000 were white, non-Hispanic; 459,000 or 14.6% were black, non-
728 Hispanic; and 225,000 or 7.1% were Hispanic. Race/ethnicity
was unknown for a large portion of the workers treated in U.S.
500 459 hospital emergency departments. (Sources: NEISS [2003]; Jack-
son [2003].)
225

0
White, non- Black, non- Hispanic Unknown
Hispanic Hispanic

Agriculture, forestry, How did the rate of nonfatal occupational injuries differ
7.0
and fishing by private industry sector in 2001?
Mining 3.9
Figure 274. Incidence rate of total nonfatal occupational
Construction 7.8 injury cases by private industry sector, 2001. The private sector
reported a total injury incidence rate of 5.4 per 100 full-time
Manufacturing 7.0 workers in 2001. Rates exceeding the private-sector rate were
reported for construction (7.8 per 100 full-time workers or
Transportation and 6.6 474,500 cases), manufacturing (7.0 per 100 full-time workers
public utilities
or 1.2 million cases), agriculture, forestry, and fishing (7.0 per
Wholesale trade 5.1 100 full-time workers or 104,400 cases), transportation and
public utilities (6.6 per 100 full-time workers or 436,900 cases),
Retail trade 5.5 and retail trade (5.5 per 100 full-time workers or 964,200 cas-
Finance, insurance, Rate for all private es). (Source: BLS [2002].)
1.5
and real estate sector workers = 5.4
Services 4.4

0 2 4 6 8
Rate per 100 workers

84
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Industry Construction Mining Wholesale trade

Manufacturing Agriculture, forestry, and fishing Retail trade
How did the rates of occupational injuries change by 16
Transportation and public utilities Services
private industry sector during 19762001? Finance, insurance,
and real estate
14
Figure 275. Incidence rates of total occupational injury cases
by private industry sector, 19762001. Incidence rates of total 12

Rate per 100 workers

occupational injury cases declined for each major industry sec-
tor during 19762001. With the general decline in rates, the 10
high-to-low rate ratio narrowed from 7.9 in 1976 to 5.2 in 2001.
Two industry sectors (construction and manufacturing) had 8
consistently higher rates than most other sectors during the 25-
year period. (Note: Data before 1992 include fatalities.) (Source: 6
BLS [2002].)
4

0
1976 1980 1984 1988 1992 1996 2000

How did the rates of lost-workday cases change by private Mining Manufacturing Retail trade
industry sector during 19762001? Construction Agriculture, forestry, Services
8 and fishing
Transportation and Finance, insurance,
Figure 276. Incidence rates of lost-workday injury cases by public utilities Wholesale trade and real estate
7
private industry sector, 19762001. The incidence rates for
recordable lost-workday injuries varied among industry sectors,
with the high-to-low rate ratio narrowing from 8.1 in 1976 to 6
Rate per 100 workers

6.0 in 2001. Three industry sectors (construction, manufactur-

ing, and transportation and public utilities) had consistently 5
higher rates than other sectors during 19762001. (Source: BLS
[2002].) 4

0
1976 1980 1984 1988 1992 1996 2000

85
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Manufacturing Construction How did the rates of injuries with restricted work activity
Transportation and public utilities Retail trade only change by private industry sector during 19922001?
2.5
Agriculture, forestry, and fishing Services
Wholesale trade Finance, insurance, and real estate
Figure 277. Incidence rates of injury cases with restricted
work activity only by private industry sector, 19922001. Dur-
Mining
2.0 ing this 10-year period, the incidence rate for cases of restricted
work activity only increased for each major industry sector. The
Rate per 100 workers

highest rates were reported for manufacturing, ranging from

1.5 a low of 1.5 per 100 full-time workers in 1992 to a high of 2.1
in 1998 and 2000. The lowest rates (0.1 to 0.2 per 100 full-time
workers) were reported for finance, insurance, and real estate.
(Source: BLS [2002].)
1.0

0.5

0.0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

86
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions
Nonfatal Injuries Involving Days Away from Work
The BLS reported 1.5 million nonfatal occupational injury and
illness cases involving days away from work in 2001. Traumatic
injuries and disorders accounted for 1.4 million or 92.1% of these
cases. Traumatic injuries and disorders required a median of 6 days
away from work in 2001 [BLS 2003a]. This section of the Chartbook
provides magnitude, trend, and demographic data for cases from
the following seven categories of injuries:
Amputations
Back, including spine and spinal cord
Bruises and contusions
Heat burns and scalds
Cuts and lacerations
Fractures
Sprains, strains, and tears
Amputations
Amputations are open-wound injuries that involve loss of a limb or
other external body part. For BLS to classify an injury in this group,
bone must be lost. Amputations are severe injuries. They involved a
median of 18 days away from work in 2001 (Figure 285) compared
with 6 days for all nonfatal injuries and illnesses [BLS 2003a].
In 1999, an estimated 19,700 occupational amputation cases were
treated in a hospital emergency departmentabout 0.5% of all
injuries and illnesses treated in hospital emergency departments
among workers aged 15 and older (Figure 280). The number of
cases corresponded to a rate of 1.5 amputations per 10,000 full-time
workers. The highest rate of occupational amputations treated in
hospital emergency departments occurred among workers under
age 25; however, the greatest number occurred among workers
aged 3544. The age disparities for amputations were smaller than
those observed for all types of injuries and illnesses treated in hos-
pital emergency departments (Figure 280). Male workers suffered
an estimated 17,200 amputations6 to 7 times more occupational
amputations than women. (Figure 282).
BLS reported 8,612 amputation cases involving days away from
work in 2001 (Figure 278). Annual rates of amputation cases
declined 37.5%, from 1.6 per 10,000 full-time workers in 1992 to
1.0 in 2001 (Figure 279). Most cases involved workers who were
aged 2554 (73.7%) (Figure 281), male (80.6%) (Figure 283),
and white, non-Hispanic (64.8%) (Figure 284). Two occupational
groups accounted for more than 75% of all amputations: opera-
tors, fabricators, and laborers (55.1%) and precision production,
craft, and repair (23%) (Figure 286). Rates exceeding the private-
sector rate were reported for agriculture, forestry, and fishing (2.7
per 10,000 full-time workers), manufacturing (2.5), construction
(1.6), and mining (1.1) (Figure 287). Manufacturing had consis-
tently higher rates than other industry sectors during 19922001
and experienced a 26.5% rate reduction (Figure 288).
87
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

14,000 Magnitude and Trend

12,352 12,222 How did the number of amputation cases change during
12,000 11,342 11,309
10,852
19922001?
10,167 10,243 9,985
10,000 9,658 Figure 278. Number of amputation cases involving days away
8,612 from work in private industry, 19922001. The annual number
Number of cases

of amputation cases involving days away from work declined

8,000 30.3% during this period, from a high of 12,352 cases in 1992
to 8,612 cases in 2001. (Sources: BLS [2003a,b].)
6,000

4,000

2,000

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

1.6 How did the annual rate of amputation cases change

1.6
1.5 during 19922001?
1.4 1.4
1.3 Figure 279. Annual rates of amputation cases involving
1.2 1.2
days away from work in private industry, 19922001. The
1.2 annual rate of amputation cases involving days away from work
1.1 1.1
Rate per 10,000 workers

declined 37.5% in the private sectorfrom a high of 1.6 per

1.0
10,000 full-time workers in 1992 to 1.0 in 2001. (Sources: BLS
[2003a,b].)
0.8

0.4

0.0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

88
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Age 6 Number Rate 5.6

3

How did numbers and rates of amputations treated in

hospital emergency departments differ by age of worker 2.3

Number of cases (thousands)

in 1999?
4.0

Rate per 100 workers

4 3.9 3.8 2
Figure 280. Numbers and rates of nonfatal occupational
amputations treated in hospital emergency departments, by
age of worker, 1999. An estimated 19,700 occupational amputa- 1.5 1.5
tions were treated in hospital emergency departmentsabout 1.3 1.3
2.3
0.5% of all injuries and illnesses treated in hospital emergency
departments among workers aged 15 and older. The number 2 1
of cases corresponded to a rate of 1.5 amputations per 10,000
full-time workers. The highest rate of occupational amputa-
tions treated in hospital emergency departments occurred
among workers under age 25; however, the greatest number
occurred among workers aged 3544. (Sources: NEISS [2003]; 0 0
Jackson [2003].) 1524 2534 3544 4554 >54
Age group

How did amputations compare with all nonfatal injuries Amputations All nonfatal injuries and illnesses
and illnesses by age of worker in 2001? 30 29.0 28.8

Figure 281. Distribution of amputation cases and all nonfatal 25.8 25.6
injury and illness cases involving days away from work in pri-
vate industry by age, 2001. Age data are available for 8,475 of 20.8
the 8,612 BLS-estimated amputation cases involving days away 20 18.9
Distribution (%)

from work in 2001. Three age groups (2534, 3544, and 45 17.1
54) accounted for 73.7% of cases, slightly less than the 75.2%
14.3
reported for all nonfatal injury and illness cases. The largest
difference is noted for workers under age 25, who accounted
10.5
for 17.1% of amputation cases compared with 14.3% of all non- 10 9.3
fatal injury and illness cases. (Source: BLS [2003a].)

0
<25 2534 3544 4554 >54
Age range

89
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

20 Number Rate Sex

17.2 How did amputation cases compare with all nonfatal
injury and illness cases by sex of worker in 2001?
Number of cases (thousands)

15
3 Figure 282. Number and rate of nonfatal occupational ampu-
tations treated in hospital emergency departments, by sex of
worker, 1999. Men suffered an estimated 17,200 amputations,
6 to 7 times more amputations at work than women. (Sources:

Rate per 100 workers

10 2.3 2 NEISS [2003]; Jackson [2003].)

5 1

2.4

0.4
0 0
Male Female

100 Amputations All nonfatal injuries and illnesses How did amputation cases compare with all nonfatal
injury and illness cases by sex of worker in 2001?

80.6 Figure 283. Distribution of amputation cases and all nonfatal

80 injury and illness cases involving days away from work in private
industry by sex, 2001. Male workers accounted for many more
66.1
amputation cases (80.6%) than all nonfatal injury and illness
Distribution (%)

60 cases (66.1%) in 2001. However, female workers accounted for

fewer amputation cases (19.4%) than all nonfatal injury and
illness cases (33.9%). (Source: BLS [2003a].)

40
33.9

19.4
20

0
Male Female

90
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Race/Ethnicity 80 Amputations All nonfatal injuries and illnesses

How did amputations compare with all nonfatal injuries 68.2

64.8
and illnesses by race/ethnicity in 2001?
60
Figure 284. Distribution of amputation cases and all nonfa-
tal injury and illness cases involving days away from work in

Distribution (%)
private industry by race/ethnicity, 2001. Race/ethnicity data
are available for 7,208 of the 8,612 BLS-estimated amputation
40
cases involving days away from work in 2001. White, non-His-
panic workers accounted for slightly fewer amputation cases
(64.8%) than all nonfatal injury and illness cases (68.2%), as
23.0
did black, non-Hispanic workers (10.3% versus 11.9%). But
Hispanic workers accounted for more amputation cases (23%) 20 17.1
than all nonfatal injury and illness cases (17.1%). (Source: BLS 10.3 11.9
[2003a].)
1.9 2.8
0
White, non- Black, non- Hispanic Other
Hispanic Hispanic

Severity 40 Amputations All nonfatal injuries and illnesses

How did amputations compare with all nonfatal injuries 34.6

and illnesses when measured by days away from work in
2001? 30

Figure 285. Distribution of amputation cases and all nonfa-

Distribution (%)

tal injury and illness cases involving days away from work in 22.0
private industry by days away from work, 2001. Higher per- 19.8
20
centages of long-term work loss (610, 1120, 2130, and 31 16.3
15.4
or more days away from work) were reported for amputation 14.5 13.9
cases in 2001. Thirty-one or more days away from work were 12.7 12.6
11.1 11.1
reported for 34.6% of amputation cases compared with 22.0% 10
of all nonfatal injury and illness cases. For amputation cases, 6.3
5.6
workers experienced a median of 18 days away from work in 4.0
2001much higher than the median of 6 days for all nonfatal
injuries and illnesses. (Source: BLS [2003a].)
0
1 2 35 610 1120 2130 >30
Days away from work

91
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Managerial and
Amputations Occupation
1.9 All nonfatal injuries and illnesses
professional
specialty 6.4
How did amputations compare with all nonfatal injuries
Technical, sales, and 3.3
and illnesses by occupation in 2001?
administrative
support 15.5
Figure 286. Distribution of amputation cases and all nonfatal
11.3 injury and illness cases involving days away from work in pri-
Service vate industry by occupation, 2001. Two occupational groups
17.4
accounted for more than 75% of all amputations in 2001:
Farming, forestry, 5.4 operators, fabricators, and laborers (55.1%) and precision pro-
and fishing 2.9 duction, craft, and repair (23%). The same two occupational
groups accounted for more than half (57.8%) of all nonfatal
Precision production, 23.0 injuries and illnesses. (Source: BLS [2003a].)
craft, and repair 18.3

Operators, fabricators, 55.1

and laborers 39.5

0 10 20 30 40 50 60
Distribution (%)

Agriculture, forestry, Industry

2.7
and fishing
1.1
How did the rate of amputations differ by private industry
Mining
sector in 2001?
Construction 1.6
Figure 287. Incidence rate of amputation cases involving
Manufacturing 2.5 days away from work in private industry by industry sector,
2001. Private industry reported an amputation incidence rate
Transportation and 0.5 of 1.0 per 10,000 full-time workers in 2001. Higher rates were
public utilities
reported for agriculture, forestry, and fishing (2.7 per 10,000
Wholesale trade 1.0 full-time workers or 401 cases), manufacturing (2.5 per 10,000
full-time workers or 4,239 cases), construction (1.6 per 10,000
Retail trade 0.8 full-time workers or 949 cases), and mining (1.1 per 10,000 full-
Finance, insurance, time workers or 64 cases). (Source: BLS [2003a].)
0.1 Rate for all private
and real estate sector workers = 1.0
Services 0.2

0.0 0.5 1.0 1.5 2.0 2.5 3.0

Rate per 10,000 workers

92
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

How did the rates of amputations change by private Agriculture, forestry, and fishing Construction
industry sector during 19922001? Manufacturing Wholesale trade
7 Mining Transportation and public utilities
Figure 288. Annual rates of amputation cases involving days Retail trade
away from work by private industry sector, 19922001. The 6 Services
annual rate of amputations declined 37.5% in the private sec-
Finance, insurance, and real estate
tor during 19922001. During this period, rates declined for

Rate per 10,000 workers

5
each of the major industry sectors. Manufacturing had consis-
tently higher rates than other industry sectors during the 10-
year period and experienced a 26.5% reduction. (Sources: BLS 4
[2003a,b].)
3

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

93
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions
Back, Including Spine and Spinal Cord
BLS uses four code structures to classify the characteristics of injury
and illness cases involving days away from work. One code structure
classifies cases by body part. The body part category back, including
spine and spinal cord (hereafter called back injury), includes cases
with injuries to the posterior part of the trunk that is bounded by
the neck and pelvis. Back injuries may include injuries to cartilage,
muscles, nerves, spine, spinal cord, tendons, veins and arteries, and
vertebra. Back injuries are of moderate severity, and injured work-
ers experience a median of 6 days away from work (Figure 294).
In 2001, BLS reported 372,683 back injury cases involving days away
from work (Figure 289). Back injury rates declined 52% during
19922001, from a rate of 85.4 per 10,000 workers in 1992 to 41.0 in
94
2001 (Figure 290). Most cases involved workers who were aged 25
54 (78.5%) (Figure 291), male (64.3%) (Figure 292), and white,
non-Hispanic (69.5%) (Figure 293). Two occupational groups
accounted for more than 54% of back injury cases: operators, fab-
ricators, and laborers (38.3%) and precision production, craft, and
repair (16.5%) (Figure 295). Back injury rates exceeding the pri-
vate-sector rate were reported for transportation and public utilities
(77.1 per 10,000 full-time workers), construction (63.9), agricul-
ture, forestry, and fishing (58.8), and wholesale trade (47.3) (Fig-
ure 296). Two industry sectors (transportation and public utilities
and construction) had consistently higher back injury rates than
other industry sectors during 19922001, and both experienced
reductions in these rates (36.1% and 52.7%) (Figure 297).
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Magnitude and Trend 700

653.4
615.0 606.5
How did the number of back injuries change during 1992
600
2001? 540.0

Number of cases (thousands)

Figure 289. Number of back injury cases involving days away 500 490.6
472.1
from work in private industry, 19922001. The annual number 440.2
424.3 411.1
of back injury cases involving days away from work declined
43% during this 10-year periodfrom 653,385 cases in 1992 to 400 372.7
372,683 in 2001. (Sources: BLS [2003a,b].)
300

200

100

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

How did the rates of back injuries change during 1992 100
2001?
85.4
Figure 290. Annual rates of back injury cases involving days
80 78.0
away from work in private industry, 19922001. The annual 75.1
rate of back injury cases involving days away from work declined
Rate per 10,000 workers

66.2
52% during this 10-year periodfrom 85.4 per 10,000 full-time
workers in 1992 to 41.0 in 2001. (Sources: BLS [2003a,b].) 60 58.4
54.7
49.6
46.9
44.7
41.0
40

20

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

95
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

40 Back, including spine, spinal cord All nonfatal injuries and illnesses Age

How did back injuries compare with all nonfatal injuries

31.3 and illnesses by age of worker in 2001?
30 28.8
27.6
25.6
Figure 291. Distribution of back injury cases and all nonfatal
injury and illness cases involving days away from work in pri-
Distribution (%)

20.8 vate industry by age, 2001. Age data are available for 369,351
19.6 of the 372,683 BLS-estimated back injury cases involving days
20
away from work in 2001. Overall, three age groups (2534,
14.3 3544, and 4554) accounted for 78.5% of back injury cases,
12.9
slightly more than the 75.2% reported for all nonfatal injury
10.5
10 8.6 and illness cases. (Source: BLS [2003a].)

0
<25 2534 3544 4554 >54
Age range

80 Back, including spine, spinal cord All nonfatal injuries and illnesses Sex

How did back injuries compare with all nonfatal injuries

66.1
64.3 and illnesses by sex of worker in 2001?
60
Figure 292. Distribution of back injury cases and all non-
fatal injury and illness cases involving days away from work
Distribution (%)

in private industry by sex, 2001. Male workers accounted for

64.3% of back injury cases in 2001, slightly less than the 66.1%
40 35.7 reported for all nonfatal injury and illness cases. Female work-
33.9 ers accounted for a slightly greater percentage of back injury
cases (35.7%) than all nonfatal injury and illness cases (33.9%).
(Source: BLS [2003a].)
20

0
Male Female

96
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Race/Ethnicity 80 Back, including spine, spinal cord All nonfatal injuries and illnesses

69.5 68.2
How did back injuries compare with all nonfatal injuries
and illnesses by race/ethnicity in 2001?
60
Figure 293. Distribution of back injury cases and all nonfatal
injury and illness cases involving days away from work in pri-

Distribution (%)
vate industry by race/ethnicity, 2001. Race/ethnicity data are
available for 269,108 of the 372,683 BLS-estimated back injury
40
cases involving days away from work in 2001. Relatively small
race/ethnicity differences existed between back injury cases
and all nonfatal injury and illness cases in 2001. White, non-
Hispanic workers accounted for 69.5% of back injury cases and
68.2% of all nonfatal injury and illness cases. Black, non-His- 20 15.7 17.1
panic workers accounted for 12.1% of back injury cases, and 12.1 11.9
Hispanic workers accounted for 15.7%. (Source: BLS [2003a].)
2.7 2.8
0
White, non- Black, non- Hispanic Other
Hispanic Hispanic

Severity 25 Back, including spine, spinal cord All nonfatal injuries and illnesses
22.4 21.9 22.0
How did back injuries compare with all nonfatal injuries
and illnesses when measured by days away from work in 19.8
20
2001?

Figure 294. Distribution of back injury cases and all nonfa- 15.4
Distribution (%)

tal injury and illness cases involving days away from work in 15 13.7
13.0 12.6 12.7 12.6
private industry by days away from work, 2001. Back injury
cases tended to involve higher percentages of short-term dis- 11.0 11.1
ability than all nonfatal injury and illness cases in 2001: 22.4% 10
of workers with back injuries reported 35 days away from
work, and 13.7% reported 610 days away from work. Workers 6.3
5.4
with back injuries had a median of 6 days away from work in 5
2001as did workers with all nonfatal injuries and illnesses.
(Source: BLS [2003a].)
0
1 2 35 610 1120 2130 >30
Days away from work

97
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Managerial and Back, including spine, spinal cord Occupation

6.5
professional All nonfatal injuries and illnesses
specialty 6.4
How did back injuries compare with all nonfatal injuries
Technical, sales, and 16.4
and illnesses by occupation in 2001?
administrative
support 15.5
Figure 295. Distribution of back injury cases and all nonfatal
19.7 injury and illness cases involving days away from work in pri-
Service vate industry by occupation, 2001. Two occupational groups
17.4
(operators, fabricators, and laborers and service workers)
Farming, forestry, 2.5 accounted for 58.0% of all back injury cases in 2001 and 56.9%
and fishing 2.9 of all nonfatal injury and illness cases. (Source: BLS [2003a].)

Precision production, 16.5

craft, and repair 18.3

Operators, fabricators, 38.3

and laborers 39.5

0 10 20 30 40
Distribution (%)

Agriculture, forestry, 58.8 Industry

and fishing
Mining 33.2 How did the rate of back injury differ by private industry
sector in 2001?
Construction 63.9
Figure 296. Incidence rate of back injury cases involving days
Manufacturing 38.4 away from work in private industry by industry sector, 2001.
In 2001, back injury incidence rates exceeding the private-sec-
Transportation and 77.1 tor rate (41.0 per 10,000 full-time workers) were reported for
public utilities
transportation and public utilities (77.1 per 10,000 full-time
Wholesale trade 47.3 workers or 50,765 cases), construction (63.9 per 10,000 full-
time workers or 38,973 cases), agriculture, forestry, and fishing
Retail trade 37.1 (58.8 per 10,000 full-time workers or 8,830 cases), and whole-
Finance, insurance, Rate for all private sale trade (47.3 per 10,000 full-time workers or 30,421 cases).
and real estate 11.1 sector workers = 41.0 (Source: BLS [2003a].)
Services 36.6

0 20 40 60 80
Rate per 10,000 workers

98
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

How did the rates of back injuries change by private Construction Mining
industry sector during 19922001? Transportation and public utilities Wholesale trade
Agriculture, forestry, and fishing Manufacturing
Figure 297. Annual rates of back injury cases involving 140
Services
days away from work by private industry sector, 19922001.
Retail trade
The annual rate for back injuries involving days away from 120
Finance, insurance, and real estate
work declined 52% during 19922001, and similar reductions

Rate per 10,000 workers

occurred in each of the major industry sectors. Two industry 100
sectors (transportation and public utilities and construction)
had consistently higher rates than other industry sectors dur- 80
ing this 10-year period and experienced 36.1% and 52.7% rate
reductions, respectively. (Sources: BLS [2003a,b].) 60

40

20

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

99
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions
Bruises and Contusions
Bruises and contusions are superficial injuries in which the skin
remains intact. These injuries accounted for 168,013 or 9.7% of all
traumatic occupational injuries and disorders involving days away
from work in 2001. Workers with bruises and contusions experi-
enced a median of 3 days away from work (Figure 2103), much
lower than the median of 6 days for all nonfatal injuries and ill-
nesses [BLS 2003a].
BLS reported 136,361 bruise and contusion cases involving days
away from work in 2001 (Figure 298). Bruise and contusion rates
declined 48.5% during 19922001, from 29.1 per 10,000 full-time
workers in 1992 to 15.0 in 2001 (Figure 299). Most cases involved
workers who were aged 2554 (70.5%) (Figure 2100), male
100
(61.0%) (Figure 2101), and white, non-Hispanic (64.3%) (Figure
2102). Two occupational groups accounted for more than 60.5%
of bruise and contusion cases: operators, fabricators, and labor-
ers (42.0%) and service workers (18.5%) (Figure 2104). Rates
exceeding the private-sector rate were reported for transportation
and public utilities (28.5 per 10,000 full-time workers), agriculture,
forestry, and fishing (26.4), construction (20.8), mining (19.0), and
wholesale trade (17.8) (Figure 2105). During this 10-year period,
four industry sectors had consistently higher rates of bruise and
contusion cases than other industry sectors: transportation and
public utilities, construction, mining, and agriculture, forestry, and
fishing. These sectors experienced rate reductions of 35%, 49%,
50%, and 31%, respectively, during 19922001 (Figure 2106).
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Magnitude and Trend 250

222.7
How did the number of bruise and contusion cases 211.2 212.0
change during 19922001?
200 192.1

Number of cases (thousands)

Figure 298. Number of bruise and contusion cases involv- 174.9
165.8
ing days away from work in private industry, 19922001. The 153.1 156.0 151.7
annual number of bruise and contusion cases involving days 150 136.4
away from work declined 38.8% during 19922001, from
222,650 cases in 1992 to 136,361 cases in 2001. (Sources: BLS
[2003a,b].)
100

50

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

How did the rates of bruise and contusion cases change 30 29.1
during 19922001?
26.8 26.3
Figure 299. Annual rates of bruise and contusion cases
23.6
involving days away from work in private industry, 19922001.
The annual rate of bruise and contusion cases involving days 20.8
Rate per 10,000 workers

away from work declined 48.5% during 19922001, from 29.1 20 19.2
per 10,000 full-time workers in 1992 to 15.0 in 2001. (Sources: 17.3 17.3
16.5
BLS [2003a,b].)
15.0

10

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

101
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Bruises, contusions All nonfatal injuries and illnesses Age

30 28.8
26.5 How did the number of bruise and contusion cases
24.9 25.6 compare with all nonfatal injury and illness cases by age
of worker in 2001?
20.8
20 19.1 Figure 2100. Distribution of bruise and contusion cases and
Distribution (%)

18.1 all nonfatal injury and illness cases involving days away from
work in private industry by age, 2001. Age data are available
14.3
for 134,783 of the 136,361 BLS-estimated bruise and contu-
11.4 sion cases involving days away from work in 2001. Overall,
10.5
10 three age groups (2534, 3544, and 4554) accounted for
70.5% of bruise and contusion cases compared with 75.2% of
all nonfatal injury and illness cases. More workers were under
age 25 among bruise and contusion cases (18.1%) than among
all nonfatal injury and illness cases (14.3%). (Source: BLS
[2003a].)
0
<25 2534 3544 4554 >54
Age range

80 Bruises, contusions All nonfatal injuries and illnesses Sex

How did bruise and contusion cases compare with all

66.1
nonfatal injury and illness cases by sex of worker?
61.0
60
Figure 2101. Distribution of bruise and contusion cases and
all nonfatal injury and illness cases involving days away from
Distribution (%)

work in private industry by sex, 2001. Male workers accounted

for fewer bruise and contusion cases in 2001 (61.0%) than all
40 39.0 nonfatal injury and illness cases (66.1%). However, female
33.9 workers accounted for more bruise and contusion cases
(39.0%) than all nonfatal injury and illness cases (33.9%).
(Source: BLS [2003a].)
20

0
Male Female

102
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Race/Ethnicity 80 Bruises, contusions All nonfatal injuries and illnesses

How did bruise and contusion cases compare with all 68.2
nonfatal injury and illness cases by race/ethnicity? 64.3
60
Figure 2102. Distribution of bruise and contusion cases and
all nonfatal injury and illness cases involving days away from

Distribution (%)
work in private industry by race/ethnicity, 2001. Race/ethnicity
data are available for 96,014 of the 136,361 BLS-estimated
40
bruise and contusion cases involving days away from work in
2001. For Hispanic workers and other workers, relatively small
differences existed between the distribution of bruise and con-
tusion cases and all nonfatal injury and illness cases in 2001.
White, non-Hispanic workers accounted for 64.3% of bruise 20 17.5 17.1
15.0
and contusion cases and 68.2% of nonfatal injury and illness 11.9
cases. Black, non-Hispanic workers accounted for 15.0% of
bruise and contusion cases and 11.9% of all nonfatal injuries 3.1 2.8
and illnesses. (Source: BLS [2003a].) 0
White, non- Black, non- Hispanic Other
Hispanic Hispanic

Severity Bruises, contusions All nonfatal injuries and illnesses

25 24.0
23.3
How did bruise and contusion cases compare with all 22.0
nonfatal injury and illness cases when measured by days
19.8
away from work in 2001? 20
17.3
Figure 2103. Distribution of bruise and contusion cases and 15.4
Distribution (%)

all nonfatal injury and illness cases involving days away from 15
work in private industry by days away from work, 2001. Com- 12.7 12.6
pared with all nonfatal injury and illness cases in 2001, bruise 11.8
11.1 10.7
and contusion cases tended to involve higher percentages of 10 8.7
short-term disability, with 64.6% of cases requiring 5 or fewer
days away from work. A median of 3 days away from work was 6.3
reported for bruise and contusion cases in 2001half the 5 4.2
median of 6 days for all nonfatal injuries and illnesses. (Source:
BLS [2003a].)
0
1 2 35 610 1120 2130 >30
Days away from work

103
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Managerial and Bruises, contusions Occupation

6.2
professional All nonfatal injuries and illnesses
specialty 6.4
How did bruise and contusion cases compare with all
Technical, sales, and nonfatal injury and illness cases by occupation in 2001?
16.3
administrative
support 15.5
Figure 2104. Distribution of bruise and contusion cases and
18.5
all nonfatal injury and illness cases involving days away from
Service work in private industry by occupation, 2001. Two occupation-
17.4
al groups accounted for the majority (60.5%) of all bruise and
Farming, forestry, 3.2 contusion cases in 2001: operators, fabricators, and laborers
and fishing 2.9 (42% of bruise and contusion cases versus 39.5% of all nonfatal
injuries and illnesses) and service (18.5% of bruise and contu-
Precision production, 13.8 sion cases versus 17.4% of all nonfatal injuries and illnesses).
craft, and repair 18.3 Overall, the distributions by occupational group were compa-
rable for bruise and contusion cases and all nonfatal injury and
Operators, fabricators, 42.0 illness cases. (Source: BLS [2003a].)
and laborers 39.5

0 5 10 15 20 25 30 35 40 45
Distribution (%)

Agriculture, forestry, 26.4 Industry

and fishing
Mining 19.0 How did the rate of bruise and contusion cases differ by
private industry sector in 2001?
Construction 20.8
Figure 2105. Incidence rate of bruise and contusion cases
Manufacturing 14.8 by private industry sector, 2001. Private industry reported an
incidence rate of 15.0 per 10,000 full-time workers for bruise
Transportation and 28.5 and contusion cases in 2001. Higher rates were reported for
public utilities
transportation and public utilities (28.5 per 10,000 full-time
Wholesale trade 17.8 workers or 18,742 cases), agriculture, forestry, and fishing
(26.4 per 10,000 full-time workers or 3,964 cases), construction
Retail trade 15.9 (20.8 per 10,000 full-time workers or 12,689 cases), mining
Finance, insurance, Rate for all private (19.0 per 10,000 full-time workers or 1,127 cases), wholesale
and real estate 4.1 sector workers = 15.0 trade (17.8 per 10,000 full-time workers or 11,461 cases), and
retail trade (15.9 per 10,000 full-time workers or 27,689 cases).
Services 11.5
(Source: BLS [2003a].)
0 5 10 15 20 25 30
Rate per 10,000 workers

104
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

How did the rates of bruise and contusion cases change Transportation and Mining Manufacturing
by private industry sector during 19922001? public utilities Agriculture, forestry, Retail trade
50
Construction and fishing Wholesale trade
Figure 2106. Annual rate of bruise and contusion cases Services
involving days away from work by private industry sector,
40 Finance, insurance,
19922001. The private-sector annual rate of bruise and contu- and real estate

Rate per 10,000 workers

sion cases declined 48% during 19922001, and rate reduc-
tions were reported for each of the major industry sectors. Four
industry sectors (transportation and public utilities, construc- 30
tion, mining, and agriculture, forestry, and fishing) had consis-
tently higher rates than other sectors during this 10-year period
and experienced rate reductions of 35%, 49%, 50%, and 31%, 20
respectively. (Sources: BLS [2003a,b].)

10

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

105
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions
Heat Burns and Scalds
Heat burns and scalds constituted the major category of traumatic
injury among the 35,960 burns reported in 2001. This category
excludes chemical, electrical, and unspecified burns. Heat burn
and scald cases are of moderate severity (Figure 2114), with
injured workers experiencing a median of 5 days away from work
[BLS 2003a].
In 1999, more than 142,000 occupational burns of all types (ther-
mal, chemical, and radiation) were treated in emergency depart-
ments for workers aged 15 and older. The rate of these burns was
about 11 per 10,000 full-time workers. Workers under age 25 had an
incidence rate 2- to 5-fold that of older age groups (Figure 2109).
The number of burns among male workers was twice the number
among female workers (Figure 2111).
106
BLS reported 25,078 heat burn and scald cases involving days away
from work in 2001 (Figure 2107). Annual rates declined 48.1%
during 19922001, from 5.4 per 10,000 full-time workers in 1992 to
2.8 in 2001 (Figure 2108). Most cases involved workers who were
aged 2554 (67.4%) (Figure 2110), male (68.2%) (Figure 2112),
and white, non-Hispanic (66.6%) (Figure 2113). Two occupation-
al groups accounted for the majority (72.7%) of all heat burn and
scald cases: service occupations (47.6%) and operators, fabricators,
and laborers (25.1%) (Figure 2115). Incidence rates exceeding
the private-sector rate were reported for retail trade (5.8 per 10,000
full-time workers) and construction (4.0) (Figure 2116). Three
industry sectors (retail trade, construction, and manufacturing)
had consistently higher rates than other industry sectors during
19922001 and experienced rate reductions of 50%, 37.5%, and
50%, respectively (Figure 2117).
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Magnitude and Trend 45,000

41,032
How did the number of heat burn and scald cases change 40,000 37,718 37,309
during 19922001? 36,119
35,000
Figure 2107. Number of heat burn and scald cases involv-
ing days away from work in private industry, 19922001. The 30,000 29,049 29,994 28,359

Number of cases
27,108
annual number of heat burn and scald cases involving days
away from work declined 38.9% during this 10-year period, 25,000 24,298 25,078
from a high of 41,032 cases in 1992 to 25,078 cases in 2001.
(Sources: BLS [2003a,b].) 20,000

15,000

10,000

5,000

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

How did the annual rate of heat burn and scald cases 6
change during 19922001?
5.4
Figure 2108. Annual rates of heat burn and scald cases 5
4.8
involving days away from work in private industry, 19922001. 4.6 4.4
The annual rate of heat burn and scald cases involving days
Rate per 10,000 workers

away from work declined 48.1% during 19922001, from a 4

high of 5.4 per 10,000 full-time workers in 1992 to 2.8 in 2001. 3.5 3.5
(Sources: BLS [2003a,b].) 3.2
3 3.0
2.8
2.6

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

107
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Number Rate 30 Age

26.8
50 How did burns treated in hospital emergency departments
44.5 differ by age of worker in 1999?
42.1
Number of cases (thousands)

Figure 2109. Number and rate of nonfatal occupational

Rate per 100 workers

40
20
burns treated in an emergency department, by age of worker,
32.2 1999. In 1999, more than 142,000 occupational burns of all
30 types (thermal, chemical, and radiation) were treated in emer-
13.3
gency departments for workers aged 15 and older. The rate of
these burns was about 11 per 10,000 full-time workers. Work-
20 8.4 10 ers under age 25 had an incidence rate that was 2 to 5 times
15.8
5.9 the rates for older age groups. (Sources: NEISS [2003]; Jackson
5.3
[2003].)
10 7.7

0 0
1524 2534 3544 4554 >54
Age group

Heat burns, scalds All nonfatal injuries and illnesses How did heat burn and scald cases compare with all
30 28.3 28.8 nonfatal injury and illness cases by age of worker in
2001?
26.0 25.6
24.0 Figure 2110. Distribution of heat burn and scald cases and
20.8 all nonfatal injury and illness cases involving days away from
20 work in private industry by age, 2001. Age data are available
Distribution (%)

for 24,244 of the 25,078 BLS-estimated heat burn and scald

15.1 cases involving days away from work in 2001. Overall, three
14.3
age groups (2534, 3544, and 4554) accounted for 67.4% of
heat burn and scald cases compared with 75.2% of all nonfatal
10.5
10 injury and illness cases. More workers were under age 35 in
heat burn and scald cases (54.3%) than in all nonfatal injury
6.6
and illness cases (39.9%). (Source: BLS [2003a].)

0
<25 2534 3544 4554 >54
Age range

108
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Sex Number Rate 14

12.5
How did the numbers and rates of burn cases treated in
100 95.3 12
hospital emergency departments differ by sex of worker in
1999?
10

Number of cases (thousands)

80

Rate per 100 workers

Figure 2111. Numbers and rates of nonfatal occupational 8.4
burns treated in an emergency department, by sex of worker,
1999. The number of burns among male workers was twice 8
the number among female workers in 1999. (Sources: NEISS 60
[2003]; Jackson [2003].) 46.9 6

40
4

20
2

0 0
Male Female

How did heat burn and scald cases compare with all 80 Heat burns, scalds All nonfatal injuries and illnesses
nonfatal injury and illness cases by sex of worker in
2001? 68.2
66.1
Figure 2112. Distribution of heat burn and scald cases and
60
all nonfatal injury and illness cases involving days away from
work in private industry by sex, 2001. Male workers accounted
Distribution (%)

for 68.2% of heat burn and scald cases in 2001 and 66.1% of
all nonfatal injury and illness cases. Female workers accounted
for a lower percentage of heat burn and scald cases (31.8%) 40
than all nonfatal injury and illness cases (33.9%). (Source: BLS 33.9
31.8
[2003a].)

20

0
Male Female

109
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

80 Heat burns, scalds All nonfatal injuries and illnesses Race/Ethnicity

66.6 68.2 How did heat burn and scald cases compare with all
nonfatal injury and illness cases by race/ethnicity in
60 2001?

Figure 2113. Distribution of heat burn and scald cases and all
Distribution (%)

nonfatal injury and illness cases involving days away from work
in private industry by race/ethnicity, 2001. Race/ethnicity data
40
are available for 18,617 of the 25,078 BLS-estimated heat burn
and scald cases involving days away from work in 2001. White,
non-Hispanic workers accounted for 66.6% of heat burn and
scald cases and 68.2% of all nonfatal injury and illness cases.
20 15.6 17.1 Black, non-Hispanic workers accounted for 12.7% of heat burn
12.7 11.9
and scald cases (slightly more than for all nonfatal injury and
5.2 illness cases), and Hispanic workers accounted for 15.6% of
2.8 heat burn and scald cases (slightly less than for all nonfatal
0 injury and illness cases). (Source: BLS [2003a].)
White, non- Black, non- Hispanic Other
Hispanic Hispanic

25 Heat burns, scalds All nonfatal injuries and illnesses Severity

21.8 22.0
How did heat burn and scald cases compare with all
19.8 nonfatal injury and illness cases when measured by days
20
17.7 17.7 away from work in 2001?
16.8
15.4 Figure 2114. Distribution of heat burn and scald cases and
Distribution (%)

15 all nonfatal injury and illness cases involving days away from
12.7 12.6 12.5 work in private industry by days away from work, 2001. In
11.1
2001, more heat burn and scald cases (85.6%) involved short-
10 9.0 term periods of disability (120 days) than did nonfatal injury
and illness cases (71.6%). The median number of days away
6.3 from work was 5 for heat burn and scald cases and 6 for all
5 4.5 nonfatal injury and illness cases. (Source: BLS [2003a].)

0
1 2 35 610 1120 2130 >30
Days away from work

110
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Occupation Managerial and Heat burns, scalds

2.8
professional All nonfatal injuries and illnesses
specialty 6.4
How did heat burn and scald cases compare with all
nonfatal injury and illness cases by occupation in 2001? Technical, sales, and 7.3
administrative
support 15.5
Figure 2115. Distribution of heat burn and scald cases and all
nonfatal injury and illness cases involving days away from work 47.6
in private industry by occupation, 2001. Service occupations Service
17.4
accounted for nearly half (47.6%) of all heat burn and scald
cases compared with 17.4% of all nonfatal injury and illness Farming, forestry, 0.5
cases in 2001. Operators, fabricators, and laborers accounted and fishing 2.9
for another 25.1% of heat, burn, and scald cases and for 39.5%
of all nonfatal injury and illness cases. (Source: BLS [2003a].) Precision production, 16.7
craft, and repair 18.3

Operators, fabricators, 25.1

and laborers 39.5

0 10 20 30 40 50
Distribution (%)

Industry Agriculture, forestry, 1.0

and fishing
How did the rate of heat burn and scald cases differ by Mining 1.7
private industry sector in 2001?
Construction 4.0
Figure 2116. Incidence rate of heat burn and scald cases
in private industry by industry sector, 2001. Private industry Manufacturing 2.7
reported an incidence rate of 2.8 per 10,000 full-time workers
for heat burn and scald cases in 2001. Incidence rates exceed- Transportation and 1.7 Rate for all private
public utilities sector workers = 2.8
ing the private-sector rate were reported for retail trade (5.8
per 10,000 full-time workers or 10,082 cases) and construction Wholesale trade 1.5
(4.0 per 10,000 full-time workers or 2,453 cases). (Source: BLS
[2003a].) Retail trade 5.8

Finance, insurance, 0.3

and real estate
Services 1.9

0 1 2 3 4 5 6
Rate per 10,000 workers

111
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Retail trade Manufacturing Agriculture, forestry, and fishing How did the rates of heat burn and scald cases change by
Construction Mining Wholesale trade private industry sector during 19922001?
12
Services Transportation and public utilities
Finance, insurance, and real estate
Figure 2117. Annual rates of heat burn and scald cases
10 involving days away from work by private industry sector,
19922001. The annual rate of heat burn and scald cases
Rate per 10,000 workers

declined by nearly half (48.1%) during 19922001, and rate

8 reductions occurred among each of the major industry sectors.
Three sectors (retail trade, construction, and manufacturing)
had higher rates than the other sectors and experienced rate
6 reductions of 50%, 37.5%, and 50%, respectively, during this
10-year period. (Sources: BLS [2003a,b].)
4

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

112
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions
Cuts and Lacerations
Cuts and lacerations constituted the major category of traumatic
injury among the 150,376 open-wounds injury cases reported in
2001. Cut and laceration cases are less severe than the average non-
fatal injury or illness case. They involved a median of 3 days away
from work in 2001 compared with 6 days for all nonfatal injuries
and illnesses (Figure 2123) [BLS 2003a].
BLS reported 114,791 cut and laceration cases involving days away
from work in 2001 (Figure 2118). Rates declined 44.5% during
19922001, from 22.7 per 10,000 workers in 1992 to 12.6 in 2001
(Figure 2119). Most cases involved workers who were aged 2554
(69.4%) (Figure 2120), male (81.9%) (Figure 2121), and white,
non-Hispanic (60.7%) (Figure 2122). Together, two occupational
groups accounted for more than 67% of cut and laceration cases:
operators, fabricators, and laborers (40.0%) and precision produc-
tion, craft, and repair (27.2%) (Figure 2124). Rates exceeding the
private-sector rate were reported for construction (35.8 per 10,000
full-time workers), agriculture, forestry, and fishing (26.5), manu-
facturing (16.1), and retail trade (15.4) (Figure 2125). Two indus-
try sectors (construction and agriculture, forestry, and fishing) had
consistently higher annual rates of cut and laceration cases than
other sectors during 19922001, and they experienced reductions
of 26.3% and 41.2%, respectively (Figure 2126).
113
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

200 Magnitude and Trend

173.6 169.9 How did the number of cut and laceration cases change
164.6
during 19922001?
160 153.2
Number of cases (thousands)

133.6 137.6 Figure 2118. Number of cut and laceration cases involving
133.2 132.4
days away from work in private industry, 19922001. The annu-
121.3
120 114.8 al number of cut and laceration cases involving days away from
work declined 33.9% during 19922001, from 173,573 cases in
1992 to 114,791 cases in 2001. (Sources: BLS [2003a,b].)

80

40

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

25 How did the annual rate of cut and laceration cases

22.7 change during 19922001?
21.5
20.4
Figure 2119. Annual rates of cut and laceration cases involv-
20 18.8 ing days away from work in private industry, 19922001. The
annual rate of cut and laceration cases involving days away
Rate per 10,000 workers

15.9 15.5 15.5 from work declined 44.5% during 19922001, from 22.7 per
14.6 10,000 full-time workers in 1992 to 12.6 in 2001. (Sources: BLS
15
13.2 [2003a,b].)
12.6

10

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

114
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Age Cuts, lacerations All nonfatal injuries and illnesses

30 28.7 28.8
How did cut and laceration cases compare with all
nonfatal injury and illness cases by age of worker in 25.6 25.3
2001? 22.4
20.8
Figure 2120. Distribution of cut and laceration cases and 20

Distribution (%)
all nonfatal injury and illness cases involving days away from
work in private industry by age, 2001. Age data are available 15.4
14.3
for 113,072 of the 114,791 BLS-estimated cut and laceration
cases involving days away from work in 2001. Overall, three
10.5
age groups (2534, 3544, and 4554) accounted for 69.4% 10
of cases compared with 75.2% reported for all nonfatal injury 8.2
and illness cases. More workers were under age 35 in cut and
laceration cases (51.1%) than in all nonfatal injury and illness
cases (39.9%). (Source: BLS [2003a].)
0
<25 2534 3544 4554 >54
Age range

Sex 100 Cuts, lacerations All nonfatal injuries and illnesses

How did cut and laceration cases compare with all

nonfatal injury and illness cases by sex of worker in 81.9
80
2001?

Figure 2121. Distribution of cut and laceration cases and 66.1

Distribution (%)

all nonfatal injury and illness cases involving days away from 60
work in private industry by sex, 2001. Male workers accounted
for more cut and laceration cases than all nonfatal injury and
illness cases (81.9% versus 66.1%). Female workers accounted
for fewer cut and laceration cases than all nonfatal injury and 40
33.9
illness cases (18.1% versus 33.9%). (Source: BLS [2003a].)

20 18.1

0
Male Female

115
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

80 Cuts, lacerations All nonfatal injuries and illnesses Race/Ethnicity

68.2 How did cut and laceration cases compare with all
nonfatal injury and illness cases by race/ethnicity in
60.7
60 2001?

Figure 2122. Distribution of cut and laceration cases and all

Distribution (%)

nonfatal injury and illness cases involving days away from work
in private industry by race/ethnicity, 2001. Race/ethnicity
40
data are available for 87,995 of the 114,791 BLS-estimated cut
and laceration cases involving days away from work in 2001.
24.5 White, non-Hispanic workers accounted for fewer cut and lac-
eration cases (60.7%) than all nonfatal injury and illness cases
20 17.1 (68.2%). Black, non-Hispanic workers accounted for 11.3% of
11.3 11.9 cut and laceration cases, and Hispanic workers accounted for
24.5% a much greater percentage than the 17.1% reported
3.5 2.8 for all nonfatal injury and illness cases. (Source: BLS [2003a].)
0
White, non- Black, non- Hispanic Other
Hispanic Hispanic

25
Cuts, lacerations All nonfatal injuries and illnesses Severity
23.2
21.4 22.0 How did cut and laceration cases compare with all
19.8 nonfatal injury and illness cases when measured by days
20
away from work in 2001?
17.6
15.4 Figure 2123. Distribution of cut and laceration cases and all
Distribution (%)

15 14.0 nonfatal injury and illness cases involving days away from work
12.7 12.6 in private industry by days away from work, 2001. Compared
11.1 with all nonfatal injury and illness cases in 2001, cut and lacera-
10 9.1 9.5 tion cases involved more short-term disability (periods of 110
days away from work). The median number of days away from
6.3 work was 3 for cut and laceration cases and 6 for all nonfatal
5.3
5 injury and illness cases. (Source: BLS [2003a].)

0
1 2 35 610 1120 2130 >30
Days away from work

116
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Occupation Managerial and Cuts, lacerations

2.0
professional All nonfatal injuries and illnesses
specialty 6.4
How did cut and laceration cases compare with all
nonfatal injury and illness cases by occupation in 2001? Technical, sales, and 9.1
administrative
support 15.5
Figure 2124. Distribution of cut and laceration cases and
all nonfatal injury and illness cases involving days away from 17.7
work in private industry by occupation, 2001. Two occupational Service
17.4
groups accounted for the majority (67.2%) of cut and lacera-
tion cases in 2001: operators, fabricators, and laborers (40% Farming, forestry, 4.1
versus 39.5% for all nonfatal injuries and illnesses) and preci- and fishing 2.9
sion production, craft, and repair (27.2%, versus 18.3% for all
nonfatal injuries and illnesses). (Source: BLS [2003a].) Precision production, 27.2
craft, and repair 18.3

Operators, fabricators, 40.0

and laborers 39.5

0 10 20 30 40
Distribution (%)

Agriculture, forestry, 26.5

and fishing
Industry Mining 11.9

How did the rate of cut and laceration cases differ by Construction 35.8
private industry sector in 2001?
Manufacturing 16.1
Figure 2125. Incidence rate of cut and laceration cases in
private industry by industry sector, 2001. For 2001, incidence Transportation and 12.7
public utilities
rates exceeding the private-sector rate of 12.6 per 10,000 full-
time workers were reported for construction (35.8 per 10,000 Wholesale trade 11.1
full-time workers or 21,849 cases), agriculture, forestry, and
fishing (26.5 per 10,000 full-time workers or 3,984 cases), man- Retail trade 15.4
ufacturing (16.1 per 10,000 full-time workers or 27,881 cases), Finance, insurance, Rate for all private
and retail trade (15.4 per 10,000 full-time workers or 26,739 3.4
and real estate sector workers = 12.6
cases). (Source: BLS [2003a].)
Services 5.6

0 10 20 30 40
Rate per 10,000 workers

117
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Construction Retail trade Wholesale trade How did the rates of cut and laceration cases change by
Agriculture, forestry, Manufacturing Transportation and public utilities private industry sector during 19922001?
and fishing Mining Services
50 Figure 2126. Annual rates of cut and laceration cases involv-
Finance, insurance, and real estate
ing days away from work by private industry sector, 19922001.
The annual rate of cut and laceration cases declined 44.5%
40 during 19922001, and rates declined for each major industry
Rate per 10,000 workers

sector. Two sectors (construction and agriculture, forestry, and

fishing) had consistently higher rates than other industry sec-
30 tors during this 10-year period and experienced rate reductions
of 26.3% and 41.2%, respectively. (Sources: BLS [2003a,b].)

20

10

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

118
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions
Fractures
Fractures accounted for 7.0% of all reported nonfatal injuries
and illnesses involving days away from work in 2001. This category
includes both open (compound) and closed fractures of bone and
teeth. The category excludes cases of fractures or broken cartilage
unless accompanied by a fracture of a bone or tooth. Fracture cases
are severe injuries. In 2001, they involved a median of 21 days away
from work (Figure 2134) compared with a median of 6 days for all
nonfatal injuries and illnesses [BLS 2003a].
In 1999, an estimated 210,000 occupational fractures were treated in
U.S. hospital emergency departments. This number corresponded
to a rate of 15.9 fractures per 10,000 full-time workers. Although
workers aged 3544 experienced the highest number of fractures,
workers aged 1524 had the highest rate of fractures. Workers aged
55 and older had the smallest number of fractures, but they expe-
rienced a slightly higher rate of fractures than workers aged 2554
(Figure 2129). Men experienced 2 to 3 times more fractures at work
than women. (Figure 2131).
BLS reported 108,127 fracture cases involving days away from work
in 2001 (Figure 2127). Rates declined 36.7% during 19922001,
from 18.8 per 10,000 full-time workers in 1992 to 11.9 in 2001
(Figure 2128). Most cases involved workers who were aged 2554
(71.0%) (Figure 2130), male (73.8%) (Figure 2132), and white,
non-Hispanic (73.9%) (Figure 2133). Two occupational groups
accounted for more than 63% of fracture cases: operators, fabrica-
tors, and laborers (41.7%) and precision production, craft, and
repair (22.2%) (Figure 2135). Rates exceeding the private-sec-
tor rate were reported for construction (32.5 per 10,000 full-time
workers), mining (25.4), agriculture, forestry, and fishing (21.7),
transportation and public utilities (20.9), and manufacturing (13.0)
(Figure 2136). Three industry sectors (construction, mining, and
agriculture, forestry, and fishing) had consistently higher rates than
other sectors during this 10-year period and experienced rate reduc-
tions of 38.9%, 35.5%, and 33.6%, respectively (Figure 2137).
119
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

160 Magnitude and Trend

143.6
136.5 138.5 How did the number of fracture cases change during
124.6 19922001?
120.5 119.5 116.7
Number of cases (thousands)

120 115.4 113.7

108.1 Figure 2127. Number of fracture cases involving days away
from work in private industry, 19922001. The annual num-
ber of fracture cases involving days away from work in 2001
declined 24.7% during 19922001, from 143,627 cases in 1992
80 to 108,127 cases in 2001. (Sources: BLS [2003a,b].)

40

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

20 How did the annual rates of fracture cases change during

18.8
19922001?
17.3 17.2
Figure 2128. Annual rates of fracture cases involving days
15.3 away from work in private industry, 19922001. The annual
15 14.3
13.8 rate of fracture cases involving days away from work declined
Rate per 10,000 workers

13.0 12.6 12.7 36.7% during 19922001, from 18.8 per 10,000 full-time work-
11.9 ers in 1992 to 11.9 in 2001. (Sources: BLS [2003a,b].)

10

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

120
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Age 60 Number Rate 57.8 25

How did occupational fractures treated in hospital 21.0

50 48.8
emergency departments differ by age of worker in 1999? 20

Number of cases (thousands)

42.4
Figure 2129. Number and rate of nonfatal occupational 16.5

Rate per 100 workers

40 15.4 15.1
fractures treated in emergency departments, by age of worker, 35.0 14.3
1999. In 1999, an estimated 210,000 occupational fractures 15
were treated in U.S. hospital emergency departments. This 30
number corresponded to a rate of 15.9 fractures per 10,000 26.2
full-time workers. Although workers aged 3544 experienced 10
the highest number of fractures, workers aged 1524 had the 20
highest rate of fractures. Workers aged 55 and older had the
smallest number of fractures, but they experienced a slightly 5
higher rate of fractures than workers aged 2554. (Sources: 10
NEISS [2003]; Jackson [2003].)
0 0
1524 2534 3544 4554 >54
Age group

How did fracture cases compare with all nonfatal injury Fractures All nonfatal injuries and illnesses
and illness cases by age of worker in 2001? 30 28.8

Figure 2130. Distribution of fracture cases and all nonfatal 25.6 25.9
24.3
injury and illness cases involving days away from work in pri-
vate industry by age, 2001. Age data are available for 107,001 20.8 20.8
of the 108,127 BLS-estimated fracture cases involving days away 20
Distribution (%)

from work in 2001. Overall, three age groups (2534, 3544,

16.5
and 4554) accounted for 71% of fracture cases and 75.2% of
14.3
all nonfatal injury and illness cases. More workers were aged
12.4
45 or older in fracture cases (40.8%) than in all nonfatal injury
10.5
and illness cases (31.3%). (Source: BLS [2003a].) 10

0
<25 2534 3544 4554 >54
Age range

121
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Number Rate 25 Sex

160 159.5
20.8 How did occupational fractures treated in hospital
emergency departments differ by sex of worker in 1999?
20
Figure 2131. Number and rate of nonfatal occupational
Number of cases (thousands)

120

Rate per 100 workers

fractures treated in emergency departments, by sex of worker,
15 1999. Men experienced 2 to 3 times more fractures at work
than women. (Sources: NEISS [2003]; Jackson [2003].)
80
9.1 10
50.7
40
5

0 0
Male Female

80 Fractures All nonfatal injuries and illnesses How did fracture cases compare with all nonfatal injury
and illness cases by sex of worker in 2001?
73.8

66.1
Figure 2132. Distribution of fracture cases and all nonfatal
injury and illness cases involving days away from work in pri-
60
vate industry by sex, 2001. Male workers accounted for a larger
proportion of fracture cases (73.8%) than all nonfatal injury
Distribution (%)

and illness cases (66.1%). However, female workers accounted

for a smaller proportion of fracture cases (26.2%) than all non-
40 fatal injury and illness cases (33.9%). (Source: BLS [2003a].)
33.9

26.2

20

0
Male Female

122
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Race/Ethnicity 80
Fractures All nonfatal injuries and illnesses
73.9
How did fracture cases compare with all nonfatal injury 68.2
and illness cases by race/ethnicity in 2001?

Figure 2133. Distribution of fracture cases and all nonfatal 60

injury and illness cases involving days away from work in pri-

Distribution (%)
vate industry by race/ethnicity, 2001. Race/ethnicity data are
available for 84,480 of the 108,127 BLS-estimated fracture cases
involving days away from work in 2001. White, non-Hispanic 40
workers accounted for a greater proportion of fracture cases
(73.9%) than for all nonfatal injury and illness cases (68.2%).
Black, non-Hispanic workers accounted for 8% of fracture cas-
es and Hispanic workers accounted for 15.9%both smaller 20 15.9 17.1
proportions than reported for all nonfatal injury and illness 11.9
cases. (Source: BLS [2003a].) 8.0
2.2 2.8
0
White, non- Black, non- Hispanic Other
Hispanic Hispanic

Severity 45 Fractures All nonfatal injuries and illnesses

40.9
How did fracture cases compare with all nonfatal injury 40
and illness cases when measured by days away from work
35
in 2001?
30
Figure 2134. Distribution of fracture cases and all nonfatal
Distribution (%)

injury and illness cases involving days away from work in pri- 25
vate industry by days away from work, 2001. In 2001, fracture 22.0
cases involved more long-term work loss (1120 or more days 19.8
20
away from work) than all nonfatal injuries and illnesses (63.9% 15.4
versus 39.4%). Fracture cases involved a median of 21 days away 15 12.7 12.8 12.6 12.7
from work3.5 times the median of 6 days for all nonfatal 11.5 11.1 10.3
injury and illness cases. (Source: BLS [2003a].) 10
6.4 5.5 6.3
5

0
1 2 35 610 1120 2130 >30
Days away from work

123
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Managerial and Fractures Occupation

6.2
professional All nonfatal injuries and illnesses
specialty 6.4
How did fracture cases compare with all nonfatal injury
Technical, sales, and and illness cases by occupation in 2001?
13.9
administrative
support 15.5
Figure 2135. Distribution of fracture cases and all nonfatal
12.8
injury and illness cases involving days away from work in pri-
Service vate industry by occupation, 2001. Two occupational groups
17.4
accounted for the majority (63.9%) of all fracture cases in 2001:
Farming, forestry, 3.3 operators, fabricators, and laborers and precision production,
and fishing 2.9 craft, and repair. These two groups accounted for 57.8% of all
nonfatal injury and illness cases. (Source: BLS [2003a].)
Precision production, 22.2
craft, and repair 18.3

Operators, fabricators, 41.7

and laborers 39.5

0 5 10 15 20 25 30 35 40 45
Distribution (%)

Agriculture, forestry, 21.7 Industry

and fishing
Mining 25.4 How did the rate of fracture cases differ by private
industry sector in 2001?
Construction 32.5
Figure 2136. Incidence rate of fracture cases by private
Manufacturing 13.0 industry sector, 2001. Private industry reported an incidence
rate of 11.9 per 10,000 full-time workers for fracture cases in
Transportation and 20.9 2001. Incidence rates exceeding the private-sector rate were
public utilities
reported for construction (32.5 per 10,000 full-time workers
Wholesale trade 11.2 or 19,786 cases), mining (25.4 per 10,000 full-time workers or
1,505 cases), agriculture, forestry, and fishing (21.7 per 10,000
Retail trade 8.8 full-time workers or 3,260 cases), transportation and public
Finance, insurance, Rate for all private
utilities (20.9 per 10,000 full-time workers or 13,758 cases), and
and real estate 4.4 sector workers = 11.9 manufacturing (13.0 per 10,000 full-time workers or 22,493
cases). (Source: BLS [2003a].)
Services 7.7

0 5 10 15 20 25 30 35
Rate per 10,000 workers

124
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

How did the rates of fracture cases change by private Construction Agriculture, forestry, Manufacturing
60 and fishing
industry sector during 19922001? Mining Wholesale trade
Transportation and Retail trade
Figure 2137. Annual rates of fracture cases involving days public utilities
50 Services
away from work by private industry sector, 19922001. The
Finance, insurance,
annual rate of fracture cases in the private sector declined

Rate per 10,000 workers

and real estate
36.7% during 19922001. Rate reductions occurred among 40
each of the major industry sectors. Three sectors (construc-
tion, mining, and agriculture, forestry, and fishing) had higher
rates than other industry sectors during this 10-year period. 30
They experienced rate reductions of 38.9%, 35.5%, and 33.6%,
respectively. (Sources: BLS [2003a,b].)
20

10

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

125
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions
Sprains, Strains, and Tears
Sprains, strains, and tears accounted for 4 out of 10 nonfatal injuries
and illnesses involving days away from work in 2001 [BLS 2003e].
Sprains, strains, and tears constituted the leading injury and illness
category for every major private industry division. Slightly more than
a fourth of these cases (27.3%) resulted from overexposure to lift-
ing, and 45.1% of the cases were back sprains, strains, or tears [BLS
2003e]. Sprain, strain, and tear cases include avulsion, hemarthrosis,
rupture, strain, sprain, or tear of joint capsule, ligament, muscle, or
tendon. Sprain, strain, and tear cases are of moderate severity (Fig-
ure 2143). In 2001, they involved a median of 6 days away from
workthe same median reported for all nonfatal injuries and ill-
nesses [BLS 2003a].
BLS reported 669,889 sprain, strain, and tear cases involving
days away from work in 2001 (Figure 2138). Rates declined
126
44.9% during 19922001, from 133.7 per 10,000 full-time work-
ers in 1992 to 73.7 in 2001 (Figure 2139). Most cases involved
workers who were aged 2554 (77.8%) (Figure 2140), male
(64.1%) (Figure 2141), and white, non-Hispanic (69.9%) (Fig-
ure 2142). Two occupational groups accounted for more than
57.6% of sprain, strain, and tear cases: operators, fabricators, and
laborers (38.8%) and service workers (18.8%) (Figure 2144).
Rates exceeding the private-sector rate were reported for trans-
portation and public utilities (147 per 10,000 full-time workers),
construction (116.8), agriculture, forestry, and fishing (91.6),
and wholesale trade (81.2) (Figure 2145). Two industry sectors
(transportation and public utilities and construction) had consis-
tently higher rates than other sectors during this 10-year period.
These sectors experienced rate reductions of 41.5% and 30.4%,
respectively (Figure 2146).
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Magnitude and Trend 1,200

How did the number of sprain, strain, and tear cases 1,022.7
change during 19922001? 1,000 959.2 963.5
876.8

Number of cases (thousands)

Figure 2138. Number of sprain, strain, and tear cases involv- 819.7 799.0
ing days away from work in private industry, 19922001. The 800 760.0 739.7 728.2
annual number of sprain, strain, and tear cases involving 669.9
days away from work declined 34.5% during 19922001, from
1,022,746 cases in 1992 to 669,889 cases in 2001. (Sources: BLS 600
[2003a,b].)

400

200

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

How did the rates of sprain, strain, and tear cases change 140 133.7
during 19922001?
121.6 119.3
Figure 2139. Annual rates of sprain, strain, and tear cases 120
107.5
involving days away from work in private industry, 19922001.
The annual rate of sprain, strain, and tear cases involving days 100 97.6
Rate per 10,000 workers

92.5
away from work declined 44.9% during 19922001, from 133.7 85.6
per 10,000 full-time workers in 1992 to 73.7 in 2001. (Sources: 81.8 79.2
BLS [2003a,b].) 80 73.7

60

40

20

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

127
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Sprains, strains, tears All nonfatal injuries and illnesses Age

30.0
30 28.8 How did sprain, strain, and tear cases compare with all
26.6 nonfatal injury and illness cases by age of worker in
25.6
2001?
21.2 20.8
Figure 2140. Distribution of sprain, strain, and tear cases
20 and all nonfatal injury and illness cases involving days away
Distribution (%)

from work in private industry by age, 2001. Age data are avail-
14.3 able for 663,779 of the 669,889 BLS-estimated sprain, strain,
12.5 and tear cases involving days away from work in 2001. Overall,
10.5 three age groups (2534, 3544, and 4554) accounted for
9.7
10
77.8% of sprain, strain, and tear cases compared with 75.2% of
all nonfatal injury and illness cases. (Source: BLS [2003a].)

0
<25 2534 3544 4554 >54
Age range

80 Sprains, strains, tears All nonfatal injuries and illnesses Sex

How did sprain, strain, and tear cases compare with

66.1
64.1 all nonfatal injury and illness cases by sex of worker in
2001?
60
Figure 2141. Distribution of sprain, strain, and tear cases
Distribution (%)

and all nonfatal injury and illness cases involving days away
from work in private industry by sex, 2001. Male workers
40 35.9 accounted for 64.1% of sprain, strain, and tear cases compared
33.9 with 66.1% of all nonfatal injury and illness cases. Female
workers accounted for 35.9% of sprain, strain, and tear cases
compared with 33.9% of all nonfatal injury and illness cases
20
(33.9%). (Source: BLS [2003a].)

0
Male Female

128
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Race/Ethnicity 80 Sprains, strains, tears All nonfatal injuries and illnesses

69.9 68.2
How did sprain, strain, and tear cases compare with
all nonfatal injury and illness cases by race/ethnicity in
2001? 60

Figure 2142. Distribution of sprain, strain, and tear cases and

Distribution (%)
all nonfatal injury and illness cases involving days away from
work in private industry by race/ethnicity, 2001. Race/ethnicity
40
data are available for 481,012 of the 669,889 BLS-estimated
sprain, strain, and tear cases involving days away from work in
2001. White, non-Hispanic workers accounted for more sprain,
strain, and tear cases (69.9%) than all nonfatal injury and ill-
ness cases (68.2%). Black, non-Hispanic workers accounted for 20 17.1
15.2
12.4% of sprain, strain, and tear cases, and Hispanic workers 12.4 11.9
accounted for 15.2%. (Source: BLS [2003a].)
2.5 2.8
0
White, non- Black, non- Hispanic Other
Hispanic Hispanic

Severity 25 Sprains, strains, tears All nonfatal injuries and illnesses

22.2 22.0
How did sprain, strain, and tear cases compare with all 21.2
nonfatal injury and illness cases when measured by days 19.8
20
away from work in 2001?

Figure 2143. Distribution of sprain, strain, and tear cases and 15.4
Distribution (%)

all nonfatal injury and illness cases involving days away from 15
13.5 13.3
12.8 12.7 12.6
work in private industry by days away from work, 2001. Com-
11.2 11.1
pared with all nonfatal injuries and illnesses in 2001, sprains,
strains, and tears involved a higher percentage of cases with 35 10
days away from work (21.2% compared with 19.8%). But over-
all, the distributions of work losses were similar. This similarity 5.8 6.3
was reflected by the median of 6 days away from work for both 5
types of cases. (Source: BLS [2003a].)

0
1 2 35 610 1120 2130 >30
Days away from work

129
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Managerial and Sprains, strains, tears Occupation

7.1
professional All nonfatal injuries and illnesses
specialty 6.4
How did sprain, strain, and tear cases compare with all
Technical, sales, and nonfatal injury and illness cases by occupation in 2001?
16.6
administrative
support 15.5
Figure 2144. Distribution of sprain, strain, and tear cases and
18.8
all nonfatal injury and illness cases involving days away from
Service work in private industry by occupation, 2001. Two occupa-
17.4
tional groups accounted for the majority (57.6%) of all sprain,
Farming, forestry, 2.2 strain, and tear cases: operators, fabricators, and laborers and
and fishing 2.9 service workers. These two groups accounted for 56.9% of all
nonfatal injury and illness cases. (Source: BLS [2003a].)
Precision production, 16.5
craft, and repair 18.3

Operators, fabricators, 38.8

and laborers 39.5

0 10 20 30 40
Distribution (%)

Agriculture, forestry, 91.6 Industry

and fishing
Mining 67.9 How did the rate of sprain, strain, and tear cases differ by
private industry sector in 2001?
Construction 116.8
Figure 2145. Incidence rate of sprain, strain, and tear cases
Manufacturing 71.2 by private industry sector, 2001. Private industry reported an
incidence rate of 73.7 per 10,000 full-time workers for sprain,
Transportation and 147.0 strain, and tear cases in 2001. Incidence rates exceeding the
public utilities
private-sector rate were reported for transportation and public
Wholesale trade 81.2 utilities (147.0 per 10,000 full-time workers or 96,700 cases),
construction (116.8 per 10,000 full-time workers or 71,225 cas-
Retail trade 65.4 es), agriculture, forestry, and fishing (91.6 per 10,000 full-time
Finance, insurance, Rate for all private
workers or 13,758 cases), and wholesale trade (81.2 per 10,000
21.8 full-time workers or 52,261 cases). (Source: BLS [2003a].)
and real estate sector workers = 73.7
Services 63.9

0 30 60 90 120 150
Rate per 10,000 workers

130
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

How did the rates of sprain, strain, and tear cases change Transportation and Agriculture, forestry, Wholesale trade
by private industry sector during 19922001? public utilities and fishing Manufacturing
Construction Mining Services
225
Figure 2146. Annual rates of sprain, strain, and tear cases Retail trade
involving days away from work by private industry sector, 200 Finance, insurance,
19922001. The annual rate for sprain, strain, and tear cases and real estate
declined 44.9% during 19922001. Rate reductions occurred 175

Rate per 10,000 workers

for each major industry sector. Two sectors (transportation and
150
public utilities and construction) had consistently higher rates
than other industry sectors during this 10-year period. They 125
experienced rate reductions of 41.5% and 30.4%, respectively.
(Sources: BLS [2003a,b].) 100

75

50

25

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

131
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions
Disorders Due to Physical Agents
Occupational disorders due to physical agents include heatstroke,
sunstroke, heat exhaustion, and other effects of environmental
heat; freezing and frostbite; effects of ionizing radiation (iso-
topes, X-rays, and radium); and effects of nonionizing radiation
(welding flash, ultraviolet rays, microwaves, and sunburn). During
19722001, the number of BLS-estimated disorders due to physi-
cal agents ranged from a high of approximately 30,100 cases in
1972 to a low of 8,300 cases in 1982; 14,600 cases were reported in
132
2001 (Figure 2147). Rates varied during 19842001 from 1.3 to
2.9 per 10,000 full-time workers; in 2001, the rate was 1.6 (Figure
2148). Within reporting States in 2001, the number of disorders
due to physical agents ranged from fewer than 50 cases to 1,300
(Figure 2149). Rates varied by State in 2001, from a reported low
of 0.2 per 10,000 full-time workers in Delaware to a high of 4.1
in Nebraska. The U.S. rate was 1.6 per 10,000 full-time workers.
(Figure 2150).
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Magnitude and Trend 35

30.1
How did the number of occupational disorders due to

27.5
30

27.1

26.2
physical agents change during 19722001?

Number of cases (thousands)

23.6

22.4
Figure 2147. Number of occupational disorders due to physi- 25

22.2

21.7
21.2
cal agents in private industry, 19722001. The number of BLS-

20.1
estimated disorders due to physical agents ranged from a high

18.2
18.2
17.7
20

17.3

16.8
16.7

16.6
16.6
of approximately 30,100 cases in 1972 to a low of 8,300 cases

15.1

15.1

14.6
in 1982. In 2001, BLS reported 14,600 cases. The pattern of

13.9
13.8
13.2
increases and decreases after 1984 seems to parallel disorders 15

11.9
associated with repeated trauma, though at substantially lower
orders of magnitude. (Source: BLS [2002].)

9.2
9.0
9.0
8.8
8.3
10

0
1972 1976 1980 1984 1988 1992 1996 2000

How did the rates of occupational disorders due to 3.0 2.9

2.8
physical agents change during 19842001? 2.7
2.5
Figure 2148. Incidence rates for occupational disorders due 2.5 2.4 2.4
2.3 2.3
to physical agents in private industry, 19842001. BLS reported
rates of disorders due to physical agents ranging from 1.3 to
Rate per 10,000 workers

2.0
2.9 per 10,000 full-time workers during 19842001. The rate 2.0 1.9 1.9 1.9
was 1.6 per 10,000 full-time workers in 2001. Disorders due to 1.7
physical agents accounted for approximately 4% of all reported 1.6
1.5
illness cases. The pattern of rate increases and decreases after 1.5
1.3 1.3 1.3
1984 seems to parallel disorders associated with repeated trau-
ma. (Source: BLS [2002].)
1.0

0.5

0.0
1984 1986 1988 1990 1992 1994 1996 1998 2000

133
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Numbers and Rates among States

How did the number of occupational disorders due to
physical agents differ by State in 2001?

Figure 2149. Number of occupational disorders due to

physical agents in private industry by State, 2001. In 2001, the
number of disorders due to physical agents within reporting
States ranged from fewer than 50 cases to 1,300. States with
the highest numbers included California (1,300), Michigan
Number of cases (1,200), Indiana (800), Illinois (700), and Wisconsin (700).
>399 (Source: BLS [2002].)
100399
<100
No data

How did the rates of occupational disorders due to

physical agents differ by State in 2001?

Figure 2150. Incidence rates for occupational disorders due

to physical agents in private industry by State, 2001. Rates of
occupational disorders due to physical agents vary among the
States from a reported low of 0.2 per 10,000 full-time workers
in Delaware to a high of 4.1 in Nebraska. The U.S. rate was 1.6
per 10,000 full-time workers. (Source: BLS [2002].)

Rate per 10,000

workers
>1.9
0.11.9
<0 .1
No data

134
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions
Poisoning
Preventing occupational poisonings and pesticide-related illnesses
and injuries requires ongoing activities to determine the underlying
causes of overexposure to chemicals and pesticides in the workplace.
Surveillance promotes prevention by describing the magnitude and
distribution of these adverse health conditions among workers and
by serving as an early warning system of harmful effects not detected
by product manufacturers. Two sources of data advance these surveil-
lance objectives: the BLS annual survey of employers for occupation-
al poisonings (part of SOII) and case-based reporting of pesticide-
related illnesses and injuries by SENSOR.
Annual Survey of Employers: Reports of
Occupational Poisonings (BLS)
Poisonings (systemic effects of toxic materials) include poisoning by
the following: (1) lead, mercury, cadmium, arsenic, or other metals;
(2) carbon monoxide, hydrogen sulfide, or other gases; (3) benzol,
carbon tetrachloride, or other organic solvents; (4) insecticide sprays
such as parathion and lead arsenate; and (5) other chemicals such as
formaldehyde, plastics, and resins. During 19722001, the number
of occupational poisonings ranged from a high of 7,600 cases in 1993
to a low of 2,800 cases in 2001 (Figure 2151). Rates varied during
19842001 from a high of 1.0 per 10,000 full-time workers in 1993 to
a low of 0.3 in 2001 (Figure 2152). Within reporting States in 2001,
the number of occupational poisoning cases ranged from fewer
than 50 to 300 (Figure 2153). Rates in 2001 varied by State from
a low of less than 0.1 per 10,000 full-time workers in many States
to a high of 1.2 in Maine; the U.S. rate was 0.3 per 10,000 full-time
workers (Figure 2154).
135
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

8 Magnitude and Trend

7.6

7.5
7.4

7.2
7.0
6.7

6.7
7 6.4 How did the number of occupational poisonings change
during 19722001?

6.2
6.1

6.1
5.8

5.8
5.7
Number of cases (thousands)

5.6
6

5.5
5.5
Figure 2151. Number of occupational poisoning cases in

5.1
private industry, 19722001. During 19722001, occupational

4.8

4.8
4.7
5

4.5
poisonings peaked at 7,400 cases in 1974, declined to 3,000 cas-

4.4
4.3
4.2
es in 1983, peaked again in 1993 at 7,600 cases, then declined

4.0
4 to 2,800 cases in 2001. (Source: BLS [2002].)

3.4

3.3
3.0

2.8
3

0
1972 1976 1980 1984 1988 1992 1996 2000

1.0 How did the rates of occupational poisonings change

1.0
during 19842001?
0.9 0.9 0.9 0.9
Figure 2152. Annual rates of occupational poisoning in pri-
0.8 0.8
0.8 vate industry, 19842001. BLS reported poisoning rates rang-
0.7 0.7 0.7 ing from a high of 1.0 per 10,000 full-time workers in 1993 to a
Rate per 10,000 workers

low of 0.3 in 2001. Occupational poisonings have low rates and

0.6 0.6 0.6 0.6 generally account for only about 1% of all illnesses. (Source:
0.6
BLS [2002].)
0.5 0.5

0.4
0.4
0.3

0.2

0.0
1984 1986 1988 1990 1992 1994 1996 1998 2000

136
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Numbers and Rates among States

How did the number of occupational poisonings differ by
State in 2001?

Figure 2153. Number of occupational poisoning cases in

private industry by State, 2001. The number of occupational
poisoning cases within reporting States ranged from fewer
than 50 to 300 in 2001. BLS reported a total of 2,800 occupa-
tional poisoning cases in 2001. States with the highest numbers
included California (300), Illinois (200), Indiana (200), Michi- Number of cases
gan (200), Missouri (200), North Carolina (2002) and Texas >199
(200). (Source: BLS [2002].)
100199
<100
No data

How did the rates of occupational poisoning differ by

State in 2001?

Figure 2154. Incidence rates for occupational poisoning in

private industry by State, 2001. Occupational poisoning rates
varied from a low of less than 0.1 per 10,000 full-time workers
in many States to a high of 1.2 per 10,000 full-time workers
in Maine. The U.S. rate was 0.3 per 10,000 full-time workers.
(Source: BLS [2002].)

Rate per 10,000

workers
>0.3
0.10.3
<0.1
No data

137
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions
Case-Based Reporting of Pesticide-Related
Illness and Injury (SENSOR)
Pesticides are substances used to prevent, destroy, repel, or mitigate
pests. They are used to protect the food supply and to control dis-
ease vectors. No perfectly safe form of pest control exists. Pesticides
continue to raise concerns about their potential toxicity to humans.
NIOSH provides technical and financial support for State-based sur-
veillance of acute, occupational, pesticide-related illness and injury
through the SENSOR program. The SENSOR-pesticides program
is partially funded by the U.S. Environmental Protection Agency
(EPA).
138
Between 1998 and 1999, a total of 1,009 cases of acute, pesticide-
related occupational illness were identified by the seven States par-
ticipating in the SENSOR-pesticides program (Arizona, California,
Florida, Louisiana, New York, Oregon, and Texas) [Calvert et al.
2004]. Cases totaled 523 in 1998 and 486 in 1999. The incidence rate
was 1.17 per 100,000 full-time workers overall, 18.2 for agricultural
workers, and 0.53 for nonagricultural workers. As measured by days
away from work during this period, the severity of most pesticide-
related illnesses was low for 69.1% of cases, moderate for 29.6%, and
high for 0.4%; three fatalities were identified [Calvert et al. 2004].
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Age 30 Agriculture
All industries
How did the rates of pesticide-related illnesses differ by Nonagriculture
25
age of worker and industry during 19981999?

Rate per 100,000 workers

Figure 2155. Incidence rates of pesticide-related illness by
20
age and industry, 19981999. Among industry sectors, agricul-
ture accounted for the highest incidence rates of pesticide-
related illness, ranging from 5 to 27 cases per 100,000 full-time 15
workers. Rates were highest among younger workers, peaking
among those aged 2024, and decreasing with increasing age.
(Sources: NIOSH [2002d]; Calvert [2002].) 10

0
1517 1819 2024 2534 3544 4554 5564 >64
Age range

Sex
How were pesticide-related illnesses distributed by sex of
worker during 19981999?

Figure 2156. Distribution and number of pesticide-related ill- Female

nesses by sex of worker, 19981999. Sex of worker was known 36.7%
for 1,006 of the 1,009 pesticide-related occupational illness 370
cases during 19981999. Male workers accounted for 63%
(636) of all cases and female workers accounted for 36.7% (370
cases). (Sources: NIOSH [2002d]; Calvert [2002].)
636
Male
63.0%

Unknown
0.3%
3

139
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Pest control
occupations
Occupation
1.3%
6 Which agricultural occupations accounted for the most
Unknown pesticide-related illnesses during 19981999?
1.7%
8 Figure 2157. Distribution and number of pesticide-related ill-
Farmer
3.6% nesses among agricultural workers by occupation, 19981999.
Farmworker Farm workers reported by far the most pesticide-related ill-
71.8% 17 Nursery worker
336 nesses (71.8% or 336 cases) during 19981999. Other occupa-
22 4.7%
tions with notable pesticide-related illnesses included graders
and sorters (7.5% or 35 cases) and nursery workers (4.7% or 22
35 cases). (Sources: NIOSH [2002d]; Calvert [2002].)
Grader and sorter
44 7.5%

Other
9.4%

Other
1.0%
Wholesale and
retail trade
Industry
9 5.5%
Which industry sectors accounted for the most pesticide-
Construction and related illnesses during 19981999?
manufacturing
6.4%
50 Figure 2158. Distribution and number of pesticide-related
Agriculture
51.5% illnesses by industry, 19981999. Employer or industry data
58
Public administration were available for 911 of the 1,009 pesticide-related illness cases
469 6.9%
63
during 199899. Most of these cases (51.5% or 469 cases) were
from the agricultural sector. Services accounted for 19.4% (177
cases) and transportation, communication, and public utilities
85 accounted for 9.3% (85) cases. (Sources: NIOSH [2002d]; Cal-
vert [2002].)
Transportation and
public utilities
177 9.3%

Services
19.4%

140
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Agent or Exposure Other Disinfectants

3.0% 4.2% Fungicides
5.3%
Which classes of pesticides were responsible for reported
cases of illness during 19981999? Insecticides and
30 42 fungicides
Figure 2159. Distribution and number of pesticide-related 53 7.3%
illnesses by pesticide functional class, 19981999. Insecticides
74
were responsible for 49% (494 cases) of the 1,009 reported
Herbicides and
occupational illnesses related to pesticides. (Sources: NIOSH algicides
[2002d]; Calvert [2002].) Insecticides 494 84 8.3%
49.0%

115

117 Fumigants
11.4%

Multiple
11.6%

Which chemical classes of insecticides were responsible

Organophosphorus
for reported cases of illness during 19981999? 47.2% Organochlorine
3.0%
Figure 2160. Distribution and number of pesticide-related Combination of
illnesses by insecticide chemical class, 19981999. The follow- acetylcholinesterase
ing insecticide classes were most commonly responsible for 233 (AChE) inhibitors
15 4.7%
pesticide-related illnesses during 19981999: organophospho-
23
rus (47.2% or 233 cases), N-methyl carbamate (15.4% or 76
cases), pyrethroid (11.1% or 55 cases), and pyrethrin (9.3% or Pyrethrin
46 cases). (Sources: NIOSH [2002d]; Calvert [2002].) 46 9.3%

46

76 55 Other
9.3%

N-methyl carbamate
15.4%
Pyrethroid
11.1%

141
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions
Respiratory Diseases
Respiratory diseases are associated with a variety of distinct causes
and account for a large number of occupational illnesses, injuries,
and deaths. Since 1991, NIOSH has periodically compiled, summa-
rized, and disseminated surveillance data on occupational respira-
tory diseases [NIOSH 1991, 1994, 1996, 1999], including asthma
and other airways diseases, the pneumoconioses, and several other
respiratory conditions. This section provides selected surveillance
data for many of these diseases.
Asthma
Work-related asthma (WRA) is the most common disease reported
in the occupational respiratory disease surveillance systems in sev-
eral developed countries. WRA is asthma that is caused or made
worse by exposures in the workplace. However, most cases are
either not recognized as work-related or not reported as such.
Population-based estimates suggest that 15%23% of new-onset
asthma cases in adults are work related [American Thoracic Society
2004]. The SENSOR program has developed surveillance systems
142
for WRA. These systems require the following to confirm a case of
WRA: a health care professionals diagnosis of asthma (or a related
diagnosis consistent with asthma) and an association between
symptoms of asthma and work.
Four States (California, Massachusetts, Michigan, and New Jersey)
maintained WRA surveillance programs during the 7-year period
(19931999) represented by the SENSOR data included in this
report. In all four States, case reports from health care profes-
sionals were the main source for identifying WRA cases (88.4%
of the 2,526 cases) (Figure 2161). By occupation, the highest
percentage of cases occurred among operators, fabricators, and
laborers (32.9%), followed by managerial and professional spe-
cialty (20.2%), and technical, sales, and administrative support
jobs (19.2%) (Figure 2162). Most cases were associated with the
manufacturing (41.4%) and services (34.2%) industries (Figure
2163). Agents most frequently associated with WRA were miscel-
laneous chemicals, cleaning materials, and mineral and inorganic
dust (Figure 2164).
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Reporting Sources
Which sources did SENSOR States use most to identify
cases of WRA during 19931999? Health care
professionals
88.4%
Figure 2161. Distribution and number of WRA cases for all
2,232
four SENSOR reporting States (California, Massachusetts,
Michigan, New Jersey) by source of report, 19931999. Reports Other sources
0.9%
from health care professionals were the primary source for iden- 24
tifying cases of WRA during 19931999: 88.4% or 2,232 WRA 270
cases were identified through physician reports. (Sources: Harri-
Hospitals
son and Flattery [2002b]; Tumpowsky and Davis [2002]; Rosenman 10.7%
et al. [2002a]; Valiante and Schill [2002a]; Filios [2002a].)

Occupation Other
3.7%
Service
How were WRA cases distributed by occupation in Operators, fabricators, 11.8%
SENSOR States during 19931999? and laborers
32.9%
94
Figure 2162. Distribution and number of WRA cases for all
297
four SENSOR reporting States (California, Massachusetts,
830
Michigan, New Jersey) by occupation, 19931999. Operators, Precision production,
fabricators, and laborers accounted for the largest proportion craft, and repair
311 12.3%
of WRA cases (32.9%), followed by managerial and profession-
al specialty occupations (20.2%). (Sources: Harrison and Flattery
[2002b]; Tumpowsky and Davis [2002]; Rosenman et al. [2002a];
Valiante and Schill [2002a]; Filios [2002a].)
509
485

Technical, sales, and

administrative support Managerial and
19.2% professional specialty
20.2%

143
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Other
15.5%
Industry
How were cases of WRA distributed by industry in
SENSOR States during 19931999?
391
Public administration Figure 2163. Distribution and number of WRA cases for all
Manufacturing 8.9%
41.4% four SENSOR reporting States (California, Massachusetts,
1,046 226 Michigan, New Jersey) by industry, 19931999. Manufactur-
ing and services accounted for the largest proportions of WRA
cases (41.4% and 34.2%, respectively). (Sources: Harrison and
Flattery [2002b]; Tumpowsky and Davis [2002]; Rosenman et al.
[2002a]; Valiante and Schill [2002a]; Filios [2002a].)

863

Services
34.2%

Welding exposures 4.3 Agent or Exposure

Polymers 5.3 Which agents were most frequently associated with WRA
during 19931999?
Hydrocarbons, n.o.s. 6.1
Figure 2164. Distribution of agent categories most frequently
Solvents 8.2
associated with WRA cases for all four SENSOR reporting States
Isocyanates 8.3 (California, Massachusetts, Michigan, New Jersey), 19931999.
During 19931999, the largest proportion of WRA cases was
Pyrolysis products 9.2 associated with miscellaneous chemicals (19.7%). This category
of agents includes many exposures that are not easily classified
Indoor air pollutants 9.9
(for example, perfumes, odors, and glues). (Sources: Harrison
Mineral and inorganic dust 11.1 and Flattery [2002b]; Tumpowsky and Davis [2002]; Rosenman et
al. [2002a]; Valiante and Schill [2002a]; Filios [2002a].)
Cleaning materials 11.6

Miscellaneous chemicals 19.7

0 5 10 15 20
% cases

144
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions
Hypersensitivity Pneumonitis
Hypersensitivity pneumonitis is a lung disease that is often related
to occupation. This inflammation of the lungs is caused by repeat-
ed inhalation of foreign substances such as organic dust, fungus, or
mold. Examples of this disease are farmers lung, mushroom work-
ers lung, and bird fanciers disease.
The annual number of deaths with hypersensitivity pneumonitis
as an underlying or contributing cause generally increased from
fewer than 20 per year before 1983 to 57 in 1999 (Figure 2165).
A geographic distribution of age-adjusted rates is presented in
Figure 2166. Hypersensitivity pneumonitis mortality rates for
19901999 were highest in the upper Midwest and northern
Plains States, along with Vermont and Idaho. Nearly 29% of
decedents during 19901999 were women, and 95.7% were white
(Figure 2167).
145
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

60 Contributing cause 57 Magnitude and Trend

Underlying cause
51 How did the pattern of mortality from hypersensitivity
50 pneumonitis change during 19791999?
46
41 Figure 2165. Number of deaths of U.S. residents aged 15 or
40 38 38 older with hypersensitivity pneumonitis recorded as an under-
36 37
Number of deaths

36 35 36
lying or contributing cause on the death certificate, 19791999.
The annual number of hypersensitivity pneumonitis deaths
30 28 generally increased during 19791999, from fewer than 15 per
26
24 24 year in 1979 to 57 in 1999. Hypersensitivity pneumonitis was
20 designated as the underlying cause of death in at least half of
20 18 deaths associated with hypersensitivity pneumonitis for every
15 15 15
year except 1982. (Source: NIOSH [2002e].)
12
10

0
1979 1981 1983 1985 1987 1989 1991 1993 1995 1997 1999

Rates among States

How did mortality rates for hypersensitivity pneumonitis
differ by State?

Figure 2166. Age-adjusted mortality rates for hypersensitiv-

ity pneumonitis in U.S. residents aged 15 and older by State,
19901999. States with higher hypersensitivity pneumonitis
mortality rates during 19901999 were in the upper Midwest,
the northern Plains and Mountain States, and New England. In
Deaths per million the group of States with the highest mortality from hypersen-
>0.60 sitivity pneumonitis, rates ranged from three to five times the
0.410.60
U.S. rate of 0.2 per million. (Source: NIOSH [2002e].)
0.210.40
<0.21

146
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Sex and Race Female

28.9%
How is hypersensitivity pneumonitis mortality distributed
115
by sex and race? Other
White 1.3%
95.7% 381 5
Figure 2167. Distribution and number of hypersensitivity
pneumonitis deaths in U.S. residents aged 15 or older by sex 12 Black
and race, 19901999. Nearly 29% of hypersensitivity pneu- 3.0%
monitis deaths occurred in women during 19901999. White 283
residents accounted for 95.7% of hypersensitivity pneumonitis Male
deaths during this period. (Source: NIOSH [2002e].) 71.1%

147
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions
Mesothelioma
Asbestos exposure is by far the leading cause of malignant mesothe-
lioma, a rare form of cancer found in the sac lining the chest (the
pleura) or the abdomen (the peritoneum). In 1999, 2,485 deaths
were recorded with malignant mesothelioma listed as an underly-
ing or contributing cause. Of these, 1,773 deaths were classified as
unspecified (Figure 2168). The highest malignant mesothelioma
mortality rates occurred in Alaska and Maine. Men accounted for
148
80.3% of the deaths from malignant mesothelioma, and white U.S.
residents accounted for 94.8% of these deaths (Figure 2170).
Industrial and miscellaneous chemicals had the highest propor-
tionate mortality ratio (PMR) for malignant mesothelioma among
the industries. Occupations with the PMRs were plumbers, pipefit-
ters, and steamfitters; electricians; and elementary school teachers
(Figure 2171).
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Magnitude and Trend 2,485 Contributing cause

2,500 Underlying cause
How many and what type of malignant mesothelioma
deaths occurred in 1999?
2,000
Figure 2168. Number of U.S. residents aged 15 or older with 1,773
malignant mesothelioma listed as an underlying or contributing

Number of deaths
cause on the death certificate by type of mesothelioma, 1999.
1,500
Of the 2,485 malignant mesothelioma deaths in 1999, the high-
est proportion was classified as an unspecified type. In nearly
95% of all deaths, malignant mesothelioma was listed as the
underlying cause. (Note: The total number of deaths by subtype 1,000
exceeds the number for all sites because more than one sub-
type was listed for some decedents.) (Source: NIOSH [2002e].)
500 427
252
92
0
All sites Pleura Peritoneum Other site Unspecified

Rates among States

How did mortality rates for malignant mesothelioma differ
by State in 1999?

Figure 2169. Age-adjusted mortality rates for malignant

mesothelioma in U.S. residents aged 15 or older by State, 1999.
The highest malignant mesothelioma mortality rates occurred
in Alaska and Maine in 1999. The rates for each of these States
were more than twice the national rate of 11.7 per million.
States in the next highest rate group were widely dispersed, Deaths per million
with a concentration on the eastern seaboard and in the West. >20.0
The rates in these States were nearly 1.5 to 2 times the U.S. rate.
15.120.0
(Source: NIOSH [2002e].)
10.115.0
<10.1

149
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Female
19.7%
Sex and Race
How was malignant mesothelioma mortality distributed by
490 sex of worker and race in 1999?
White Other Figure 2170. Distribution and number of malignant meso-
94.8% 2,355 1.0%
25 thelioma deaths in U.S. residents aged 15 and older by sex and
105 race, 1999. More than 80% of malignant mesothelioma deaths
Black
4.2% occurred in men in 1999. White residents accounted for 94.8%
of malignant mesothelioma deaths. (Source: NIOSH [2002e].)
1,995

Male
80.3%

Industrial and Industry 2.9 7.5 Occupation and Industry

miscellaneous
chemicals 4.8 Which industries and occupations were most frequently
Electric light 1.5 5.7 associated with malignant mesothelioma mortality in
and power 1999?
3.1
1.2 1.9 Figure 2171. PMRs and 95% confidence intervals for malig-
Construction
1.6 nant mesothelioma in U.S. residents aged 15 or older by indus-
try and occupation, 1999. Industrial and miscellaneous chemi-
Occupation 2.8 7.5
Plumbers, pipefitters, cals, electric light and power, and construction industries were
and steamfitters 4.8 associated with the highest significant malignant mesothe-
lioma PMRs. Plumbers, pipefitters, steamfitters, and electri-
1.3 4.2
Electricians cians (which are occupations associated with the construction
2.4 industry) were highly associated with malignant mesothelioma
Elementary school
1.1 3.6 mortality. Elementary school teachers also had a significant
teachers malignant mesothelioma PMR. (Note: This figure presents the
2.1
highest significant PMRs based on 10 or more deaths.) (Source:
0 1 2 3 4 5 6 7 8 NIOSH [2002e].)
PMR

150
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions
Pneumoconioses
The pneumoconioses make up a class of respiratory diseases attributed
solely to occupational exposures. They include the major fibrotic lung
diseases such as asbestosis, coal workers pneumoconiosis, and silicosis
as well as rarer interstitial diseases such as siderosis and berylliosis. For
this report, byssinosis is also included in this category, though it dif-
fers substantially in its pathology and clinical manifestations. During
19681999, pneumoconiosis was an underlying or contributing cause
of 121,982 deaths in the United States. The number of pneumoconio-
sis deaths declined from more than 5,400 in 1972 to 2,745 deaths in
1999 (Figure 2172). Coal workers pneumoconiosis (CWP) accounted
for the largest number of pneumoconiosis deaths during this 30-year
period. However, asbestosis deaths outnumbered CWP deaths dur-
ing 1998 and 1999, displacing the latter as the most frequent type of
pneumoconiosis death. Men accounted for 98% of all pneumoconiosis
deaths between 1990 and 1999 but for only 67% of byssinosis deaths
during this period (Figure 2173). White residents accounted for 94%
of pneumoconiosis decedents but for only 85% of silicosis decedents;
14% of silicosis decedents were black (Figure 2174).
151
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Total deaths Magnitude and Trend

263 Byssinosis
15,841 Silicosis How did the pattern of pneumoconiosis mortality change

5,430
6,000 during 19681999?
20,293 Other/unspecified pneumoconioses

5,067
4,936
4,904
4,751
68,513 Coal workers' pneumoconiosis
Figure 2172. Number of deaths of U.S. residents aged 15

4,448
5,000 4,132 18,181 Asbestosis
or older with pneumoconiosis recorded as an underlying or

4,151
4,057

4,053
4,004

3,932
3,879
3,858

3,836
3,783
contributing cause on the death certificate, 19681999. Dur-

3,703

3,644
3,619
3,594
3,589
3,514

3,486
Number of deaths

4,000 ing 19681999, deaths from asbestosis increased over time,

3,290

3,238
3,230

3,151
3,114
3,126
whereas deaths from CWP decreased. Deaths from all pneu-

2,928
2,790
2,745
3,000 moconioses are shown at the top of each stacked bar. The
bars slightly overstate the numbers because a small fraction of
deaths was associated with more than one type of pneumoconi-
2,000 osis. (Note: Byssinosis data were not available before 1979. Also
note that the sum of deaths for various types of pneumoconio-
1,000 sis (N=123,091) exceeds the total number of pneumoconiosis
deaths (N=121,982) because some decedents had more than
one type of pneumoconiosis recorded on their death certifi-
0 cates.) (Source: NIOSH [2002f].)
1968 1972 1976 1980 1984 1988 1992 1996 1999

Male Female Number of

deaths
Sex
Asbestosis 96% 10,914 How did deaths from pneumoconiosis differ by sex of
worker?
Coal workers' 99% 15,036
pneumoconiosis Figure 2173. Distribution of pneumoconiosis deaths in U.S.
residents aged 15 or older by sex, 19901999. Men accounted
Silicosis 96% 2,405 for more than 98% of the 31,452 decedents with any type of
pneumoconiosis during 19901999. However, an unusually
large proportion of byssinosis decedents (33%) were female.
Byssinosis 67% 125 (Note: The sum of deaths for various types of pneumoconiosis
exceeds the total number of pneumoconiosis deaths because
Unspecified/other some decedents had more than one type of pneumoconiosis.)
97% 3,164
pneumoconiosis (Source: NIOSH [2002f].)

Pneumoconiosis 98% 31,452

(any type)

0 20 40 60 80 100
Distribution (%)

152
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Race/Ethnicity White Black Other Number of

deaths
How did deaths from pneumoconiosis differ by race? Asbestosis 93% 10,914

Figure 2174. Distribution of pneumoconiosis deaths in U.S.

Coal workers' 97% 15,036
residents aged 15 or older by race, 19901999. During 1990 pneumoconiosis
1999, decedents with pneumoconiosis were predominantly
white. Less than 4% of CWP deaths occurred among nonwhite Silicosis 85% 2,405
residents. By contrast, 15% of silicosis decedents were nonwhite.
(Note: The sum of deaths for various types of pneumoconiosis
exceeds the total number of pneumoconiosis deaths because Byssinosis 88% 125
some decedents had more than one type of pneumoconiosis.)
(Source: NIOSH [2002f].) Unspecified/other 94% 3,164
pneumoconiosis

Pneumoconiosis 94% 31,452

(any type)

0 20 40 60 80 100
Distribution (%)

153
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Asbestosis
Asbestosis is a chronic, disabling, fatal lung disease caused by inhal-
ing asbestos fibers. The number of deaths due to asbestosis each year
increased from 77 in 1968 to 1,265 in 1999 (Figure 2175). West Virgin-
ia and Delaware had the highest asbestosis mortality rates during
19901999 (Figure 2176). Miscellaneous nonmetallic mineral and
stone products had the highest asbestosis PMR among industries,
and insulation workers and boilermakers had the highest asbestosis
PMRs among occupations (Figure 2177).

154
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Magnitude and Trend 1,400 Contributing cause

1,265
1,221
Underlying cause

1,176
1,169

1,171
How did the pattern of asbestosis mortality change during
1,200

1,060
19681999?

999
959
948
946
Figure 2175. Number of deaths of U.S. residents aged 15 or 1,000

878
older with asbestosis recorded as an underlying or contribut-

Number of deaths
ing cause on the death certificate, 19681999. The number of

769
710
800

702
asbestosis deaths increased from 77 in 1968 to 1,265 in 1999.
During this period, asbestosis was listed each year as the under-

534
lying cause in nearly a third of all asbestosis deaths. (Source: 600

476
NIOSH [2002f].)

445
428
339
318
309
400

240
163
143
138

126
117
114
200

87
83
77
71
0
1968 1972 1976 1980 1984 1988 1992 1996

Rates among States

How did asbestosis mortality rates differ by State during

19901999?

Figure 2176. Age-adjusted mortality rates for asbestosis in

U.S. residents aged 15 or older by State, 19901999. Delaware
and West Virginia had the highest asbestosis mortality rates
during 19901999. States in the second highest mortality rate
category were predominantly coastal States. All States in these
two groupings had asbestosis mortality rates above the U.S. rate Deaths per million
of 5.4 per million. (Source: NIOSH [2002f].)
>15.0
5.115.0
3.15.0
0.03.0

155
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Industry Occupation and Industry

Miscellaneous nonmetallic 13.0 20.7
mineral and stone Which industries and occupations were associated with
products 16.4 asbestosis mortality during 19901999?

Ship and boat building
and repairing
Lumber and construction
materials
Industrial and miscellaneous
chemicals
13.5 18.3 Figure 2177. PMRs and 95% confidence intervals for asbes-
tosis in U.S. residents aged 15 or older by industry and occupa-
15.7
tion, adjusted for age, race, and sex, 19901999. Miscellaneous
nonmetallic mineral and stone products and ship and boat
4.2 10.8
building and repairing had the highest significant asbestosis
7.0 PMRs among industries. Among occupations, insulation work-
ers and boilermakers had the highest asbestosis PMRs. (Note:
4.0 5.7 The figure presents the highest significant PMRs based on 10
or more deaths.) (Source: NIOSH [2002f].)
4.8

Other rubber products and 3.1 5.9

plastics footwear
and belting 4.3

Occupation
69.5 102.3
Insulation workers
84.3

15.6 26.4
Boilermakers
20.3

8.3 10.7
Plumbers, pipefitters,
and steamfitters 9.4

4.7 8.1
Sheet metal workers
6.1

Separating, filtering, and 2.9 7.3

clarifying machine
operators 4.8

0 10 20 70 80 90 100
PMR

156
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Byssinosis
Byssinosis, also known as brown lung disease, is a chronic condi-
tion that involves small airways obstruction. Common causes of
byssinosis are exposures to airborne dusts from hemp, flax, and
cotton processing. Byssinosis deaths constitute the smallest propor-
tion of all pneumoconiosis deaths. Fewer than 20 byssinosis deaths
occurred annually between 1979 and 1999 (Figure 2178). Byssinosis
deaths are concentrated in the textile-producing States. During the
1990s, more than 50% of byssinosis deaths occurred in Georgia and
the Carolinas (Figure 2179). Yarn, thread, and fabric mills had the
highest PMR for byssinosis among industries, and miscellaneous
textile machine operators had the highest PMR among occupa-
tions (Figure 2180).

157
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Contributing cause Magnitude and Trend

18 18 Underlying cause
18 17 17 How did the pattern of byssinosis mortality change during
16 16 16 19791999?
16 15
14 14 14 Figure 2178. Number of deaths of U.S. residents aged 15 or
14 13 older with byssinosis recorded as an underlying or contribut-
12 ing cause on the death certificate, 19791999. The number
12
Number of deaths

10 10
of byssinosis deaths was fewer than 20 for each year between
10 9 9 1979 and 1999. During this period, byssinosis was listed as
8 the underlying cause in 50% of the byssinosis deaths. (Source:
8 7 NIOSH [2002f].)
6
6
4
4

0
1979 1981 1983 1985 1987 1989 1991 1993 1995 1997 1999

Rates among States

How did the rates of byssinosis mortality differ by State

during 19901999?

Figure 2179. Age-adjusted mortality rates for byssinosis in

U.S. residents aged 15 or older by State, 19901999. States
with the highest byssinosis mortality rates during 19901999
were located predominantly in the Southeast in the textile-pro-
ducing States. During this period, more than half of byssinosis
decedents were residents of North Carolina, South Carolina,
Deaths per million and Georgia. (Source: NIOSH [2002f].)
>0.3
0.20.3
00.1

158
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Occupation and Industry Industry

15.8 30.4
Which industries and occupations were associated with Yarn, thread, and
fabric mills
byssinosis mortality during 19901999? 22.3

Figure 2180. PMRs and 95% confidence intervals for bys- Occupation
sinosis in U.S. residents aged 15 or older by industry and occu- 17.9 64.0
pation, adjusted for age, race, and sex, 19901999. Significant Miscellaneous textile
machine operators
byssinosis PMRs were associated with a single industryyarn, 35.8
thread, and fabric mills. Among occupations, elevated byssino-
sis PMRs were associated with miscellaneous textile machine Industrial machinery 11.3 57.9
operators, industrial machine repairers, and winding and twist- repairers
28.1
ing machine operators. (Note: The figure presents the highest
significant PMRs based on five or more deaths.) (Source: NIOSH 11.9 54.1
Winding and twisting
[2002f].) machine operators
27.5

0 10 20 30 40 50 60 70
PMR

159
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions
Coal Workers Pneumoconiosis (CWP)
CWP is a chronic, disabling, and sometimes fatal dust disease of the
lungs caused by inhaling coal mine dust. The prevalence of CWP
reported here is based on data for underground coal miners who
participated in the U.S. National Coal Workers X-Ray Surveillance
Program (CWXSP). In the CWXSP, CWP is defined as agreement
between two Readers (one of whom must be a B Reader*) that
small pneumoconiotic opacities are present at a category of 1/0 or
higher, using the International Labour Office (ILO) International
Classification of Radiographs of Pneumoconioses.
Among miners in this program with 25 or more years of under-
ground coal mining, the prevalence of CWP category 1/0 or greater
was 34% during 19731978; but it declined to 4% during 19961999
*
See Reader in Glossary.
160
(Figure 2181). Among miners with the same number of years of
underground coal mining, the prevalence of a more severe CWP
category (2/1 or greater) declined from 10.5% during 19701973 to
less than 1% during 19961999 (Figure 2182). During 19701999,
decreases in CWP prevalence occurred in all categories of tenure in
underground coal mining (Figures 2181 and 2182).
Deaths from CWP declined significantly, from a high of 2,870 in
1972 to 1,003 in 1999 (Figure 2183). West Virginia had the high-
est age-adjusted mortality ratenearly 20 times the rate of 7.56 per
million for the entire United States (Figure 2184). Coal mining
and metal mining had the highest PMRs for CWP among indus-
tries, and mining machine operators had the highest PMR among
the occupations (Figure 2185).
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Magnitude and Trend 35 Tenure (years)

>24
What was the prevalence of CWP category 1/0 or greater 2024
30
among underground coal miners participating in the 1519
CWXSP during 19701999? 1014
25
09
Figure 2181. Prevalence of CWXSP-examined miners with

Prevalence (%)
CWP category 1/0 or greater by tenure in underground coal
mining, 19701999. During 19701999, the prevalence of CWP 20
category 1/0 or greater decreased among all tenure groups
toward the prevalence of the baseline tenure group (09 years 15
in underground coal mining). (Source: NIOSH [2002g].)

10

0
197073 197378 197881 198286 198791 199295 199699

What was the prevalence of CWP category 2/1 or greater 12 Tenure (years)
among underground coal miners participating in the >24
CWXSP during 19701999? 2024
10 1519
Figure 2182. Prevalence of CWXSP-examined miners with 1014
CWP category 2/1 or greater by tenure in underground coal
09
mining, 19701999. During 19701999, the prevalence of CWP 8
Prevalence (%)

category 2/1 or greater decreased among all tenure groups

toward the prevalence of the baseline tenure group (09 years
in underground coal mining). (Source: NIOSH [2002g].) 6

0
197073 197378 197881 198286 198791 199295 199699

161
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Contributing cause How did the pattern of CWP mortality change during

2,870

2,753
2,732
19681999?

2,708

2,701
3,000 Underlying cause

2,683
2,670

2,615
2,576
2,554
2,544

2,481

2,443
2,417
Figure 2183. Number of deaths of U.S. residents aged 15

2,340
2,280

2,257
2,219
2,500 or older with CWP recorded as an underlying or contributing
2,189

2,136
cause on the death certificate, 19681999. The number of

1,990
1,938
CWP deaths experienced a long-term decline during 1968

1,766
1,775

2,000
Number of deaths

1999, from more than 2,500 deaths per year in the early 1970s

1,631
1,534

and 1980s to fewer than 1,500 in the late 1990s. Although the

1,478

1,417
1,413
annual number of deaths declined steadily after 1982, the pro-

1,297
1,500
portion of deaths with CWP listed as the underlying cause on

1,103
1,003
the death certificate remained fairly constant, hovering around
1,000 37% from 1980 to 1999. (Source: NIOSH [2002f].)

500

0
1968 1972 1976 1980 1984 1988 1992 1996

Rates among States

How did CWP mortality rates differ by State during 1990

1999?

Figure 2184. Age-adjusted mortality rates for CWP in U.S.

residents aged 15 or older by State, 19901999. West Virginia
had the highest CWP mortality ratenearly 20 times the rate
of 7.56 per million for the entire United States. The second
highest rate category included the Appalachian and western
Deaths per million
coal mining regions. (Source: NIOSH [2002f].)
>100.0
10.1100.0
1.110.0
0.01.0

162
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Occupation and Industry Industry 51.5 54.9

Coal mining
Which industries and occupations were associated with 53.2
1.3 2.9
CWP mortality during 19901999? Metal mining
2.0
Figure 2185. PMRs and 95% confidence intervals for CWP Occupation 50.0 53.4
in U.S. residents aged 15 or older by industry and occupation, Mining machine operators
adjusted for age, race, and sex, 19901999. Among industries, 51.7
Supervisors, extractive 10.6 19.0
coal mining and metal mining were associated with elevated
CWP mortality during 19901999. Among occupations, the occupations
14.4
three highest significant PMRs were associated with mining. 2.4 7.5
Mining occupations n.e.c.
(Note: This figure presents the highest significant PMRs based 4.5
on 10 or more deaths.) (Source: NIOSH [2002f].) 1.2 4.0
Miscellaneous material moving
equipment operators
2.3
Locomotive operating 1.3 3.1
occupations
2.0
0 10 20 30 40 50 60
PMR

163
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Pneumoconiosis, Other or Unspecified

This disease category includes pneumoconiosis caused by inhaling
other inorganic dusts or unknown agents. Examples include alumi-
nosis, bauxite fibrosis, berylliosis, graphite fibrosis, and others. The
number of deaths recorded with unspecified/other pneumoconio-
sis as an underlying or contributing cause declined sharply after
1972 and ranged between 243 and 395 deaths per year between
1982 and 1999 (Figure 2186). West Virginia had the highest age-
adjusted mortality ratenearly 20 times the rate of 1.59 per million
for the entire United States during 19901999 (Figure 2187). Among
industries, coal mining and metal mining had the highest PMRs for
unspecified/other pneumoconiosis; and among occupations, mining
machine operators had the highest PMR (Figure 2188).

164
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Magnitude and Trend Contributing cause

1,524
1,487
1,600 Underlying cause

1,401
1,384
How did the pattern of mortality from unspecified/other

1,284
pneumoconiosis change during 19681999? 1,400

1,212
Figure 2186. Number of deaths of U.S. residents aged 15 1,200

1,043
1,000
or older with unspecified/other pneumoconiosis recorded as

Number of deaths
an underlying or contributing cause on the death certificate, 1,000

888
845
19681999. The number of unspecified/other pneumoconio-

805
sis deaths declined sharply from a high of 1,524 in 1972 to few-
800
er than 400 per year in 1983 and thereafter. The proportion of

610
584
558
these deaths in which unspecified/other pneumoconiosis was
600
listed as the underlying cause hovered around 34%. (Source:

395
378
NIOSH [2002f].)

351
343

340
332

329

318
316
306
307

305
303

296
400

292

265
249
243
200

0
1968 1972 1976 1980 1984 1988 1992 1996

Rates among States

How did the mortality rates for unspecified/other

pneumoconiosis differ by State during 19901999?

Figure 2187. Age-adjusted mortality rates for unspecified/

other pneumoconiosis in U.S. residents aged 15 or older by
State, 19901999. During 19901999, West Virginia had the
highest mortality rates for unspecified/other pneumoconio-
sismore than 20 times the U.S. rate of 1.59 per million. High
rates were observed among other Appalachian and Western Deaths per million
mining States, ranging from two to nine times the U.S. rate.
>15.0
(Source: NIOSH [2002f].)
3.115.0
1.13.0
<1.1

165
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Industry 39.5 45.4 Occupation and Industry

Coal mining
42.4 Which industries and occupations were associated with
3.1 8.2
Metal mining unspecified/other pneumoconiosis mortality during 1990
5.2 1999?
Glass and glass 1.0 3.6
products Figure 2188. PMRs and 95% confidence intervals for unspecified/
2.0
Occupation 38.0 44.0 other pneumoconiosis in U.S. residents aged 15 or older by indus-
Mining machine
operators try and occupation, adjusted for age, race, and sex, 19901999.
40.9
10.7 29.4 Coal and metal mining industries were associated with elevated
Supervisors, extractive
occupations mortality from unspecified/other pneumoconiosis (as these
18.4 industries were also associated with high CWP mortality). In
1.2 2.8
Welders and cutters addition, the glass and glass products industry had a significantly
1.9 high PMR. Among occupations, mining machine operators and
1.1 2.5 supervisors, extractive occupations were associated with the
Electricians
1.7 highest PMRs, followed by welders and cutters and electricians.
0 10 20 30 40 50 (Note: This figure presents the highest significant PMRs based on
10 or more deaths.) (Source: NIOSH [2002f].)
PMR

166
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions
Silicosis
Silicosis is a chronic, disabling, and sometimes fatal dust disease of
the lungs caused by inhaling silica particles. Data on the prevalence
of silicosis are available through the SENSOR program. For surveil-
lance purposes, a silicosis case must have a history of occupational
exposure to airborne silica dust and one or both of the following:
(1) a chest radiograph (or other imaging technique) interpreted as
consistent with silicosis and (2) pathologic findings characteristic
of silicosis.
During 19931997, three States (Michigan, New Jersey, and
Ohio) conducted surveillance for silicosis through the SENSOR
program. Together these States identified 576 cases of silicosis,
mostly through hospital reports (74.8%), reports by health care
professionals (15.6%), workers compensation (6.4%), and death
certificates (1.7%) (Figure 2189). Most cases (67.4%) occurred
among operators, fabricators, and laborers (Figure 2190) in the
manufacturing industry (85.8%) (Figure 2191).
The number of deaths due to silicosis declined sharply during
19681999, from more than 1,157 deaths in 1968 to 187 deaths
in 1999 (Figure 2192). Metal mining had the highest PMR
among industries, and miscellaneous metal and plastic processing
machine operators had the highest PMR among occupations (Fig-
ure 2194).
167
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Silicosis Prevalence
Hospitals Source of reports
74.8%

Other sources What sources did SENSOR States use to identify silicosis
431 1.4% cases during 19931997?
8
Death Figure 2189. Distribution and number of silicosis cases for
10 certificates all three reporting SENSOR States (Michigan, New Jersey,
1.7% Ohio) by source of report, 19931997. During 19931997, hos-
37
Workers' pitals were the largest source of reports (74.8%) for identifying
compensation the largest proportion of confirmed cases of silicosis (74.8%),
6.4%
90 followed by health care professionals (15.6%). (Sources: Rosen-
man et al. [2002b]; Socie and Migliozzi [2002]; Valiante and Schill
[2002b]; Filios [2002b].)
Health care
professionals
15.6%

Precision production, Occupation

craft, and repair
20.5%
In which occupations did SENSOR States find silicosis
cases during 19931997?
118
Figure 2190. Distribution and number of silicosis cases for
all three reporting SENSOR States (Michigan, New Jersey,
Other Ohio) by occupation, 19931997. The largest proportion of
13 2.3% silicosis cases (67.4%) occurred among operators, fabrica-
388 tors, and laborers during 19931997. (Sources: Rosenman et al.
57
[2002b]; Socie and Migliozzi [2002]; Valiante and Schill [2002b];
Operators, fabricators, Unclassified or Filios [2002b].)
and laborers unemployed
67.4% 9.9%

168
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Industry

In which industries did SENSOR States find silicosis cases

during 19931997?
Construction
Figure 2191. Distribution and number of silicosis cases for all 7.8%
three reporting SENSOR States (Michigan, New Jersey, Ohio) 45
by industry, 19931997. The largest proportion of silicosis cases Unknown
Manufacturing 494 0.3%
occurred in manufacturing (85.8%), followed by construction 85.8% 2
(7.8%). (Sources: Rosenman et al. [2002b]; Socie and Migliozzi 27
[2002]; Valiante and Schill [2002b]; Filios [2002b].) Other
1.4%
8
Mining
4.7%

Silicosis Mortality Contributing cause

1,157
1,143
Underlying cause

1,086
1,200
Magnitude and trend

982
How did the pattern of silicosis mortality change during

925
1,000
19681999?

850
789
Figure 2192. Number of deaths of U.S. residents aged 15

728
800
Number of deaths

671
or older with silicosis recorded as an underlying or contribut-
ing cause on the death certificate, 19681999. The number of

562
538
silicosis deaths declined sharply from 1,157 deaths in 1968 to 600

452
448
187 deaths in 1990. Silicosis was listed as the underlying cause

390

381
378
of death in nearly half of all silicosis deaths from 1990 to 1999.

359

342
334
400

318

314
308
302
(Source: NIOSH [2002f].)

301

276
255

242
235

212
198

187
178
200

0
1968 1972 1976 1980 1984 1988 1992 1996

169
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Rates among States

How did silicosis mortality rates differ by State during

19901997?

Figure 2193. Age-adjusted mortality rates for silicosis in U.S.

residents aged 15 or older by State, 19901997. States with the
highest silicosis mortality rates during 19901999 were region-
ally dispersed: West Virginia, Pennsylvania, and Vermont make
up the eastern cluster; and Colorado, New Mexico, and Utah
constitute the western cluster. Mortality rates for each of these
Deaths per million States were at least three times the rate of 1.21 per million for
>3.0 the entire United States. (Source: NIOSH [2002f].)
2.13.0
1.12.0
<1.1

170
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Occupation and industry Industry

33.6 51.8
Which industries and occupations were associated with Metal mining
silicosis mortality during 19901999? 41.7

Figure 2194. PMRs and 95% confidence intervals for silicosis Miscellaneous nonmetallic 22.3 41.2
in U.S. residents aged 15 or older by industry and occupation, mineral and stone
adjusted for age, race, and sex, 19901999. During 19901999, products 30.7
metal mining was associated with the highest significant silico-
sis PMR among industries. Among occupations, miscellaneous Pottery and related 17.1 47.0
metal and plastic processing machine operators had the highest products
29.4
silicosis PMR. (Note: This figure presents the highest significant
PMRs based on 10 or more deaths.) (Source: NIOSH [2002f].) 21.5 38.8
Nonmetallic mining and
quarrying, except fuel
29.3

15.6 28.0
Iron and steel foundries
21.1

Occupation
Miscellaneous metal and 44.6 170.4
plastic processing
machine operators 92.7

Hand molders and shapers, 21.3 65.3

except jewelers
38.9

Crushing and grinding 17.8 50.5

machine operators
31.1

Molding and casting 12.5 28.6

machine operators
19.4

11.0 15.5
Mining machine operators
13.1

0 20 40 60 80 100 120 140 160 180

PMR

171
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions
Dust Diseases of the Lungs
BLS defines dust diseases of the lungs (pneumoconioses) to include
silicosis, asbestosis and other asbestos-related diseases, CWP, byssi-
nosis, siderosis, and other pneumoconioses. During 19722001, the
number of BLS-estimated dust diseases of the lungs ranged from a
low of approximately 1,000 cases in 1975 to a high of 3,500 cases in
1996; BLS reported 1,300 cases in 2001 (Figure 2195). Rates varied
during 19842001 from a high of 0.5 per 10,000 full-time workers in
172
1986 and in 1987 to a low of 0.1 in 2001. The overall trend during
this period was downward (Figure 2196). Within reporting States
in 2001, the number of cases ranged from fewer than 50 to 200
(Figure 2197). Rates varied by State in 2001, from a low of 0.1 per
10,000 full-time workers in most States to a high of 3.8 per 10,000
full-time workers in West Virginia; the U.S. rate was 0.1 per 10,000
full-time workers (Figure 2198).
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Magnitude and Trend

3.5
3.4
3.5

3.2
How did the number of cases of occupational dust

3.0
2.9

2.9
diseases of the lungs change during 19722001? 3.0

2.7
2.7
2.7
2.6

2.6
Number of cases (thousands)

2.5
Figure 2195. Number of cases of dust diseases of the lungs
in private industry, 19722001. During 19722001, the number 2.5

2.2

2.2
2.1

2.1
of BLS-estimated dust diseases of the lungs ranged from a low

2.0

2.0
of approximately 1,000 cases in 1975 to a high of 3,500 cases in 2.0

1.8
1.7

1.7

1.7

1.7

1.7
1996. BLS reported 1,300 cases in 2001. (Source: BLS [2002].)

1.6
1.5
1.4
1.5

1.3
1.2
1.0
1.0

0.5

0.0
1972 1976 1980 1984 1988 1992 1996 2000

How did the rates of occupational dust diseases of the 0.5 0.5
0.5
lungs change during 19842001?

Figure 2196. Incidence rates of dust diseases of the lungs in

0.4 0.4 0.4
private industry, 19842001. During 19842001, BLS reported 0.4
incidence rates of dust diseases of the lungs ranging from a
Rate per 10,000 workers

high of 0.5 per 10,000 full-time workers in 1986 and in 1987 to

a low of 0.1 in 2001. The overall trend during this period was 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3
0.3
downward. Dust diseases of the lungs are the least prevalent of
the illness conditions, accounting for approximately 1% of all
reported illness cases. (Source: BLS [2002].) 0.2 0.2 0.2 0.2
0.2

0.1
0.1

0.0
1984 1986 1988 1990 1992 1994 1996 1998 2000

173
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Numbers and Rates among States

How did the number of occupational dust diseases of the
lungs differ by State in 2001?

Figure 2197. Number of cases of dust diseases of the lungs

in private industry by State, 2001. The number of dust diseases
of the lungs within reporting States ranged from fewer than 50
cases to 200 in 2001. BLS reported 1,300 cases of dust diseases
of the lung in 2001. Eight States (California, Illinois, New York,
Oklahoma, Texas, Virginia, Washington, and West Virginia)
Number of cases reported 100 or more cases. (Source: BLS [2002].)
100 and >
<100
No data

How did the rates of occupational dust diseases of the

lungs differ by State in 2001?

Figure 2198. Incidence rates for dust diseases of the lungs

in private industry by State, 2001. Rates for occupational dust
diseases of the lungs varied by State in 2001, from a low of 0.1
per 10,000 full-time workers in most States to a high of 3.8 per
10,000 full-time workers in West Virginia. The U.S. rate was 0.1
per 10,000 full-time workers. Lower rates were reported for
States in the South, the Southwest, and the West. (Source: BLS
Rate per 10,000 [2002].)
workers
>0.1
0.1
<0.1
No data

174
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions
Respiratory Conditions Due to Toxic Agents
Respiratory conditions due to toxic agents include pneumonitis,
pharyngitis, farmers lung, and rhinitis or acute congestion due
to chemicals. During 19722001, the number of BLS-estimated
cases of respiratory conditions due to toxic agents ranged from
a low of approximately 7,900 cases in 1983 to a high of 25,300
cases in 1994 (Figure 2199). Rates varied from a high of 3.1
per 10,000 full-time workers (reported for 19921994) to a low
of 1.6 (reported for 1984 and 20002001) (Figure 2200). With-
in reporting States in 2001, the number of cases ranged from
fewer than 50 to 1,400 (Figure 2201). Rates of occupational
respiratory conditions due to toxic agents varied by State in
2001 from a low of 0.7 per 10,000 full-time workers in Louisiana
to a high of 5.0 in Maine; the U.S. rate was 1.6 per 10,000 full-
time workers (Figure 2202).
175
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

30 Magnitude and Trend

25.3
24.4
How did the number of occupational respiratory

24.2
23.5
25 conditions due to toxic agents change during 19722001?

21.7
20.5
Number of cases (thousands)

20.3
Figure 2199. Number of cases of respiratory conditions

18.9

18.3
20 due to toxic agents in private industry, 19722001. During

17.5
16.5
16.1
19722001, the number of BLS-estimated cases of occupational

14.7
14.5
respiratory conditions due to toxic agents ranged from a low of

14.3
13.6
13.2
13.1
13.1
15
12.7

approximately 7,900 cases in 1983 to a high of 25,300 cases in

12.3
11.9

11.6
11.5

11.3
1994. BLS reported 14,500 cases in 2001. (Source: BLS [2002].)

10.7

10.6
10.2

8.8
10

7.9
5

0
1972 1976 1980 1984 1988 1992 1996 2000

3.5 How did the rates of occupational respiratory conditions

3.1 3.1 3.1 due to toxic agents change during 19842001?
3.0
3.0 Figure 2200. Incidence rates of respiratory conditions due to
2.7
2.6 toxic agents in private industry, 19842001. During 19842001,
2.5
2.5 2.4 2.4 BLS reported relatively low rates of respiratory conditions due
Rate per 10,000 workers

2.2 to toxic agents. The highest rate (3.1 per 10,000 full-time work-
2.0 2.0 ers) was reported for 19921994, and the lowest rate (1.6) was
2.0 reported for 1984 and 20002001. Respiratory conditions due
1.8
1.7 1.7
1.6 1.6 1.6 to toxic agents accounted for approximately 4%5% of all
1.5 reported illness cases. (Source: BLS [2002].)

1.0

0.5

0.0
1984 1986 1988 1990 1992 1994 1996 1998 2000

176
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Numbers and Rates among States

How did the number of occupational respiratory
conditions due to toxic agents differ by State in 2001?

Figure 2201. Number of respiratory conditions due to toxic

agents in private industry by State, 2001. The number of respi-
ratory conditions due to toxic agents within reporting States in
2001 ranged from fewer than 50 cases to 1,400. BLS reported
14,500 cases in 2001. States with the highest numbers of these
conditions included California (1,400), Michigan (900), Texas Number of cases
(700), North Carolina (700), and New York (700). (Source: BLS >399
[2002].)
200399
<200
No data

How did the rates of occupational respiratory conditions

due to toxic agents differ by State in 2001?

Figure 2202. Incidence rates for respiratory conditions due

to toxic agents in private industry by State, 2001. In 2001, inci-
dence rates of occupational respiratory conditions due to toxic
agents varied by State from a low of 0.7 per 10,000 full-time
workers in Louisiana to a high of 5.0 in Maine. The U.S. rate
was 1.6 per 10,000 full-time workers. Lower rates were reported
for Southern, Southwestern, and Western States. (Source: BLS
[2002].) Rate per 10,000
workers
>1.7
1.41.7
<1.4
No data

177
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Tuberculosis (TB)
TB is a disease caused by Mycobacterium tuberculosis. This bacterium
can attack any part of the body, but it usually attacks the lungs. Data
for TB incidence among health care workers come from CDCs
National Center for HIV, STD, and TB Prevention (NCHSTP). The
NCHSTP maintains ongoing surveillance through the National
Tuberculosis Surveillance System. In 2000, CDC reported 16,377
cases of TB; 15,242 of these cases included information about occu-
pation.

178
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Magnitude and Trend 6

5.4
What was the trend of TB incidence in health care workers
5 4.9 4.8
during 19942000? 4.6
4.5
Figure 2203. Incidence rates of TB in health care workers,

Rate per 100,000 workers

19942000. The TB incidence rate in health care workers 4 3.7
3.6
declined from 5.4 per 100,000 workers in 1994 to 3.7 in 2000.
(Note: The TB incidence rate for each year was computed using
the number of health care workers as the denominator. This 3
number was obtained from the U.S. Census Bureaus Current
Population Survey for each year.) (Source: CDC [2002c].)
2

0
1994 1995 1996 1997 1998 1999 2000

179
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions
Skin Diseases and Disorders
Occupational skin diseases and disorders include contact der-
matitis, eczema, or rash caused by primary irritants and sensitiz-
ers or poisonous plants; oil acne; chrome ulcers; and chemical
burns or inflammations. During 19722001, the number of skin
diseases and disorders ranged from a peak of 89,400 cases in
1974 to a low of 38,900 in 2001 (Figure 2204). Rates varied from
a high of 8.2 cases per 10,000 full-time workers in 1992 to 4.3 in
180
2001the lowest rate ever reported by BLS (Figure 2205). With-
in reporting States in 2001, the number of cases ranged from
fewer than 50 to 3,700 (Figure 2206). Rates of skin diseases
and disorders varied by State in 2001 from a low of 1.2 cases
per 10,000 full-time workers in New Mexico to a high of 9.8 in
Kansas; the U.S. rate was 4.3 cases per 10,000 full-time workers
(Figure 2207).
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Magnitude and Trend

89.4
89.2
86.5
90
How did the number of occupational skin diseases and

74.4

73.0
disorders change during 19722001? 80

71.6

67.9
Number of cases (thousands)

65.9

65.7
64.2
62.9
Figure 2204. Number of skin diseases and disorders in pri- 70

62.1
60.9

60.2
58.2

58.1
57.9

57.9
vate industry, 19722001. The number of skin diseases and dis-

56.2

54.2

53.1
60

51.2
orders peaked at 89,400 cases in 1974 then declined steadily to
a low of 39,500 in 1983. Cases increased to 65,700 in 1994 then

44.6
50

42.2
41.9

41.8
41.9

41.8
declined steadily to 38,900 in 2001. (Source: BLS [2002].)

39.5

38.9
40

30

20

10

0
1972 1976 1980 1984 1988 1992 1996 2000

How did rates of occupational skin diseases and disorders 9

change during 19842001? 8.1 8.2 8.1
7.9 7.9
8 7.7 7.7 7.6
7.4
Figure 2205. Incidence rates of skin diseases and disorders
6.9
in private industry, 19842001. Rates of skin diseases and dis- 7 6.7
6.3
Rate per 10,000 workers

orders increased from 6.3 cases per 10,000 full-time workers in 6.0 5.9 6.0
1984 to 8.2 in 1992. Rates remained elevated through 1995 then 6
declined to 4.3 cases per 10,000 full-time workers in 2001the
4.9
lowest rate ever reported by BLS. (Source: BLS [2002].) 5 4.6
4.3
4

0
1984 1986 1988 1990 1992 1994 1996 1998 2000

181
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Numbers and Rates among States

How did the number of occupational skin diseases and
disorders differ by State in 2001?

Figure 2206. Number of skin diseases and disorders in pri-

vate industry by State, 2001. The number of occupational skin
diseases and disorders within reporting States ranged from
fewer than 50 cases to 3,700 in 2001. BLS reported 38,900 cases
in 2001. States with the highest numbers included California
Number of cases (3,700), Michigan (2,800), Texas (2,000), and Florida (1,900).
>1,999 (Source: BLS [2002].)
1,0001,999
<1,000
No data

How did the rates of occupational skin diseases and

disorders differ by State in 2001?

Figure 2207. Incidence rates for skin diseases and disorders

in private industry by State, 2001. In 2001, rates of occupation-
al skin diseases and disorders varied by State from a low of 1.2
cases per 10,000 full-time workers in New Mexico to a high of
9.8 in Kansas. The U.S. rate was 4.3 cases per 10,000 full-time
workers. Lower rates were reported for the West, the South-
west, and the Mid-Atlantic States. (Source: BLS [2002].)
Rate per 10,000
workers
>4.7
3.84.7
<3.8
No data

182
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions
Dermatitis
Dermatitis is an inflammation of the skin resulting from contact
with allergens or irritants. Dermatitis may also be caused by reac-
tion to something ingested. Several forms of dermatitis exist,
including atopic dermatitis, contact dermatitis, allergic dermatitis,
and irritant dermatitis. These disorders tend to be less severe (Fig-
ure 2213) than the average nonfatal injury or illness case. They
involve a median of 3 days away from work compared with 6 days
for the average nonfatal injury or illness case [BLS 2003a].
BLS reported 4,714 dermatitis cases involving days away from
work in 2001 (Figure 2208). Rates declined 58.3% during 1992
2001, from 1.2 per 10,000 full-time workers in 1992 to 0.5 cases in
2001 (Figure 2209). In 2001, most cases involved workers who were
aged 2554 (72.8%) (Figure 2210), male (Figure 2211), and
white, non-Hispanic (64.5%) (Figure 2212). Two occupational
groups accounted for 56% of all dermatitis cases in 2001: opera-
tors, fabricators, and laborers (28.4% or 1,334 cases) and service
workers (27.6% or 1,298 cases) (Figure 2214). Dermatitis inci-
dence rates exceeding the private-sector rate of 0.5 per 10,000
full-time workers were reported in 2001 for agriculture, forestry,
and fishing (1.3 per 10,000 full-time workers), manufacturing
(0.7), transportation and public utilities (0.7), and services (0.6)
(Figure 2215). Agriculture had consistently higher incidence
rates than other industry sectors during 19922001 and experi-
enced a 78% rate reduction over this period (Figure 2216).
183
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

10,000
9,452 Magnitude and Trend
9,000 8,835
8,453 How did the number of occupational dermatitis cases
8,000 change during 19922001?
7,202
7,000 6,884 Figure 2208. Number of dermatitis cases involving days away
6,589
from work in private industry, 19922001. The annual number
Number of cases

6,000 5,715 5,529 of dermatitis cases involving days away from work declined sig-
4,996 nificantly (50.1%) during 19922001, from 9,452 cases in 1992
5,000 4,714 to 4,714 cases in 2001. (Sources: BLS [2003a,b].)
4,000

3,000

2,000

1,000

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

1.2 How did the annual rate of occupational dermatitis cases

1.2
1.1 1.1
change during 19922001?

Figure 2209. Annual rates of dermatitis cases involving days

1.0
away from work in private industry, 19922001. The annual
0.9
rate of private-sector dermatitis cases involving days away
Rate per 10,000 workers

0.8 0.8 from work declined 58.3% during 19922001, from 1.2 per
0.8
10,000 full-time workers in 1992 to 0.5 in 2001. (Sources: BLS
[2003a,b].)
0.6 0.6
0.6
0.5 0.5

0.4

0.2

0.0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

184
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Age 30
27.2%
How did the number of dermatitis cases differ by age of 1,267 25.5%
25 1,189
worker in 2001?
21.2%
Figure 2210. Distribution and number of dermatitis cases 20.1%
20 988
involving days away from work in private industry by age, 2001. 937

Distribution (%)
Age data are available for 4,658 of the 4,714 BLS-estimated der-
matitis cases involving days away from work. Workers aged 25 15
34 accounted for 1,267 cases or 27.2%, and workers aged 3544
accounted for 1,189 cases or 25.5%. (Sources: BLS [2003a,b];
Booth-Jones et al. [2003d].) 10

5.9%
5 277

0
<25 2534 3544 4554 >54
Age range

Sex 70 Male Female

60.3

58.8
58.7

57.8
56.7
How did the distribution of dermatitis cases differ by sex

55.6

55.5
60

53.4
of worker during 19922001?

52.5

51.5
48.5
47.5

46.6
Figure 2211. Distribution of dermatitis cases involving days 50

44.4

44.5
43.3

42.2
41.3

41.2
away from work in private industry by sex, 19922001. Male

39.7
Distribution (%)

workers accounted for the greatest proportions of dermatitis

40
cases, ranging from 53.4% to 60.3% during 19922001. In
2001, male workers accounted for 55.5% of dermatitis cases.
(Sources: BLS [2003a,b]; Booth-Jones et al. [2003d]. 30

20

10

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

185
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Black,
non-Hispanic
Race/Ethnicity
12.0%
Hispanic How did dermatitis cases differ by race/ethnicity in 2001?
20.1%
416 Figure 2212. Distribution and number of dermatitis cases
involving days away from work in private industry by race/
696 ethnicity, 2001. Race/ethnicity data are available for 3,464 of
the 4,714 BLS-estimated dermatitis cases involving days away
from work in 2001. White, non-Hispanic workers accounted for
Asian or
117 Pacific Islander 64.5% of the cases, and Hispanic workers accounted for 20.1%.
3.4% (Sources: BLS [2003a,b]; Booth-Jones et al. [2003d].)
American Indian or
Alaska Native
0.0%
2,235 ()

White,
non-Hispanic
64.5%

Dermatitis All nonfatal injuries and illnesses Severity

25 24.1 24.1
22.3 22.0 How did dermatitis cases compare with all nonfatal injury
and illness cases when measured by days away from work
19.8
20 in 2001?

15.4 Figure 2213. Distribution of dermatitis cases and all nonfatal

Distribution (%)

15 injury and illness cases involving days away from work in pri-
12.7 vate industry by days away from work, 2001. Higher percent-
11.9 12.6
11.1 ages of short-term work loss (1, 2, and 35 days) were reported
10 for dermatitis cases in 2001. The median number of days away
from work was 3 for dermatitis cases, whereas it was 6 days
6.2 6.1 6.3 for all nonfatal injuries and illnesses. (Sources: BLS [2003a,b];
5.3
5 Booth-Jones et al. [2003d].

0
1 2 35 610 1120 2130 >30
Days away from work

186
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Occupation Managerial and

professional 349 7.4%
specialty
How were dermatitis cases distributed by occupation in
2001? Technical, sales, and
administrative 545 11.6%
support
Figure 2214. Distribution and number of dermatitis cases
involving days away from work in private industry by occupa-
Service 1,298 27.6%
tion, 2001. Operators, fabricators, and laborers along with ser-
vice workers constituted more than half (56.0%) of the 4,701
dermatitis cases reported in 2001. (Sources: BLS [2003a,b]; Farming, forestry, 367 7.8%
Booth-Jones et al. [2003d].) and fishing

Precision production, 808 17.2%

craft, and repair

Operators, fabricators, 1,334 28.4%

and laborers

0 10 20 30
Distribution (%)

Industry Agriculture, forestry, 1.3

and fishing
How did the rate of dermatitis cases differ by private Mining ()
industry sector in 2001?
Construction 0.5
Figure 2215. Incidence rate of dermatitis cases by private
industry sector, 2001. For dermatitis cases, private industry Manufacturing 0.7
reported an incidence rate of 0.5 per 10,000 full-time workers
in 2001. Higher rates were reported for agriculture, forestry, Transportation and 0.7
public utilities
and fishing (1.3), manufacturing (0.7), transportation and
public utilities (0.7), and services (0.6). (Note: A dash in paren- Wholesale trade 0.2
theses indicates that no data were reported or that data do not
meet BLS publication criteria.) (Source: BLS [2003a].) Retail trade 0.4
Rate for all private
Finance, insurance, 0.1 sector workers = 0.5
and real estate
Services 0.6

0.0 0.2 0.4 0.6 0.8 1.0 1.2 1.4

Rate per 10,000 workers

187
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions

Agriculture, forestry, and fishing Construction How did the rates of dermatitis cases change by major
6 Manufacturing Mining private industry sector during 19922001?
Services Transportation and
public utilities Figure 2216. Annual rates of dermatitis cases involving days
5 Retail trade away from work by private industry sector, 19922001. The
Finance, insurance, annual rate for dermatitis cases in the private sector declined
Rate per 10,000 workers

and real estate 58.3% during 19922001, and rates declined for each industry
4 Wholesale trade sector. Agriculture had consistently higher rates of dermatitis
cases than other industry sectors and experienced a 78% rate
reduction during this 10-year period. (Sources: BLS [2003a,b].)
3

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

188
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions
References
American Thoracic Society [2004]. Guidelines for assessing and
managing asthma risk at work, school, and recreation. Am J Respir
Crit Care Med 169:873881.
BLS [2002]. Survey of occupational injuries and illnesses. Nonfa-
tal (OSHA recordable) injuries and illnesses. Industry incidence
rates and counts. Washington, DC: U.S. Department of Labor,
Bureau of Labor Statistics, Safety and Health Statistics Program.
[www.bls.gov/iif/oshsum.htm]
BLS [2003a]. Survey of occupational injuries and illnesses. Nonfa-
tal (OSHA recordable) injuries and illnesses. Case and demograph-
ic characteristics. Washington, DC: U.S. Department of Labor,
Bureau of Labor Statistics, Safety and Health Statistics Program.
[www.bls.gov/iif/oshcdnew.htm]
BLS [2003b]. Occupational injuries and illnesses in the United
States: profiles data 19922001, version 9.0. CDROM. Washington,
DC: U.S. Department of Labor, Bureau of Labor Statistics, Safety
and Health Statistics Program. [www.bls.gov/iif/]
BLS [2003c]. Census of fatal occupational injuries. Fatal injuries.
Washington, DC: U.S. Department of Labor, Bureau of Labor
Statistics, Safety and Health Statistics Program. [www.bls.gov/iif/
oshcfoi1.htm]
BLS [2003d]. Survey of occupational injuries and illnesses. Non-
fatal (OSHA recordable) injuries and illnesses. Case and demo-
graphic characteristics. Special tabulationnumber of nonfatal
occupational injuries and illnesses involving days away from work
involving musculoskeletal disorders by selected worker and case
characteristics, 19922001. Washington, DC: U.S. Department of
Labor, Bureau of Labor Statistics, Safety and Health Statistics Pro-
gram. [www.bls.gov/iif/oshcdnew.htm]
BLS [2003e]. Occupational injuries and illnesses. Counts, rates,
and characteristics. Washington, DC: U.S. Department of Labor,
Bureau of Labor Statistics, Safety and Health Statistics Program.
September 2003, Bulletin 2560. [www.bls.gov/iif/oshwc/osh/
case/osnr0017.pdf]
Booth-Jones AD, Sestito JP, Alterman T [2003a]. Analysis of anxiety,
stress, and neurotic disorders case data from occupational injuries
and illnesses in the United States: profiles data 19922001. Cincin-
nati, OH: U.S. Department of Health and Human Services, Centers
for Disease Control and Prevention, National Institute for Occupa-
tional Safety and Health. Unpublished.
Booth-Jones AD, Sestito JP, Alterman T [2003b]. Analysis of carpal
tunnel syndrome data from occupational injuries and illnesses in
the United States: profiles data 19922001. Cincinnati, OH: U.S.
Department of Health and Human Services, Centers for Disease
Control and Prevention, National Institute for Occupational Safety
and Health. Unpublished.
Booth-Jones AD, Sestito JP, Alterman T [2003c]. Analysis of tendon-
itis cases data from occupational injuries and illnesses in the United
States: profiles data 19922001. Cincinnati, OH: U.S. Department
of Health and Human Services, Centers for Disease Control and
Prevention, National Institute for Occupational Safety and Health.
Unpublished.
Booth-Jones AD, Sestito JP, Alterman T [2003d]. Analysis of der-
matitis cases data from occupational injuries and illnesses in the
189
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions
United States: profiles data 19922001. Cincinnati, OH: U.S.
Department of Health and Human Services, Centers for Disease
Control and Prevention, National Institute for Occupational Safety
and Health. Unpublished.
Calvert G [2002]. Analysis of SENSOR pesticide surveillance data.
Cincinnati, OH: U.S. Department of Health and Human Services,
Centers for Disease Control and Prevention. National Institute for
Occupational Safety and Health. Database.
Calvert GM, Plate DK, Das R, Rosales R, Shafley O, Thomsen C,
Male D, Beckman J, Arvisu E, Lackovic M [2004]. Acute occupa-
tional pesticide-related illness in the U.S., 19981999: surveillance
findings from the SENSOR-pesticides program. Am J Ind Med 45:
1423.
CDC [2002a]. National Notifiable Diseases Surveillance System
(NNDSS). Atlanta, GA: U.S. Department of Health and Human
Services, Centers for Disease Control and Prevention, National
Center for Infectious Disease. Unpublished.
CDC [2002b]. National Surveillance System for Health Care Work-
ers (NaSH). Atlanta, GA: U.S. Department of Health and Human
Services, Centers for Disease Control and Prevention, National
Center for Infectious Disease. Unpublished.
CDC [2002c]. National Tuberculosis Surveillance System. Atlanta,
GA: U.S. Department of Health and Human Services, Public
Health Service, Centers for Disease Control and Prevention,
National Center for HIV, STD, and TB Prevention. Database.
[www.cdc.gov/nchstp/od/nchstp.html] (See also Reported Tuber-
culosis in the United States, 2000 [www.cdc.gov/nchstp/tb/surv/
surv2000/default.htm] and Table 32 [www.cdc.gov/nchstp/tb/
surv/surv2000/pdfs/t32.pdf].)
190
CDC (Centers for Disease Control and Prevention) [2002d].
Adult blood lead epidemiology and surveillance, United States,
19982001. MMWR 51(SS11):110. [www.cdc.gov/mmwr/PDF/
SS/SS5111.pdf]
CDC [2003]. Surveillance of healthcare personnel with HIV/
AIDS, as of December 2002. [www.cdc.gov/ncidod/hip/BLOOD/
hivpersonnel.htm]
CFR. Code of Federal regulations. Washington, DC: U.S. Govern-
ment Printing Office, Office of the Federal Register.
DHHS [2000]. Tracking Healthy People 2010. Washington, DC:
U.S. Department of Health and Human Services. [www.cdc.gov/
nchs/hphome.htm]
Filios MS [2002a]. Analysis of SENSOR work-related asthma data,
19931997. Morgantown, WV: U.S. Department of Health and
Human Services, Centers for Disease Control and Prevention,
National Institute for Occupational Safety and Health. Database.
Filios MS [2002b]. Analysis of SENSOR silicosis data, 19931997.
Morgantown, WV: U.S. Department of Health and Human Servic-
es, Centers for Disease Control and Prevention, National Institute
for Occupational Safety and Health. Database.
Harrison R, Flattery J [2002a]. Analysis of SENSOR carpal tunnel
syndrome data, 19982000. Oakland, CA: California Department of
Health Services, Occupational Health Branch, Occupational Health
Surveillance and Evaluation Program. Database. [www.dhs.ca.gov/
ohb/OHSEP/Default.htm]
Harrison R, Flattery J [2002b]. Analysis of SENSOR work-related
asthma data, 19931997. Oakland, CA: California Department of
Health Services, Occupational Health Branch, Occupational Health
 Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions
Surveillance and Evaluation Program. Database. [www.dhs.ca.gov/
ohb/OHSEP/Default.htm]
Jackson L [2003]. Analysis of nonfatal occupational injuries and ill-
nesses treated in U.S. hospital emergency departments through the
Work-Related Injury Statistics Query System (Work-RISQS). Mor-
gantown, WV: U.S. Department of Health and Human Services,
Centers for Disease Control and Prevention, National Institute for
Occupational Safety and Health. Database. [www2a.cdc.gov/risqs]
NEISS [2003]. National Electronic Injury Surveillance System.
Washington, DC: Consumer Product Safety Commission, Division
of Hazard and Injury Data Systems; and Morgantown, WV: U.S.
Department of Health and Human Services, Public Health Service,
Centers for Disease Control and Prevention, National Institute for
Occupational Safety and Health. Database.
NIOSH [1991]. Work-related lung disease (WoRLD) surveillance
report 1991. Cincinnati, OH: U.S. Department of Health and
Human Services, Public Health Service, Centers for Disease Con-
trol, National Institute for Occupational Safety and Health, DHHS
(NIOSH) Publication No. 91113. [www.cdc.gov/niosh/docs/91-
113/91-113.html]
NIOSH [1994]. Work-related lung disease (WoRLD) surveillance
report 1994. Cincinnati, OH: U.S. Department of Health and
Human Services, Public Health Service, Centers for Disease Con-
trol and Prevention, National Institute for Occupational Safety and
Health, DHHS (NIOSH) Publication No. 94120. [www.cdc.gov/
niosh/docs/94-120/94-120.html]
NIOSH [1996]. Work-related lung disease surveillance report 1996.
Cincinnati, OH: U.S. Department of Health and Human Services,
Public Health Service, Centers for Disease Control and Preven-
tion, National Institute for Occupational Safety and Health, DHHS
(NIOSH) Publication No. 96134. [www.cdc.gov/niosh/docs/96-
134/96-134.html]
NIOSH [1999]. Work-related lung disease surveillance report 1999.
Cincinnati, OH: U.S. Department of Health and Human Services,
Public Health Service, Centers for Disease Control and Preven-
tion, National Institute for Occupational Safety and Health, DHHS
(NIOSH) Publication No. 2000105. [www.cdc.gov/niosh/docs/
2000-105/2000-105.html]
NIOSH [2001]. National Traumatic Occupational Fatalities Sur-
veillance System. Morgantown, WV: U.S. Department of Health
and Human Services, Centers for Disease Control and Prevention,
National Institute for Occupational Safety and Health. Database.
[www.cdc.gov/niosh/NTOF2000/2001129state.html]
NIOSH [2002a]. Noise and hearing loss prevention. [www.cdc.gov/
niosh/hpnoisei.html]
NIOSH [2002b]. Fact sheet on work-related hearing loss. [www.cdc.gov/
niosh/hpworkrel.html]
NIOSH [2002c]. Adult Blood Lead Epidemiology and Surveillance
Program (ABLES). Cincinnati, OH: U.S. Department of Health
and Human Services, Public Health Service, Centers for Disease
Control and Prevention, National Institute for Occupational Safety
and Health. Database. [www.cdc.gov/niosh/ables.html]
NIOSH [2002d]. SENSOR Pesticide Illness and Injury Surveil-
lance Program. Cincinnati, OH: U.S. Department of Health and
Human Services, Centers for Disease Control and Prevention,
National Institute for Occupational Safety and Health. Database.
[www.cdc.gov/niosh/topics/pesticides/]
191
Chapter 2 Fatal and Nonfatal Injuries, and Selected Illnesses and Conditions
NIOSH [2002e]. National Occupational Respiratory Mortality
System (NORMS). Morgantown, WV: U.S. Department of Health
and Human Services, Centers for Disease Control and Prevention,
National Institute for Occupational Safety and Health. Database.
NIOSH [2002f]. National Surveillance System for Pneumoconiosis
Mortality (NSSPM). Morgantown, WV: U.S. Department of Health
and Human Services, Centers for Disease Control and Prevention,
National Institute for Occupational Safety and Health. Database.
NIOSH [2002g]. Coal Workers X-Ray Surveillance Program 1970
2000 (CWXSP). Morgantown, WV: U.S. Department of Health and
Human Services, Public Health Service, Centers for Disease Con-
trol and Prevention, National Institute for Occupational Safety and
Health. Database.
NIOSH [2003]. National Traumatic Occupational Fatalities Sur-
veillance System. Morgantown, WV: U.S. Department of Health
and Human Services, Centers for Disease Control and Prevention,
National Institute for Occupational Safety and Health. Database.
[www.cdc.gov/niosh/NTOF2000/2001129state.html]
Rosenman KD, Reilly MJ, Simms A, Panasuk B [2002]. 2001 Annual
report on occupational noise-induced hearing loss in Michigan.
Joint reportMichigan State University, Department of Medicine,
and the Michigan Department of Consumer, and Industry Services,
Occupational Health Division. [www.chm.msu.edu/oem/hearing/
01NIHL_all.pdf]
Rosenman KD, Reilly MJ [2002]. Analysis of reports on occupation-
al noise-induced hearing loss, 19912000. Reporting required by
the Michigan Occupational Disease Reporting Law (Public Health
Code Part 56 of Public Act 368 of 1978). East Lansing, MI: Michi-
gan State University, Department of Medicine, Occupational and
192
Environmental Medicine. Database. [www.chm.msu.edu/oem/
index.htm]
Rosenman KD, Reilly MJ, Kalinowski D [2002a]. Analysis of SEN-
SOR work-related asthma data, 19931997. East Lansing, MI: Mich-
igan State University, Department of Medicine, Occupational and
Environmental Medicine. Database. [www.chm.msu.edu/oem/
index.htm]
Rosenman KD, Reilly MJ, Kalinowski D [2002b]. Analysis of SEN-
SOR silicosis data, 19931997. East Lansing, MI: Michigan State
University, Department of Medicine, Occupational and Environ-
mental Medicine. Database. [www.chm.msu.edu/oem/index.htm]
Socie E, Migliozzi A [2002]. Analysis of SENSOR silicosis data,
19931997. Ohio Department of Health, SENSOR Silicosis Surveil-
lance Program. Database. [www.odh.state.oh.us/]
Tumpowsky C, Davis L [2002]. Analysis of SENSOR work-related
asthma data, 19931997. Massachusetts Department of Public
Health, Bureau of Health Statistics, Research & Evaluation, Occu-
pational Health Surveillance Program. Database. [www.state.ma.us/
dph/bhsre/ohsp/ohsp.htm]
Valiante D, Schill D [2002a]. Analysis of SENSOR work-related
asthma data, 19931997. New Jersey Department of Health and
Senior Services, Division of Epidemiology, Environmental and
Occupational Health, Occupational Health Surveillance Program.
Database. [www.state.nj.us/health/eoh/survweb/]
Valiante D, Schill D [2002b]. Analysis of SENSOR silicosis,
19931997. New Jersey Department of Health and Senior Ser-
vices, Division of Epidemiology, Environmental and Occupational
Health, Occupational Health Surveillance Program. Database.
[www.state.nj.us/health/eoh/survweb/]
M ore than 3.1 million workers were employed in the agricul-
ture, forestry, and fishing industry during 2001 (Table 14
in Chapter 1). Compared with all industries, agriculture employed
proportionately more workers aged 1619 (7.2% versus 5.1% for
all industries) and workers aged 55 and older (22.9% versus 13.6%
for all industries) [BLS 2001b]. In 2001, agricultural workers were
predominately male (72.4%) (Table 14 in Chapter 1) and white
(94.4%) (BLS [2001a]).
Advances in science and technology have greatly improved the
safety of agricultural production in recent years. Nevertheless, fatal
occupational injury rates in the agricultural sector, though decreas-
ing, averaged more than four times the rate for the private sector
during 19922002 (Figure 32) and were disproportionately high
for older workers (Figure 33). Rates for nonfatal occupational
injuries also declined, from 11.7 per 100 full-time workers in 1981
to 7.0 in 2001 (Figure 314). Although important strides have been
made in reducing the risk of all occupational injuries, agricultural
production remains one of the most hazardous industrial sectors.
Fatal Agricultural Injuries
This section provides data for answering basic questions about fatal
injuries among workers and youths exposed to agricultural hazards.
The agriculture industry as discussed in this section includes
the following types of operations: farming, agricultural services,
forestry, commercial fishing, and commercial hunting. On-farm
deaths among youths in this section include both occupational and
nonoccupational fatalities, and they exclude those involving motor
vehicles and intentional causes.
Data for the figures come from three sources: (1) the Bureau
of Labor Statistics (BLS) Census of Fatal Occupational Injuries
(CFOI) Surveillance System, which is a multisource census of
fatal occupational injuries occurring in the United States; (2) the
National Institute for Occupational Safety and Health (NIOSH)
National Traumatic Occupational Fatalities (NTOF) Surveillance
System, which is a census of fatal occupational injuries for persons
aged 16 or older as identified by death certificates in the United
States; and (3) the National Center for Health Statistics (NCHS)
Vital Statistics Mortality Surveillance System, which is a census of all
death certificates filed in the United States.
Fatal injuries constitute a significant burden on the agricultural
sector, as indicated by the annual average of 806 fatal occupational
injuries that occurred during 19922002 (Figure 31). Fatal
occupational injury rates for this period ranged 26.5 per 100,000
employed workers in 1993 to 21.3 in 2000 (Figure 32). Rates by
age ranged from 13.7 per 100,000 for the youngest agricultural
workers to 62.0 for the oldest group (Figure 33). Most cases of
fatal occupational injuries in agriculture involved white workers
193
Chapter 3 Focus on Agriculture
(93%) (Figure 34). Non-Hispanic workers accounted for higher
rates than Hispanic workers (20.2 versus 15.8 fatalities per 100,000
employed workers) (Figure 35). Farm tractors were the leading
source of fatal occupational injuries in agriculture during 1992
2001, but trucks and fishing boats were also major sources (Fig-
ure 36). Leading causes listed on death certificates included
machinery, motor vehicles, and falls (Figure 37). The highest
number of fatal occupational injuries in agriculture, forestry, and
fishing occurred in California, followed by Texas, Florida, Kentucky,
194
Pennsylvania, and Tennessee (Figure 38). Surveys confirm that
the farming environment presents risks to youths living or work-
ing on farms. During 19821996, an annual average of 145 on-farm
deaths occurred among youths under age 20 (Figure 310). The
major causes of unintentional on-farm deaths among youths were
machinery, drowning, and firearms (Figure 311). Texas reported
the highest number of on-farm deaths among youths under age 20,
and Pennsylvania, Iowa, Missouri, and Wisconsin reported the next
highest numbers (Figure 312).
 Chapter 3 Focus on Agriculture

Magnitude and Trend Other private sector

Agriculture, forestry, and fishing
6,000
How did the number of fatal occupational injuries in

5,107
agriculture, forestry, and fishing compare with the number

4,779

4,791

4,783
4,689

4,695

4,674
4,617
in the private sector during 19922002?

4,627
5,000

4,540

4,181
Figure 31. Fatal occupational injuries in agriculture, forestry,

Number of fatal injuries

and fishing and the private sector, 19922002. Fatal occupa- 4,000
tional injuries in agriculture, forestry, and fishing industry
ranged from 864 (16.2% of the total) in 1993 to 720 (13.5%)
3,000
in 2000. (Sources: BLS [2003]; Myers [2003].)

2,000

1,000

864

852

840
833

814
808

800

806

789
741
720
0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

How did the annual rates of fatal occupational injury in 30

Agriculture, forestry, and fishing
agriculture, forestry, and fishing compare with the rates in 26.5
the private sector during 19922002?
23.9 24.4 24.2 24.2
25 23.9
22.8 23.0 22.8 22.7
Figure 32. Annual rates of fatal occupational injury in the
21.3
agriculture, forestry, and fishing industry and the private sec-
Rate per 100,000 workers

tor, 19922002. Annual rates of fatal occupational injury in 20

agriculture, forestry, and fishing ranged from 26.5 per 100,000
employed workers in 1993 to 21.3 in 2000. The rates during
19922002 were 3.9 to 5.4 times the private-sector rates. Both 15
agriculture, forestry, and fishing and the private sector show
declining rates of fatal occupational injuries since 1993. (Sources:
BLS [2003]; Myers [2003].) 10
Private sector
6.1 6.2 5.7 5.2 5.2 5.0 4.8 4.8 4.8 4.5 4.2
5

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

195
 Chapter 3 Focus on Agriculture

70 Private sector Agriculture, forestry, and fishing Age

62.0
60 How did fatal occupational injury rates in agriculture,
forestry, and fishing compare with the private sector by
age of worker during 19922001?
Rate per 100,000 workers

50
Figure 33. Fatal occupational injury rates in the agriculture,
40 forestry, and fishing industry and the private sector by age,
19922001. (Fatality data exclude New York City.) During
30.4
30 19922001, fatal occupational injury rates in agriculture, for-
estry, and fishing were higher in every age group than in the
21.3
private sector. The rates in agriculture ranged from 13.7 per
20 15.9 17.3
13.7 13.3
100,000 for workers aged 1624 to 62.0 for workers older than
64. These differences increase with age. The greatest differ-
10 6.3 ences were noted for workers aged 55 or older. (Sources: BLS
3.1 3.9 4.1 4.6
[2002a]; Myers [2003].)
0
1624 2534 3544 4554 5564 >64
Age range

8,000 Number Rate 30 Race/Ethnicity

26.9
7,018 26.0
How did the number and rate of fatal occupational injuries
differ by race in agriculture, forestry, and fishing during

Rate per 100,000 workers

6,000 21.2 20.7 19922001?
Number of fatal injuries

20
Figure 34. Number and rate of fatal occupational injuries
by race in the agriculture, forestry, and fishing industry,
4,000 19922001. (Fatality data exclude New York City.) White work-
ers accounted for the highest number of fatal occupational
injuries (7,018) in agriculture, forestry, and fishing during
10 19922001. The highest rate was observed among black work-
ers (26.9 fatalities per 100,000 employed workers). American
2,000
Indians or Alaska Natives had the lowest number (60) and rate
(20.7 per 100,000) of fatal occupational injuries. (Sources: BLS
355 [2002a,b]; Myers [2003].)
60 117
0 0
White Black American Indian or Asian or Pacific
Alaska Native Islander

196
 Chapter 3 Focus on Agriculture

How did fatal occupational injury rates differ between 25

Hispanic and non-Hispanic workers in agriculture, forestry,
and fishing during 19922001?
20.2
Figure 35. Fatal occupational injury rates among Hispanic 20

Rate per 100,000 workers

and non-Hispanic workers in the agriculture, forestry, and
fishing industry, 19922001. (Fatality data exclude New York 15.8
City.) During 19922001 in the agriculture, forestry, and fish- 15
ing industry, non-Hispanic workers accounted for a higher rate
of fatal occupational injuries than Hispanic workers (20.2 com-
pared with 15.8 fatal injuries per 100,000 employed workers).
10
(Sources: BLS [2002a,b]; Myers [2003].)

0
Hispanic Non-Hispanic

Sources and Causes of Death Farm tractors 2,165

What were the leading sources of fatal occupational Trucks 795

injuries in agriculture, forestry, and fishing during 1992 Fishing boats 434
2001?
Ground 403
Figure 36. Leading sources of fatal occupational injuries Trees, logs 357
in the agriculture, forestry, and fishing industry, 19922001.
(Fatality data exclude New York City.) Farm tractors accounted Harvesting machines 253
for 2,165 fatal occupational injuries during 19922001 and Animals (mammals) 242
were the leading source of these deaths in agriculture, forestry,
and fishing. Trucks and fishing boats were also major sources Mowing machines 228
of death in this industry and accounted for 795 and 434 fatal Bullets 226
occupational injuries, respectively. (Sources: BLS [2002a]; Myers
[2003].) Water 209
Agricultural machines, 168
n.e.c.
0 500 1,000 1,500 2,000 2,500
Number of fatal injuries

197
Chapter 3 Focus on Agriculture

Machinery 1,021 What did death certificates show to be the leading causes
Motor vehicles 624 of fatal occupational injuries in agriculture, forestry, and
Falls 235 fishing during 19921997?
Water transport 213
Other causes 212 Figure 37. Leading causes of fatal occupational injuries in the
Nature/environment 209 agriculture, forestry, and fishing industry, 19921997. During
Struck by falling 191 19921997, machinery caused 1,021 fatal occupational injuries
Electrocution 156 and was the leading cause of these deaths in agriculture, for-
Drowning 119 estry, and fishing as reported on death certificates. The next
Suffocation 92 leading causes of these deaths were motor vehicles (624 fatali-
Homicide 90 ties) and falls (235 fatalities). (Sources: NIOSH [2001a]; Myers
Air transport 88 [2001a].)
Struck by flying/caught in 49
Poisoning 45
Fires 39
Unknown 22
Explosion 21
0 200 400 600 800 1,000 1,200
Number of fatal injuries

Numbers and Rates among States

How did the number of fatal occupational injuries in
agriculture, forestry, and fishing differ by State during
19922000?

Figure 38. Fatal occupational injuries in the agriculture, for-

estry, and fishing industry by State, 19922000. (Fatality data
exclude New York City.) During 19922000, the highest num-
bers of fatal occupational injuries in agriculture, forestry, and
Number of fatal fishing were reported by California (646), Texas (384), Florida
injuries
(313), Kentucky (298), Pennsylvania (289), and Tennessee
271646
(271). (Sources: BLS [2001a]; Myers [2001b].)
181270
91180
090

198
 Chapter 3 Focus on Agriculture

How did the rates of fatal occupational injury in

agriculture, forestry, and fishing differ by State during
19922000?

Figure 39. Fatal occupational injury rates in the agriculture,

forestry, and fishing industry by State, 19922000. (Fatality
data exclude New York City.) During 19922000, the highest
fatal occupational injury rates in agriculture, forestry, and fish-
ing were reported by Alaska (175.9 per 10,000 workers), Ken-
tucky (62.3), and Tennessee (44.3). (Sources: BLS [2001a,b];
Myers [2001b].) Rate per 10,000
workers
40.0175.9
25.039.9
14.024.9
9.613.9

Youths 800
742

Age 700

How were unintentional on-farm deaths distributed by age 600

Number of fatal injuries

among youths during 19921996? 527

500 484
Figure 310. Age distribution for unintentional on-farm 421
deaths of youths under age 20, 19821996. Youths aged 1519
400
accounted for the most unintentional on-farm deaths (742)
during 19821996, and youths under age 5 accounted for the
300
next highest number of these deaths (527). (Sources: NCHS
[2002]; Adekoya and Pratt [2001].)
200

100

0
<5 59 1014 1519
Age range

199
Chapter 3 Focus on Agriculture

Machinery 773 Causes of Death

Drowning 585 What were the major causes of unintentional on-farm
Firearms 237 death for youths during 19821996?
Struck by/against 109 Figure 311. Unintentional on-farm deaths of youths under
Mechanical suffocation 107 age 20 by cause of death, 19821996. During 19821996,
unintentional on-farm deaths of youths under age 20 most
Animals 82
frequently involved machinery (773 fatalities), drowning (585
Electric current 78 fatalities), or firearms (237 fatalities). (Sources: NCHS [2002];
Falls 69 Adekoya and Pratt [2001].)

Nature, environment 43
Poisoning 23
Fire and flame 22
All other causes 46

0 100 200 300 400 500 600 700 800

Number of fatal injuries

Numbers among States

How were unintentional on-farm deaths of youths
distributed by State during 19821996?

Figure 312. Unintentional on-farm deaths of youths under

age 20 by State, 19821996. During 19821996, the highest
numbers of unintentional on-farm deaths of youths under age
20 were reported by Texas (204), Pennsylvania (109), Iowa
(107), Missouri (106), and Wisconsin (105). (Sources: NCHS
Number of fatal [2002]; Adekoya and Pratt [2001].)
injuries
>150
101150
51100
050

200

Nonfatal Agricultural Injuries
This section provides data for answering basic questions about non-
fatal injuries among workers and youths exposed to agricultural
hazards. These injuries occurred in the following types of opera-
tions: farming, agricultural services, forestry, commercial fishing,
and commercial hunting. Farming refers to both crop and livestock
operations unless otherwise specified.
Data for the figures come from four sources: (1) the BLS Survey
of Occupational Injuries and Illnesses (SOII), which is an annual
survey of U.S. business establishments that collects data on injuries
and illnesses reportable to the Occupational Safety and Health
Administration (OSHA); (2) the NIOSH Traumatic Injury Sur-
veillance of Farmers (TISF) survey, which is a farm study on occu-
pational farm injuries for 19931995; (3) the NIOSH Childhood
Agricultural Injury Survey (CAIS), which is a farm survey on farm-
related injuries among youths during 1998; and (4) the Minority
Farm Operator Childhood Agricultural Injury Study (MCAIS),
a study of farm-related injuries among youths on minority farm
operations in 2000.
The number of nonfatal occupational injuries in the agriculture,
forestry, and fishing industry has been slowly increasing, and an
estimated 104,400 of these injuries occurred in 2001 (Figure 313).
Although injury rates in agriculture have declined since 1981, they
Chapter 3 Focus on Agriculture
consistently exceed those in the private sector (Figure 314). Cali-
fornia had the highest number of nonfatal occupational farming
injuries during 19931995, followed by Minnesota, Iowa, and Wis-
consin (Figure 315). Nonfatal occupational farming injuries were
highest on cattle, hog, or sheep operations, followed by cash grain
and dairy operations (Figure 317). Rates for crop and livestock
operations were similar (Figure 318), and injuries were primarily
caused by machinery and livestock (Figure 319).
The farming environment is a concern for youths living or work-
ing on farms. Nearly 33,000 youths under age 20 were injured on
farms in 1998 [Myers and Hendricks 2001]. The major causes of
these injuries were falls, animals, and on-farm vehicles such as all-
terrain vehicles [Myers and Hendricks 2001]. The rates of both
occupational and nonoccupational injuries are higher for youths
who reside and work on farms than for youths hired for on-farm
labor (Figures 320 and 321). The Midwest region of the United
States had the highest number and rate of occupational on-farm
injuries among youths under age 20 in 1998 (6,107 injuries at a rate
of 0.95 per 1,000 youths) (Figure 323). Youths residing on racial
minority and Hispanic farms had the highest numbers and rates of
nonfatal injuriesboth nonoccupational (Figures 326 and 330)
and occupational (Figures 327 and 331).
201
 Chapter 3 Focus on Agriculture

Magnitude and Trend

115,400
113,100
110,700

109,400

108,400

107,100
106,900
105,100

104,400
103,400
100,400
120,000

100,000
How did the number of occupational injuries in

98,000
97,300
95,000
agriculture, forestry, and fishing change during 1981

90,200
88,300
2001?

86,400
85,900

84,600
100,000

83,300 Figure 313. Number of occupational injuries in the agricul-

ture, forestry, and fishing industry (excluding farms with fewer
Number of injuries

80,000
than 11 employees), 19812001. The number of occupational
injuries in agriculture, forestry, and fishing slowly increased
60,000 from 83,300 injuries in 1982 to 115,400 in 1995. An estimated
104,400 nonfatal occupational injuries occurred in this indus-
40,000 try in 2001. (Note: Data before 1992 include fatalities.) (Sources:
BLS [2002c]; Myers [2002].)

20,000

0
1981 1983 1985 1987 1989 1991 1993 1995 1997 1999 2001

Agriculture, forestry, and fishing How did the annual rates of occupational injuries in
11.7 11.5 11.5 agriculture, forestry, and fishing compare with the rates in
12
11.0 11.0 the private sector during 19812001?
10.7 10.7 10.6
11.3
10 10.4 10.4 9.4 9.3 Figure 314. Occupational injury rates in the agriculture, for-
10.2
Private sector 10.0 estry, and fishing industry (excluding farms with fewer than 11
8.3 8.2 8.3 8.3 8.4
8.1 8.0 7.9 7.9 7.7 7.9 employees) and the private sector, 19812001. Occupational
Rate per 100 workers

8 7.6 7.5 7.5 7.7 7.7 7.5 7.6

7.0 6.8 7.0
injury rates in agriculture, forestry, and fishing declined from
6.9 6.6
11.7 per 100 full-time workers in 1981 to 6.8 in 2000. The rate
6.2
5.9 5.8 increased slightly in 2001 to 7.0 per 100 full-time workers. Inju-
6 5.4
ry rates for agriculture consistently exceeded comparable rates
in the private sector. (Note: Data before 1992 include fatalities.)
4 (Sources: BLS [2002c]; Myers [2002].)

0
1981 1983 1985 1987 1989 1991 1993 1995 1997 1999 2001

202
 Chapter 3 Focus on Agriculture

Numbers and Rates among States

How did the number of nonfatal occupational farming
injuries differ by State during 19931995?

Figure 315. Number of nonfatal occupational farming injuries

by State, 19931995. During 19931995, the highest numbers
of nonfatal occupational farming injuries occurred in California
(12,695), Minnesota (11,847), Iowa (11,137), and Wisconsin
(10,173). (Note: For reporting purposes, the following States
were combined: Alaska and Washington; Connecticut, Mas- Number of injuries
sachusetts, and Rhode Island; Delaware and Maryland; Maine, 9,00112,695
New Hampshire, and Vermont; Montana and Wyoming; and 6,0019,000
Nevada and Utah.) (Sources: NIOSH [2001b]; Myers [2001c].)
3,0016,000
4933,000

How did the rates of nonfatal occupational farming

injuries differ by State during 19931995?

Figure 316. Rates of nonfatal occupational farming injuries

by State, 19931995. Mississippi had the highest rate of nonfa-
tal occupational farming injury (14.5 per 100 full-time work-
ers), followed by Alaska and Washington (combined injury rate
of 14.3), Arizona (13.7), Ohio (13.1), and Colorado (11.3).
(Note: For reporting purposes, the following States were com-
bined: Alaska and Washington; Connecticut, Massachusetts,
and Rhode Island; Delaware and Maryland; Maine, New Hamp- Rate per 100
shire, and Vermont; Montana and Wyoming; and Nevada and workers
Utah.) (Sources: BLS [2002b]; NIOSH [2001b]; Myers [2001c].) 10.614.5
7.110.5
3.67.0
2.03.5

203
Chapter 3 Focus on Agriculture

Cattle, hogs,
191,772
Type of Farm
sheep
How did nonfatal occupational farming injuries differ by
Cash grain 90,781
the type of farm operation during 19931995?

Dairy 72,017 Figure 317. Number of nonfatal occupational farming inju-

ries by type of farm operation, 19931995. During 19931995,
Vegetable,
fruit, nuts 60,632 most nonfatal occupational injuries occurred on cattle, hog, or
sheep operations, followed by cash grain and dairy operations.
Field crop 44,138 (Sources: NIOSH [2001b]; Myers [2001c].)

Nursery 36,961

Poultry 6,393

Other 16,221

0 50,000 100,000 150,000 200,000

Number of injuries

How did nonfatal occupational injury rates differ by type

of farm operation during 19931995?
Crop farms 8.2
Figure 318. Rates of nonfatal occupational farming injuries
by type of farm operation, 19931995. Nonfatal occupational
injury rates were similar for crop and livestock farms during
19931995, but rates were slightly higher for crop farms. (Sourc-
es: NIOSH [2001b]; Myers [2001c].)
Livestock farms 7.0

All farms 7.5

0 1 2 3 4 5 6 7 8 9
Rate per 100 workers

204
 Chapter 3 Focus on Agriculture

Source of Injury
Machinery 99,402
What were the leading sources of nonfatal occupational
farming injuries during 19931995?
Livestock 99,310
Figure 319. Number of nonfatal occupational farming inju-
ries by leading sources of injury, 19931995. Nonfatal occu-
pational farming injuries were primarily caused by machinery
Working 43,417
and livestock during 19931995. Other major sources of injury surfaces
included working surfaces and hand tools. (Sources: NIOSH
[2001b]; Myers [2001c].)
Hand tools 41,777

Tractors 24,590

0 25,000 50,000 75,000 100,000

Number of injuries

Youths on Farms 30,000

Number Rate 1.87 2.0

How were injured youths related to the farms where the 25,768
injuries occurred in 1998? 25,000 23,640
1.5
Figure 320. Number and rate of all nonfatal on-farm injuries 1.33

Rate per 100 youths

to youths under age 20 by relationship to the farm, 1998. In 20,000
Number of injuries

1998, farm youths accounted for 25,768 nonfatal on-farm inju-

ries, both occupational and nonoccupational. Household farm
youths had a higher overall nonfatal injury rate (1.87 per 100) 15,000 1.0
than youths hired to work on the farm (0.32 per 100). (Note:
A probability sample was used to produce different injury
estimates. Because of rounding in calculating these estimates, 10,000
data may not sum to the totals.) (Source: Myers and Hendricks 0.5
[2001].) 0.32
5,000
2,127

0 0.0
All farm youths Household Hired

205
 Chapter 3 Focus on Agriculture

Number Rate 1.6 How were injured youths related to the farms where they
1.41 were injured while working in 1998?

14,000
Figure 321. Number and rate of nonfatal occupational on-
farm injuries to youths under age 20 by relationship to the
12,382 1.2
farm, 1998. In 1998, farm youths under age 20 accounted for
12,000

Rate per 100 youths

12,382 nonfatal occupational on-farm injuries. Youth visitors
10,254 and hired youths accounted for similar numbers of occupa-
10,000 0.89
Number of injuries

tional injuries (2,208 and 2,127 injuries, respectively). House-

0.8 hold farm youths had a higher overall occupational injury rate
8,000
than youths hired to work on the farm. (Note: A probability
sample was used to produce different injury estimates. Because
6,000
of rounding in calculating these estimates, data may not sum to
0.32 0.4 the totals.) (Source: Myers and Hendricks [2001].)
4,000
2,127
2,000

0 0.0
All farm youths Household Hired

Number Rate 1.5 How did the number and rate of all nonfatal on-farm
1.36 1.38
14,000 1.33 injuries differ by U.S. region for youths in 1998?
1.21 Figure 322. Number and rate of all nonfatal on-farm injuries
12,040
12,000 to youths under age 20 by region, 1998. In 1998, the Midwest
region of the United States had the highest number of all non-

Rate per 100 youths

10,000 1.0 fatal on-farm injuries to youths under age 20 (12,040 injuries),
Number of injuries

whereas the West had the highest rate of these injuries (1.38
8,000 7,557 per 100 youths). (Source: Myers and Hendricks [2001].)

6,000
0.5
4,174
4,000

1,996
2,000

0 0.0
Northeast Midwest South West

206
 Chapter 3 Focus on Agriculture

How did the number and rate of nonfatal occupational on- Number Rate
farm injuries differ by U.S. region for youths in 1998? 7,000 0.95 1.0
0.88
Figure 323. Number and rate of occupational on-farm injuries 0.83 6,107
0.82
to youths under age 20 by region, 1998. The Midwest region of 6,000
0.8
the United States had the highest number of occupational on-
farm injuries to youths in 1998 (6,107 injuries) as well as the 5,000

Rate per 100 youths

Number of injuries
highest occupational injury rate (0.95 per 100 youths). (Source:
Myers and Hendricks [2001].) 0.6
4,000
3,142
3,000 0.4
2,041
2,000

1,091 0.2
1,000

0 0.0
Northeast Midwest South West

Youths on Minority Farms 250 All youths Working youths

How did the number of nonfatal injuries to youths on 206

racial minority farms differ by race in 2000? 200

Figure 324. Number of nonfatal injuries to all youths and

Number of injuries

working youths under age 20 on racial minority farm opera-

150
tions by race, 2000. On minority farm operations in 2000, the
most nonfatal injuries to all youths under age 20 occurred
among American Indian or Alaska Native youths (206 injuries), 105
followed by other (105), white youths (92), black youths (78), 100 92
85
and Asian or Pacific Islanders (50). Far fewer nonfatal injuries 78
occurred among working youths. (Source: Myers et al. [2003].)
50
50 38 37
27
13
0
White Black American Indian or Asian or Pacific Other
Alaska Native Islander

207
 Chapter 3 Focus on Agriculture

Number Rate 24.0 25 How did the number and rate of nonfatal injuries to
household youths on racial minority farms differ by race
in 2000?
20
Figure 325. Number and rate of nonfatal injuries to house-
177 hold youths under age 20 on racial minority farm operations

Rate per 1,000 youths

180
by race, 2000. American Indian and Alaska Native youths had
15 the highest number (177) and rate (24.0 per 1,000 youths) of
150
12.3 nonfatal injuries among household youths on minority farm
Number of injuries

120
operations. Youths of other races had the second highest num-
96 10 ber (96) and rate (12.3 per 1,000 youths) of nonfatal injuries
90 among household youths, followed by black youths and Asian
6.4 or Pacific Islander youths. (Source: Myers et al. [2003].)
60 49 4.6
5
30 26

0 0
Black American Indian or Asian or Pacific Other
Alaska Native Islander

Number Rate How did the number and rate of nonfatal injuries to
348 youths on racial minority farms differ by relationship to
350 14 the farm in 2000?
12.2
300 12 Figure 326. Number and rate of nonfatal injuries to youths
under age 20 on racial minority farm operations by relation-
250 10 ship to the farm, 2000. Household youths had the highest

Rate per 1,000 youths

number (348) and rate (12.2 per 1,000 youths) of nonfatal
Number of injuries

injuries among youths on racial minority farm operations in

200 8
2000. Hired workers had the second highest injury rate (2.7
per 1,000 hired working youths) but the lowest number of
150 6 injuries (20). Visiting relatives accounted for the second high-
124
est number of nonfatal youth injuries (124), followed by hired
100 4 workers (20). (Source: Myers et al. [2003].)
2.7

50 37 2
20 0.6
0.2
0 0
Household Hired Visiting relatives Other visitors

208
 Chapter 3 Focus on Agriculture

How did the number and rate of nonfatal occupational Number Rate
injuries to youths on racial minority farms differ by 140 138
relationship to the farm in 2000? 11.7 12

Figure 327. Number and rate of nonfatal occupational inju- 120

10
ries to youths under age 20 on racial minority farm operations
by relationship to the farm, 2000. Household youths had the 100

Rate per 1,000 youths

Number of injuries
highest number (138) and rate (11.7 per 1,000 youths) of non- 8
fatal occupational injuries to youths on racial minority farm
80
operations in 2000. Visiting relatives had the next highest num-
ber of injuries (42) and the same rate of nonfatal occupational 6
injuries as hired workers (2.7 per 1,000 youths). (Source: Myers 60
et al. [2003].) 42 4
40 2.7 2.7
20 2
20

0 0
Household Hired Visiting relatives

What injury hazard accounted for the highest number and Number Rate
rate of nonfatal injuries to household youths on racial 11.7
12
minority farm operations in 2000?
138
Figure 328. Number and rate of nonfatal injuries to house- 140
10
hold youths under age 20 on racial minority farm operations by
known injury hazard, 2000. Of the four known injury hazards 120 8.0

Rate per 1,000 youths

to household youths in 2000, work accounted for the highest 8
number (138) and rate (11.7 per 1,000 youths) of nonfatal 100
Number of injuries

injuries to these youths on racial minority farm operations.

Horses accounted for the second highest number (60) and 80 6
rate (8.0 per 1,000 youths) of these nonfatal injuries, followed 4.5 60
by all-terrain vehicles (ATVs) and tractors. (Source: Myers et al. 60
4
[2003].)
40 2.2
29
2
20 14

0 0
Work ATVs Tractors Horses

209
 Chapter 3 Focus on Agriculture

All youths Working youths Youths on Hispanic Farms

300 289
How did the number of nonfatal injuries to youths differ
between Hispanic and non-Hispanic youths on Hispanic
250 farm operations in 2000?

Figure 329. Nonfatal injuries to Hispanic and non-Hispanic

200
Number of injuries

youths under age 20 on Hispanic farm operations, 2000. On

Hispanic farm operations in 2000, Hispanic youths accounted
150 for much higher numbers of nonfatal injuries (289) and occu-
124 pational nonfatal injuries (124) than did non-Hispanic youths.
(Source: Myers et al. [2003].)
100
77

50
16
0
Hispanic Non-Hispanic

Number Rate 16 How did the number and rate of nonfatal injuries to
14.2 youths on Hispanic farms differ by relationship to the
300 14 farm in 2000?
256 Figure 330. Number and rate of nonfatal injuries to youths
250 12
under age 20 on Hispanic farm operations by relationship to

Rate per 1,000 youths

the farm, 2000. Household youths had the highest number
10 (256) and rate (14.2 per 1,000) of nonfatal injuries to youths
Number of injuries

200
on Hispanic farm operations in 2000. Visiting relatives account-
8 ed for an additional 58 injuries on these farms, followed by
150 other visitors (33 injuries). Hired workers accounted for the
6 lowest number of nonfatal injuries to youths (17), but they had
100
the second highest injury rate (3.3 per 1,000 youths). (Source:
3.3 4 Myers et al. [2003].)
58
50 33 2
17 0.5 0.2
0 0
Household Hired Visiting relatives Other visitors

210
 Chapter 3 Focus on Agriculture

How did the number and rate of nonfatal occupational Number Rate
16
injuries to youths on Hispanic farms differ by relationship 120 114
to the farm in 2000? 14.4
14
Figure 331. Number and rate of nonfatal occupational inju- 100
ries to youths under age 20 on Hispanic farm operations by 12

Rate per 1,000 youths

relationship to the farm, 2000. On Hispanic farm operations
80

Number of injuries
in 2000, household youths had a much higher number (114) 10
of occupational injuries than nonhousehold youths, and their
rate of injury (14.4 per 1,000 youths) was 8 times the rate for 8
60
nonhousehold working youths (1.7 per 1,000 youths). (Source:
Myers et al. [2003].) 6
40
26 4
20 1.7
2

0 0
Household Nonhousehold

What injury hazard accounted for the highest number and Number Rate 16
rate of nonfatal injuries to youths on Hispanic farms in 14.4
2000? 14
120 114
Figure 332. Number and rate of nonfatal injuries to house-
12
hold youths under age 20 on Hispanic farm operations by

Rate per 1,000 youths

known injury hazard, 2000. Of the four recognized hazards 100
to household youths in 2000, work accounted for the highest 10
Number of injuries

number (114) and rate (14.4 per 1,000 youths) of nonfatal 80

injuries to these youths on Hispanic farm operations. Horses 8
accounted for the second highest number (31) and rate (5.8
60 5.8
per 1,000 youths) of these nonfatal injuries, followed by ATVs 5.1 6
5.0
and tractors. (Source: Myers et al. [2003].)
40
31 4
25 22
20 2

0 0
Work ATVs Tractors Horses

211
Chapter 3 Focus on Agriculture
Farm Workers
This section provides data for answering basic questions about the
occupational health of hired agricultural workers. Data for the
figures come from the U.S. Department of Labor (DOL) National
Agricultural Workers Survey (NAWS). This annual workplace-based
survey of hired crop workers across the United States has included
occupational farm injury and health questions since 1999 [DOL
2001]. During that year, 84% of farm workers were foreign born and
53% lacked legal documentation [DOL 2001]. These characteris-
tics distinguished farm workers from other employed workers. One
criterion for inclusion in the survey is employment in agriculture
during the preceding 14 days. To capture seasonal and geographic
variations in the volume of farm labor, NAWS bases its sampling of
agricultural workplaces on three interviewing cycles that last 10 to
12 weeks each. Cycles begin in February, June, and October.
In 1999, 49% of farm workers were settled (residing within 75 miles of
their farm work job) (Figure 333), and 36% had been employed
in farm work for more than 10 years (Figure 334). Farm workers
were predominately young (85% were under age 45), male (78%),
and Hispanic (93%) (Figures 335 and 336). The highest number
of nonfatal injuries occurred among farm workers aged 3034 (Fig-
ure 337). Occupational injury rates in 1999 ranged from 1.5
per 100 workers under age 20 to 11.2 per 100 workers aged 4554.
212
(Figure 338). The percentage of farm workers reporting at least one
health condition (respiratory, musculoskeletal, dermatologic, or gas-
trointestinal) during the preceding 12 months increased with years of
U.S. farm work, and the highest percentage (34%) was reported for
farm workers with more than 10 years of this work (Figure 339).
During 1999, the percentage of workers with musculoskeletal pain
or discomfort ranged from 11% of those in their first year of farm
work in the United States to 19% in workers having more than 10
years of this work (Figure 340). The percentage of farm workers
with joint or muscle pain was highest in those reporting work in
multiple crop categories (Figure 341). The percentage of workers
reporting dermatitis was similar regardless of the number of years
in U.S. farm work (Figure 342), ranging from 6.7% to 7.8% (Fig-
ure 342). Dermatitis was most common in farm workers report-
ing work in multiple crop categories (8.0%) and in fruits and nuts
(7.9%) (Figure 343). The percentage of farm workers reporting
wheezing increased steadily with years of U.S. farm work, from 1.5%
for workers with less than 1 year to 4.7% for workers with more than
10 years of this work (Figure 344). Wheezing was most common
in farm workers reporting work in multiple crop categories (4.8%)
(Figure 345).
 Chapter 3 Focus on Agriculture

Migrant Status 50 49

What was the migrant status of farm workers in 1999?

40
Figure 333. Distribution of farm workers by migrant status,
1999. In 1999, 49% of farm workers were settled (residing
within 75 miles of their farm work job). The rest were migrant

Distribution (%)
30
workers to varying degrees: 22% were newcomers (entered the
United States to work in farm work during the past year); 21%
21 22
were shuttle migrants (have a residence in the United States
but commute to farm work at a distance); and 8% were follow- 20
the-crop migrants (perform farm work in more than one loca-
tion and must move for employment). (Sources: DOL [2001];
Steege and Baron [2002].) 10 8

0
Settled Shuttle Follow-the-crop Newcomer
Migrant status

Years in Farm Work 40

36
How were farm workers distributed by years in U.S. farm 35
work in 1999?
30
Figure 334. Distribution of farm workers by years in U.S.
24 24
Distribution (%)

farm work, 1999. In 1999, 36% percent of farm workers had 25

been employed more than 10 years in farm work. (Sources: DOL
[2001]; Steege and Baron [2002].) 20
16
15

10

0
<1 14 510 >10
Years in farm work

213
 Chapter 3 Focus on Agriculture

30 29 Age
How were farm workers distributed by age in 1999?
25
22 Figure 335. Distribution of farm workers by age, 1999. Farm
20
workers were predominately young in 1999, with 85% under
20
age 45. (Sources: DOL [2001]; Steege and Baron [2002].)
Distribution (%)

15 14

10 9

5
5

1
0
<20 2024 2534 3544 4554 5564 >64
Age range

Female, Hispanic Sex and Hispanic Ethnicity

21%
How were farm workers distributed by sex and Hispanic
ethnicity in 1999?

Figure 336. Distribution of farm workers by sex and Hispan-

ic ethnicity, 1999. In 1999, farm workers were predominately
Female, non-Hispanic male (78%) and Hispanic (93%). (Sources: DOL [2001]; Steege
1% and Baron [2002].)
Male, non-Hispanic
6%
Male, Hispanic
72%

214
 Chapter 3 Focus on Agriculture

Nonfatal Injuries 14,000

12,543
12,130 12,211
How did nonfatal occupational injuries differ by age 12,000
among farm workers in 1999?
10,000
Figure 337. Nonfatal occupational injuries to farm workers

Number of injuries
by age, 1999. In 1999, the highest number of nonfatal occu- 7,985
pational injuries (12,543) occurred among farm workers aged 8,000 7,434
3034. However, workers aged 3539 and 4549 accounted for 6,662 6,579
similar numbers of injuries (12,130 and 12,211). (Note: A dash 6,000
in parentheses indicates that no injury data were reported or
estimated from the survey for this age group.) (Sources: DOL 3,825 3,812
4,000
[2001]; Myers [2001d].)

2,000
235 ()
0
<20 2024 2529 3034 3539 4044 4549 5054 5559 6064 >64
Age range

How did nonfatal occupational injury rates among farm 12

11.2 11.2
workers differ by age in 1999?

Figure 338. Occupational injury rates for farm workers by 10

age, 1999. In 1999, nonfatal occupational injury rates for farm
workers increased with age, peaking at 11.2 per 100 workers
Rate per 100 workers

8
aged 4554 and declining steeply for workers aged 5564.
(Note: A dash in parentheses indicates that no injury data were 6.3
6.1
reported or estimated from the survey for this age group; thus 6 5.7
no rate estimates were made.) (Sources: DOL [2001]; Myers 4.9
[2001d].)
4
2.8 3.0
2.0
2 1.5

()
0
<20 2024 2529 3034 3539 4044 4549 5054 5559 6064 >64
Age range

215
 Chapter 3 Focus on Agriculture

40 Health Conditions or Symptoms

35 34
How did the percentage of farm workers reporting at least
one health condition in 1999 differ by years in U.S. farm
30 29 29
work?
Prevalence (%)

25 Figure 339. Percentage of farm workers reporting at least

one health condition during the preceding 12 months by years
20 19 in U.S. farm work, 1999. In 1999, the percentage of farm work-
ers reporting at least one health condition (respiratory, mus-
15 culoskeletal, dermatologic, or gastrointestinal) during the pre-
ceding 12 months increased gradually with years of farm work.
10 The lowest percentage (19%) was reported for farm workers
with less than 1 year of work experience in U.S. farming. The
5 highest percentage (34%) was reported for farm workers with
more than 10 years of U.S. farm work. (Sources: DOL [2001];
0 Steege and Baron [2002].)
<1 14 510 >10
Years in farm work

20 19 Joint or Muscle Pain

18
How did the percentage of farm workers reporting joint or
16 15 muscle pain differ by years of U.S. farm work in 1999?

14 Figure 340. Percentage of farm workers reporting joint or

12 muscle pain in at least one body part during the preceding 12
Prevalence (%)

12 11 months by years in U.S. farm work, 1999. In 1999, the percent-

10 age of workers reporting joint or muscle pain in the back,
shoulder, elbow/arm, hand/wrist, or legs/feet ranged from
8 11% for those in their first year of U.S. farm work to 19% for
6
workers with more than 10 years of this work. (Sources: DOL
[2001]; Steege and Baron [2002].)
4

0
<1 14 510 >10
Years in farm work

216
 Chapter 3 Focus on Agriculture

How did the percentage of farm workers reporting joint or 25

muscle pain differ by crop in 1999?
20
Figure 341. Percentage of farm workers reporting joint or 20
muscle pain in at least one body part during the preceding 12
months by crop category last worked, 1999. The percentage of 16
farm workers reporting joint or muscle pain in 1999 is high- 15 15

Prevalence (%)
est (20%) among those working in multiple crop categories 15
and lowest (11%) among horticulture workers. An average of
11
15% of workers in vegetables, fruits and nuts, and field crops
reported joint or muscle pain. (Sources: DOL [2001]; Steege and 10
Baron [2002].)

0
Field crops Fruits and nuts Horticulture Vegetables Other or multiple
Crop category

Dermatitis 8 7.8

How did the percentage of farm workers reporting 7 6.7 6.7 6.8
dermatitis differ by years of U.S. farm work in 1999?
6
Figure 342. Percentage of farm workers reporting dermatitis
during the preceding 12 months by years in U.S. farm work,
Prevalence (%)

5
1999. The percentage of farm workers reporting dermatitis on
the hands, arms, face, torso, or legs in 1999 was similar regard- 4
less of the number of years in U.S. farm work. The percentage
ranged from 6.7% in farm workers with less than 5 years of 3
U.S. farm work to 7.8% in those with 510 years of this work.
(Sources: DOL [2001]; Steege and Baron [2002].) 2

0
<1 14 510 >10
Years in farm work

217
 Chapter 3 Focus on Agriculture

9 How did the percentage of farm workers reporting

7.9 8.0 dermatitis differ by crop in 1999?
8
Figure 343. Percentage of farm workers reporting dermatitis
7 6.8 6.7 during the preceding 12 months by crop category last worked,
1999. In 1999, dermatitis was most common in farm workers
6 5.7
reporting work in multiple crop categories (8.0%) and fruits
Prevalence (%)

5 and nuts (7.9%). The percentage of workers with dermatitis

was lowest in vegetable workers (5.7%). (Sources: DOL [2001];
4 Steege and Baron [2002].)

0
Field crops Fruits and nuts Horticulture Vegetables Other or multiple
Crop category

5
4.7 Wheezing
How did the percentage of farm workers reporting
4 wheezing or whistling in the chest differ by years of U.S.
farm work in 1999?

Figure 344. Percentage of farm workers reporting wheez-

Prevalence (%)

3 2.9
ing or whistling in the chest at any time during the preceding
12 months by years in U.S. farm work, 1999. The percentage
2.2
of farm workers reporting wheezing or whistling in the chest
2 increased with years of U.S. farm work, from 1.5% of farm
1.5 workers with less than 1 year to 4.7% of those with more than
10 years of this work. (Sources: DOL [2001]; Steege and Baron
1 [2002].)

0
<1 14 510 >10
Years in farm work

218
 Chapter 3 Focus on Agriculture

How did the percentage of farm workers reporting 5 4.8

wheezing or whistling in the chest symptoms differ by
crop in 1999?
4
Figure 345. Percentage of farm workers reporting wheezing 3.6 3.6
or whistling in the chest at any time during the preceding 12
months by crop category last worked, 1999. Wheezing or whis-

Prevalence (%)
3
tling in the chest was most common in farm workers reporting 2.7 2.6
work in multiple crop categories (4.8%) and less common
in vegetable workers (2.6%) and workers in fruits and nuts
(2.7%). (Sources: DOL [2001]; Steege and Baron [2002].) 2

0
Field crops Fruits and nuts Horticulture Vegetables Other or multiple
Crop category

219
Chapter 3 Focus on Agriculture
References
Adekoya N, Pratt SG [2001]. Fatal unintentional farm injuries among
persons less than 20 years of age in the United States: geographic
profiles. Cincinnati, OH: U.S. Department of Health and Human
Services, Public Health Service, Centers for Disease Control and
Prevention, National Institute for Occupational Safety and Health,
DHHS (NIOSH) Publication No. 2001131. [www.cdc.gov/niosh/
childag/docs/2001131.html] and [www.cdc.gov/niosh/childag/
pdfs/Childag2.pdf]
BLS [2001a]. Census of fatal occupational injuries. Washington,
DC: U.S. Department of Labor, Bureau of Labor Statistics, Safety
and Health Statistics Program. [www.bls.gov/iif/oshcfoi1.htm]
BLS [2001b]. Current population survey. Washington, DC: U.S.
Department of Labor, Bureau of Labor Statistics. [www.bls.gov/
cps/] and [www.bls.census.gov/cps/]
BLS [2002a]. Census of fatal occupational injuries. Washington,
DC: U.S. Department of Labor, Bureau of Labor Statistics, Safety
and Health Statistics Program. [www.bls.gov/iif/oshcfoi1.htm]
BLS [2002b]. Current population survey. Washington, DC: U.S.
Department of Labor, Bureau of Labor Statistics. [www.bls.gov/
cps/] and [www.bls.census.gov/cps/]
BLS [2002c]. Survey of occupational injuries and illnesses. Detailed
statistics. Occupational injuries and illnesses: industry data. Wash-
ington, DC: U.S. Department of Labor, Bureau of Labor Statistics.
Database. [data.bls.gov/labjava/outside.jsp?survey=sh]
220
BLS [2003]. Census of fatal occupational injuries. Washington, DC:
U.S. Department of Labor, Bureau of Labor Statistics, Safety and
Health Statistics Program. [www.bls.gov/iif/oshcfoi1.htm]
DOL [2001]. National Agricultural Workers Survey (NAWS) Occu-
pational Injury and Health Supplement. Washington, DC: U.S.
Department of Labor, Office of the Assistant Secretary for Policy.
Database.
Myers J [2001a]. Analysis of the National Traumatic Occupational
Fatalities (NTOF) Surveillance System data, 19921997. Mor-
gantown, WV: U.S. Department of Health and Human Services,
Centers for Disease Control and Prevention, National Institute for
Occupational Safety and Health. Unpublished.
Myers J [2001b]. Analysis of the census of fatal occupational injury
(CFOI) data, 19922000. Morgantown, WV: U.S. Department of
Health and Human Services, Centers for Disease Control and
Prevention, National Institute for Occupational Safety and Health.
Unpublished.
Myers J [2001c]. Analysis of the Traumatic Injury Surveillance of
Farmers (TISF) Survey, 19931995. Morgantown, WV: U.S. Depart-
ment of Health and Human Services, Centers for Disease Control
and Prevention, National Institute for Occupational Safety and
Health. Unpublished.
Myers J [2001d]. Analysis of the National Agricultural Workers
Survey (NAWS) Occupational Injury and Health Supplement. Mor-
gantown, WV: U.S. Department of Health and Human Services,
Centers for Disease Control and Prevention, National Institute for
Occupational Safety and Health. Unpublished.

Myers J [2002]. Analysis of the survey of occupational injuries and
illnesses data, 19812001. Morgantown, WV: U.S. Department of
Health and Human Services, Centers for Disease Control and
Prevention, National Institute for Occupational Safety and Health.
Unpublished.
Myers J [2003]. Analysis of the census of fatal occupational injury (CFOI)
data, 19922001. Morgantown, WV: U.S. Department of Health and
Human Services, Centers for Disease Control and Prevention, National
Institute for Occupational Safety and Health. Unpublished.
Myers JR, Hendricks KJ [2001]. Injuries among youth on farms in
the United States, 1998. U.S. Department of Health and Human
Services, Public Health Service, Centers for Disease Control and
Prevention, National Institute for Occupational Safety and Health,
DHHS (NIOSH) Publication No. 2001154. [www.cdc.gov/niosh/
childag/pdfs/2001154.pdf]
Myers J, Hendricks K, Goldcamp E, Layne L [2003]. Analysis of the
Minority Farm Operator Childhood Agricultural Injury Study (M
CAIS). Morgantown, WV: U.S. Department of Health and Human
Services, Centers for Disease Control and Prevention, National
Institute for Occupational Safety and Health. Unpublished.
Chapter 3 Focus on Agriculture
NCHS [2002]. Multiple-cause-of-death public-use data files. Hyatts-
ville, MD: U.S. Department of Health and Human Services, Centers
for Disease Control and Prevention, National Center for Health
Statistics. [www.cdc.gov/nchs/about.htm] and [www.cdc.gov/nchs/
products/elec_prods/subject/mortmcd.htm]
NIOSH [2001a]. National Traumatic Occupational Fatalities (NTOF)
Surveillance System. Morgantown, WV: U.S. Department of Health
and Human Services, Centers for Disease Control and Prevention,
National Institute for Occupational Safety and Health. Database.
NIOSH [2001b]. Traumatic Injury Surveillance of Farmers (TISF)
Survey. Morgantown, WV: U.S. Department of Health and Human
Services, Centers for Disease Control and Prevention, National
Institute for Occupational Safety and Health. Database.
Steege A, Baron S [2002]. Analysis of the National Agricultural
Workers Survey (NAWS) Occupational Injury and Health Supple-
ment. Cincinnati, OH: U.S. Department of Health and Human
Services, Centers for Disease Control and Prevention, National
Institute for Occupational Safety and Health. Unpublished.
221
T he National Institute for Occupational Safety and Health
(NIOSH) conducts comprehensive surveillance and research
programs focused on selected high-risk industrial sectors such as
agriculture, mining, and construction. Historically, workers in
these industries have suffered the highest rates of fatal injury. The
most recent data from the Bureau of Labor Statistics (BLS) Census
of Fatal Occupational Injuries (CFOI) reveal that fatal injury rates
in these high-risk industries range from 3.0 to 5.6 times the private
industry rate of 4.2 per 100,000 workers (Figure 41) [BLS 2003a].
Except for mining, these high-risk industries also have elevated
rates of nonfatal occupational injuries and illnesses, as shown by
data from the BLS annual Survey of Occupational Injuries and Ill-
nesses (SOII) (Figure 42).
This chapter provides data on nonfatal and fatal injuries and ill-
nesses in the mining* and construction industries as well as asso-
ciated occupations. Similar data for the agriculture industry are
provided in Chapter 3.
*The Mine Safety and Health Administration (MSHA) provides BLS with data conforming
to the Occupational Safety and Health Administration (OSHA) definitions for mining
operators in coal, metal, and nonmetal mining. Readers should note the following with-
in the BLS data: (1) mining includes oil and gas extraction, and (2) independent mining
contractors are excluded from the coal, metal, and nonmetal mining industries.
223
 Chapter 4 High-Risk Industries and Occupations

Figure 41. Fatal occupational injury rates by industry divi-

Mining 23.5
sion, 2002. Fatal occupational injury rates in 2002 were high-
Agriculture, forestry, 22.7 est in mining (23.5 per 100,000 workers), agriculture, forestry,
and fishing
and fishing (22.7), construction (12.2), and transportation and
Construction 12.2 public utilities (11.3). The rate for all private industry was 4.2
Transportation and per 100,000 workers. (Source: BLS [2003a].)
11.3
public utilities
Wholesale trade 4.0

Manufacturing 3.1

Government 2.7

Retail trade 2.1

Services 1.7
Finance, insurance, 1.0
and real estate
0 5 10 15 20 25
Rate per 100,000 workers

14 13.1 Construction Figure 42. Incidence rates of nonfatal occupational injuries

Agriculture, forestry, and fishing and illnesses in private industry and in high-risk industrial sec-
12.2
11.6 11.8 Private industry tors, 19922001. During 19922001, the rates of total record-
12
11.2 Mining able injuries and illnesses in construction and agriculture
10.6
10.0 9.9 exceeded those for all private industry by an average of 37%
10 9.7 9.5 and 22%, respectively. However, the rates all decreased by simi-
8.9
Rate per 100 workers

8.5 8.7 8.8 8.6 lar percentages during this period36% for all private indus-
8.4 8.4 8.3
8.1 7.9
7.9 try, 40% for construction, and 37% for agriculture, forestry,
8 7.3 7.4 7.3
6.8 7.1 7.1 7.3 and fishing. (Source: BLS [2002a].)
6.3 6.7
6.2 6.3 6.1
5.9 5.7
6 5.4
4.9
4.4 4.7
4.0
4

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

224

Mining
This section contains an overview of the occupational health status
of workers in the mining industry (excluding oil and gas extrac-
tion). An estimated 567,000 workers were employed in the mining
industry in 2001. Most of these workers were aged 2554, (79.4%
compared with 71.5 % for all employed workers), male (85.4%
compared with 53.4% for all employed workers), and white (93.3%
compared with 83.8% for all employed workers) (BLS [2001]).
Although fatal occupational injury rates among mine workers
decreased from 1966 to 2000 (Figure 45), these rates were still
high27 per 100,000 workers for metal/nonmetal mine workers
and 33 per 100,000 for coal mine workers. Both fatal occupational
injuries and lost-workday injuries were distributed unevenly among
various subpopulations in mining (Tables 41 and 42). For exam-
ple, the 19982002 rate of lost-workday cases in the underground
areas of underground mines (7.8 per 100 full-time equivalent work-
ers) was more than double the rate for all mining (Table 42).
Chapter 4 High-Risk Industries and Occupations
Hence, surveillance of the mining population continues to be an
important part of mining safety and health research.
Data in this section were obtained primarily from the Mine Safety
and Health Administration (MSHA) databases of employment and
accident/injury/illness cases for mine operators and independent
contractors. Major commodities covered under MSHA jurisdiction
include coal, metal ores, stone, sand and gravel, and other nonmet-
als (for example, clay). In the following figures, the employer type
metal/nonmetalindependent contractor includes contractors working
at metal, nonmetal, stone, and sand and gravel operations. Data
on coal workers pneumoconiosis were obtained from the National
Surveillance System for Pneumoconiosis Mortality (NSSPM), which
is developed and maintained by the NIOSH Division of Respiratory
Disease Studies and is based on a subset of multiple-cause-of-death,
public-use mortality data obtained annually from the National Cen-
ter for Health Statistics (NCHS).
225
Chapter 4 High-Risk Industries and Occupations

Stone operator
61.3 Employment
68.0
Surface
60.6
Coal operator
43.4 How has the number of workers employed at surface work
27.7 mining operations changed in recent years?
Sand and gravel
operator 32.8
Figure 43. Number of full-time equivalent workers at surface
39.6 1992 work locations by type of employer, 1992 and 2002. From 1992
Metal operator
22.2 2002 to 2002, overall employment at surface mining work locations
23.0 decreased by 8.5%, from 237,300 to 217,000. At surface loca-
Nonmetal operator tions, the number of metal operator workers decreased 44%,
18.3
Metal/nonmetal
the number of coal operator workers decreased 28%, and the
13.1 number of nonmetal operator workers decreased 21%. The
independent
contractor 17.7
number employed at surface operations increased for stone
Coalindependent 12.0 operator workers, sand and gravel operator workers, and inde-
contractor 14.7 pendent contractor workers. (Sources: MSHA [2003]; NIOSH
[2003a].)
0 10 20 30 40 50 60 70
Number of workers (thousands)

56.7 Underground
Coal operator
35.2 How has employment at underground mining operations
5.7
changed in recent years?
Metal operator
3.7 Figure 44. Number of full-time equivalent workers at under-
3.6 ground work locations by type of employer, 1992 and 2002.
Nonmetal operator From 1992 to 2002, the number of full-time equivalent work-
2.3 1992 ers at underground locations declined by 34% (from 69,300 to
1.3 2002 46,000). The number of workers in coal operations declined
Coalindependent
contractor 2.1 38% but still accounted for 77% of underground employment
during this period. The number of metal and nonmetal opera-
1.5 tor workers also declined, whereas the number increased for
Stone operator
1.9 stone operator workers and metal/nonmetalindependent
Metal/nonmetal contractor workers. (Sources: MSHA [2003]; NIOSH [2003a].)
0.4
independent
contractor 0.8

0 10 20 30 40 50 60
Number of workers (thousands)

226
 Chapter 4 High-Risk Industries and Occupations

Fatal Injuries Coal mining Number Metal/nonmetal mining Number

Rate Rate
Magnitude and Trend 1968 Farmington underground coal mine explosion
(78 deaths)
How many fatal injuries occurred in coal and metal/
Federal Coal Mine Health and Safety Act of 1969
nonmetal mining during 19662000? (Regulatory enforcement vastly increased)
1,250 1,229
Figure 45. Number and average annual rate of fatal occu-
pational injuries in coal and metal/nonmetal mining for each
5-year period during 19662000, including factors affecting
reductions in these injuries. The Federal Coal Mine Health and
Safety Act of 1969 was passed soon after 78 coal miners died in
1968 during an underground explosion in the Consol No. 9
Mine at Farmington, West Virginia. Numbers and rates of fatal 1,000
injuries in coal mining declined steadily after passage of the
1969 Act. During the most recent 5-year period (19962000), 902 1972 Sunshine Silver Mine, underground fire
(91 deaths)
the fatal injury rate for coal mining was at its lowest33 per 176 854
100,000 full-time equivalent workers. 180

The Federal Mine Safety and Health Act of 1977 (which 757

Average annual rate per 100,000 workers

160

Number of fatal injuries

750 Federal Mine Safety and Health Act of 1977
included metal/nonmetal mining) was passed a few years after (Consolidated Federal mine regulations for
91 miners lost their lives in a 1972 underground mine fire at coal and metal/nonmetal under MSHA)
660
the Sunshine Silver Mine. The fatal occupational injury rate 140
for metal/nonmetal mining declined to its lowest rate (25.3 609
per 100,000 full-time equivalent workers) in 19911995. Dur- 120
ing 19962000, this rate increased to 27.1 fatalities per 100,000 538
full-time equivalent workers. 500
100
Safety and health legislation has been an important factor in
reducing fatal occupational injury rates over the past three 89 80
decades. However, other critical factors include improvements 329 338
in mining technology such as roof bolting to prevent roof 75 65
72 59
cave-ins, dust suppression and ventilation techniques, and use 266 252 258 60
of noncombustible materials to prevent explosions and fires. 250 45 227
Despite large declines in the numbers and rates of fatal injuries 52 41
171 40
to miners, mining continues to be one of the most hazardous
38 33
occupations. (Sources: MSHA [2002]; NIOSH [2003a].)
30 27
25 20

0 0
196670 197175 197680 198185 198690 199195 19962000

227
Chapter 4 High-Risk Industries and Occupations

Metal/nonmetal 66.3 Type of Employer and Commodity

independent
contractor 54.1
How has the rate of fatal mining injuries changed in
Coalindependent 49.9 recent years?
contractor 39.2
30.3
Figure 46. Rates of fatal mining injuries by type of employer
Sand and gravel
operator 31.1 and commodity, 19931997 and 19982002. For these two peri-
ods, the 5-year average rate of fatal mining injuries declined
24.4 19931997 from 30.2 per 100,000 full-time equivalent workers (19931997)
Stone operator
17.8 19982002 to 27.7 (19982002). Most of this decline was due to decreases
13.3 in the rates of fatal mining injuries among independent con-
Nonmetal operator
7.0 tractor workers, stone operator workers, and nonmetal opera-
tor workers. Increased rates occurred among sand and gravel
18.7
Metal operator operator workers and metal operator workers. (Sources: MSHA
21.3
[2003]; NIOSH [2003a].)
34.4
Coal operator
34.1

0 10 20 30 40 50 60 70
Rate per 100,000 workers

228
 Chapter 4 High-Risk Industries and Occupations

Work Location
Which sectors of the mining industry posed the highest risks of fatal injury to mine workers during 19982002?

Table 41. Number and 5-year average rate of fatal mining injuries by type of employer and commodity at various work locations, 19982002. Underground
mines posed the greatest risk of fatal injury to mine workers during 19982002. At these mines, the highest fatal injury rates were among metal mine opera-
tor workers and all independent contractor workers. At surface locations, the highest fatal injury rate was at the dredge. All 11 fatalities at the dredge
occurred at sand and gravel mines. Within each commodity, fatal injury rates were highest for independent contractor workers at two metal/nonmetal
surface locations: strip/open pit/quarry and mills. (Sources: MSHA [2003]; NIOSH [2003a].)

Work location
Underground mines Surface locations
Strip/
open pit/
Underground Surface areas quarry* Dredge Mills/plants All
Type of employer
and commodity Number Rate Number Rate Number Rate Number Rate Number Rate Number Rate
Mine operator:
Coal 97 51.4 2 NC 27 17.6 0 0.0 12 25.9 138 34.1
Metal 24 103.1 3 NC 3 NC 0 0.0 6 8.1 36 21.3
Nonmetal 3 NC 0 0.0 4 14.9 0 0.0 1 NC 8 7.0
Stone 3 NC 0 0.0 42 26.7 0 0.0 19 10.0 64 17.8
Sand and gravel NA NA NA NA 41 28.6 11 46.0 NR** NR 52 31.1
Independent contractor:
Coal 9 86.7 5 39.2 11 26.2 NA NA 8 42.5 33 39.2
Metal and nonmetal 5 86.5 2 NC 31 48.7 0 0.0 22 58.7 60 54.1
All 141 56.2 12 29.2 159 24.4 11 40.8 68 15.5 391 27.7
*Also includes culm banks, auger mining, independent shops and yards, and surface mining n.e.c.

Computed per 100,000 full-time equivalent workers.

NC = Not computed for 3 or fewer fatalities.

NA = Not applicable for this commodity.
**NR = Not reported separately. Sand and gravel operators report mill employment under strip or dredge operations.

Includes metal, nonmetal, stone, and sand and gravel.

229
 Chapter 4 High-Risk Industries and Occupations

Fall of ground (from 9 3.6% Type of Incident

in place) 61 43.3%
How and where were mine workers fatally injured during
101 40.4%
Powered haulage 19982002?
26 18.4%
Ignition/explosion 4 1.6% Figure 47. Number and distribution of fatal mining injuries
of gas/dust 16 11.3%
by type of incident and work location, 19982002. During
52 20.8% 19982002, most fatal injuries to miners working at surface
Machinery
15 10.6% Surface
mining locations (61.2%) were associated with the use of pow-
10 4.0% Underground ered haulage (such as motors and rail cars, conveyors, bucket
Electrical
9 6.4%
elevators, vertical manlifts, shuttle cars, haulage trucks, and
Falling, rolling, or sliding 8 3.2% front-end loaders) and machinery (for example, electric and
rock or material 3 2.9% air-powered tools and mining machinery such as drills, drag-
33 13.2% lines, power shovels, and loading machines). Most fatal mining
Slip or fall of person
2 1.4% injuries underground (43.3%) were classified as fall of ground
Other
33 13.2% (that is, fall of roof or back). (Sources: MSHA [2003]; NIOSH
9 6.4% [2003a].)
0 10 20 30 40 50
Distribution (%)

70 Number Rate Size of Operation (Employment)

63
60
How did fatal injury rates vary by employment size of the
57
mining operation in 19982002?
51 51
50 Figure 48. Number and rate of fatal mining injuries by
Number of fatal injuries

40
40.0 employment size of mining operation (excluding independent
41

Rate per 100,000 workers

40 contractor workers), 19982002. During 19982002, rates of
35 30 fatal mining injuries generally decreased as the employment
28.7 size of mining operations increased. The highest fatal injury rate
30 26.3 occurred in mining operations employing fewer than 10 work-
22.8 20 ers (40.0 fatal per 100,000 workers). Conversely, the lowest
20.9
20 17.8 fatal injury rate (17.8 per 100,000 workers) occurred in mining
operations employing 250 or more workers. (Sources: MSHA
10 [2003]; NIOSH [2003a].)
10

0 0
<10 1019 2049 5099 100249 >249
Employment size of mining operation

230
 Chapter 4 High-Risk Industries and Occupations

Nonfatal Injuries and Illnesses

Magnitude and Trend
Which sectors of the mining industry posed the highest risks of nonfatal injury to mine workers during 19982002?

Table 42. Number and 5-year average rate of lost-workday injuries by type of employer and commodity at various work locations, 19982002. During
19982002, both the highest numbers and rates of lost-workday injuries occurred in the underground work areas of underground mines. Within under-
ground work areas, the highest rates were observed for coal mine operator and coal mine contractor workers, who together accounted for 88% (17,260)
of all the lost-workday injuries in underground work areas. Within surface locations, the highest injury rates were in stone and nonmetal dredge locations.
High numbers and rates of injuries were also experienced by stone mine operator workers at both surface production areas and processing (mill) work
areas. (Sources: MSHA [2003]; NIOSH [2003a].)

Work location
Underground mines Surface locations
Strip/
open pit/
Underground Surface areas quarry* Dredge Mills/plants All
Type of employer
and commodity Number Rate Number Rate Number Rate Number Rate Number Rate Number Rate
Mine operator:
Coal 15,980 8.5 847 5.1 3,501 2.3 7 2.3 1,475 3.2 21,810 5.4
Metal 1,273 5.5 150 3.2 1,397 2.1 40 2.9 1,839 2.5 4,699 2.8
Nonmetal 510 3.9 62 3.3 687 2.6 7 5.0 2,110 2.9 3,376 3.0
Stone 354 3.7 115 6.0 5,527 3.5 9 5.0 7,416 3.9 13,421 3.7
Sand and gravel NA NA NA NA 4,034 2.8 777 3.2 NR NR 4,811 2.9
Independent contractor:
Coal 1,280 12.3 245 1.9 871 2.1 NA NA 531 2.8 2,927 3.5
Metal and nonmetal** 246 4.3 99 3.1 971 1.5 16 2.0 886 2.4 2,218 2.0
All 19,643 7.8 1,518 3.7 16,988 2.6 856 3.2 14,257 3.2 53,262 3.8
*Also includes culm banks, auger mining, independent shops and yards, and surface mining n.e.c.

Computed per 100 full-time equivalent workers.

NA = Not applicable for this commodity.

NR = Not reported separately. Sand and gravel operators report mill employment under strip or dredge operations.
**Includes metal, nonmetal, stone, and sand and gravel.

231
 Chapter 4 High-Risk Industries and Occupations

Stone operator Nonmetal operator Type of Employer and Commodity

Coal operator Metal operator
Surface
5 Sand and gravel operator Metal/nonmetalindependent contractor
Coalindependent contractor How did the rate of lost-workday injuries change for
surface mining operations during 19932002?
4
Figure 49. Rate of lost-workday injuries for surface mining
Rate per 100 workers

operations by type of employer and commodity, 19932002.

From 1993 to 2002, the rate of lost-workday injuries declined
3
overall for operator workers in all commodities and for metal/
nonmetalindependent contractor workers. Throughout this
10-year period, the highest rates of lost-workday injuries were
2
consistently observed for stone operator workers. (Sources:
MSHA [2003]; NIOSH [2003a].)
1

0
1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

Coal operator Metal operator Underground

Coalindependent contractor
15
Metal/nonmetalindependent contractor
Nonmetal operator
Stone operator
How did the rate of lost-workday injuries change for
underground mining operations during 19932002?

12 Figure 410. Rate of lost-workday injuries for underground

mining operations by type of employer and commodity, 1993
Rate per 100 workers

2002. During 19932002, underground coal operator work-

ers and underground coalindependent contractor workers
9
consistently had the highest rates of lost-workday injuries.
Although marked by slight increases and decreases during this
10-year period, lost-workday injury rates for underground non-
6 metal operator workers and underground stone operator work-
ers have remained relatively constant. (Sources: MSHA [2003];
NIOSH [2003a].)
3

0
1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

232
 Chapter 4 High-Risk Industries and Occupations

Work Location and Type of Incident Handling materials 1.03

2.59
How and where were mine workers injured during 1998 Fall of ground (from 0.0
2002? in place) 1.25
0.80
Slip or fall of person
Figure 411. Rate of lost-workday injuries by type of incident 1.23
and work location, 19982002. During 19982002, miners at Powered haulage 0.27
underground locations generally had higher nonfatal injury 0.93
rates than those working on the surface. Injuries to miners at 0.30 Surface
Machinery
0.85 Underground
both surface and underground locations were most frequently
associated with handling materials and slip or fall of person. Hand tools 0.31
0.50
Miners working underground also had relatively high rates of
0.11
injury from fall of ground incidents (caving rock), or in inci- Other 0.25
dents involving powered haulage or machinery. (Sources: MSHA Stepping/kneeling 0.05
[2003]; NIOSH [2003a].) on object 0.17
Electrical 0.02
0.05
0.0 0.5 1.0 1.5 2.0 2.5 3.0
Rate per 100 workers

Age Age <25 Age 2544 Age >44 Age unknown Total
cases
Metal/nonmetal
How were injured mine workers distributed by age in independent 9 57 33 2 318
2002? contractor
Coalindependent 16 55 27 2 641
Figure 412. Distribution of lost-workday injuries by age of contractor
worker and type of employer and commodity, 2002. The pro- Sand and gravel 12 55 30 3 826
portion of injured workers above age 44 at the time of injury operator
was highest among coal and metal operator workers and low-
est among coalindependent contractor workers. Conversely, Stone operator 12 51 35 2 2,462
the proportion of injured workers under age 25 was highest
among coalindependent contractor workers, sand and gravel Nonmetal operator 7 49 42 2 594
operator workers, and stone operator workers. (Sources: MSHA
[2003]; NIOSH [2003a].) Metal operator 4 50 44 1 640

Coal operator 7 44 47 3 3,877

0 20 40 60 80 100
Distribution (%)

233
Chapter 4 High-Risk Industries and Occupations

Male Female Sex

Metal/nonmetal
independent 99% 318 How did the proportion of injured male and female mine
contractor workers differ by type of employer and commodity in
Coalindependent 98% 641 2002?
contractor
Sand and gravel Figure 413. Number of lost-workday injuries by sex of worker
98% 826
operator and type of employer and commodity, 2002. In 2002, only 2%
(190) of all nonfatally injured mine workers were female,
Stone operator 97% 2,462 whereas 14.6% of the entire mining workforce was female
(Chapter 1, Table 14). The highest proportion of female
Nonmetal operator 96% 594 workers with lost-workday injuries was reported by metal opera-
tors (6%), and the lowest proportion was reported by metal/
Metal operator 94% 640 nonmetalindependent contractors (1%) and coal operators
(2%). (Note: Percentages shown within the bars represent the
Coal operator 99% 3,877 proportion of male workers with lost-workday injuries.) (Sourc-
es: MSHA [2003]; NIOSH [2003a].)
0 1,000 2,000 3,000 4,000
Number of injuries

Fall of ground (from 37.5

in place) 21 Severity
18 What was the median number of lost workdays due to
Slip or fall of person 27
nonfatal lost-time mining injuries during 19982002?
Powered haulage 17
27
Figure 414. Median number of lost workdays due to nonfatal
12
Handling materials 20 lost-time mining injuries by work location and selected types of
Stepping/kneeling Surface incidents, 19982002. During 19982002, the median number
11.5
on object 26 Underground of lost workdays due to nonfatal lost-time mining injuries was
11 21 for miners injured underground and 14 for miners injured
Machinery 20 at surface locations. At surface locations, falls of ground (e.g.,
11 rock dislodging from a highwall) accounted for the highest
Electrical 12 median number of lost workdays. At underground locations,
10 powered haulage and slip or fall of person accounted for
Other 20 the highest median number of lost workdays. (Sources: MSHA
10 [2003]; NIOSH [2003a].)
Hand tools 15
0 5 10 15 20 25 30 35 40
Median number of lost workdays

234
 Chapter 4 High-Risk Industries and Occupations

Experience <1 year 15 years >5 years Unknown Total

cases
Metal/nonmetal
How were lost-workday injuries distributed among mine independent 21 21 28 30 318
workers by years of total mining experience in 2002? contractor
Coalindependent 23 21 37 19 641
Figure 415. Distribution of lost-workday injuries among min- contractor
ers by type of employer and commodity and years of total min- Sand and gravel
ing experience, 2002. In 2002, the proportion of workers with 19 30 39 12 826
operator
lost-workday injuries was highest among coal operator work-
ers with more than 5 years of experience, and lowest among Stone operator 17 28 46 9 2,462
coal operator workers with less than 1 year of experience. Of
the mine workers with less than 1 year of mining experience, Nonmetal operator 7 26 55 13 594
independent contractor workers had the highest proportions
of lost-workday injuries. These differences must be interpreted Metal operator 7 20 61 13 640
with caution, since years of mining experience were not report-
ed for 10% of cases. (Sources: MSHA [2003]; NIOSH [2003a].) 5 16 6
Coal operator 72 3,877

0 20 40 60 80 100
Distribution (%)

235
 Chapter 4 High-Risk Industries and Occupations

A. Mine operator cases 19911995 19962000 Metal/Nonmetal Mines

10
How did the number of nonfatal injuries and illnesses
vary in metal/nonmetal mines by years of total mining
experience during 19912000?
8
Number of cases (thousands)

Figure 416. Number of nonfatal injury and illness cases in

metal/nonmetal mines by years of total mining experience for
6 19911995 and 19962000: (A) mine operator cases, and (B)
independent contractor cases. During 19912000, the role of
total mining experience was fairly consistent and stable over
4 time among mine operator worker cases of nonfatal injury or
illness in metal/nonmetal mines. The number of cases was
characteristically reduced during the second year of experi-
2 ence and followed by an upsurge for the next 3 to 4 years. A
steady decline thereafter suggests that experience continually
reduces risk for miners. The later period (19962000) showed
0 some improvement over the early period (19911995). Metal/
Under 1.0 2.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 or nonmetalindependent contractor cases showed a similar
1.0 1.9 4.9 9.9 14.9 19.9 24.9 29.9 34.9 more pattern, but with higher case counts for the least experienced
Years of total mining experience miners. (Sources: MSHA [2002]; NIOSH [2003b].)
B. Independent contractor cases 19911995 19962000
10

8
Number of cases (hundreds)

0
Under 1.0 2.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 or
1.0 1.9 4.9 9.9 14.9 19.9 24.9 29.9 34.9 more
Years of total mining experience

236
 Chapter 4 High-Risk Industries and Occupations

Coal Mines A. Mine operator cases 19911995 19962000

18
How did the number of injuries and illnesses vary in coal
mines by years of total mining experience during 1991
2000? 15

Number of cases (thousands)

Figure 417. Number of injury and illness cases in coal mines
by years of total mining experience for 19911995 and 1996 12
2000: (A) mine operator cases, and (B) independent contractor
cases. Coal mining showed a distinctly different pattern from 9
metal/nonmetal mining for 19912000. Mine operators report-
ed increasing numbers of cases with increasing years of mining
experience up until 2024.9 years. As with metal/nonmetal 6
mining, a dramatic drop in overall case count occurred for
coal miners between the early and late 1990s. The shift in the
3
experience group with the highest case count may reflect the
aging of the mining workforce. The role of experience among
independent contractor workers was similar but more pro- 0
nounced for new miners. Note that case counts alone may be Under 1.0 2.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 or
misleading. Incidence rates (cases per 100 full-time equivalent 1.0 1.9 4.9 9.9 14.9 19.9 24.9 29.9 34.9 more
workers) may show different patterns, but they could not be Years of total mining experience
developed because employment by years of experience was not B. Independent contractor cases 19911995 19962000
available. (Sources: MSHA [2002]; NIOSH [2003b].) 6

Number of cases (hundreds) 5

0
Under 1.0 2.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 or
1.0 1.9 4.9 9.9 14.9 19.9 24.9 29.9 34.9 more
Years of total mining experience

237
 Chapter 4 High-Risk Industries and Occupations

Black, unexposed White, unexposed Hearing Loss

Black, exposed White, exposed
Frequency (kilohertz) How did the hearing loss of sand and gravel workers
0.5 1.0 2.0 3.0 4.0 6.0 compare with that of a group unexposed to workplace
0 noise?
10 Figure 418. Mean hearing thresholds over a range of fre-
(n=74)
20 Age 2029 (n=38) quencies (0.56.0 kilohertz) among black and white male sand
and gravel workers and a population unexposed to workplace
0 noise, by age, 2000. Hearing loss among black and white male
10 (n=40) sand and gravel workers was greater than hearing loss among
(n=19) a population that was unexposed to workplace noise. Different
20 Age 3039 (n=47) patterns of hearing loss were observed for black and white work-
30 (n=51) ers: Most statistically significant differences in hearing thresholds
40
occurred among the younger white workers (those aged 2029
and 3039) and among the older black workers (those aged
0
4049 and 5059). (Sources: Royster and Thomas [1979]; Royster et
Mean hearing threshold level (decibels)

10 al. [1980]; NIOSH [2003a,c].)

20 (n=24)
Age 4049
(n=20)
30 (n=55)
(n=44)
40
0
10
20 (n=22)
30 Age 5059
40 (n=21)
(n=24)
50
(n=30)
60
0
10
20
30 Age 6069
40
(n=14)
50
60 (n=7)

238
 Chapter 4 High-Risk Industries and Occupations

Fatal Illnesses 3.5 Number Age-adjusted rate Crude rate

Coal Workers Pneumoconiosis 3.0

25

How did the numbers of deaths and rates of mortality

Number of deaths (thousands)

from coal workers pneumoconiosis change during 1968 2.5 20
1999?

Rate per million population

Figure 419. Numbers of deaths, crude mortality rates, and 2.0
15
age-adjusted mortality rates for U.S. residents aged 15 or older
with coal workers pneumoconiosis recorded as an underlying
1.5
or contributing cause on the death certificate, 19681999. After
passage of the Federal Coal Mine Health and Safety Act of 1969, 10
an increase occurred in the number and rate of deaths report- 1.0
ed with coal workers pneumoconiosis (black lung) recorded
on the death certificate. The number and rate of these deaths 5
0.5
were at their lowest in 1999, the last year for which data are
currently available. The number decreased from 2,870 in 1972
to 1,003 in 1999. In 1972, the crude and age-adjusted mortality 0.0 0
rates were 18.9 and 21.2 per million population, respectively. 1970 1975 1980 1985 1990 1995
Both rates declined to 4.7 per million in 1999. (Note: Age-
adjusted mortality rates are standardized to the year 2000 stan-
dard population.) (Sources: NCHS [2002]; NIOSH [2002].)

239
Chapter 4 High-Risk Industries and Occupations
Construction Trades
This section provides data for tracking trends in fatal and nonfatal
occupational injuries and illnesses among workers in the construc-
tion trade. An estimated 9.6 million persons were employed in the
construction industry in 2001. Most of these workers were aged
2554 (75.4%), male (90.3%), and white (90.8%) [BLS 2001].
Over the years, construction has ranked among industries with the
highest rates of both fatal and nonfatal occupational injuries. BLS
reported that the number and rate of fatal occupational injuries
in the construction sector in 2001 were the highest recorded since
the inception of CFOI (1,225 fatal occupational injuries with an inci-
dence rate of 13.3 per 100,000 employed workers) [BLS 2002b]. For
the same year, BLS reported that the construction industry experi-
enced 481,400 nonfatal injuries and illnesses at a rate of 7.9 per 100
full-time workers in the industry [BLS 2002a].
Since the early 1990s, NIOSH has supported extensive extramural
surveillance and research on the construction sector of private
industry. The Center to Protect Workers Rights (CPWR) is a prin-
cipal partner of NIOSH in conducting these activities. Early efforts
focused on surveillance data and surveillance research, including
the preparation of the first of three chart books focusing on con-
struction safety and health issues [Pollack and Chowdhury 2001].
The underlying data for Figures 420 through 452 come from a
number of the BLS statistical programs, including the Current Pop-
ulation Survey (CPS), CFOI, and SOII. The CPS provides data for
estimating the construction trade occupation denominators used
for many of the rate estimates. The CPWR uses CFOI to character-
ize occupational fatalities and SOII to characterize nonfatal injuries
240
and illnesses. Twelve construction trade occupations are the princi-
pal focus of this section:
Brickmasons Operating engineers
Carpenters Painters
Drywall installers Plumbers
Electricians Roofers
Ironworkers Truck drivers
Construction laborers Welders and cutters
Among the trades monitored by CPWR, the estimated distribution
of employed construction workers by trade ranged from 0.6% to
13.3% during 19922001. Carpenters made up the largest propor-
tion of construction workers (13.3%), followed by construction
laborers (8.8%) and electricians (5.9%) (Figure 420). The con-
struction workforce has been growing older: In 2001, the average
age for construction workers was 38.7 (1.5 years older than it was
in 1992). In addition, the median age increased from 35 to 39 dur-
ing this 10-year period. The aging of the construction workforce
is reflected in the distribution of fatal occupational injuries in this
group by age (Figure 421). From 1992 to 2001, the largest propor-
tion of fatal occupational injuries shifted from construction work-
ers aged 2534 to those aged 3544. For construction workers aged
25 or 34, the proportion with fatal injuries declined (from 27.8%
to 21.7%), whereas it increased for workers aged 65 or older (from
3.9% to 5.9%).
Fatal occupational injury rates in the construction trades for 2001
ranged from 6.0 per 100,000 full-time workers for drywall installers

to 75.6 for ironworkersmore than a 12-fold difference (Figure
423). Falls to lower level accounted for the highest number of
fatal injuries among construction workers (410 or 4.3 per 100,000
full-time workers), and highway accidents accounted for the next
highest number (161 or 1.7 per 100,000 full-time workers) (Figure
425). This section includes figures that chart fatal injury rates for
each of the 12 construction trades that form our focus. For each
trade, the figure contrasts fatal occupational injury rates for all
construction workers during each year from 1992 through 2001
(Figures 429, 431, 433, 435, 437, 439, 441, 443, 445, 447, rates for each of the 12 construction trades that form our focus. For
449, and 451).
Rates of nonfatal injuries and illnesses involving days away from
work in the construction trades in 2001 ranged from 131.2 per
Chapter 4 High-Risk Industries and Occupations
10,000 full-time workers for painters to 751.8 for ironworkers
nearly a 6-fold difference (Figure 427). Injuries and illnesses asso-
ciated with ergonomic events or exposures made up 26.5% (49,237
of 185,662) of all nonfatal occupational injuries and illnesses involv-
ing days away from work in the construction industry in 2001 [BLS
2003c]. The rate of bending, climbing, crawling, reaching, twisting
injuries in construction was 15 per 10,000 full-time workersnearly
double the rate of 8 for all private industry that year (Figure 428).
This section includes figures that chart nonfatal injury and illness
each trade, the figure contrasts nonfatal injury and illness rates for
all construction workers during each year from 1992 through 2001
(Figures 430, 432, 434, 436, 438, 440, 442, 444, 446, 448,
450, and 452).
241
 Chapter 4 High-Risk Industries and Occupations

Brickmasons 2.0 Distribution of Construction Workers

Carpenters 13.3 by Trade
Drywall installers 1.9
How were construction workers distributed by major
Electricians 5.9 construction trade during 19922001?
Ironworkers 0.6
Figure 420. Average distribution of full-time construction
Construction laborers 8.8
workers by trade, 19922001. Among the trades monitored
Operating engineers 2.3 by CPWR, the estimated distribution of employed construc-
Painters 5.0 tion workers by trade ranged from 0.6% to 13.3% during
19922001. Carpenters made up the largest proportion of
Plumbers 4.7
construction workers (13.3%), followed by construction labor-
Roofers 2.2 ers (8.8%) and electricians (5.9%). (Notes: (1) Apprentices are
Truck drivers 2.2 included for some trades when data were available. (2) All other
Welders and cutters 0.9 includes managers, professionals, supervisors, clerical workers,
sales personnel, and trades that each totaled less than 1% of
All other 50.3 the industry. (3) Computations were based on a definition of
0 10 20 30 40 50 60 full-time work as 2,000 employee hours per year.) (Sources: BLS
Distribution (%) [2002c]; Dong et al. [2004].)

Fatal Injuries
30
1992 2001 Age
27.8 28.2
26.3 How did the numbers and rates of fatal occupational
injuries in construction workers vary by age during 1992
25
21.7 and 2001?
20.8
20 19.1 Figure 421. Distribution of fatal occupational injuries among
Distribution (%)

construction workers by age, 1992 and 2001. The construction

workforce has been growing older: In 2001, the average age
15 for construction workers was 38.7 (1.5 years older than it was
11.3 in 1992). In addition, the median age increased from 35 to
9.3 10.0 9.4 39 during this 10-year period. The aging of the construction
10 workforce is reflected in the distribution of fatal occupational
5.9 injuries in this group by age. From 1992 to 2001, the largest
5 3.9 proportion of fatal occupational injuries shifted from construc-
3.3
2.1 tion workers aged 2534 to those aged 3544. For construc-
tion workers aged 25 or 34, the proportion with fatal injuries
0 declined (from 27.8% to 21.7%), whereas it increased for
1619 2024 2534 3544 4554 5564 >64 workers aged 65 or older (from 3.9% to 5.9%). (Sources: BLS
Age range [2002b,c]; Dong et al. [2004].)

242
 Chapter 4 High-Risk Industries and Occupations

Race/Ethnicity 25 Hispanic Non-Hispanic

How did fatal occupational injury rates differ between

Hispanic and non-Hispanic construction workers during
20
19922001?

Rate per 100,000 workers

Figure 422. Fatal occupational injury rates among Hispanic
and non-Hispanic workers in the construction industry, 1992 15
2001. Fatal occupational injuries among Hispanic construction
workers increased from 108 in 1992 to 281 in 2001. Since 1992,
Hispanic construction workers have had markedly higher fatal
occupational injury rates than their non-Hispanic counter- 10
parts. In 2001 (the most recent year measured), the rate of
work-related deaths from construction injuries for Hispanics
was 19.5 per 100,000 full-time workers62.5% higher than 5
the rate of 12.0 for non-Hispanic construction workers. Dur-
ing 19902001, Hispanic employment in the U.S. construction
industry increased greatly, from 649,800 in 1990 to 1.5 million
(or 15.6% of the construction workforce) in 2001. (Sources: BLS 0
[2002b,c]; Dong et al. [2004].) 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

Occupation Ironworkers 75.6

How did the fatal occupational injury rates differ by Roofers 41.2
construction trade in 2001? Welders and cutters 39.9

Figure 423. Fatal occupational injury rates by construction Construction laborers 38.4
trade, 2001. Fatal occupational injury rates in the construction Truck drivers 29.5
trades for 2001 ranged from 6.0 per 100,000 full-time workers
Operating engineers 17.2
for drywall installers to 75.6 for ironworkersmore than a 12-
fold difference. (Sources: BLS [2002b,c]; Chowdhury and Dong Electricians 12.2
[2002].) Plumbers 8.6 Rate for all construction
Painters 8.5 workers = 13.2

Carpenters 8.3
Brickmasons 6.3
Drywall installers 6.0
0 10 20 30 40 50 60 70 80
Rate per 100,000 workers

243
 Chapter 4 High-Risk Industries and Occupations

60
55.5
Employees Fatal injuries Establishment Size
How did fatal occupational injury rates vary by
50 employment size of establishment?

Figure 424. Distribution of construction workers and fatal

40 38.2
occupational injuries by employment size of establishment,
Distribution (%)

2001. In 2001, more than 80% of construction establishments had

28.4 fewer than 10 employees, and establishments with fewer than 20
30
employees employed only 38.2% of the wage-and-salary workforce.
However, fatal occupational injuries among these smaller estab-
20.1 18.8
20 lishments accounted for more than 55.5% of fatal occupational
16.3
13.4 injuries in 2001. (Note: The calculation excludes the self-employed
workers and deaths reported without establishment-size informa-
9.4
10 tion.) (Sources: BLS [2002b,c]; Census [2003]; Dong et al. [2004].)

0
119 2049 5099 >99
Employment size of establishment

450 Number Rate Event or Exposure

410 5
400 How did the numbers and rates of fatal occupational
injuries differ by fatal event in 2001?
350
4.3 4
Number of fatal injuries

Rate per 100,000 workers

Figure 425. Numbers and rates of fatal occupational injuries
300
among construction workers by fatal event, 2001. In 2001, falls
250 3 to lower level accounted for the greatest number of fatal occu-
pational injuries among construction workers (410 fatalities or
200 4.3 per 100,000 full-time workers). Highway accidents account-
161 156 2 ed for 161 deaths, a fatal injury rate of 1.7 per 100,000 full-time
150
117 workers. (Sources: BLS [2002b,c]; Dong et al. [2004].)
1.7 1.6 106
100
1.2 1
1.1
50

0 0
Falls to Highway Contact with Struck by Pedestrian/
lower level accident electric current object nonpassenger
struck by vehicle or
mobile equipment

244
 Chapter 4 High-Risk Industries and Occupations

How did fatal fall rates differ by construction trade in

2001? Ironworker 66.8

Figure 426. Fatal occupational fall rates by selected construc-

Roofer 30.1
tion trade, 2001. The 2001 rate for fatal occupational falls
among ironworkers was 66.8 per 100,000 workers15 times
Construction 10.2
the average rate for all construction. For roofers, the fatal fall laborer
rate was 30.1, or 7 times the average rate for all construction.
(Sources: BLS [2002b,c]; Dong et al. [2004].) Carpenter 5.4

Painter 4.6
Rate for all construction
workers = 4.4
Supervisor 2.8

Electrician 2.1

0 10 20 30 40 50 60 70
Rate per 100,000 workers

Nonfatal Injuries and Illnesses Ironworkers 751.8

Construction laborers 512.1
Occupation
Truck drivers 422.9
How did the rate of nonfatal occupational injury and
illness differ by construction trade in 2001? Roofers 337.1
Plumbers 335.7
Figure 427. Rate of nonfatal occupational injury and illness
Drywall installers 334.6
cases with days away from work by construction trade, 2001. In
2001, the rate of nonfatal injuries and illnesses involving days Carpenters 313.5
away from work ranged from 131.2 per 10,000 full-time work- Electricians 246.5
ers among painters to 751.8 for ironworkersnearly a 6-fold
difference. (Sources: BLS [2002c; 2003b]; Pollack and Chowdhury Brickmasons 201.5
[2001]; Dong et al. [2004].) Welders and cutters 171.4 Rate for all construction
Operating engineers 161.6 workers = 268.0

Painters 131.2

0 100 200 300 400 500 600 700 800

Rate per 10,000 workers

245
 Chapter 4 High-Risk Industries and Occupations

70 Construction Private industry Event or Exposure

63.2
How did rates of nonfatal occupational injury and illness
60
differ by type of ergonomic exposure in construction and
all private industry in 2001?
Rate per 10,000 workers

50
45.0 Figure 428. Rates of nonfatal occupational injury and illness
cases with days away from work in construction and private
40
industry by selected ergonomic events or exposures, 2001.
Injuries and illnesses associated with ergonomic events or
30 exposures made up 26.5% (49,237 of 185,662) of all nonfatal
occupational injuries and illnesses involving days away from
20 work in the construction industry in 2001. The rate of bend-
15.0 ing, climbing, crawling, reaching, twisting injuries in construc-
tion was 15 per 10,000 full-time workersnearly double the
10 8.0 7.2
6.1 rate of 8 for all private industry that year. (Sources: BLS [2002c;
2003b,c]; Dong et al. [2004].)
0
Bending, climbing, crawling Overexertion Repetitive motion
reaching, twisting

246
 Chapter 4 High-Risk Industries and Occupations

Brickmasons 16 Brickmasons All construction workers

Fatal Injuries
How did the fatal occupational injury rates for
brickmasons compare with those for all construction 12

Rate per 100,000 workers

workers during 19922001?

Figure 429. Fatal occupational injury rates for brickmasons

and all construction workers, 19922001. During 19922001, 8
fatal occupational injury rates for brickmasons were generally
lower than those for all construction workers. Rates for brick-
masons showed an up-and-down decreasing pattern, varying
from 6.3 per 100,000 full-time workers in 2001 to 15.2 in 1995.
BLS reported 145 fatal occupational injuries among brickma- 4
sons during this 10-year periodan average of 14 fatalities per
year. (Sources: BLS [2002b,c]; Pollack and Chowdhury [2001];
Chowdhury and Dong [2003].)
0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

Nonfatal Injuries and Illnesses 500

Brickmasons All construction workers

How did the rates of nonfatal occupational injuries and

illnesses for brickmasons compare with those for all
construction workers during 19922001? 400
Rate per 10,000 workers

Figure 430. Rates of nonfatal occupational injuries and ill-

nesses involving days away from work for brickmasons and all
construction workers, 19922001. During 19922001, rates of 300
nonfatal occupational injuries and illnesses involving days away
from work were generally lower for brickmasons than for all
construction workers. Rates for brickmasons showed a down- 200
ward trend from a 424 per 10,000 full-time workers in 1994
to 201 in 2001. BLS reported 36,172 nonfatal occupational
injuries and illnesses among brickmasons during this 10-year
100
periodan average of 3,617 nonfatal cases per year. (Sources:
BLS [2002c; 2003b]; Pollack and Chowdhury [2001]; Dong et al.
[2004].)
0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

247
 Chapter 4 High-Risk Industries and Occupations

16 Carpenters All construction workers Carpenters

Fatal Injuries
How did the fatal occupational injury rates for carpenters
12 compare with those for all construction workers during
Rate per 100,000 workers

19922001?

Figure 431. Fatal occupational injury rates for carpenters

8
and all construction workers, 19922001. During 19922001,
fatal occupational injury rates for carpenters were parallel to
and consistently lower than rates for all construction workers.
Rates for carpenters varied within a narrow range, from 8.9 per
100,000 full-time workers in 1995 to 6.7 in 2000. BLS reported
4 848 fatal occupational injuries among carpenters during this
10-year periodan average of 85 fatalities per year. (Sources:
BLS [2002b,c]; Pollack and Chowdhury [2001]; Chowdhury and
Dong [2003].)
0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

500
Carpenters All construction workers Nonfatal Injuries and Illnesses
How did the rates of nonfatal occupational injuries
and illnesses for carpenters compare with those for all
400 construction workers during 19922001?
Rate per 10,000 workers

Figure 432. Rates of nonfatal occupational injuries and ill-

nesses involving days away from work for carpenters and all
300 construction workers, 19922001. During 19922001, rates of
nonfatal occupational injuries and illnesses involving days away
from work were slightly higher for carpenters than for all con-
200 struction workers, but they were comparable in overall mag-
nitude. Rates for carpenters showed a downward trend, from
489 per 10,000 full-time workers in 1993 to 313 in 2001. BLS
reported 285,705 nonfatal occupational injuries and illnesses
100
among carpenters during this 10-year periodan average of
28,570 nonfatal cases per year. (Sources: BLS [2002c; 2003b]; Pol-
lack and Chowdhury [2001]; Dong et al. [2004].)
0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

248
 Chapter 4 High-Risk Industries and Occupations

Drywall Installers 16 Drywall installers All construction workers

Fatal Injuries
How did the fatal occupational injury rates for drywall
installers compare with those for all construction workers 12

Rate per 100,000 workers

during 19922001?

Figure 433. Fatal occupational injury rates for drywall install-

ers and all construction workers, 19922001. Fatal occupation- 8
al injury rates for drywall installers were consistently lower than
those for all construction workers during 19922001. Except
for 1992, the rates for drywall installers varied within a narrow
range, from 6.7 per 100,000 full-time workers in 1993 to 3.4
in 1998. BLS reported 80 fatal occupational injuries among 4
drywall installers during this 10-year periodan average of 10
fatalities per year. (Sources: BLS [2002b,c]; Pollack and Chowd-
hury [2001]; Chowdhury and Dong [2003].)
0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

Nonfatal Injuries and Illnesses 800 Drywall installers All construction workers

How did the rates of nonfatal occupational injuries and

illnesses for drywall installers compare with those for all
construction workers during 19922001?
600
Rate per 10,000 workers

Figure 434. Rates of nonfatal occupational injuries and ill-

nesses involving days away from work for drywall installers and
all construction workers, 19922001. Rates of nonfatal occupa-
tional injuries and illnesses involving days away from work for 400
drywall installers showed a downward trend during 19922001,
from 720 per 10,000 full-time workers in 1992 to 259 in 2000.
BLS reported 43,575 nonfatal occupational injuries and illness-
es among construction workers during this 10-year periodan
200
average of 4,357 nonfatal cases per year. (Sources: BLS [2002c;
2003b]; Pollack and Chowdhury [2001]; Dong et al. [2004].)

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

249
 Chapter 4 High-Risk Industries and Occupations

20 Electricians All construction workers Electricians

Fatal Injuries
How did the fatal occupational injury rates for electricians
15
compare with those for all construction workers during
Rate per 100,000 workers

19922001?

Figure 435. Fatal occupational injury rates for electricians

10 and all construction workers, 19922001. Fatal occupational
injury rates for electricians during 19922001 were comparable
with those for all construction workers. Rates for electricians
showed an up-and-down decreasing pattern, from 18.3 per
100,000 full-time workers in 1995 to 9.0 in 2000. BLS reported
5
671 fatal occupational injuries among electricians during this
10-year periodan average of 67 fatalities per year. (Sources:
BLS [2002b,c]; Pollack and Chowdhury [2001]; Chowdhury and
Dong [2003].)
0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

600 Electricians All construction workers Nonfatal Injuries and Illnesses

How did the rates of nonfatal occupational injuries and
500 illnesses for electricians compare with those for all
construction workers during 19922001?
Rate per 10,000 workers

400 Figure 436. Rates of nonfatal occupational injuries and ill-

nesses involving days away from work for electricians and all
construction workers, 19922001. During 19922001, rates of
300 nonfatal occupational injuries and illnesses involving days away
from work for electricians were slightly higher but comparable
with those for all construction workers. Rates for electricians
200 showed a downward trend, from 522 per 10,000 full-time work-
ers in 1994 to 246 in 2001. BLS reported 142,811 nonfatal occu-
pational injuries and illnesses among electricians during this
100 10-year periodan average of 14,281 nonfatal cases per year.
(Sources: BLS [2002c; 2003b]; Pollack and Chowdhury [2001];
Dong et al. [2004].)
0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

250
 Chapter 4 High-Risk Industries and Occupations

Ironworkers 160 Ironworkers All construction workers

Fatal Injuries
How did the fatal occupational injury rates for ironworkers
compare with those for all construction workers during 120

Rate per 100,000 workers

19922001?

Figure 437. Fatal occupational injury rates for ironworkers

and all construction workers, 19922001. Fatal occupational 80
injury rates for ironworkers during 19922001 were substan-
tially greater (4.810.5 times greater) than those for all con-
struction workers. Rates for ironworkers showed a downward
trend, from 147.6 per 100,000 full-time workers in 1992 to 60.0
in 2000. BLS reported 424 fatal occupational injuries among 40
ironworkers during this 10-year periodan average of 42 fatali-
ties per year. (Sources: BLS [2002b,c]; Pollack and Chowdhury
[2001]; Chowdhury and Dong [2003].)
0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

Nonfatal Injuries and Illnesses

2,000 Ironworkers All construction workers
How did the rates of nonfatal occupational injuries and
illnesses for ironworkers compare with those for all
construction workers during 19922001?
1,600
Figure 438. Rates of nonfatal occupational injuries and ill-
Rate per 10,000 workers

nesses involving days away from work for ironworkers and

all construction workers, 19922001. Rates of nonfatal occu-
pational injuries and illnesses involving days away from work 1,200
for ironworkers during 19922001 were consistently greater
(1.73.9 times greater) than those for all construction work-
ers. Rates for ironworkers showed a downward trend, from 800
1,750 per 10,000 full-time workers in 1992 to 550 in 1997. The
2001 rate of 752 per 10,000 full-time workers represents a 57%
decrease from the 1992 rate of nonfatal injury and illness for
ironworkers. BLS reported 40,173 cases of nonfatal occupa- 400
tional injuries and illnesses among ironworkers during this
10-year periodan average of 4,017 nonfatal cases per year.
(Sources: BLS [2002c; 2003b]; Pollack and Chowdhury [2001]; 0
Dong et al. [2004].) 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

251
 Chapter 4 High-Risk Industries and Occupations

48
Construction laborers All construction workers Construction Laborers
Fatal Injuries
How did the fatal occupational injury rates for
36 construction laborers compare with those for all
Rate per 100,000 workers

construction workers during 19922001?

Figure 439. Fatal occupational injury rates for construction

laborers and all construction workers, 19922001. Fatal occupa-
24
tional injury rates for construction laborers during 19922001
were substantially greater (2.53.4 times greater) than those
for all construction workers. Between 1992 and 1997, rates
increased from 36.8 per 100,000 full-time workers to 47.3, then
12 decreased to a low of 30.8 in 2000. BLS reported 2,873 fatal
occupational injuries among construction laborers during this
10-year periodan average of 287 fatalities per year. (Sources:
BLS [2002b,c]; Pollack and Chowdhury [2001]; Chowdhury and
0 Dong [2003].)
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

1,400 Construction laborers All construction workers Nonfatal Injuries and Illnesses
How did the rates of nonfatal occupational injuries and
1,200 illnesses for construction laborers compare with those for
all construction workers during 19922001?
1,000 Figure 440. Rates of nonfatal occupational injuries and ill-
Rate per 10,000 workers

nesses involving days away from work for construction labor-

800 ers and all construction workers, 19922001. Rates of non-
fatal occupational injuries and illnesses involving days away
from work for construction laborers during 19922001 were
600 consistently greater (1.82.7 times greater) than those for all
construction workers. Rates for construction laborers showed
400 a downward trend, from 1,330 per 10,000 full-time workers in
1992 to 512 in 2001. The 2001 rate represents a 62% decrease
from the 1992 rate. BLS reported 467,258 nonfatal occupa-
200 tional injuries and illnesses among construction laborers dur-
ing this 10-year periodan average of 46,726 nonfatal cases
0 per year. (Sources: BLS [2002c; 2003b]; Pollack and Chowdhury
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 [2001]; Dong et al. [2004].)

252
 Chapter 4 High-Risk Industries and Occupations

Operating Engineers 24 Operating engineers All construction workers

Fatal Injuries
How did the fatal occupational injury rates for operating
18
engineers compare with those for all construction workers

Rate per 100,000 workers

during 19922001?

Figure 441. Fatal occupational injury rates for operating

engineers and all construction workers, 19922001. Fatal occu- 12
pational injury rates for operating engineers during 19922001
exceeded those for all construction workers except during 1995.
Rates for operating engineers showed an increasing trend, vary-
ing between 12.2 per 100,000 full-time workers and 23.0 (com-
6
pared with 12.4 and 14.8 per 100,000 full-time workers for all
construction workers). BLS reported 342 fatal occupational inju-
ries among operating engineers during this 10-year periodan
average of 34 fatalities per year. (Sources: BLS [2002b,c]; Pollack
and Chowdhury [2001]; Chowdhury and Dong [2003].) 0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

Nonfatal Injuries and Illnesses 600 Operating engineers All construction workers

How did the rates of nonfatal occupational injuries and

illnesses for operating engineers compare with those for 500
all construction workers during 19922001?
Rate per 10,000 workers

Figure 442. Rates of nonfatal occupational injuries and ill- 400

nesses involving days away from work for operating engineers
and all construction workers, 19922001. During 19922001,
rates of nonfatal occupational injuries and illnesses involving 300
days away from work were lower for operating engineers than
for all construction workers, but both rates were comparable
in overall magnitude. Rates for operating engineers showed a 200
downward trend, from 581 per 10,000 full-time workers in 1992
to 162 in 2001. BLS reported 37,431 nonfatal occupational
injuries and illnesses among operating engineers during this 100
10-year periodan average of 3,743 nonfatal cases per year.
(Sources: BLS [2002c; 2003b]; Pollack and Chowdhury [2001];
Dong et al. [2004].) 0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

253
 Chapter 4 High-Risk Industries and Occupations

16 Painters All construction workers Painters

Fatal Injuries
How did the fatal occupational injury rates for painters
12 compare with those for all construction workers during
Rate per 100,000 workers

19922001?

Figure 443. Fatal occupational injury rates for painters and

8 all construction workers, 19922001. During 19922001, fatal
occupational injury rates for painters were lower than those
for all construction workers. Rates for painters showed an up-
and-down decreasing pattern, varying from 12.2 per 100,000
full-time workers in 1996 to 7.9 in 1999. BLS reported 384 fatal
4 occupational injuries among painters during this 10-year peri-
odan average of 38 fatalities per year. (Sources: BLS [2002b,c];
Pollack and Chowdhury [2001]; Chowdhury and Dong [2003].)

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

500
Painters All construction workers Nonfatal Injuries and Illnesses
How did the rates of nonfatal occupational injuries
and illnesses for painters compare with those for all
400 construction workers during 19922001?
Rate per 10,000 workers

Figure 444. Rates of nonfatal occupational injuries and

illnesses involving days away from work for painters and all
300 construction workers, 19922001. During 19922001, rates of
nonfatal occupational injuries and illnesses involving days away
from work for painters were consistently lower (0.5 to 0.8 times
200 lower) than those for all construction workers. Rates showed
a downward trend, from 368 per 10,000 full-time workers in
1992 to 131 in 2001. The 2001 rate of 131 per 10,000 full-time
workers represents a 64% decrease in rates since 1992. BLS
100
reported 50,264 nonfatal occupational injuries and illnesses
among painters during this 10-year periodan average of
5,026 nonfatal cases per year. (Sources: BLS [2002c; 2003b]; Pol-
0 lack and Chowdhury [2001]; Dong et al. [2004].)
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

254
 Chapter 4 High-Risk Industries and Occupations

Plumbers 16 Plumbers All construction workers

Fatal Injuries
How did the fatal occupational injury rates for plumbers
compare with those for all construction workers during 12

Rate per 100,000 workers

19922001?

Figure 445. Fatal occupational injury rates for plumbers

and all construction workers, 19922001. During 19922001, 8
fatal occupational injury rates for plumbers were lower than
those for all construction workers. Rates for plumbers showed
a downward trend, from 9.7 per 100,000 full-time workers in
1994 to 5.1 in 1998. BLS reported 284 fatal occupational inju-
ries among plumbers during this 10-year periodan average of 4
28 fatalities per year. (Sources: BLS [2002b,c]; Pollack and Chow-
dhury [2001]; Chowdhury and Dong [2003].)

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

Nonfatal Injuries and Illnesses 600 Plumbers All construction workers

How did the rates of nonfatal occupational injuries

and illnesses for plumbers compare with those for all 500
construction workers during 19922001?
Rate per 10,000 workers

Figure 446. Rates of nonfatal occupational injuries and ill- 400

nesses involving days away from work for plumbers and all
construction workers, 19922001. During 19922001, rates of
nonfatal occupational injuries and illnesses involving days away 300
from work for plumbers were slightly higher than those for all
construction workers, though they were comparable in overall
magnitude. Rates for plumbers showed a downward trend, 200
from 504 per 10,000 full-time workers in 1992 to 326 in 1998.
BLS reported 113,679 nonfatal occupational injuries and ill-
nesses among plumbers during this 10-year periodan average 100
of 11,370 nonfatal cases per year. (Sources: BLS [2002c; 2003b];
Pollack and Chowdhury [2001]; Dong et al. [2004].)
0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

255
 Chapter 4 High-Risk Industries and Occupations

48 Roofers All construction workers Roofers

Fatal Injuries
How did the fatal occupational injury rates for roofers
36
compare with those for all construction workers during
Rate per 100,000 workers

19922001?

Figure 447. Fatal occupational injury rates for roofers and

24 all construction workers, 19922001. Fatal occupational injury
rates for roofers were 1.62.8 times greater than those for all
construction workers during 19922001. Rates followed an up-
and-down increasing pattern, with a high of 41.2 per 100,000
full-time workers in 2001 and a low of 22.3 in 1998. BLS report-
12 ed 569 fatal occupational injuries among roofers during this
10-year periodan average of 57 fatalities per year. (Sources:
BLS [2002b,c]; Pollack and Chowdhury [2001]; Chowdhury and
Dong [2003].)
0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

1,000 Roofers All construction workers Nonfatal Injuries and Illnesses

How did the rates of nonfatal occupational injuries
and illnesses for roofers compare with those for all
800 construction workers during 19922001?
Rate per 10,000 workers

Figure 448. Rates of nonfatal occupational injuries and

600 illnesses involving days away from work for roofers and all
construction workers, 19922001. During 19922001, rates
of nonfatal occupational injuries and illnesses involving days
away from work were consistently greater for roofers (1.11.8
400 times greater) than for all construction workers. Rates for roof-
ers showed a downward trend, from 838 per 10,000 full-time
workers in 1994 to 325 in 1998. BLS reported 61,539 nonfatal
occupational injuries and illnesses among roofers during this
200
10-year periodan average of 6,154 nonfatal cases per year.
(Sources: BLS [2002c; 2003b]; Pollack and Chowdhury [2001];
Dong et al. [2004].)
0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

256
 Chapter 4 High-Risk Industries and Occupations

Truck Drivers 40 Truck drivers All construction workers

Fatal Injuries
How did the fatal occupational injury rates for truck
30
drivers compare with those for all construction workers

Rate per 100,000 workers

during 19922001?

Figure 449. Fatal occupational injury rates for truck drivers

and all construction workers, 19922001. Fatal occupational 20
injury rates for truck drivers were 1.32.9 times greater than
those for all construction workers during 19922001. Rates
for truck drivers showed a down-and-up pattern, with a low of
17.0 per 100,000 full-time workers in 1993 and a high of 39.2
10
in 1999. BLS reported 479 fatal occupational injuries among
truck drivers during this 10-year periodan average of 48 fatal-
ities per year. (Sources: BLS [2002b,c]; Pollack and Chowdhury
[2001]; Chowdhury and Dong [2003].)
0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

Nonfatal Injuries and Illnesses 600 Truck drivers All construction workers

How did the rates of nonfatal occupational injuries and

illnesses for truck drivers compare with those for all 500
construction workers during 19922001?
Rate per 10,000 workers

Figure 450. Rates of nonfatal occupational injuries and ill- 400

nesses involving days away from work for truck drivers and all
construction workers, 19922001. During 19922001, rates of
nonfatal occupational injuries and illnesses involving days away 300
from work for truck drivers usually exceeded rates for all con-
struction workers. Rates for truck drivers varied from 533 per
10,000 full-time workers in 1992 to 359 in 1998. BLS reported 200
57,999 nonfatal occupational injuries and illnesses among
truck drivers during this 10-year periodan average of 5,800
nonfatal cases per year. (Sources: BLS [2002c; 2003b]; Pollack and 100
Chowdhury [2001]; Dong et al. [2004].)

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

257
 Chapter 4 High-Risk Industries and Occupations

48 Welders and cutters All construction workers Welders and Cutters

Fatal Injuries
How did the fatal occupational injury rates for welders
36 and cutters compare with those for all construction
Rate per 100,000 workers

workers during 19922001?

Figure 451. Fatal occupational injury rates for welders and cut-
24
ters and all construction workers, 19922001. Fatal occupational
injury rates for welders and cutters were 1.73.3 times greater
than those for all construction workers during 19922001. Rates
for welders and cutters showed an increasing trend, from 23.7
per 100,000 full-time workers in 1992 to 45.4 in 1997. The 2001
12 fatal injury rate of 39.9 per 100,000 full-time workers was 3 times
the rate for all construction workers and represented a 68%
increase from 1992. BLS reported 257 fatal occupational injuries
among welders and cutters during this 10-year periodan aver-
0 age of 26 fatalities per year. (Sources: BLS [2002b,c]; Pollack and
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 Chowdhury [2001]; Chowdhury and Dong [2003].)

600 Welders and cutters All construction workers Nonfatal Injuries and Illnesses
How did the rates of nonfatal occupational injuries and
500 illnesses for welders and cutters compare with those for
all construction workers during 19922001?

400 Figure 452. Rates of nonfatal occupational injuries and ill-

nesses involving days away from work for welders and cutters
and all construction workers, 19922001. During 19922001,
300 rates of nonfatal occupational injuries and illnesses involving
days away from work for welders and cutters show an over-
all decreasing trend, ranging from 573 per 10,000 full-time
200 workers in 1994 to 171 in 2001. BLS reported 21,940 nonfatal
occupational injuries and illnesses among welders and cutters
during this 10-year periodan average of 2,194 nonfatal cases
100 per year. (Sources: BLS [2002c; 2003b]; Pollack and Chowdhury
[2001]; Dong et al. [2004].)

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

258

References
BLS [2001]. Current population survey. Washington, DC: U.S.
Department of Labor, Bureau of Labor Statistics. [www.bls.gov/
cps/] and [www.bls.census.gov/cps]
BLS [2002a]. Survey of occupational injuries and illnesses. Wash-
ington, D.C.: U.S. Department of Labor, Bureau of Labor Statistics,
Safety and Health Statistics Program. Nonfatal (OSHA record-
able) injuries and illnesses. Industry incidence rates and counts.
[www.bls.gov/iif/oshsum.htm]
BLS [2002b]. Census of fatal occupational injuries. Fatal injuries.
Washington, DC: U.S. Department of Labor, Bureau of Labor
Statistics, Safety and Health Statistics Program. [www.bls.gov/iif/
oshcfoi1.htm]
BLS [2002c]. Current population survey. Washington, DC: U.S.
Department of Labor, Bureau of Labor Statistics. [www.bls.gov/
cps/] and [www.bls.census.gov/cps]
BLS [2003a]. Census of fatal occupational injuries. Fatal injuries.
Washington, DC: U.S. Department of Labor, Bureau of Labor
Statistics, Safety and Health Statistics Program. [www.bls.gov/iif/
oshcfoi1.htm]
BLS [2003b]. Survey of occupational injuries and illnesses. Nonfa-
tal (OSHA recordable) injuries and illnesses. Case and demograph-
ic characteristics. Washington, DC: U.S. Department of Labor,
Bureau of Labor Statistics, Safety and Health Statistics Program.
[www.bls.gov/iif/oshcdnew.htm]
Chapter 4 High-Risk Industries and Occupations
BLS [2003c]. Survey of occupational injuries and illnesses. Non-
fatal (OSHA recordable) injuries and illnesses. Number of non-
fatal occupational injuries and illnesses with days away from work
involving musculoskeletal disorders by selected worker and case
characteristics, 2001. Washington, DC: U.S. Department of Labor,
Bureau of Labor Statistics, Safety and Health Statistics Program.
[www.bls.gov/iif/oshwc/osh/case/ostb1154.pdf]
Census [2003]. County business patternsUnited States: 2001.
Washington, DC: U.S. Department of Commerce, Economics and
Statistics Administration, U.S. Census Bureau. [www.census.gov/
prod/2003pubs/01cbp/cbp01-1.pdf]
Chowdhury RT, Dong X [2003]. Analysis of census of fatal occu-
pational injuries (CFOI) data, 19922001. Silver Spring, MD: The
Center to Protect Workers Rights. Unpublished.
Dong X, Men R, Hu H, Chauhan J, Gittleman J [2004]. Trends in
work-related deaths and injury rates among U.S. construction work-
ers, 19922001. Washington, DC: The Center to Protect Workers
Rights (CPWR). Unpublished.
MSHA [2002]. Quarterly employment and coal production,
accidents/injuries/illnesses reported to MSHA under 30 CFR Part
50, 19912000. Denver, CO: U.S. Department of Labor, Mine Safety
and Health Administration, Office of Injury and Employment Infor-
mation. [www.msha.gov/STATS/PART50/p50y2k/p50y2k.HTM]
MSHA [2003]. Quarterly employment and coal production, accidents/
injuries/illnesses reported to MSHA under 30 CFR Part 50, 1991
2000. Denver, CO: U.S. Department of Labor, Mine Safety and Health
259
Chapter 4 High-Risk Industries and Occupations
Administration, Office of Injury and Employment Information.
[www.msha.gov/STATS/PART50/p50y2k/p50y2k.HTM]
NCHS [2002]. Multiple-cause-of-death public-use data files. Hyattsville,
MD: U.S. Department of Health and Human Services, Centers for
Disease Control and Prevention, National Center for Health Statistics.
[www.cdc.gov/nchs/products/elec_prods/subject/mortmcd.htm]
NIOSH [2002]. National surveillance system for pneumoconio-
sis mortality. Morgantown, WV: U.S. Department of Health and
Human Services. Centers for Disease Control and Prevention,
National Institute for Occupational Safety and Health. Database.
NIOSH [2003a]. Surveillance, statistics, and research support activ-
ity (SSRSA). Pittsburgh, PA: U.S. Department of Health and Human
Services, Centers for Disease Control and Prevention, National
Institute for Occupational Safety and Health. [www.cdc.gov/niosh/
mining/]
NIOSH [2003b]. Mining surveillance and statistical support activity
(MSSSA). Spokane, WA: U.S. Department of Health and Human
Services, Centers for Disease Control and Prevention, National
260
Institute for Occupational Safety and Health. [www.cdc.gov/niosh/
mining/]
NIOSH [2003c]. Analysis of 33 volunteer sand and gravel opera-
tions, 19992000. Pittsburgh, PA: Department of Health and Human
Services, Centers for Disease Control and Prevention, National Insti-
tute for Occupational Safety and Health. Unpublished.
Pollack ES, Chowdhury RT [2001]. Trends in work-related deaths
and injury rates among U.S. construction workers, 19921998. Wash-
ington, DC: The Center to Protect Workers Rights. [www.cpwr.com/
krdeaths.pdf]
Royster LH, Thomas WG [1979]. Age effect hearing levels for a
white nonindustrial noise exposed population (ninep) and their use
in evaluating industrial hearing conservation programs. Am Ind Hyg
Assoc J 40:504511.
Royster LH, Driscoll DP, Thomas WG, Royster JD [1980]. Age effect
hearing levels for a black nonindustrial noise exposed population
(ninep). Am Ind Hyg Assoc J 41:113119.
Introduction
T his final chapter provides data describing the distribution of
fatal occupational injuries and nonfatal occupational injuries
and illnesses among selected special populations at risk within the
labor force. The chapter focuses on young workers, older workers,
and Hispanic workers.
The importance of providing data on special populations is sup-
ported by two National Institute for Occupational Safety and Health
(NIOSH) surveillance program needs: the National Occupational
Research Agenda (NORA) and the NIOSH surveillance strategic
plan. NORA emphasizes the need to increase the amount of infor-
mation available to guide research, and thus it looks to surveillance
sources for data on special populations. This NORA priority reflects
the view of the public health community that workers with certain
biologic, social, or economic characteristics may be at increased
risk of occupational injuries and illnesses. The increasing size of
the U.S. labor force and its shifts in ethnic and age distributions
forecast increasing numbers of workers in these at-risk groups.
The focus on special populations is also supported by the NIOSH
surveillance strategic plan. The objective of this plan is to analyze
existing sources of data and disseminate findings to add to exist-
ing knowledge about the magnitude, circumstances, and trends
in injuries among special populations at risk (see Objective 3.5 in
NIOSH [2001]). Many of these populations have been underserved
within the occupational safety and health community. Many ques-
tions exist about these population groups and the prevalence and
incidence of fatal occupational injuries and nonfatal injuries and
illnesses. This Chartbook represents an attempt to compile and dis-
seminate available information.
Data for the figures come from the Bureau of Labor Statistics (BLS)
and the Massachusetts Department of Public Health. BLS data
sources include the Census of Fatal Occupational Injuries (CFOI)
and the Survey of Occupational Injuries and Illnesses (SOII). CFOI
is used to characterize fatal occupational injuries among these spe-
cial populations at risk, and SOII is used to characterize nonfatal
injuries and illnesses among the three groups. The Massachusetts
Department of Public Health conducts occupational injury surveil-
lance activities through the NIOSH Sentinel Event Notification
System for Occupational Risk (SENSOR) Program to develop
model surveillance and related outreach activities for preventing
occupational injuries among young workers in the Commonwealth
of Massachusetts. Data from this program are included to provide
perspective from one of the NIOSH State partners.
Young workers aged 1619 accounted for 6.9 million or 5.1% of all
employed workers in 2001, and those aged 55 and older accounted
for 18.3 million or 13.6%. The wholesale trade, retail trade, and
261
Chapter 5 Special Populations
services industry sectors were the major employment sectors for
both the younger and older workers (Table 51). Fatality rates dif-
fered by age group, ranging from a low of 1.1 per 100,000 among
workers aged 1617 to a high of 11.5 per 100,000 among workers
aged 65 and older (Figure 51). Of the 1.5 million injury and ill-
ness cases involving days away from work during 2001, younger
workers accounted for 3.0%, and older workers accounted for
262
10.5% (Figure 52). The severity of work loss varied by age group:
Workers aged 1415 and 1619 had median work losses of 2 and 4
days in 2001, and workers aged 5564 and 65 and older had median
work losses of 10 and 14 days, respectively (Figure 53). The sever-
ity of work loss varied slightly among racial and ethnic groups, from
5 to 7 days in 2001. Hispanic workers had the highest median work
loss of 7 days (Figure 54).
 Chapter 5 Special Populations

Employment and Age

How were employed workers distributed by age and industry in 2001?

Table 51. Number and distribution of employed workers in major industry groups by age, 2001. Young workers aged 1619 accounted for 6.9 million
or 5.1% of all employed workers, and those aged 55 and older accounted for 18.3 million or 13.6%. Of the young workers aged 1619, 54.2% were
employed in wholesale and retail trade, and 27.5% in services. Of the employed workers aged 55 and older, 40.0% were employed in services, and 17.5%
in wholesale and retail trade. (Source: BLS [2001].)

Age group
16 to 19 years 20 to 24 years 25 to 54 years 55 years and older
Number Distribution Number Distribution Number Distribution Number Distribution
Industry (thousands) (%) (thousands) (%) (thousands) (%) (thousands) (%)
All 6,889 100.0 13,361 100.0 96,515 100.0 18,307 100.0
Agriculture 225 3.3 302 2.3 1,899 2.0 718 3.9
Mining 8 0.1 38 0.3 450 0.5 71 0.4
Construction 321 4.7 1,040 7.8 7,227 7.5 993 5.4
Manufacturing 335 4.9 1,405 10.5 14,695 15.2 2,535 13.8
Durable goods 202 2.9 840 6.3 9,013 9.3 1,534 8.4
Nondurable goods 133 1.9 565 4.2 5,682 5.9 1,001 5.5
Transportation, communications,
and other public utilities 138 2.0 730 5.5 7,663 7.9 1,206 6.6
Wholesale and retail trade 3,735 54.2 4,178 31.3 16,565 17.2 3,195 17.5
Finance, insurance, and real estate 181 2.6 753 5.6 6,517 6.8 1,346 7.4
Services 1,892 27.5 4,650 34.8 36,617 37.9 7,318 40.0
Public administration 54 0.8 265 2.0 4,883 5.1 924 5.0

263
 Chapter 5 Special Populations

1,600 Number Rate 11.5 12 Fatal Injuries and Age

1,402
How did fatal occupational injuries differ by age of worker
1,250 10 in 2002?
1,200

Rate per 100,000 workers

Figure 51. Number and rate of fatal occupational injuries
Number of fatal injuries

1,020 8 by age of worker, 2002. Workers aged 2554 accounted for

3,672 or 66.5% of the 5,524 fatal occupational injuries in 2002.
783 Fatality rates ranged from 1.1 per 100,000 among workers aged
800 6
1617 to 11.5 per 100,000 among workers aged 65 and older.
Fatalities among workers aged 65 and older accounted for 9%
5.0
494 4 (494 fatalities) of all fatal occupational injuries. (Note: Labor
435 4.0 4.0 force data are unavailable for youths aged 15 and younger.
400 3.3
2.2 3.2 This precludes estimating rates for these workers.) (Source: BLS
2 [2003a].)
1.1
92
16 25
0 0
<16 1617 1819 2024 2534 3544 4554 5564 >64
Age range

Age 4554
20.8%
Nonfatal Injuries and Illnesses
Age
315,794 How did nonfatal occupational injuries and illnesses differ
Age >54 by age of worker in 2001?
10.5%
Age 3544 160,231 Figure 52. Number and distribution of nonfatal injuries and
28.8% illnesses involving days away from work in private industry by
438,445
45,443 Age <20 age of worker, 2001. Younger workers accounted for 45,443
3.0%
cases or 3.0% of the 1.5 million injury and illness cases involv-
171,659 ing days away from work for which age was reported. Workers
aged 55 and older accounted for 160,231 cases or 10.5%. Age
Age 2024 was not reported for 16,930 cases. (Source: BLS [2003b,c].)
389,065 11.3%

Age 2534
25.6%

264
 Chapter 5 Special Populations

Severity 14
14

How did the severity of work loss from nonfatal

occupational injuries and illnesses vary by age group in 12
2001? Median for all

Median days away from work

ages = 6 10
10
Figure 53. Median days away from work due to occupational
injury or illness in private industry by age, 2001. Median days 8
away from work due to injury or illness increased with age. In 8
7
2001, workers aged 1415 and 1619 had median work losses
of 2 and 4 days, respectively. Workers aged 5564 and 65 and 6
older had median work losses of 10 and 14 days, respectively. 5
(Sources: BLS [2003b,c].) 4 4
4

2
2

0
1415 1619 2024 2534 3544 4554 5564 >64
Age range

How did the severity of work loss from nonfatal Median for all
occupational injuries and illnesses vary by race/ethnicity race/ethnicity = 6
in 2001? White, non-Hispanic 6

Figure 54. Median days away from work due to occupational

injury or illness in private industry by race/ethnicity, 2001. Black, non-Hispanic 6
Median days of work loss varied from 5 to 7 days in 2001.
Hispanic workers had the highest median work loss of 7 days.
Hispanic 7
Race/ethnicity was not reported for 415,616 of the 1.5 million
reported injuries and illnesses involving days away from work.
(Sources: BLS [2003b,c].) Asian or Pacific 6
Islander

American Indian or 5
Alaska Native

Not reported 7

0 1 2 3 4 5 6 7
Median days away from work

265
Chapter 5 Special Populations
Young Workers
Young workers are generally believed to be at increased risk of
occupational injury owing to their limited job knowledge, train-
ing, and skills. Physical and psychosocial factors may also place
young workers at increased risk of injury, and age-related factors
may render youths more susceptible to chemical and other physi-
cal exposure risks at work. Every year, about 67 teenage workers die
of work injuries [DOL 2000], and NIOSH estimates that 230,000
teenagers suffer from nonfatal occupational injuries. For the year
2010, BLS forecasts that 17.8 million youths aged 1619 will be in
the labor forceup from 16 million in 2000. Labor force data are
unavailable for youths aged 15 and younger, though BLS collects
occupational fatality data and nonfatal injury and illness data on
workers in these age groups.
Data for the figures come from three sources: CFOI, SOII, and the
Occupational Health Surveillance (SENSOR) Program within the
Massachusetts Department of Public Health [Davis 2002]. The fig-
ures in this section illustrate fatal occupational injuries and nonfa-
tal occupational injuries and illnesses among young workers. They
are described for the following age groups (data permitting):
Fatal occupational Nonfatal occupational
injuries injuries and illnesses
17 or younger Younger than 14
1617 1415
1819 1619
BLS reported that during 19932002, the number of fatal injuries
ranged from 32 to 46 for workers aged 1617, and from 92 to 137
for workers aged 1819. Rates declined during the same period
266
from 2 to 1.1 per 100,000 employed workers aged 1617 and from 3
to 2.2 per 100,000 employed workers aged 1819 (Figure 55). Most
fatalities (60.5%) affect workers aged 16 and 17 (Figure 56) and
occur among male workers (Figure 57) and white, non-Hispanic
youths (73.6%) (Figure 58). Work in farming, forestry, and fishing
accounted for 289 or 42.3% of all fatal occupational injuries among
youths aged 17 during 19922002 (Figure 59). Transportation
incidents were responsible for 320 or 45.4% of fatal occupational
injuries among youths; incidents on highways, farms, and industrial
premises accounted for more than 137 or 74% of all transportation
incidents among youths (Figure 511).
BLS reports from employers show a consistent downward trend
since 1992 in the estimated number of nonfatal injuries and ill-
nesses involving days away from work among workers under age 14
(Figure 512), aged 1415 (Figure 513), and aged 1619 (Figure
514). In 2001, workers aged 1619 accounted for 44,535 or 2.9%
of all reported cases of nonfatal occupational injury and illness
involving days away from work. Younger workers experienced less
severe injuries as measured by median days away from work. Work-
ers aged 1415 had a median loss of 2 days (62.3% of the cases had
a work loss of 1 or 2 days), and workers aged 1619 had a median
loss of 4 days (60.1% of the cases involved a work loss of 5 days or
less) (Figure 515). During 2001, the highest proportion of non-
fatal injury and illness cases among workers aged 1619 occurred
in operators, fabricators, and laborers (37.4% or 16,566 cases) and
service (30.8% or 13,640) (Figure 516). The wholesale and retail
trade and services industry sectors accounted for the highest per-
centages (45.6% and 21.2%, respectively) of nonfatal occupational
injuries and illnesses among workers aged 1619 (Figure 517).
 Chapter 5 Special Populations

Fatal Injuries Age 1617 Number Age 1819 Number

3.5
Rate Rate
Magnitude and Trend 160 3 3 3
3.1 3.1
2.8 2.8 3.0
How did the numbers and rates of fatal occupational 137 2.7 2.7
140 130
injuries change among young workers during 19932002? 125 127

Rate per 100,000 workers

122 122 2.5
120 114 113 2.2

Number of fatal injuries

Figure 55. Numbers and rates of fatal occupational injuries
102
among workers aged 1617 and 1819, 19932002. Fatal occu- 100 2.0
92
pational injury rates declined during this 10-year period from 2 2 2
2 to 1.1 per 100,000 employed workers aged 1617 and from 3 80
1.6 1.5
to 2.2 per 100,000 employed workers aged 1819. Fatal injury 1.6 1.6
1.5
rates were higher each year for workers aged 1819 compared 60 1.3
with workers aged 1617. The number of fatal injuries ranged 43 1.2 46 44 1.0
39 42 42 41
from 32 in 1998 to 46 in 1999 for workers aged 1617, and from 40 33 1.1
32
92 in 2002 to 137 in 1998 for workers aged 1819. (Note: BLS 25
0.5
rounded rates to whole numbers for 19931995.) (Source: BLS 20
[2003d].)
0 0.0
1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

Age Age <13

13.3%
How did fatal occupational injuries differ by age of young
workers during 19922002?
Age 13
94 5.8%
Figure 56. Number and distribution of fatal occupational Age 17
injuries by age among young workers, 19922002. Fatal occu- 38.2%
41
pational injuries among workers aged 16 and 17 accounted 270 Age 14
for 158 and 270 fatalities, respectively, or 60.5% of all fatal 55 7.8%
occupational injuries among workers aged 17 and younger
for the period 19922002. A significant number of deaths (94
or 13.3% of the total) occurred among youths aged 12 and 89
younger. (Source: BLS [2003d].)
Age 15
158 12.6%

Age 16
22.3%

267
 Chapter 5 Special Populations

Male Female Sex

70 67 66
How did the number of fatal occupational injuries differ
60 61 60 60
60 58 by sex of worker among young workers during 1992
57
2002?
53
50
50 Figure 57. Number of fatal occupational injuries among
Number of fatal injuries

workers aged 17 and younger by sex of worker, 19922002. For

40 this period, the total number of fatal occupational injuries for
36 workers aged 17 and younger ranged from 41 in 2002 to 73 in
2000. Deaths among male workers predominated, accounting
30 for 89% of the worker deaths reported in this age group during
19922002. (Note: Dash in parentheses indicates that no data
20 were reported or that data do not meet BLS publication crite-
12 ria.) (Source: BLS [2003d].)
10 10 9 9
10 8 7
5 5
() ()
0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

Black, non-Hispanic
8.9%
Race/Ethnicity
How did fatal occupational injuries differ by race/ethnicity
among young workers during 19922002?
491 Hispanic
15.2%
Figure 58. Number and distribution of fatal occupational
injuries among workers aged 17 and younger by race/ethnicity,
840 19922002. White, non-Hispanic youths accounted for 520 or
Asian or
Pacific Islander 73.6% of fatal occupational injuries among workers aged 17
2.5% and younger during 19922002. In contrast, 39 fatal occupa-
140 tional injuries (5.5%) were reported for black, non-Hispanic
American Indian or
Alaska Native youths, and 114 (16.1%) were reported for Hispanic youths
3,917 0.7% during the 11-year period. (Source: BLS [2003d].)
40
Other or
White, non-Hispanic unspecified
70.9% 1.7%
96

268
 Chapter 5 Special Populations

Occupation Managerial and

professional 10 1.5%
How did fatal occupational injuries differ by major specialty
occupational group among young workers during 1992 Technical, sales, and
2002? administrative 65 9.5%
support
Figure 59. Distribution and number of fatal occupational
injuries among workers aged 17 and younger by occupation, Service 85 12.4%
19922002. Work in farming, forestry, and fishing accounted
for 289 or 42.3% of all fatal occupational injuries among youths Farming, forestry, 289 42.3%
aged 17 and younger during 19922002. Youths employed as and fishing
operators, fabricators, and laborers accounted for 195 or
28.6% of the fatal injuries. (Source: BLS [2003d].) Precision production, 39 5.7%
craft, and repair

Operators, fabricators, 195 28.6%

and laborers

0 10 20 30 40 50
Distribution (%)

Industry Agriculture, forestry, 287 43.3%

and fishing
How did fatal occupational injuries vary by private
Mining ()
industry sector among young workers during 19922002?
Construction 107 16.1%
Figure 510. Distribution and number of fatal occupational
injuries among workers aged 17 and younger by industry, 40 6.0%
Manufacturing
19922002. During 19922002, young workers in agriculture,
forestry, and fishing accounted for 287 or 43.3% of all fatal Transportation and 17 2.6%
occupational injuries among workers aged 17 or younger. public utilities
Workers in retail trade and construction had the next largest Wholesale trade 15 2.3%
numbers of fatal injuries among young workers (127 fatal inju-
ries [or 19.2%] and 107 fatal injuries [or 16.1%], respectively). Retail trade 127 19.2%
(Note: Dash in parentheses indicates that no data were reported
Finance, insurance, ()
or that data do not meet BLS publication criteria.) (Source: BLS and real estate
[2003d].)
Services 70 10.6%

0 10 20 30 40 50
Distribution (%)

269
 Chapter 5 Special Populations

Assaults and
violent acts
Event or Exposure
17.8%
Exposure to How did fatal occupational injuries differ by event or
harmful Nonhighway exposure among young workers during 19922002?
environments Transportation (farm, industrial
9.6% incidents premises)
126 45.3% Figure 511. Distribution and number of fatal occupational
injuries among workers aged 17 and younger by event or
Other
0.3% 68 101
exposure, 19922002. Transportation incidents accounted for
2 45.4% (320) of fatal occupational injuries among youths. These
48 320 Other incidents are further described by the smaller pie chart, which
Falls 7
6.8% shows incidents on highways, farms, and industrial premises
137 Railway accounting for more than 74% of all transportation incidents
15
8 among youths. Overall, assaults and violent acts accounted for
132
Fires and Highway 52 126 or 17.8% of all fatal occupational injuries among youths.
Water
explosions vehicle
1.6% (Source: BLS [2003d].)
11
Contact with objects Worker struck by vehicle,
and equipment mobile equipment
18.7%

100
91
Nonfatal Injuries and Illnesses
90
Magnitude and Trend
80
How did nonfatal occupational injuries and illnesses
70 involving days away from work change among workers
under age 14 during 19922001?
Number of cases

60 55
Figure 512. Number of nonfatal occupational injuries and ill-
50
nesses among workers under age 14 involving days away from
40 work in private industry, 19922001. Reported cases of non-
34 fatal occupational injury and illness involving days away from
30 work are very rare among workers younger than 14. No cases
23 are reported by BLS for 19972001, and relatively few cases are
20 17 reported for 19921996. The highest estimated count of 91
cases was reported in 1992 (compared with an estimated 2.3
10
million for all age groups). (Note: Dash in parentheses indicates
() () () () () that no data were reported or that data do not meet BLS publi-
0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 cation criteria.) (Sources: BLS [2003b,c].)

270
 Chapter 5 Special Populations

How did nonfatal occupational injuries and illnesses 1,600

involving days away from work change among workers 1,476
aged 1415 during 19922001? 1,400
1,247
Figure 513. Number of nonfatal occupational injuries and 1,181
1,200
illnesses involving days away from work among workers aged
1415 in private industry, 19922001. Among workers aged

Number of cases
1,000
1415, reported cases of nonfatal occupational injury and ill- 889 908
865 866
ness involving days away from work ranged from 1,476 in 1996
to 276 in 1998. (Sources: BLS [2003b,c].) 800

600 573

400
284 276
200

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

How did nonfatal occupational injuries and illnesses 100 96.0 95.8 97.3
involving days away from work change among workers
aged 1619 during 19922001? 83.5
Figure 514. Number of nonfatal occupational injuries and 80
73.8
Number of cases (thousands)

illnesses involving days away from work among workers aged

1619 in private industry, 19922001. Among workers aged 16
59.7 60.4
19, reported cases of nonfatal occupational injury and illness 60 58.2
involving days away from work ranged from 97,262 in 1994 to 54.1
44,535 in 2001. Overall, this age group accounts for 2.9% of all 44.5
reported cases of nonfatal occupational injury and illness. Data
for 19922001 show a consistently decreasing trend in reported 40
cases. (Sources: BLS [2003b,c].)

20

0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

271
 Chapter 5 Special Populations

60 Age 1415 Age 1619 Severity

52.1
How did nonfatal occupational injuries and illnesses
50 involving days away from work vary by severity of work
loss for young workers in 2001?
40 Figure 515. Distribution of nonfatal occupational injuries
Distribution (%)

and illnesses involving days away from work among workers

30 aged 1415 and 1619 in private industry by number of days
24.9 away from work, 2001. Young workers tended to experience
more short-term than long-term work loss. For workers aged
20 18.1 18.6 1415, 62.3% of the cases had a work loss of 1 or 2 days. For
17.1
14.4 workers aged 1619, 60.1% of the cases involved work loss of 5
10.2 10.5 days or less. Workers aged 1415 had a median loss of 2 days,
10 8.5 8.4 9.4 and workers aged 1619 had a median loss of 4 days. Overall,
5.6
private sector workers had a median of 6 days away from work.
1.8
0.4 (Sources: BLS [2003b,c].)
0
1 2 35 610 1120 2130 >30
Days away from work

Managerial and Occupation

professional 661 1.5%
specialty How did nonfatal occupational injuries and illnesses
Technical, sales, and involving days away from work differ by major
administrative 7,558 17.1% occupational group among young workers in 2001?
support
Figure 516. Distribution and number of occupational injuries
Service 13,640 30.8% and illnesses involving days away from work among workers
aged 1619 in private industry by occupation, 2001. BLS esti-
Farming, forestry, mates that 44,249 cases of occupational injury and illness involv-
and fishing 1,908 4.3%
ing days away from work occurred among workers aged 1619
during 2001. The highest proportions of these cases occurred
Precision production, in operators, fabricators, and laborers (37.4% or 16,566 cases)
craft, and repair 3,916 8.8%
and service (30.8% or 13,640). (Sources: BLS [2003b,c].)

Operators, fabricators, 16,566 37.4%

and laborers

0 5 10 15 20 25 30 35 40
Distribution (%)

272
 Chapter 5 Special Populations

Industry Agriculture, forestry, 1,987 4.5%

and fishing
How did nonfatal occupational injuries and illnesses Mining 110 0.2%
involving days away from work differ by industry among
young workers in 2001? Construction 4,484 10.1%

Figure 517. Distribution and number of nonfatal occupation- Manufacturing 3,041 6.8%
durable
al injuries and illnesses involving days away from work among
workers aged 1619 in private industry by industry, 2001. Manufacturing 1,935 4.3%
nondurable
Wholesale and retail trade and services accounted for the high-
Transportation and 2,771 6.2%
est percentages (45.6% and 21.2%, respectively) of nonfatal public utilities
occupational injuries and illnesses among workers aged 1619. Wholesale and
(Sources: BLS [2003b,c].) 20,290 45.6%
retail trade
Finance, insurance, 456 1.0%
and real estate
Services 9,461 21.2%

0 10 20 30 40 50
Distribution (%)

273
Chapter 5 Special Populations
Case-Based Reporting of Work-Related Injuries to Adolescents in
Massachusetts (SENSOR)
Work is part of life for millions of adolescents throughout the Unit-
ed States. Working adolescents are exposed to a variety of health
hazards at work, and many are injured at work each year. Employ-
ment data for working youths under age 16 are not published rou-
tinely. A recent Department of Labor report estimates that 2.9 mil-
lion youths aged 1517 worked during school years, and 4 million
worked during the summer months [DOL 2000].
The Massachusetts Occupational Health Surveillance Program has
been conducting surveillance of occupational injuries to adoles-
cents since 1992. The program collects data about occupational
injuries to youths under age 18. The Massachusetts public health
code mandates that physicians and hospitals report cases of occu-
pational injuries among adolescents. These data are used for sur-
veillance and prevention purposes. Workers compensation claims
and hospital emergency room data are also used to identify cases.
Cases identified through workers compensation claims are limited
to injuries resulting in 5 or more lost workdays. Not all emergency
rooms report injuries to the surveillance program (14 hospitals
report regularly). The actual number of occupational injuries
274
requiring medical treatment of an adolescent worker is believed to
be much higher than the number reported by the Massachusetts
surveillance program.
Of the 3,389 cases of injuries among young workers during 1993
1999, 2,391 cases were identified solely from workers compensation
claims (Figure 518). Workers aged 16 and 17 accounted for 30.0%
and 58.3%, respectively, of occupational injuries among adolescents.
Male workers accounted for 62.5% of the adolescents injured (Fig-
ure 519). Most cases identified through emergency department
reports involved cuts, lacerations, and punctures (46.8%), followed
by heat burns and scalds (14.0%). These data contrast with the data
for workers compensation claims, which report that the majority of
cases involved strains and sprains (35.5%), followed by cuts, lacera-
tions, and punctures (23.8%) (Figure 520). The largest numbers
of occupational injury cases identified among young workers in
Massachusetts through workers compensation claims occurred in
restaurants (25.6%), grocery stores (15.0%), retail bakeries (6.7%),
and nursing homes (5.8%) (Figure 521).
 Chapter 5 Special Populations

Data Sources Emergency

department only
26.3%
What data sources were used in Massachusetts for
the surveillance of occupational injuries among young
workers during 19931999?
893
Figure 518. Occupational injuries among young workers in
Massachusetts by data source, 19931999. Cases are identified
from two sourcesworkers compensation claims resulting in Both data
105 sources
5 or more lost workdays and reports from emergency depart- 3.1%
ments. Of the 3,389 cases identified, 2,391 were identified sole-
ly from workers compensation claims. (Source: Davis [2002].)
2,391

Workers'
compensation
only
70.6%

Age and Sex 70

How did occupational injuries differ by age and sex among 60 62.5
young workers in Massachusetts during 19931999? 58.3

Figure 519. Occupational injuries among young workers in 50

Massachusetts by age and sex, 19931999. Workers aged 16
Distribution (%)

accounted for 30.0% of occupational injuries among adoles- 40

cents, and workers aged 17 accounted for 58.3%. Male workers 37.5
accounted for 62.5% of the adolescents injured. (Source: Davis
30 30.0
[2002].)

20

10 8.3
2.9
0
14 15 16 17 Male Female
Age range Sex

275
 Chapter 5 Special Populations

50 Workers' compensation Emergency departments Type of Injury

46.8 How did occupational injuries differ by type of injury
40 among young workers in Massachusetts during 1993
1999?
35.5
Figure 520. Occupational injuries among young workers
Distribution (%)

30 aged 1417 in Massachusetts by injury type and data source,

19931999. Of the 945 cases of occupational injury among
23.8
young workers in Massachusetts who were identified through
20 19.3 emergency department reports, the majority involved cuts, lac-
erations, and punctures (46.8%), followed by heat burns and
14.0
12.3 scalds (14.0%). These data contrast with the data for workers
10 9.6 9.5 9.4 9.5 compensation claims, which report that most cases involved
7.3
strains and sprains (35.5%), followed by cuts, lacerations, and
3.1 punctures (23.8%). (Source: Davis [2002].)
0
Sprains, Cuts, Bruises, Heat burns, Fractures Others
strains, lacerations, contusions, scalds
tears punctures crushings

All other Industry

industries
42.1% How did occupational injuries differ by private industry
Department stores
4.7% sector among young workers in Massachusetts during
19931999?
1,019
Nursing homes
5.8% 113
Figure 521. Occupational injuries identified by workers com-
pensation data among young workers aged 1417 in Massachu-
141 setts by selected industry, 19931999. The largest numbers of
Retail occupational injury cases identified among young workers in
162 Massachusetts through workers compensation claims occurred
bakeries
6.7% in restaurants (25.6%), grocery stores (15.0%), retail bakeries
(6.7%), and nursing homes (5.8%). (Source: Davis [2002].)
363
620

Grocery
stores
15.0%
Restaurants
25.6%

276

Older Workers
As the U.S. labor force grows, it becomes markedly older. As illus-
trated in Chapter 1, the age distribution of the labor force is shift-
ing. Employment data for 2001 show that workers aged 55 and older
represented 22.9% of the workers employed in agriculture versus
10%15% in the other major industry sectors [BLS 2001]. By 2010,
middle-aged and older workers will outnumber younger workers
(see Figure 11). For the year 2010, BLS projects employment of
21.2 million workers aged 5564 (compared with 13.9 million in
2000) and 5.4 million workers aged 65 and older (compared with
4.2 million in 2000) (see Figure 11). Older workers are known to
experience high rates of traumatic fatalities and are also more sus-
ceptible to chronic disease and related conditions.
BLS reported that the number of fatal injuries during 19922002
ranged from 767 in 1992 to 875 in 1997 for workers aged 5564,
and from 467 in 1992 to 565 in 1999 for workers aged 65 and older.
Rates varied from 8 per 100,000 workers in 1994 to 5 per 100,000
workers aged 5564 in 2002. For workers aged 65 and older, rates
declined from 15 per 100,000 workers in 1993 to 11.5 in 2002 (Fig-
ure 522). Most fatalities (94% during the 11-year period) occurred
among male workers (Figure 523), and white, non-Hispanic work-
ers (82.1% among workers aged 55 and older) (Figure 524).
During 19922002, slightly more than half of all fatal occupational
injuries among workers aged 55 and older occurred among opera-
tors, fabricators, and laborers (4,075 or 28.0%) and workers in
farming, forestry, and fishing (3,880 or 26.7%) (Figure 525). The
agriculture, forestry, and fishing industry experienced the largest
Chapter 5 Special Populations
share of fatal occupational injuries (3,629 or 27.1%) (Figure 526).
Transportation incidents accounted for 6,737 or 45.8% of fatal
occupational injuries among workers aged 55 and older during
19922002 (Figure 527). Among transportation incidents, high-
way, nonhighway (farm and industrial), and being struck by vehicle
or mobile equipment were principal sources of fatal occupational
injuries (Figure 527).
BLS reports from employers show that cases of nonfatal occupa-
tional injury and illness involving days away from work among
workers aged 55 and older ranged from 148,249 cases in 1993 to
126,494 cases in 1996 (Figure 528). The number of cases in 2001
(135,690 cases) is consistent with a slight increase in reported cases
since 1996. Older workers experience more severe injuries as mea-
sured by the median number of days away from work. Workers aged
5564 had a median of 10 days away from work, and those aged 65
and older had a median of 14 days. Overall, private sector work-
ers had a median of 6 days away from work (Figure 529). During
2001, the highest proportions of cases occurred among operators,
fabricators, and laborers for workers aged 5564 (34.8% or 47,095
cases) and 65 and older (31.5% or 7,704 cases) (Figure 530).
Services, manufacturing (durable), and wholesale and retail trade
together account for 67% of all nonfatal occupational injuries and
illnesses involving days away from work among workers aged 5564.
The same industry sectors predominated for workers aged 65 and
older, accounting for nearly 75% of all cases (Figure 531).
277
 Chapter 5 Special Populations

Age 5564 Number Age >64 Number Fatal Injuries

Rate Rate
900 866 855 875 Magnitude and Trend
827 836 816 831
811 16
800 767 775 783 How did the numbers and rates of fatal occupational
14.3 14.4
14 14 13.8
15 13.3 14 injuries change among older workers during 19922002?
700 13 12.7
12.0
Number of fatal injuries

Figure 522. Numbers and rates of fatal occupational injuries

Rate per 100,000 workers

11.5 12
600 565 among workers aged 5564 and older, 19922002. Rates of
522 525 541 530
515 504 520
488 494 10 fatal occupational injuries among older workers declined dur-
500 467
ing 19922002. For workers aged 5564, rates varied from 8
400 8 per 100,000 workers in 1994 to 5 in 2002. The number of fatal
8

occupational injuries ranged from 767 in 1992 to 875 in 1997.

7.1
7.2
6
7

300 For workers aged 65 and older, rates declined from 15 per

6.5

6.1
6.1
100,000 workers in 1993 to 11.5 in 2002. The number of fatal

5.5
4

5.0
200
occupational injuries in this group ranged from 467 in 1992 to
100 2 565 in 1999. (Note: BLS rounded rates to whole numbers for
19921995.) (Source: BLS [2003d].)
0 0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

1,400
Male Female Sex
1,312 1,308 1,291 1,310
1,252 1,241 1,269 1,240 1,225 How did fatal occupational injuries vary by sex of worker
1,191
1,200 1,167 among workers aged 55 and older during 19922002?

Figure 523. Number of fatal occupational injuries among

1,000
Number of fatal injuries

workers aged 55 and older by sex, 19922002. Male workers

accounted for most fatal occupational injuries among older
800 workers (94% during the 11-year period). From year to year,
small differences occur in the number of fatal injuries among
women, ranging from 67 in 1992 to 101 in 1995. (Source: BLS
600
[2003d].)

400

200
81 79 101 90 87 86 79 80 86
67 71
0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

278
 Chapter 5 Special Populations

Race/Ethnicity
White, non-Hispanic 12,075 82.1%
How did fatal occupational injuries vary by race/ethnicity
among workers aged 55 and older during 19922002?
Black, non-Hispanic 1,237 8.4%
Figure 524. Distribution and number of fatal occupational
injuries among workers aged 55 and older by race/ethnicity,
19922002. White, non-Hispanic workers accounted for 12,075 Hispanic 854 5.8%
or 82.1% of fatal occupational injuries among workers aged
55 and older. Black, non-Hispanic workers in this age group American Indian or 53 0.4%
accounted for 1,237 fatal occupational injuries or 8.4% of the Alaska Native
total. Hispanic workers suffered 854 fatal occupational injuries
or 5.8%. (Source: BLS [2003d].) Asian or Pacific 326 2.2%
Islander

Other or unspecified 168 1.1%

0 10 20 30 40 50 60 70 80 90
Distribution (%)

Occupation Managerial and

professional 1,902 13.1%
How did fatal occupational injuries differ by major specialty
occupational group among workers aged 55 and older Technical, sales, and
during 19922002? administrative 1,845 12.7%
support
Figure 525. Distribution and number of fatal occupational
injuries among workers aged 55 and older by occupation, Service 949 6.5%
19922002. Two groups accounted for slightly more than half
of fatal occupational injuries among workers aged 55 and Farming, forestry, 3,880 26.7%
older: operators, fabricators, and laborers (4,075 or 28.0%) and fishing
and farming, forestry, and fishing (3,880 or 26.7%). Three
occupations each accounted for approximately 13% of the fatal Precision production, 1,896 13.0%
injuries: managerial and professional specialty; technical, sales, craft, and repair
and administrative support; and precision production, craft,
and repair. (Source: BLS [2003d].) Operators, fabricators, 4,075 28.0%
and laborers

0 5 10 15 20 25 30
Distribution (%)

279
Chapter 5 Special Populations

Agriculture, forestry, 3,629 27.1%

Industry
and fishing
How did fatal occupational injuries differ by major private
Mining 215 1.6%
industry sector among workers aged 55 and older during
Construction 1,756 13.1%
19922002?

Manufacturing 1,554 11.6% Figure 526. Distribution and number of fatal occupational
injuries among workers aged 55 and older by industry, 1992
Transportation and 1,974 14.7% 2002. Among workers aged 55 and older, those in agriculture,
public utilities
forestry, and fishing experienced the largest share of fatal
Wholesale trade 632 4.7% occupational injuries (3,629 or 27.1%) during 19922002. Five
industries accounted for nearly 64% of these fatalities: trans-
Retail trade 1,474 11.0% portation and public utilities (1,974 or 14.7%), services (1,817
Finance, insurance, or 13.6%), construction (1,756 or 13.1%), manufacturing
and real estate 346 2.6% (1,554 or 11.6%), and retail trade (1,474 or 11.0%). (Source:
BLS [2003d].)
Services 1,817 13.6%

0 5 10 15 20 25 30
Distribution (%)

Assaults and
violent acts
Event or Exposure
Exposure to
harmful substances 15.4%
How did fatal occupational injuries differ by event or
or environments Nonhighway
4.7% exposure among workers aged 55 and older during 1992
Transportation (farm, industrial
incidents premises) 2002?
2,270 45.8%
Water Figure 527. Distribution and number of fatal occupational
686
vehicle injuries among workers aged 55 and older by event or expo-
1,701 126
Falls sure, 19922002. Transportation incidents (6,737 or 45.8%),
14.0% 2,062
6,737 Railway contacts with objects and equipment (2,508 or 17.0%), and
174 assaults and violent acts (2,270 or 15.4%) were major types of
Fires 3,200 440 fatal occupational injuries during this 11-year period. Among
Other
and 22 the transportation incidents, highway (3,200), nonhighway
explosions 2,508 Highway 1,074
2.5%
(farm and industrial) (1,701), and being struck by a vehicle or
Aircraft
361 mobile equipment (1,074) were principal sources of fatal occu-
pational injuries. (Source: BLS [2003d].)
Other events Worker struck
Contact with objects by vehicle, mobile
and equipment or exposures
0.6% equipment
17.0%
89

280
 Chapter 5 Special Populations

Nonfatal Injuries and Illnesses 160

Age 5564 Age >64
147.7 148.2 147.5
142.5
Magnitude and Trend 140 134.7
138.4 135.7
131.3 131.7
126.5
How did nonfatal occupational injuries and illnesses

Number of cases (thousands)

involving days away from work change among workers 120
aged 55 and older during 19922001?
100
Figure 528. Number of nonfatal occupational injuries and
illnesses involving days away from work among workers aged 80
55 and older in private industry, 19922001. Recorded cases
of nonfatal occupational injury and illness involving days away
60
from work among workers aged 55 and over ranged from
148,249 cases in 1993 to 126,494 cases in 1996. The number of
cases in 2001 (135,690 cases) is consistent with a slight increase 40
in reported cases since 1996. Data for workers aged 65 and 22.4 22.5 25.3 24.5
21.0 21.6 21.1 18.9 21.1
20 17.7
older show a similar pattern (a decrease in the first half of the
decade followed by an increase in the second half), with num-
bers ranging from 17,664 in 1996 to 25,334 in 2000. (Sources: 0
BLS [2003b,c].) 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

Severity 35
Age 5564 Age >64 34.5

How did nonfatal occupational injuries and illnesses 29.6

involving days away from work vary by severity for workers 30
aged 55 and older in 2001?
25
Figure 529. Distribution of nonfatal occupational injuries
Distribution (%)

and illnesses involving days away from work among workers

20
aged 55 and older in private industry by days away from work, 17.0
2001. Workers aged 65 and older tended to experience lower 15.3
percentages of short-term work loss (1 and 35 days) and a 15
11.8 11.8 11.0 12.1 12.8
substantially higher percentage of long-term work losses of 31
9.7 9.7 9.7
days or more (29.6% for workers aged 5564, and 34.5% for 10 8.0
those aged 65 and older). Workers aged 5564 had a median 7.0
loss of 10 days away from work, and those aged 65 and older 5
had a median of 14 days. Overall, private sectors workers had a
median of 6 days away from work. (Sources: BLS [2003b,c].)
0
1 2 35 610 1120 2130 >30
Days away from work

281
Chapter 5 Special Populations

Managerial and
Age 5564 Occupation
10,486 7.8% Age >64
professional
specialty 1,370 5.6% How did nonfatal occupational injuries and illnesses differ
Technical, sales, and by major occupational group among workers aged 55 and
24,550 18.2%
administrative older in 2001?
support 4,929 20.1%
Figure 530. Distribution and number of nonfatal occupa-
27,438 20.3%
Service tional injuries and illnesses involving days away from work
7,012 28.7%
among workers aged 55 and older in private industry by occu-
Farming, forestry, 2,357 1.7% pation, 2001. The distribution of cases by occupation for work-
and fishing 601 2.5% ers aged 55 and older shows the highest proportions of cases
among operators, fabricators, and laborers aged 5564 (34.8%
Precision production, 23,322 17.2% or 47,095 cases) and those aged 65 and older (31.5% or 7,704
craft, and repair 2,853 11.7% cases). Service has the next highest proportions of cases for
workers aged 5564 (20.3% or 27,438 cases) and those aged 65
Operators, fabricators, 47,095 34.8%
and laborers 7,704 31.5% and older (28.7% or 7,012 cases). (Sources: BLS [2003b,c].)

0 5 10 15 20 25 30 35
Distribution (%)

Agriculture, forestry, 1,844 1.4% Age 5564 Industry

and fishing 537 2.2% Age >64
775 0.6% How did nonfatal occupational injuries and illnesses
Mining 78 0.3% involving days away from work vary by major private
Construction
10,663 7.9% industry sector among workers aged 55 and older in
1,440 5.9% 2001?
Manufacturing 21,283 15.7%
durable 2,398 9.8% Figure 531. Distribution and number of nonfatal occupa-
Manufacturing 11,227 8.3% tional injuries and illnesses involving days away from work
nondurable 1,410 5.7%
among workers aged 55 and older by major private industry
Transportation and 16,129 11.9% sector, 2001. Services, manufacturing (durable), and wholesale
public utilities 1,755 7.2%
and retail trade together account for 67% of all nonfatal occu-
Wholesale and 30,305 22.3%
retail trade 8,477 34.5% pational injuries and illnesses involving days away from work
Finance, insurance, 4,072 3.0%
among workers aged 5564. The same industry sectors pre-
and real estate 1,018 4.1% dominate for workers aged 65 and older, accounting for nearly
39,391 29.0% 75% of all cases. (Sources: BLS [2003b,c].)
Services 7,427 30.3%

0 5 10 15 20 25 30 35
Distribution (%)

282

Hispanic Workers
As the U.S. labor force grows, the number and proportion of His-
panic workers increase. Hispanic workers accounted for 10.9% of
the 135 million workers employed in 2001 (Tables 13 and 14).
But BLS projects that by 2010, the Hispanic labor force will number
30.3 millionup from 22.4 million in 2000. This figure represents
a 3.1% annual growth rate. In 2001, Hispanic workers exceeded
10.9% of those employed in four occupational groups (service
occupations, 16.3%; precision production, craft, and repair, 14.7%;
operators, fabricators, and laborers, 17.7%; and farming, forestry,
and fishing, 21.5%) and in two industries (agriculture, 20.3%; and
construction, 15.8%) (Tables 13 and 14). Limited data are avail-
able on occupational injury and disease risks among Hispanic work-
ers.
During 19922002, BLS reported that the number of fatal injuries
ranged from 533 to 895 among Hispanic workers. Rates varied from
5 to 6 per 100,000 employed (Figure 533). Most fatalities (4,239 or
55.2%) affect workers aged 2544 (Figure 534) and occur among
male workers (94%) (Figure 535). Work as operators, fabricators,
and laborers accounted for the most fatalities (41.4% or 3,128
cases) (Figure 536). The largest proportion of fatal occupational
injuries among Hispanic workers was in the construction industry
Chapter 5 Special Populations
(27.7% of the total, or 1,994 cases) (Figure 537). Transportation
incidents accounted for 2,593 or 33.7% of fatal occupational inju-
ries among Hispanic workers (Figure 538).
Cases of nonfatal occupational injury and illness with days away
from work among Hispanic workers ranged from 198,022 in 1992
to 169,300 in 1996. When presented as a percentage of all nonfa-
tal occupational injuries and illnesses with days away from work,
the cases among Hispanic workers show a fairly consistent upward
trend, from 8.5% in 1992 to 12.5% in 2001 (Figure 540). Hispanic
workers had the highest median work loss (7 days) (Figure 541).
Compared with white or black workers, Hispanic workers had the
lowest percentages of short-term work loss (1 or 2 days) and the
highest percentage of long-term work loss (31 days or more) (Fig-
ure 541). Among Hispanic workers, the distribution of nonfatal
occupational injury and illness cases involving days away from work
by occupation shows the highest proportion of cases (43.5% or
83,319 cases) among operators, fabricators, and laborers (Figure
542). Wholesale and retail trade and services accounted for the
largest percentages of Hispanic cases (22.3% and 21.4%, respec-
tively) (Figure 543).
283
 Chapter 5 Special Populations

Black, non-Hispanic
8.9% Fatal Injuries
Magnitude and Trend
How were fatal occupational injuries distributed by race/
491 Hispanic
15.2%
ethnicity among Hispanic and non-Hispanic workers in
2002?
840
Asian or
Pacific Islander Figure 532. Number and distribution of fatal occupational
2.5% injuries by race/ethnicity among Hispanic and non-Hispanic
140 workers, 2002. The 840 fatal occupational injuries among
American Indian or
Alaska Native Hispanic workers (15.2% of the total) represented a 5.7%
3,917 0.7% decrease from the 891 fatal occupational injuries reported in
40 2001. The 3,917 fatal injuries among white, non-Hispanic work-
Other or ers represented 70.9% of all fatal occupational injuries in 2002.
White, non-Hispanic unspecified (Source: BLS [2003a].)
70.9% 1.7%
96

Number Rate 6.0 How did the number and rate of fatal injuries change
5.6 6 among Hispanic workers during 19922002?
6 6 6 5.3 5.2 5.2
5 5.1 5.0 Figure 533. Number and rate of fatal occupational injuries
895 5 among employed Hispanic workers, 19922002. During the 11-
900 840
815 year period 19922002, the number of fatal occupational inju-

Rate per 100,000 workers

800 ries among Hispanic workers ranged from 533 in 1992 to 895
707 730 4
700
in 2001. The fatal occupational injury rates varied from 5 to
658
Number of fatal injuries

634 624 619 638 6.0 per 100,000 employed workers during this 11-year period.
600 (Note: BLS rounded rates to whole numbers for 19921995.)
533 3
500 (Sources: BLS [2003a,d].)

400
2
300
200 1
100
0 0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

284
 Chapter 5 Special Populations

Age 35

How did fatal occupational injuries differ by age among 30.1%

30
Hispanic workers during 19922002? 2,310
25.1%
Figure 534. Distribution and number of fatal occupational 25
1,929
injuries among Hispanic workers by age, 19922002. During

Distribution (%)
19922002, workers aged 2534 had the most fatal occupation- 20
al injuries (2,310 or 30.1%), followed by workers aged 3544
(1,929 or 25.1%). (Source: BLS [2003d].) 15.4%
15 13.8%
1,182
1,059
10 8.0%
613
5 4.6%
3.1%
352
241
0
<20 2024 2534 3544 4554 5564 >64
Age range

Sex 900 Male Female

837
797
How did fatal occupational injuries differ by sex among 800 775
Hispanic workers during 19922002?
700 687
668
Figure 535. Number of fatal occupational injuries among 625
599
Number of fatal injuries

594 593
Hispanic workers by sex, 19922002. In 2002, male workers 600 571
accounted for about 94% of all fatal occupational injuries 512
among Hispanic workers. During this period, fatal occupa- 500
tional injuries among Hispanic female workers ranged from 21
in 1992 to 54 in 2001. (Source: BLS [2003d].) 400

300

200

100 54
35 30 48 45 33 39 43 40 43
21
0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

285
Chapter 5 Special Populations

Managerial and Occupation

professional 357 4.7%
specialty How did fatal occupational injuries differ by major
Technical, sales, and occupational group among Hispanic workers during 1992
administrative 653 8.6% 2002?
support
Figure 536. Distribution and number of fatal occupational
Service 684 9.1% injuries among Hispanic workers by occupation, 19922002.
During this period, three occupational groups accounted for
Farming, forestry, nearly 77% of all fatal occupational injuries among Hispanic
and fishing 1,225 16.2%
workers: operators, fabricators, and laborers (41.4% or 3,128
cases), precision production, craft, and repair occupations
Precision production, 1,504 19.9% (19.9% or 1,504 cases), and farming, forestry, and fishing
craft, and repair (16.2% or 1,225 cases). (Source: BLS [2003d].)

Operators, fabricators, 3,128 41.4%

and laborers

0 10 20 30 40 50
Distribution (%)

Agriculture, forestry, 1,202 16.7%

Industry
and fishing
How did fatal occupational injuries differ by major private
Mining 213 3.0%
industry sector among Hispanic workers during 1992
1,994 27.7%
2002?
Construction

744 10.3%
Figure 537. Distribution and number of fatal occupational
Manufacturing
injuries among Hispanic workers by industry, 19922002. Dur-
Transportation and 908 12.6% ing this period, the largest proportion of fatal occupational
public utilities injuries among Hispanic workers was in construction, which
Wholesale trade 287 4.0% accounted for 27.7% of the total, or 1,994 cases. (Source: BLS
[2003d].)
Retail trade 858 11.9%
Finance, insurance, 111 1.5%
and real estate
Services 890 12.3%

0 5 10 15 20 25 30
Distribution (%)

286
 Chapter 5 Special Populations

Event or Exposure Exposure to

Assaults and
violent acts
harmful substances 20.6%
How did fatal occupational injuries differ by event or or environments
exposure among Hispanic workers during 19922002? 10.9% Nonhighway
Transportation (farm, industrial
Fires and incidents premises)
Figure 538. Distribution and number of fatal occupational explosions 1,584
33.7%
injuries among Hispanic workers by event or exposure, 1992 2.8% Railway
842 67
2002. Transportation incidents accounted for 33.7% of
Other 368
fatal occupational injuries among Hispanic workers dur- 216 Water
0.2% vehicle
ing 19922002. Other events or exposures that accounted 19 2,593
66
1,427 100
for substantial proportions of fatal injuries included 1,155
assaults and violent acts (20.6%), contact with objects and Aircraft
Falls Highway
equipment (16.7%), and falls (15.0%). The 2,593 trans- 15.0% 1,284 562
portation fatalities were primarily associated with inci-
dents on highways (1,427 cases) or on farm or industrial
premises (368 cases), or with incidents in which workers Worker struck
Contact with objects Other by vehicle, mobile
were struck by a vehicle or mobile equipment (562 cases). and equipment 3 equipment
(Source: BLS [2003d].) 16.7%

Nonfatal Injuries and Illnesses

Magnitude and Trend Black, non-Hispanic
11.9%
How did nonfatal occupational injuries and illnesses
White, non-Hispanic
involving days away from work differ by race/ethnicity 68.2% 133,785
among Hispanic and non-Hispanic workers in 2001? 765,228 Asian or
25,317 Pacific Islander
Figure 539. Distribution and number of nonfatal occupa- 2.3%
tional injuries and illnesses involving days away from work in
private industry by race/ethnicity among Hispanic and non- 191,959
Hispanic workers, 2001. Among cases reporting race/ethnicity
Hispanic
in 2001, white, non-Hispanic workers accounted for 68.2% 17.1%
of the cases involving days away from work. Hispanic workers
represented 17.1% of the cases involving days away from work, American Indian or
Alaska Native
and black, non-Hispanic workers accounted for 11.9%. (Note: 0.5%
Race/ethnicity was not reported for 415,616 of the 1.5 million 5,651
cases involving days away from work in 2001). (Source: BLS
[2003b].)

287
 Chapter 5 Special Populations

Number % total How did nonfatal occupational injuries and illnesses

198.0 involving days away from work change among Hispanic
200 192.3 189.7 191.7 192.0 14
187.2 182.9 186.0 workers during 19922001?
179.4 12.5
180 169.3
11.2 12 Figure 540. Annual number and percentage of nonfatal occu-
160 10.7 pational injuries and illnesses involving days away from work
Number of cases (thousands)

10.2 10.4
9.4 among Hispanic workers in private industry, 19922001. Cases
140 9.0 10
8.5 8.5
of nonfatal occupational injury and illness with days away from
120 8.1 work among Hispanic workers ranged from 198,022 in 1992 to
8 169,300 in 1996. The decrease for 19921996 contrasts with the

% total
100 increase for 19962001, when reported cases increased from
80 6 169,300 cases to 191,959. When presented as a percentage of
all nonfatal occupational injuries and illnesses with days away
60 4 from work, the cases among Hispanic workers show a fairly
consistent upward trend, from 8.5% in 1992 to 12.5% in 2001.
40
(Sources: BLS 2003b,c].)
2
20

0 0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

25 White, non-Hispanic Black, non-Hispanic Hispanic Severity

How did nonfatal occupational injuries and illnesses
20 involving days away from work vary by severity among
non-Hispanic and Hispanic workers in 2001?

Figure 541. Distribution of nonfatal occupational injuries

Distribution (%)

15 and illnesses involving days away from work in private industry

among non-Hispanic and Hispanic workers by number of days
away from work, 2001. Compared with white, non-Hispanic or
10 black workers, Hispanic workers had the lowest percentages
of short-term work loss (1 or 2 days) and the highest percent-
age of long-term work loss (31 days or more). (Sources: BLS
5 [2003b,c].)

0
1 2 35 610 1120 2930 >30
Days away from work

288
 Chapter 5 Special Populations

Occupation Managerial and

professional 5,050 2.6%
How did nonfatal occupational injuries and illnesses specialty
among Hispanic workers differ by major occupational Technical, sales, and
group in 2001? administrative 18,593 9.7%
support
Figure 542. Distribution and number of nonfatal occupation-
al injuries and illnesses involving days away from work among Service 33,140 17.3%
Hispanic workers in private industry by occupation, 2001.
Among Hispanic workers, the distribution of nonfatal occupa- Farming, forestry, 18,555 9.7%
tional injury and illness cases involving days away from work by and fishing
occupation shows the highest proportion of cases (43.5% or
83,319 cases) among operators, fabricators, and laborers. Ser- Precision production,
craft, and repair 32,816 17.1%
vice and precision production, craft, and repair accounted for
17.3% (33,140 cases) and 17.1% (32,816 cases), respectively.
(Sources: BLS [2003b,c].) Operators, fabricators, 83,319 43.5%
and laborers

0 5 10 15 20 25 30 35 40 45
Distribution (%)

Industry Agriculture, forestry, 17,717 9.2%

and fishing
How did nonfatal occupational injuries and illnesses
Mining 721 0.4%
involving days away from work differ by major private
industry sector among Hispanic workers in 2001?
Construction 29,749 15.5%
Figure 543. Distribution and number of nonfatal occupation- Manufacturing 24,481
24,481 12.8%
al injuries and illnesses involving days away from work among durable
Hispanic workers by industry, 2001. Among the total 191,959 Manufacturing 18,301 9.5%
cases of nonfatal occupational injury and illness, wholesale and nondurable
retail trade and services accounted for the largest percentages Transportation and 12,324 6.4%
public utilities
of Hispanic cases (22.3% and 21.4%, respectively). (Sources:
Wholesale and
BLS [2003b,c].) retail trade 42,836 22.3%
Finance, insurance,
and real estate 4,785 2.5%

Services 41,045 21.4%

0 5 10 15 20 25
Distribution (%)

289
Chapter 5 Special Populations
References
BLS [2001]. Current population survey. Washington, DC: U.S.
Department of Labor, Bureau of Labor Statistics. [www.bls.gov/
cps/] and [www.bls.census.gov/cps]
BLS [2003a]. Census of fatal occupational injuries. Washington,
DC: U.S. Department of Labor, Bureau of Labor Statistics, Safety
and Health Statistics Program.
BLS [2003b]. Survey of occupational injuries and illnesses. Nonfatal
(OSHA recordable) injuries and illnesses. Case and demographic
characteristics. Washington, DC: U.S. Department of Labor, Bureau
of Labor Statistics, Safety and Health Statistics Program.
BLS [2003c]. Occupational injuries and illnesses in the United
States: profiles data 19922001, version 9.0, CDROM. Washington,
DC: U.S. Department of Labor, Bureau of Labor Statistics, Safety
and Health Statistics Program. [www.bls.gov/iif/]
BLS [2003d]. Census of fatal occupational injuries. Special tabula-
tionnumber and rate of fatal occupational injuries by selected
290
worker characteristics, 19922002. Washington, DC: U.S. Depart-
ment of Labor, Bureau of Labor Statistics, Safety and Health Statis-
tics Program.
DOL [2000]. Report on the youth labor force. Chapter 6. Occu-
pational injuries, illnesses, and fatalities. Washington, DC: U.S.
Department of Labor. [www.bls.gov/opub/rylf/rylfhome.htm]
Davis L [2002]. Unpublished SENSOR work-related injuries to
adolescents data. Massachusetts Department of Public Health,
Bureau of Health Statistics, Research and Evaluation, Occupational
Health Surveillance Program. [www.state.ma.us/dph/bhsre/ohsp/
ohsp.htm]
NIOSH [2001]. Tracking occupational injuries, illnesses, and haz-
ards: the NIOSH surveillance strategic plan. Cincinnati, OH: U.S.
Department of Health and Human Services, Public Health Service,
Centers for Disease Control and Prevention, National Institute for
Occupational Safety and Health, DHHS (NIOSH) Publication No.
2001118. [www.cdc.gov/niosh/pdfs/2001-118.pdf]
Adult Blood Lead Epidemiology
and Surveillance (ABLES)
Program
Since 1987, the National Institute for Occupational Safety and
Health (NIOSH) of the Centers for Disease Control and Preven-
tion (CDC) has sponsored the ABLES program to track laboratory-
reported blood lead levels (BLLs) in adults. The public health goal
of the ABLES program, as stated in Healthy People 2010, is to reduce
the number of adults with work-related BLLs equal to or greater
than 25 micrograms per deciliter (g/dL) [DHHS 2000]. For
the States that report data to ABLES, the primary sources of BLL
reports are public and private laboratories; physician reporting may
supplement laboratory reporting. ABLES requires the laboratory
reporting of BLL results, both occupational and nonoccupational.
These laboratory reports include basic demographic information,
including personal identifiers, to differentiate between incidence
and prevalence cases and to account for multiple reports for the
same person. In coordination with the ABLES program, the Coun-
cil of State and Territorial Epidemiologists (CSTE) has adopted
a surveillance case definition for adult BLLs to be reported. The
definition provides that (an) adult blood lead level that should be
maintained under surveillance is defined as an adult (16 or older)
with a venous (or comparable) blood lead level equal to or greater
than 25 micrograms per deciliter (g/dL) of whole blood [Stan-
bury and Roscoe 1999].
The ABLES program aims to accomplish the Healthy People 2010
objective by building capacity at the State level to initiate or improve
surveillance programs that can accurately measure trends in adult
BLLs and intervene to prevent further exposures to lead. Nation-
wide data and findings from the ABLES program are periodically
published in the CDCs Morbidity and Mortality Weekly Report
(MMWR) [CDC 1999]. The NIOSH ABLES program has published
24 reports in the MMWR, which may be retrieved at www.cdc.gov/
mmwr/mmwrsrch.htm by searching for ables AND blood lead for
the years 1989 to the present year.
For further information, contact
Surveillance Branch
Division of Surveillance, Hazard Evaluations, and Field Studies
National Institute for Occupational Safety and Health
4676 Columbia Parkway, MSR21
Cincinnati, OH 45226
Telephone: 5138414424
www.cdc.gov/niosh/ables.html
291
 Appendix A Survey and Surveillance Program Descriptions
Census of Fatal Occupational
Injuries (CFOI)
CFOI, administered by the Bureau of Labor Statistics (BLS) in con-
junction with participating State agencies, compiles comprehensive
and timely information about fatal work injuries occurring in the
50 States and the District of Columbia [BLS 2003a]. To compile
counts that are as complete as possible, CFOI uses multiple data
sources to identify, verify, and profile fatal work injuries. BLS com-
piles the census of fatalities from various Federal, State, and local
administrative sources, including death certificates, workers com-
pensation reports and claims, reports to various regulatory agen-
cies, medical examiner reports, police reports, and news reports.
These diverse sources are used because studies have shown that no
single source captures all job-related fatalities. Source documents
are matched so that each fatality is counted only once. To ensure
that a fatality occurred while the decedent was at work, information
is verified from two or more source documents or from a source
document and a follow-up questionnaire.
Key information about each workplace fatality (occupation and
worker characteristics, equipment or machinery involved, and the
circumstances of the event) is obtained by cross-referencing the
source records. A work relationship is verified for each work injury
fatality by using at least two independent source documents. For
a fatality to be included, the decedent must have been employed
(that is, working for pay, compensation, or profit) at the time of
the event, engaged in legal work activity, or present at the site of
the incident as a requirement of his or her job. Fatalities that occur
during a persons commute to or from work are excluded from the
census counts.
States may identify additional fatal work injuries after data collection
closeout for a reference year. In addition, other fatalities excluded
292
from the published count because of insufficient information to
determine work relationships may subsequently be verified as work-
related. States have up to 1 year to update their initial published
State counts. BLS revises fatality counts but not rates. Occupational
fatalities and rates shown in this report may reflect such changes,
except for the most recent year, and may differ from original data
published by BLS. Since 1992, the updates have averaged less than
1.0 % of each years total that was initially published.
For further information, contact
U.S. Bureau of Labor Statistics
OCWC/OSH Suite 3180
2 Massachusetts Avenue, NE
Washington, DC 202120001
Fatality information: 2026916175
Fax: 2026916196
Fatalities questions: cfoistaff@bls.gov
www.bls.gov/iif/oshcfoi1.htm
The Center to Protect Workers
Rights (CPWR)
CPWR is a research, development, and training arm of the Build-
ing and Construction Trades Departmentthe 15 construction
unions in the AFL-CIO. Since 1990, CPWR has conducted much of
its safety and health research under a cooperative agreement with
NIOSH. The overriding goal for CPWR has been to build a safety
culture in the construction industryimproving work conditions
while lowering long-term costs and improving productivity. To help
address the issues and find solutions, CPWR has led a consortium
of experts at leading universities, government agencies, unions,
and corporations (project owners, contractors, and insurers). The
consortium has used a variety of approaches to improve safety and

health, including on-site interventions, national meetings, and
publications for a broad audience. Research publications include
technical reports and the groundbreaking Construction Chartbook:
the U.S. Construction Industry and its Workers, first published in 1997.
The third edition, completed in 2002, is available at www.cpwr.com
or www.elcosh.org.
For further information, contact
Janie Gittleman, Ph.D., M.R.P.
Associate Director, Safety and Health Research
Center to Protect Workers Rights
Suite 1000
8484 Georgia Avenue
Silver Spring, MD 20910
Telephone: 3015788500, extension 107
Cell phone: 2023021340
Fax: 3015788572
email: jgittleman@cpwr.com
1998 Childhood Agricultural
Injury Survey (CAIS)
CAIS was conducted using a computer-assisted telephone inter-
view (CATI) survey instrument. Randomly selected farming
operations across the United States were contacted by eight
U.S. Department of Agricultures National Agricultural Statisti-
cal Service (USDA/NASS) calling centers during February and
March of 1999. The CAIS was conducted in these winter months
to increase the response rate of the survey. The sample selection
and sampling frame information for the survey was provided by
USDA/NASS through an interagency agreement. All agricultural
production operations in the NASS area sampling frame, exclud-
ing large swine confinement operations, were in the population of
study. NASS drew all samples, conducted all telephone contacts to
Appendix A Survey and Surveillance Program Descriptions
the farm operations, entered all data, and provided all sampling
frame information required for the NIOSH sampling design.
For the survey, a farm was defined as any operation of $1,000 or
more of gross agricultural production within a calendar year; it
included both crop and livestock operations. An injury was defined
as any condition that resulted in 4 hours or more of restricted activ-
ity (e.g., a person could not perform work or other normal duties,
missed work, or missed school), or a condition that required pro-
fessional medical treatment. In this survey, a youth was defined as
any person under age 20. Household youths were defined as all
youths who resided on the farm. Hired farm workers were defined
as youths who were hired directly by the farm operator (excluding
contract laborers) to work on the farm but were not household
members. Visitors were defined as all other youths who were on the
farm but were not household members or hired workers.
An agricultural work-related injury was defined as any injury meet-
ing the above definition that occurred while performing work on
the farm associated with the farm business, including chores. Non-
work injuries were defined as injuries occurring on the farm that
were not due to farm work. The survey excluded injuries to con-
tractors working for the farm operation or injuries that occurred
to youths off the farm property. The categorical injury variables of
source of injury and event or exposure were coded from narrative
injury descriptions using the American National Standards Insti-
tute Z16.21995 classification system [Toscano et al. 1996].
All information provided in the survey was self-reported by the
farm operator, spouse, or the injured youths if they were aged 16 or
older. As such, responses to items such as age and the cause of the
injury event were subject to the interpretation of the respondent.
Although the total number of childhood agricultural lost-time
injuries was requested for the calendar year 1998, descriptive infor-
mation was only requested for the four most recent injury events.
293
 Appendix A Survey and Surveillance Program Descriptions
A stratified random sample of 50,000 farm operations was drawn
to provide estimates for the study population. The strata for the
sampling design were the four Census Bureau geographic regions.
An equal sample allocation of 12,500 farms was selected in each
region. A farm was considered to be a valid member of the sample
regardless of whether youths were on the farm in 1998. This was
necessary to allow for meaningful estimates of both injuries and
the number of youths on farms for the various youth populations
covered in the survey (i.e., household youths, youths directly hired
to work on the farm, and youths visiting the farm).
For further information, contact
Surveillance and Field Investigations Branch
Division of Safety Research
National Institute for Occupational Safety and Health
1095 Willowdale Rd, MS H1808
Morgantown, WV 26505
Telephone: 3042855916
Coal Workers X-Ray
Surveillance Program (CWXSP)
CWXSP is a NIOSH-administered occupational health program
mandated by the U.S. Federal Coal Mine Health and Safety Act of
1969. The primary objective of the CWXSP is to screen miners for
coal workers pneumoconiosis (CWP). Since 1970, all active under-
ground coal miners have been required to have a chest radiograph
at the time of hire and again 3 years later. Subsequently, miners can
volunteer for radiographs at approximately 5-year intervals. The
chest X-rays are taken at no cost to the miner. In addition, other
information is collected, including the miners identification, age,
tenure, and specific job in the mine.
294
The chest films are read by physicians certified by NIOSH as pro-
ficient in the use of the International Labour Office (ILO) clas-
sification system for radiographs of pneumoconiosis [ILO 1980].
Each film is read by at least two Readers (one of whom must be a B
Reader*), and a consensus rule is used to reach a final determination
for each film. The CWXSP defines CWP as a small opacity profusion
category of at least 1/0 or large opacities (i.e., larger than 1 cm in
diameter) consistent with pneumoconiosis. Miners with radiograph-
ic evidence of CWP on their chest radiographs are offered the option
to work in an area of the mine with a respirable coal dust concentra-
tion of 1 mg/m3 or less and have personal dust exposures monitored
at frequent intervals.
The large number of chest X-rays collected since 1970 provide a
means of monitoring the prevalence of CWP among active under-
ground coal miners. However, coal miner participation rates have
generally decreased since 1970 to less than 30% of working under-
ground coal miners. Thus, tenure-specific prevalence estimates
may be biased because of selective participation. Also, overall crude
prevalence estimates may reflect over-representation of newly
employed miners. Inferences regarding the entire coal mine work
force that are based on CWXSP data should be used with caution.
Tabulations of CWXSP data presented in this report may vary from
those presented in related NIOSH surveillance reports because of
criteria for categorizing tenure and rounding.
For further information, contact
Coal Workers X-Ray Surveillance Program Activity
Division of Respiratory Disease Studies
National Institute for Occupational Safety and Health
1095 Willowdale Road, MSHG900
Morgantown, WV 265052888
Telephone: 3042855724
www.cdc.gov/niosh/docs/2002-122/
*
See Reader in Glossary.

Current Population Survey
(CPS)
CPS is a household sample survey of the civilian noninstitutional-
ized population conducted by the BLS [BLS 2003b]. Respondents
are interviewed to obtain information about the employment sta-
tus of each member of the household aged 15 and older, although
data are routinely published on those aged 16 and older. The
survey inquires about work activity or status during the calendar
week (Sunday through Saturday) that includes the 12th day of the
month. This is known as the reference week. Field interviewing is
conducted in the following week, referred to as the survey week.
The CPS sample is drawn from 754 sample areas, with coverage in
every State and the District of Columbia. The sample provides esti-
mates for the Nation as a whole and provides data for model-based
estimates for individual States and other geographic areas. Since
2001, estimates have been based on interviews of an expanded
sample of 60,000 households per month. Before 2001, estimates
were based on 50,000 households per month. In an average month,
the nonresponse rate is about 6%7%.
The CPS provides estimates of employment, unemployment, and
other characteristics of the general labor force, the population as
a whole, and various other population subgroups. These statistics
are available for various demographic characteristics including age,
sex, race, marital status, and education. They are also available by
occupation, industry, and class of worker. Supplemental questions
are also often added to the regular CPS questionnaire to produce
estimates on other topics, including school enrollment, income,
previous work experience, health, employee benefits, and work
schedules.
Appendix A Survey and Surveillance Program Descriptions
For further information, contact
U.S. Bureau of Labor Statistics
Division of Labor Force Statistics
Suite 4675
2 Massachusetts Avenue, NE
Washington, DC 202120001
Telephone: 2026916378
CPS data questions: cpsinfo@bls.gov
www.bls.gov/cps/ and www.bls.census.gov/cps/
Mine Safety and Health
Research at NIOSH
NIOSH conducts mining surveillance through laboratories in Pitts-
burgh, Pennsylvania, and Spokane, Washington. These surveillance
activities make extensive use of data obtained from the Mine Safety
and Health Administration (MSHA). MSHA maintains databases
of reported employment and reported cases of accident/injury/
illness for mine operators as well as for independent contractors
working on mine property, as required under 30 CFR Part 50
[MSHA 2003a]. Data sources for mining are described as follows:
Accident/injury/illness database. Mine operators and independent
contractors whose employees perform certain types of work on
mine property (e.g., construction or demolition of mine facilities,
shaft and slope sinking, drilling, and blasting) are required to file
a Mine Accident, Injury, and Illness Report (Form 70001) [30 CFR
50.20; MSHA 2003b] for reportable incidents within 10 working
days after the accident or injury, or within 10 working days follow-
ing the illness diagnosis. MSHA defines reportable injury as all
incidents that require medical treatment or result in death, loss
of consciousness, inability to perform all job duties, or temporary
295
 Appendix A Survey and Surveillance Program Descriptions
assignment or transfer to another job. Injuries involving first-aid
only are not reportable: these include one-time treatment and sub-
sequent observation of minor scratches, cuts, burns, splinters, etc.
that do not ordinarily require medical care, even if it was provided
by a physician or a registered health care professional. Information
reported on MSHA Form 70001 includes demographics of the
injured or ill worker such as age, sex, years of total mining expe-
rience, years of experience at current mine, where the incident
occurred (i.e., underground, surface, plant/mill), days away from
work, days of restricted work activity, source of the injury, body
part(s) injured, and a narrative description of the incident.
Employment database. Mine operators and independent contractors
whose employees perform certain types of work on mine property
are required to file a Quarterly Mine Employment and Coal Production
Report (MSHA Form 70002) [30 CFR 50.30; MSHA 2003c] within
15 days after the end of each calendar quarter. This information is
contained in MSHAs address and employment files and includes
the address and other contact information, production of clean
coal tonnage, average number of persons employed during the
reporting period, and the corresponding number of hours worked
for each type of mining operational subunit (MSHA identifies 10
different operational subunits within mining, including under-
ground operations, surface areas at underground mines, strip/
open pit operations, culm banks, auger mining, dredging opera-
tions, other surface mines, independent shops, coal preparation
plants or mills, and offices).
MSHA data compared with other surveillance systems. The mining
data presented in this report may differ from mining industry data
for the same period using the National Traumatic Occupational
Fatalities (NTOF) Surveillance System (see NTOF description
below) and CFOI (described previously). Both NTOF and CFOI
use the 1987 Standard Industrial Classification (SIC) Manual [OMB
1987] to categorize fatal injuries by industry. The SIC classification
296
scheme includes oil and gas extraction in the mining industry.
MSHA excludes oil and gas extraction, as regulatory authority is
delegated to OSHA. In addition, MSHA data include only incidents
that occur on mine property. Therefore, an injury occurring dur-
ing the course of work, but off mine property, is excluded from the
MSHA file. NTOF and CFOI systems capture this type of injury. On
the other hand, fatal incidents that occur on mine property under
MSHA jurisdiction but are not work-related may be included in the
MSHA file but may not be captured by NTOF or CFOI (e.g., visitors
or customers at the mine). In addition, workers in other industries
who are injured on mine property may be reported in the MSHA
data under mining. In the CFOI or NTOF data, these workers are
reported in the industry of the workers employer.
Hearing loss data. Data on hearing loss include unpublished audio-
metric data collected by NIOSH at 33 volunteer sand and gravel
operations in 19992000.
For further information, contact
Surveillance and Research Support Activity
Pittsburgh Research Laboratory
National Institute for Occupational Safety and Health
P.O. Box 18070
Pittsburgh, PA 15236
Telephone: 4123866613
or
Surveillance, Statistics, and Research Support Activity
Spokane Research Laboratory
National Institute for Occupational Safety and Health
315 E. Montgomery Avenue, MSP11
Spokane, WA 99207
Telephone: 5093548065

For more detailed information about mining employment and
fatal and nonfatal injuries, please visit our Web site at www.cdc.gov/
niosh/mining/topics/data/default.htm.
2000 Minority Farm Operator
Childhood Agricultural Injury
Survey (MCAIS)
MCAIS was conducted for NIOSH by the USDA, National Agricul-
tural Statistical Service (NASS) through an Interagency Agreement.
The survey was defined as a census of the 49,270 minority farm
operations identified in the NASS 1997 Census of Agriculture list. A
farm was considered to be eligible for MCAIS regardless of wheth-
er youths were on the farm in 2000. This was necessary to allow for
meaningful estimates of both injuries and the number of youths
on farms for the various youth populations covered in the survey.
Because of confidentiality concerns, racial minority farm operators
and Hispanic operators were handled independently. This resulted
in farms being used to calculate both the racial minority estimate
and the Hispanic estimate. In other words, individual operators
who reported being a racial minority and of Hispanic ethnicity are
represented in both estimates. Because of this overlap, it is not pos-
sible to add racial and Hispanic estimates together.
The survey used a CATI survey instrument. The interviews were con-
ducted by 10 NASS calling centers between February and March of
2001. The MCAIS survey was conducted in these winter months to
increase the response rate of the survey. Participation in the survey
was strictly voluntary. In addition to the main CATI data collection
effort, five NASS State offices conducted personal interviews with a
sample of 2,088 minority operators that were not contacted during
Appendix A Survey and Surveillance Program Descriptions
the CATI survey period. The two main reasons for not contacting
these farm operators during this period were their lack of availabil-
ity (even after repeated contact attempts) and their lack of a work-
ing telephone number on file with the NASS. The five States that
conducted the personal interviews were Alabama, Arizona, Califor-
nia, New Mexico, and Texas. These States were selected because
they had the largest number of minority farm operations. The per-
sonal interviews were conducted during April and May of 2001 with
the same survey instrument used in the CATI process.
The data collected for MCAIS were self-reported by either the
female or male head of household. If an injury occurred to a house-
hold youth aged 16 or older, and the youth was available to talk to
the NASS enumerator, he or she was asked to answer the injury
section of the survey. Information such as youth demographics, the
occurrence of an injury, and the characteristics of an injury event
were subject to the interpretation of the respondent.
For the survey, a farm was defined as any operation with $1,000 or
more of gross agricultural production within a calendar year and
included both crop and livestock operations. A youth was defined
as any person under age 20. Household youths were defined as
all youths who resided on the farm. Hired youths were defined as
youths who were hired directly by the farm operator (excluding
contract laborers) to work on the farm but were not household
members. Visitors were defined as all other youths who were on
the farm but were not household members or hired workers. An
injury was defined as any condition that resulted in 4 hours or more
of restricted activity (e.g., the person could not perform work or
other normal duties, missed work, or missed school) or a condi-
tion that required professional medical treatment. Although the
total number of childhood agricultural injuries was requested for
the calendar year 2000, descriptive information was collected only
for the four most recent injury events. An agricultural work-related
injury was defined as any injury meeting the above definition that
297
 Appendix A Survey and Surveillance Program Descriptions
occurred while performing work on the farm associated with the
farm business, including chores. Non-work injuries were defined as
injuries occurring on the farm that were not due to farm work. The
survey excluded injuries to contractors working for the farm opera-
tion or injuries that occurred to youths off the farm property.
The racial and Hispanic origin classification for the farm operator
and all household youths were set to the racial classification pro-
vided on the 1997 Census of Agriculture sampling frame. In addi-
tion, Asians and Native Hawaiian or Other Pacific Islanders were
combined into a single Asian category for all analyses.
The estimation procedure for the MCAIS was developed as a
two-step process. The first step involved post-stratifying the CATI
and personal interview results to account for farm operators who
refused to participate in the survey or were inaccessible. For the
racial minority data, the results were post-stratified by the four farm
operator racial categories (Black, Native American, Asian, and
Other) within the nine U.S. geographic regions defined by the U.S.
Census Bureau. For the Hispanic data, post-stratification was for
the nine geographic regions only.
The second step in the estimation process was benchmarking the
post-stratified survey results to the published counts for minority-
operated farms released in the 1997 Census of Agriculture. These
published counts from the 1997 Census of Agriculture include
imputed values for minority farm operations (i.e., some farm oper-
ations without racial data for the operator were classified as racial
minority operations based on characteristics of the farm operation
or other factors). Since these imputed values caused the published
minority farm counts to be higher than the sampling frame minor-
ity farm counts, the benchmarking process was necessary. Bench-
marking was applied by race within the nine geographic regions.
298
For further information, contact
Surveillance and Field Investigations Branch
Division of Safety Research
National Institute for Occupational Safety and Health
1095 Willowdale Rd, MS H1808
Morgantown, WV 26505
Telephone: 3042855916
Multiple-Cause-of-Death Data
The National Center for Health Statistics (NCHS) compiles and
publishes annual national statistics on causes of death. NCHS is one
of the 12 centers, institutes, and offices of CDC. As the Nations prin-
cipal health statistics agency, NCHS provides statistical information
to guide actions and policies to improve the health of people in the
United States. NCHS surveys and data systems provide fundamen-
tal public health and health policy statistics that are used to track
changes in health and health care delivery. Statistics are obtained
through a broad-based program of ongoing and special studies in
partnership with State government, including household interview
surveys, examination surveys, surveys of health care providers, and
collection of statistics on birth and death. NCHS participates with
other agencies, such as NIOSH, and promotes the use and dissemi-
nation of vital and health statistics.
The Division of Vital Statistics obtains information about deaths
from the registration offices of all States, New York City, the Dis-
trict of Columbia, Puerto Rico, the U.S. Virgin Islands, and Guam.
Geographic coverage has been complete since 1933. The mortality
data file comprises demographic and medical information. Demo-
graphic data are provided by the funeral director and are based
on information supplied by an informant. Medical certification

of cause of death is provided by a physician, medical examiner, or
coroner. Mortality data are used to profile deaths by underlying
demographic and geographic characteristics to compare mortality
trends with other countries and determine life expectancy.
Traditionally, national mortality statistics have been based on
a count of deaths with one underlying cause assigned for each
death. National single-cause mortality statistics are available from
the early 1900s. Beginning in 1968, electronic files with multiple-
cause-of-death information were compiled and made available by
NCHS. Causes of death are coded according to the International
Classification of Diseases as adapted for use in the United States.
Public-use files contain records of all U.S. deaths that are reported
to State vital statistics offices (approximately 2 million annually).
Each death record includes codes for up to 20 conditions listed on
the death certificate, including both underlying and contributing
causes of death. Other data include age, race, sex, and State and
county of residence at the time of death. In addition, usual occu-
pation and industry codes have been available for decedents from
some States since 1985 [NIOSH 1997], and NCHS annually deter-
mines that certain quality criteria have been met by usual industry
and occupation data from selected States.
Potential limitations posed by multiple-cause-of-death data include
the following: under-reporting or over-reporting of conditions on
the death certificate by certifying physicians, incomplete or unclas-
sified reporting of usual occupation and industry, and nonspecific-
ity of codes.
For further information, contact
Mortality Statistics Branch
Division of Vital Statistics
National Center for Health Statistics
Centers for Disease Control and Prevention
Appendix A Survey and Surveillance Program Descriptions
3311 Toledo Road, Floor 7
Hyattsville, MD 20782
Telephone: 3014584666
www.cdc.gov/nchs/about.htm and
www.cdc.gov/nchs/products/elec_prods/subject/
mortmcd.htm
National Agricultural Workers
Survey (NAWS)
The Office of the Assistant Secretary for Policy (OASP), U.S. Depart-
ment of Labor, advises the Secretary of Labor and coordinates and
provides leadership to the Departments activities in economic pol-
icy issues. Activities are both short-term and long-term and include
economic research and regulatory policies and procedures bearing
on the welfare of all U.S. workers. The U.S. Department of Labor
is the only national information source on the demographics and
working and living conditions of U.S. farm workers.
The U.S. Department of Labor began surveying farm workers in
1988 and has collected information from more than 25,000 work-
ers. Each year, NAWS interviews approximately 2,500 randomly
selected farm workers across the United States. The sampling pro-
cedure accounts for seasonal and regional fluctuations in the level
of agricultural work activity. Each survey year includes a fall cycle,
a winter cycle, and a spring/summer cycle of interviews. The num-
ber of interviews conducted during a cycle is proportionate to the
amount of agricultural activity at that time of year.
NAWS uses area sampling of sites to obtain a nationally representative
group of farm workers while containing travel costs of survey staff.
A sample of 288 counties in 25 States is selected to represent 12
299
 Appendix A Survey and Surveillance Program Descriptions
distinct agricultural regions. No fewer than four counties were
chosen from each region. Multistage sampling is used to choose
respondents in each cycle. The likelihood of a given site being
selected varies with the size of its agricultural payroll. Agricultural
employers within each of the selected counties are chosen ran-
domly from public agency records, including unemployment insur-
ance files and Agricultural Commissioners pesticide registrations.
These sources of employer names are supplemented from lists
maintained by such agencies as the Bureau of Labor Statistics, the
Agricultural Soil and Conservation Service, and State Departments
of Industrial Relations.
NAWS locates and samples workers at their work sites, avoiding
the well-publicized undercount of this difficult-to-find population.
During the initial contact, arrangements are made to interview the
respondent at home or at another convenient location. The inter-
viewed farm workers reveal detailed information about their basic
demographics, legal status, education, family size and household
composition, wages and working conditions in agricultural jobs,
and participation in the nonagricultural U.S. labor force. This
information permits in-depth research on current farm workers
and for the tracing of changes occurring since 1988.
For further information, contact
Office of the Assistant Secretary for Policy
U.S. Department of Labor
200 Constitution Ave., NW
Suite S2312
Washington, DC 20210
Telephone: 2026935959
www.dol.gov/asp/programs/agworker/naws.htm
300
National Electronic Injury
Surveillance System (NEISS)
NIOSH collects information about nonfatal work-related inju-
ries and illnesses treated in U.S. hospital emergency departments
through the NEISS in collaboration with the U.S. Consumer Product
Safety Commission (data are collected without regard to consumer
product involvement). Data are abstracted from emergency depart-
ment records in a national probability-based sample of 67 hospitals
with 24-hr emergency departments. Case information is collected
for noninstitutionalized civilian workers who were working for pay
or other compensation, doing production-related activities on a
farm or ranch, or working as a volunteer for an organized group at
the time that they were injured or became ill. Cases are included
without regard to age or other demographic characteristics, indus-
try or size of employer, self or household employment, or indica-
tion of workers compensation as medical care payer. However, for
the purposes of this Chartbook, only emergency department-treated
injuries and illnesses to workers aged 15 and older were included.
Each included case is assigned a statistical weight on the basis of
the size (annual number of emergency department visits) for the
hospital where treatment was received. By using the statistical
weights, nationally representative estimates of emergency depart-
ment-treated injuries and illnesses are made and can be character-
ized by demographics, nature of injury/illness, and injury event
characteristics.
NEISS estimates are for nonfatal injuries and illnesses treated in
an emergency department and as such exclude those workplace
injuries or illnesses treated in other medical venues. Additionally,
occupational fatalities, military injuries/illnesses, revisits to the
emergency department, common illnesses (e.g., cold or flu), and
routine drug and alcohol screenings are excluded. Indications of

lost-work time or medical claim payer are not included in NEISS.
As a result of the types of injuries and illnesses treated in an emer-
gency department, the broad, unrestricted population base, and
the limitations of information available in emergency department
records, NEISS estimates of work-related injuries and illnesses are
complementary to BLS estimates through the Survey of Occupa-
tional Injuries and Illnesses and are not directly comparable.
NEISS work-related injury and illness data are publicly available
through an online query system: Work-Related Injury Statistics
Query System (Work-RISQS) [www2a.cdc.gov/risqs]. Technical
details of the NEISS work-related injury and illness data collection,
query help, and additional work-related statistics resources are
available in addition to user-directed queries for national injury/
illness estimates and rates per 100 full-time workers.
For further information, contact
Surveillance and Field Investigations Branch
Division of Safety Research
National Institute for Occupational Safety and Health
1095 Willowdale Rd, MS H1808
Morgantown, WV 26505
Telephone: 3042855916
www2a.cdc.gov/risqs
National Notifiable Diseases
Surveillance System (NNDSS)
In partnership with the Council of State and Territorial Epide-
miologists (CSTE), the Epidemiology Program Office of CDC
Appendix A Survey and Surveillance Program Descriptions
operates NNDSS. The primary purpose of the system is to provide
weekly provisional information about the occurrence of diseases
defined as notifiable by CSTE. The system also provides summary
data on an annual basis. State epidemiologists report cases of noti-
fiable diseases to the Epidemiology Program Office, which tabu-
lates and publishes these data in the Morbidity and Mortality Weekly
Report (MMWR) and the Summary of Notifiable Diseases, United States
(entitled Annual Summary before 1985). Notifiable disease surveil-
lance is conducted by public health practitioners at local, State, and
national levels to support disease prevention and control activities.
Notifiable disease reports are received from health departments in
the 50 States, 5 territories, New York City, and the District of Colum-
bia. Policies for reporting disease cases may vary by disease or report-
ing jurisdiction, depending on case status classification (i.e., con-
firmed, probable, suspect). CSTE and CDC annually re-review the
status of national infectious disease surveillance and recommend
additions or deletions to the list of nationally notifiable diseases
on the basis of the need to respond to emerging priorities. Report-
ing nationally notifiable diseases to CDC is voluntary. Reporting is
currently mandated by law or regulation only at the local or State
level. Thus the list of diseases that are considered notifiable varies
slightly among the States. The degree of completeness of report-
ing is influenced by the diagnostic facilities available; the control
measures in effect; public awareness of a disease; and the interests,
resources, and priorities of State and local officials responsible
for disease control and public health surveillance. Factors such as
changes in case definition for public health surveillance, introduc-
tion of new diagnostic tests, or discovery of new disease entities can
cause changes in disease reporting that are independent of the true
incidence of disease.
301
 Appendix A Survey and Surveillance Program Descriptions

For further information, contact mesothelioma of pleura

Chief, Surveillance System Branch mesothelioma of peritoneum
Division of Public Health Surveillance and Informatics
Epidemiology Program Office mesothelioma of other sites
Centers for Disease Control and Prevention mesothelioma, unspecified
4770 Buford Highway, MSK74
Atlanta, GA 303413717 malignant neoplasms of the peritoneum
malignant neoplasms of the pleura
www.cdc.gov/epo/dphsi/phs.htm
www.cdc.gov/epo/dphsi/nndsshis.htm mycobacterial infections
all sites (aggregated)
National Occupational pulmonary and unspecified sites

Respiratory Mortality System pleural plaque

pneumoconioses
(NORMS) all (aggregated)
NORMS is a data storage and retrieval system developed and main- asbestosis
tained by NIOSH. The National Surveillance System for Pneumo-
coniosis Mortality (NSSPM), which is the precursor to NORMS, byssinosis
is now a component of it. These data are a compilation of NCHS coal workers pneumoconiosis
multiple-cause-of-death records for the following respiratory condi-
tions: silicosis
unspecified/other pneumoconioses
asthma
tuberculosis
chronic obstructive pulmonary disease (COPD)
all sites (aggregated)
conditions due to chemical fumes and vapors
hypersensitivity pneumonitis respiratory

interstitial pulmonary diseases pulmonary

lung cancer
Deaths for these conditions are defined on the basis of World
malignant mesothelioma Health Organization (WHO) International Classification of Dis-
all sites (aggregated) eases coding categories: ICD8 (WHO 1967) from 19681979 and

302

ICD9 (WHO 1977) from 19791998. Since 1999, ICD10 (WHO
1992) codes specific to each condition have been used.
NORMS provides statistics for the surveillance of occupational
respiratory diseases in an easily accessible, user-friendly format
and is the source for much of the mortality data presented in the
1999 and 2002 Work Related Lung Disease Surveillance (WoRLD)
reports. The data are a subset of national mortality data obtained
annually from NCHS since 1968. NORMS contains death certifi-
cate information for all U.S. residents aged 15 and older identified
with any of the previously mentioned respiratory conditions as the
underlying cause or a contributing cause of death. Additional infor-
mation includes age, race, sex, and State and county of residence
at the time of death.
The All 50 States query is designed to generate a variety of sum-
mary statistics in the form of tables, charts, and maps. Examples
of the types of statistics that this application generates are counts
of deaths, crude and age-adjusted mortality rates, and years of
potential life lost by year, age group, race, sex, underlying cause,
contributing cause, or any mention of death at the national, State,
and county levels since 1968. Data from additional sources, such
as population statistics, comparative standard population, and life-
table values are incorporated into the system.
The Industry/Occupation query generates only tabular counts of
deaths and years of potential life lost by usual industry/occupation,
year, age group, race, sex, underlying cause, contributing cause, or
any mention of death for a selected list of States (and years), but
only for 19851999. Proportionate mortality ratios (PMRs) by usual
industry/occupation are likewise available by age group, race, sex,
underlying cause, contributing cause, or any mention of death but
only at the national level and only for specific time intervals.
Appendix A Survey and Surveillance Program Descriptions
For further information, contact
Public Health Surveillance Team
Surveillance Branch
Division of Respiratory Disease Studies
National Institute for Occupational Safety and Health
1095 Willowdale Road, MSHG900
Morgantown, WV 265052888
Telephone: 3042856115
National Surveillance System
for Health Care Workers
(NaSH)
NaSH is a CDC surveillance system that focuses on exposures and
infections among hospital-based health care workers. NaSH was
developed by the Division of Health Care Quality Promotion,
National Center for Infectious Diseases (NCID); the Division of Viral
Hepatitis, NCID; the Division of Tuberculosis Elimination, National
Center for HIV, STD, and TB Prevention; the National Immuniza-
tion Program; and NIOSH. The objectives of NaSH are to moni-
tor national trends and incidence rates of occupational infections
among health care workers; identify newly emerging hazards for
health care workers; assess the risk of occupational exposures and
infections; and evaluate preventive measures including engineer-
ing controls, work practices, protective equipment, and post-expo-
sure prophylaxis to prevent occupational infections.
NaSH enrollment is voluntary. To ensure that a representative
sample of U.S. hospitals from every demographic category (includ-
ing urban and rural, large and small, teaching and nonteaching,
and serving minority and nonminority populations), the system
303
 Appendix A Survey and Surveillance Program Descriptions
has been advertised in several ways, including at scientific meet-
ings of professional organizations and in their national newsletters.
Hospitals participating in the CDC National Nosocomial Infection
Surveillance System (NNIS) have also been invited to participate.
Initial entry of a health care worker into NaSH usually occurs dur-
ing the provision of health care at the hospitals employee health
service for a relevant event (e.g., routine tuberculin skin test, ini-
tial assessment or follow-up after an exposure to blood, or initial
assessment or follow-up after an exposure to a vaccine-preventable
disease).
Data are collected in NaSH to assist hospitals, health care workers,
health care organizations, and public health agencies. Hospitals
participating in this system benefit by receiving technical support
and standardized methodologies (including software) for conduct-
ing occupational health surveillance activities. NaSH software per-
mits hospitals to analyze their own data in an integrated system and
compare their data with aggregate data from all NaSH hospitals.
The system collects the following data on health care workers:
demographic information (identifying data is not sent to CDC),
occupation, vaccination history, serologic results/immune status
for vaccine-preventable diseases (including hepatitis B virus),
tuberculin skin test results, evaluation for positive tuberculin skin
tests and therapy status as appropriate, detailed information about
the nature of the exposure to blood, body fluids and bloodborne
pathogens, postexposure prophylaxis treatment, information about
exposures and infections from vaccine-preventable diseases such as
measles, and information about exposures to infectious TB. Hospi-
tals provide CDC with denominator data (such as number of staff)
once a year. Every 2 to 5 years, participating hospitals distribute a
survey to employees (to be filled out anonymously) that asks about
history of needlestick or sharps injuries; the purpose of this survey
is to assess underreporting of incidents in the NaSH system.
304
For further information, contact
Health Care Outcomes Branch
Division of Health Care Quality Promotion
National Center for Infectious Diseases
Centers for Disease Control and Prevention
1600 Clifton Road, NE, MSE55
Atlanta, GA 30333
Telephone: 8008930485
Nash@cdc.gov
www.cdc.gov/ncidod/hip/SURVEILL/nash.htm
National Surveillance System
for Pneumoconiosis Mortality
(NSSPM)
NSSPM is a pneumoconiosis mortality surveillance system devel-
oped and maintained by the Division of Respiratory Disease Stud-
ies, NIOSH. Types of pneumoconioses included in the NSSPM are
based on International Classification of Diseases coding categories
(ICD8 [WHO 1967] from 19681979, ICD9 [WHO 1977] from
19791998, and ICD10 [WHO 1992] since 1999): asbestosis,
coal workers pneumoconiosis (CWP), silicosis, byssinosis, other/
unspecified pneumoconioses, and all pneumoconioses aggregated.
The system provides statistics for the surveillance of occupational
respiratory diseases in an easily accessible, user-friendly format.
The data are a subset of national mortality data obtained annually
from NCHS since 1968 (see multiple-cause-of-death data described
above). Currently, NSSPM contains death certificate informa-
tion for 19681996 for all U.S. decedents aged 15 and older with
any type of pneumoconiosis listed on the death certificate as an
underlying or contributing cause of death. Additional information

includes age, race, sex, and State and county of residence at the
time of death. Usual occupation and industry of each decedent
have been available for several States since 1985.
NSSPM is designed to generate a variety of summary statistics,
tables, charts, and maps. Examples of the types of statistics this
system generates are counts of deaths, crude and age-adjusted
rates, and years of potential life lost by year, age group, race, sex,
and usual occupation or industry at the national, State, and county
levels. Data from additional sources, such as population statistics,
comparative standard population, and life table values are incorpo-
rated into the system.
For further information, contact
Public Health Surveillance Team
Surveillance Branch
Division of Respiratory Disease Studies
National Institute for Occupational Safety and Health
1095 Willowdale Road, MSHG900
Morgantown, WV 265052888
Telephone: 3042856115
National Traumatic
Occupational Fatality (NTOF)
Surveillance System
The NTOF Surveillance System was developed in the 1980s by
NIOSH to fill gaps in the knowledge of work-related injury deaths
in the United States. Data was first being collected for calendar year
1980. NTOF supports descriptive and analytical epidemiologic
uses of the data, such as describing the nature and magnitude of
Appendix A Survey and Surveillance Program Descriptions
occupational injuries and fatal injury trends, identifying risk fac-
tors, testing hypothesis, and setting safety research priorities.
For a case to be included in NTOF, the death certificate must meet
three criteria: (1) the decedent must be aged 16 or older; (2) the exter-
nal cause of death is classified as E800E999 (ICD9 [WHO 1977]);
and (3) the Injury at Work item on the death certificate is marked posi-
tive by the certifier. The NTOF data system contains 30 variables useful
for describing characteristics of victims, as well as injury circumstances.
Data elements include coded characteristics such as age, gender, race,
occupation, and cause of death. In addition, narrative text for industry,
occupation, causes of death, and injury characteristics are entered and
maintained for focused research studies.
For this Chartbook, fatality rates are computed using NTOF data as
numerators and BLS CPS data to estimate employed groups. As
noted above, the BLS CPS is a sample survey of the civilian nonin-
stitutional population. The employment data used for rate calcula-
tions are based on the number of workers rather than hours of work
(or full-time equivalents). Fatality rates were calculated as average
annual deaths per 100,000 workers. Rates were not calculated for
cells with fewer than three cases because of the instability of rates
based on small numbers. Frequencies and rates are presented only
for the civilian workforce because denominator data are not easily
obtainable for military personnel.
For further information, contact
Surveillance and Field Investigations Branch
Division of Safety Research
National Institute for Occupational Safety and Health
1095 Willowdale Road, MS1808
Morgantown, WV 26505
Telephone: 3042856009
www.cdc.gov/niosh/injury/traumadata.html
305
 Appendix A Survey and Surveillance Program Descriptions

Sentinel Event Notification 1095 Willowdale Road, MSHG900

Morgantown, WV 265052888
System for Occupational Risk Telephone: 3042856115

(SENSOR) State-based surveillance of carpal tunnel syndrome, noise-induced

hearing loss, and pesticide poisoning
NIOSH has a longstanding commitment to State-based surveillance Surveillance Branch
efforts dating from the early 1980s. This commitment is reflected Division of Surveillance, Hazard Evaluations, and Field Studies
in (1) NIOSH funding of State-initiated occupational safety and National Institute for Occupational Safety and Health
health activities; (2) increased occupational disease, injury, and 4676 Columbia Parkway, MSR17
fatality surveillance; and (3) increased occupational and envi- Cincinnati, OH 45226
ronmental capacity building activities; i.e., assisting State health
Telephone: 5138414589
departments to increase the capacity for investigating problems
related to occupational and environmental health issues. State-based surveillance of injuries to working teens
Surveillance and Field Investigations Branch
In 1987, NIOSH began the SENSOR program. The goal was to Division of Safety Research
develop models for State-based disease or injury condition-specific National Institute for Occupational Safety and Health
1095 Willowdale Road, MS1808
surveillance and enhance the capability of the participating States
Morgantown, WV 26505
to direct appropriate and effective intervention and prevention
efforts. In addition to ongoing disease and injury surveillance, Telephone: 3042856009
NIOSH/State collaborative efforts have supported the standard- California SENSOR program surveillance of work-related asthma and
ization of variables collected by the State programs, the creation carpal tunnel syndrome
of software to facilitate capacity building of surveillance systems by Occupational Health Branch
additional States, the evaluation and comparison of SENSOR sur- Division of Environmental and Occupational Disease Control
veillance data with other surveillance data sources, and publication California Department of Health Services
and dissemination of SENSOR reports. 1515 Clay Street, Suite 1901
Oakland, CA 94612
Contact the office listed below each topic for further information. Telephone: 5106224300
State-based asthma and silicosis surveillance www.dhs.ca.gov/ohb/
Public Health Surveillance Team Massachusetts SENSOR program surveillance of work-related asthma
Surveillance Branch and injuries to working teens
Division of Respiratory Disease Studies Occupational Health Surveillance Program
National Institute for Occupational Safety and Health Bureau of Health Statistics, Research and Evaluation

306
 Appendix A Survey and Surveillance Program Descriptions

Massachusetts Department of Public Health

250 Washington Street, 6th Floor Surveillance of Health Care
Boston, MA 021084619
Telephone: 6176245621
Workers with AIDS
www.state.ma.us/dph/bhsre/ohsp/ohsp.htm Acquired immunodeficiency syndrome (AIDS) surveillance is
Michigan SENSOR program surveillance of work-related asthma, noise- conducted by CDC and collaborating health departments in each
induced hearing loss, and silicosis State, territory, and the District of Columbia. Although surveillance
Occupational and Environmental Medicine activities range from passive to active, most areas employ multifac-
Michigan State University eted active surveillance programs, including four major sources
117 West Fee Hall of AIDS information: hospitals and hospital-based physicians, phy-
East Lansing, MI 488241315 sicians in nonhospital practice, public and private clinics, and
Telephone: 5173531846 medical record systems (death certificates, tumor registries,
www.chm.msu.edu/oem/ hospital discharge abstracts, and communicable disease reports).
AIDS surveillance data are used to detect epidemiologic trends to
New Jersey SENSOR program surveillance of work-related asthma and identify unusual cases requiring follow-up and publish these trends
silicosis
in the semiannual publication in the HIV/AIDS Surveillance
Occupational Health Surveillance Program Report [CDC 2001].
Division of Epidemiology, Environmental and
Occupational Health Of the adults reported with AIDS in the United States through
New Jersey Department of Health and Senior Services December 31, 2002, 24,844 had been employed in health care.
P.O. Box 360
These cases represented 5.1% of the 486,826 AIDS cases reported
Trenton, NJ 086250360
to CDC for whom occupational information was known (informa-
Telephone: 6099841863 tion about employment in the health care setting was missing for
www.state.nj.us/health/eoh/survweb/ 337,225 reported AIDS cases). The type of job is known for 23,212
(93%) of the 24,844 reported health care workers with AIDS.
Ohio SENSOR program surveillance of silicosis CDC is aware of 57 health care workers in the United States who
Silicosis Surveillance have been documented as having seroconverted to HIV following
Ohio Department of Health occupational exposures [CDC 2003]. Twenty-six have developed
246 North High Street AIDS. CDC is also aware of 139 other cases of HIV infection or
P.O. Box 118 AIDS among health care workers who have not reported other risk
Columbus, OH 432160118 factors for HIV infection. They reported occupational exposure to
Telephone: 6144664183 blood, body fluids, or HIV-infected laboratory material, but sero-
www.odh.state.oh.us/ODHPrograms/SILSUR/silsur1.htm conversion after exposure was not documented. The number of

307
 Appendix A Survey and Surveillance Program Descriptions
these workers who acquired their infection through occupational
exposures is unknown.
For more information contact
Chief, Surveillance Branch
Division of HIV/AIDS PreventionSurveillance and
Epidemiology
National Center for HIV, STD, and TB Prevention
Centers for Disease Control and Prevention
1600 Clifton Road, NE, MSE47
Atlanta, Georgia 30333
www.cdc.gov/nchstp/od/nchstp.html
www.cdc.gov/hiv/surveillance.htm
Surveillance for Tuberculosis (TB)
Infection in Health Care Workers
CDC recommends periodic tuberculin skin testing of health care
workers with a potential for exposure to Mycobacterium tuberculosis.
However, many health care facilities (e.g., hospitals, correctional
facilities, long-term care facilities, and health departments) do
not have a system for identifying and tracking workers due for
tuberculin skin testing or a means of analyzing aggregate data. To
facilitate surveillance for TB infection in health care workers in
health departments, CDC undertook several studies designed to
examine rates of skin test conversions in health care workers. The
most comprehensive of these was a study initiated in 1995 called
StaffTRAKTB. The study included more than 13,000 health care
workers. Data from this study are used to track, analyze, and report
information pertaining to tuberculin skin testing surveillance in
health care workers.
308
For further information, contact
Surveillance and Epidemiology Branch
Division of Tuberculosis Elimination
National Center for HIV, STD, and TB Prevention
1600 Clifton Road, NE, MSE10
Atlanta, GA 30333
Telephone: 4046398117
www.cdc.gov/nchstp/tb/
Survey of Occupational Injuries
and Illnesses (SOII)
Since 1971, the BLS has conducted an annual survey of establish-
ments in the private sector to collect statistics on occupational
injuries and illnesses. The SOII is a Federal and State program
through which employer reports are collected from about 183,000
private industry establishments and processed by State agencies
cooperating with BLS [BLS 2003c,d]. Data for the mining industry
and railroad activities are provided by the Department of Labors
Mine Safety and Health Administration and Department of Trans-
portations Federal Railroad Administration. Excluded from the
survey are the self-employed, farmers with fewer than 11 employees,
private households, Federal government agencies, and employees
in State and local government agencies. Establishments are clas-
sified in industry categories based on the 1987 Standard Industrial
Classification Manual [OMB 1987].
Survey estimates of occupational injuries and illnesses are based
on a statistically designed probability sample rather than a cen-
sus of the entire working population. An independent sample is
selected for each State and the District of Columbia that represents

industries in that jurisdiction. BLS includes all State samples in
the national sample. State agencies mail report forms to selected
employers in February to cover the previous calendar years expe-
rience. For those States not participating in the program, report-
ing forms are mailed by BLS. Each employer completes a single
report form, which is used for both national and State estimates
of occupational injuries and illnesses. This procedure eliminates
duplicate reporting by respondents and, together with the use of
identical survey techniques at the national and State levels, insures
maximum comparability of estimates. Since 2002, employers have
collected, maintained, and disseminated information about work-
related injuries and illnesses using the Log of Work-Related Injuries
and Illnesses (OSHA Form 300) [OSHA 2003a], the Summary of
Work-Related Injuries and Illnesses (OSHA Form 300A) [OSHA
2003b], and the Injury and Illness Incident Report (or an equiva-
lent form containing the information sought) (OSHA Form 301)
[OSHA 2003c].
An occupational injury is any injury that results from a work-related
event or from a single instantaneous exposure in the work environ-
ment. An occupational illness is any abnormal condition or disorder
(other than one resulting from an occupational injury) caused by
exposure to factors associated with employment. It includes acute
and chronic illnesses or diseases that may be caused by inhala-
tion, absorption, ingestion, or direct contact. Lost workday cases
involve days away from work, days of restricted activity, or both. The
response rate is about 92%.
In addition to publishing injury and illness counts, rates, and char-
acteristics, the Bureau estimates injury and illness severity using
information provided by employers about the number of days away
from work needed to recuperate from each disabling condition. If,
as a result of injury or illness, the employee did not return to work
by the end of the survey year, then the employer reports an approxi-
Appendix A Survey and Surveillance Program Descriptions
mate return date, which, in conjunction with the date of injury or
illness, yields an estimate of days away from work for that case. Two
basic measures of severity are used with the characteristics of days
away from work cases:
Median days away from work is the measure used to
summarize the varying lengths of absences from work
among the cases involving days away from work. Half the
cases involved more days and half involved fewer days
than a specified median.
Distribution of cases involving various lengths of absences
from work, ranging from 1 or 2 days to 31 days or longer.
Summary data on nonfatal counts and rates for all recordable inju-
ries and illnesses are issued by BLS in December of each year. Data
are separated into cases with and without lost workdays. The follow-
ing April, summary data are issued by BLS on the characteristics of
workers sustaining days-away-from-work injuries and illnesses and
how those incidents occurred.
For further information, contact
U.S. Bureau of Labor Statistics
OCWC/OSH, Suite 3180
2 Massachusetts Avenue, NE
Washington, DC 202120001
Nonfatal summary information: 2026916179
Nonfatal case and demographic information: 2026916170
Fax: 2026916196
Nonfatal injuries and illnesses questions: oshstaff@bls.gov
www.bls.gov/iif/
309
 Appendix A Survey and Surveillance Program Descriptions
Traumatic Injury Surveillance
of Farmers (TISF) Survey
The TISF Survey was a mail survey of farms and ranches conducted
by the U.S. Department of Agricultures National Agricultural
Statistics Service (NASS), in cooperation with NIOSH. The NASS
provided the sampling frame and sample selection. All agricultural
production operations were in the population for study. The NASS
drew all samples, conducted the mailings, contacted farm opera-
tions that did not respond, and processed the data for NIOSH use.
In cooperation with the National Safety Council and NASS, NIOSH
developed the TISF to determine the frequency, incidence rate,
and characteristics of agricultural work-related injuries occurring
in the United States. The TISF database permits NIOSH to produce
injury estimates at the State, regional, and national levels. Injuries
were defined as any condition that resulted in one-half day or more
of restricted activity or required professional medical treatment. An
agricultural work-related injury was defined as an injury meeting
this definition that occurred while performing work (either on the
farm or off the farm) associated with the farm business. Respon-
dents provided detailed information about the demographic char-
acteristics of the victim (age, gender, race), characteristics of the
injury (body part, nature, and type of injury), work, and causal
factors.
For further information, contact
Surveillance and Field Investigations Branch
Division of Safety Research
National Institute for Occupational Safety and Health
1095 Willowdale Road, MS1808
Morgantown, WV 26505
www.cdc.gov/niosh/injury/traumaagric.html
310
References
BLS [2003a]. Census of fatal occupational injuries. Washington,
DC: U.S. Department of Labor, Bureau of Labor Statistics, Safety
and Health Statistics Program. Fatal Injuries. [www.bls.gov/iif/
oshcfoi1.htm] Date accessed: November 2002.
BLS [2003b]. Current population survey. The employment situ-
ation: Washington, DC: U.S. Department of Labor, Bureau of
Labor Statistics. [www.bls.gov/news.release/pdf/empsit.pdf] Date
accessed: June 2003.
BLS [2003c]. Survey of occupational injuries and illnesses. Nonfa-
tal (OSHA recordable) injuries and illnesses. Industry incidence
rates and counts. Washington, DC: U.S. Department of Labor,
Bureau of Labor Statistics, Safety and Health Statistics Program.
[www.bls.gov/iif/oshsum.htm] Date accessed: November 2002.
BLS [2003d]. Survey of occupational injuries and illnesses. Nonfa-
tal (OSHA recordable) injuries and illnesses. Case and demograph-
ic characteristics. Washington, DC: U.S. Department of Labor,
Bureau of Labor Statistics, Safety and Health Statistics Program.
[www.bls.gov/iif/oshsum.htm] Date accessed: November 2002.
CDC [1999]. Adult blood lead epidemiology and surveillance
United States, second and third quarters 1998, and annual 1994
1997. MMWR 48(10):213223. [www.cdc.gov/mmwr/PDF/wk/
mm4810.pdf]
CDC [2001]. HIV/AIDS Surveill Rep 13(2):44. [www.cdc.gov/hiv/
stats/hasr1302.pdf]
CDC [2003]. Surveillance of healthcare personnel with HIV/
AIDS, as of December 2002. [www.cdc.gov/ncidod/hip/BLOOD/
hivpersonnel.htm] Date accessed: February 2004.

CFR. Code of Federal regulations. Washington, DC: U.S. Govern-
ment Printing Office, Office of the Federal Register.
DHHS [2000]. Tracking healthy people 2010. U.S. Department of
Health and Human Services. Washington, DC: U.S. Government
Printing Office, November 2000.
ILO [1980]. Guidelines for the use of ILO international classifica-
tion of radiographs of pneumoconioses. Rev. ed. Geneva, Switzer-
land: International Labour Office, Occupational Safety and Health
Series No. 22. (Rev.).
MSHA [2003a]. Quarterly employment and coal production,
accidents/injuries/illnesses reported to MSHA under 30 CFR Part 50,
19922002. Denver, CO: U.S. Department of Labor, Mine Safety and
Health Administration, Office of Injury and Employment Information.
[www.msha.gov/STATS/PART50/p50y2k/p50y2k.HTM] Date
accessed: August 2003.
MSHA [2003b]. MSHA form 7000-1Mine accident, injury and
illness report. [www.msha.gov/forms/elawsforms/7000-1.htm] and
[www.msha.gov/FORMS/7000-1.pdf] Date accessed: August 2003.
MSHA [2003c]. MSHA form 7000-2Quarterly mine employment
and coal production report. [www.msha.gov/forms/elawsforms/
7000-2.htm] and [www.msha.gov/FORMS/7000-2.pdf] Date accessed:
August 2003.
NIOSH [1997]. Mortality by occupation, industry, and cause of
death, 24 reporting States, 19841988. Cincinnati, OH: U.S.
Department of Health and Human Services, Public Health Service,
Centers for Disease Control and Prevention, National Institute for
Occupational Safety and Health, DHHS (NIOSH) Publication No.
97114. [www.cdc.gov/niosh/tc97114.html]
OMB [1987]. Standard industrial classification manual. Washing-
ton, DC: Office of Management and Budget.
Appendix A Survey and Surveillance Program Descriptions
OSHA [2003a]. OSHA No. 300 formLog of work-related injuries
and illnesses. [www.osha-slc.gov/recordkeeping/OSHArecordkeep
ingforms.pdf] Date accessed: June 2003.
OSHA [2003b]. OSHA No. 300A formSummary of work-related
injuries and illnesses. [www.osha-slc.gov/recordkeeping/OSHArec
ordkeepingforms.pdf] Date accessed: June 2003.
OSHA [2003c]. OSHA No. 301 formInjury and illness incident
report. [www.osha-slc.gov/recordkeeping/OSHArecordkeepingfo
rms.pdf] Date accessed: June 2003.
Stanbury M, Roscoe RJ [1999]. Surveillance case definition for
adult blood lead levels to be reported to the National Public Health
Surveillance System. Council of State and Territorial Epidemiolo-
gists (CSTE) position statement 99ENV-2. [www.cste.org/ps/1999/
1999-env-02.htm]
Toscano G, Windau J, Drudi D [1996]. Using the BLS occupational
injury and illness classification system as a safety and health man-
agement tool. Compensation and Working Conditions: June.
WHO [1967]. Manual of the international statistical classification
of diseases, injuries, and causes of death, based on the recommen-
dations of the Eighth Revision Conference, 1965. Geneva, Switzer-
land: World Health Organization.
WHO [1977]. Manual of the international statistical classification
of diseases, injuries, and causes of death, based on the recommen-
dations of the Ninth Revision Conference, 1975. Geneva, Switzer-
land: World Health Organization.
WHO [1992]. International statistical classification of diseases
and related health problems, tenth revision. Geneva, Switzerland:
World Health Organization.
311
T he Worker Health Chartbook, 2004 is based on data collected
from the surveys and surveillance programs described in
Appendix A. The information used is largely in the public domain
and is available from existing bulletins, reports, or government pub-
lications. The extensive use of electronic media and the World Wide
Web have increased dissemination channels for government agencies,
particularly where database management systems support customiza-
tion of data queries from data users. At times, users overlook or are
not sensitive to aspects of data collection, analysis methods, and dis-
semination practices that limit the uses and inferences of data. The fol-
lowing information is provided to assist the users of the Chartbook and
reinforce the cautionary guides that accompany the dissemination of
survey and surveillance data.
Census of Fatal Occupational
Injuries (CFOI)
Census Measures
The Bureau of Labor Statistics (BLS) CFOI provides numeric and
percentage distributions of its fatality totals for worker and case
characteristics. Frequencies indicate the magnitude of a problem
or the number of injuries that could be prevented. Worker and case
characteristics used in the Chartbook include gender, age, race,
and event or exposure.
Fatality Rates
Fatality counts from the BLS census are combined with annual aver-
age employment from the Current Population Survey [BLS 2003a]
to produce a fatal work injury rate. Fatality rates depict the risk of
incurring a deadly injury faced by all or a subgroup of workers,
such as workers in a certain occupation or industry. The formula
for calculating a fatality rate is
Fatality rate = (N/W) 100,000
where N = the number of fatally injured workers aged 16 and older,
and W = the number of employed workers aged 16 and older.
Because neither hours nor employment is collected in the BLS cen-
sus, fatality rates are calculated using annual average employment
estimates from the Current Population Survey (CPS). Employment-
based fatality rates measure the incidence of a fatal injury for all
workers in the group regardless of exposure time.
Uses and Limitations
The CFOI helps safety and health experts to monitor the number
and types of fatal work injuries over time and focus on work settings
with particularly high risks. The CFOI database can produce fatal-
ity profiles for specific worker groups (self-employed or female
workers, for example), certain types of machinery (such as farm
equipment), and specific fatal circumstances (for instance, work
313
 Appendix B Data and Analysis Methods
activities at the time of fatal contact with electric current). Such
profiles help identify existing work standards that may require revi-
sion and highlight safety problems for which intervention strategies
need to be developed.
Although States are using independent data sources to identify and
substantiate work-related fatalities, some fatal injuries at work are
missed by the BLS census. Some unidentified work-related fatali-
ties undoubtedly occur on farms, at sea, and on highways. States
continue to search for new ways of verifying work-related fatalities
to make their census counts as complete as possible. In that regard,
States have up to 1 year to update their initial published counts
with fatalities that were verified as work-related after data collection
had ended for a given census. Since 1992, the average change due
to updates in each years initially published total has been less than
1%.
Publication Guidelines
BLS considers data that could identify a person, company, or data
source to be confidential and not for public release. Data that do
not meet publication criteria are suppressed using dashes in tables
and charts [BLS 2003b].
For further information, contact
U.S. Bureau of Labor Statistics
OCWC/OSHSuite 3180
2 Massachusetts Avenue, NE
Washington, DC 202120001
Fatality information: 2026916175
Fax: 2026916196
Fatalities questions: cfoistaff@bls.gov
www.bls.gov/iif/oshcfoi1.htm
314
The Center to Protect Workers
Rights (CPWR)
The following methods were used in conjunction with producing
the data in the Chapter 4 Figures of the NIOSH Worker Health Chart-
book, 2004.
Fatal Injury Rates
Fatal injury rates were calculated using fatality counts from the BLS
Census of Fatal Occupational Injuries (CFOI) as numerators, and
a workforce estimate (denominator) based on hours worked data
from the BLS Current Population Survey (CPS).
Construction trades were identified using CFOI three-digit occupa-
tion codes. A full-time equivalent (FTE) for each construction trade
was obtained from the CPS, corresponding to the three-digit occu-
pation codes. Each FTE was computed as an average value within
each occupation group over the 12 months during each survey year
using the formula FTE = 52HW/2000, where H = hours worked per
week, and W = the weighted value in CPS. This formula assumes a
full-time employee works 40 hours per week and 50 weeks per year,
or 2,000 hours per year. Respondents who did not report hours
were excluded from the calculation.
A fatal rate was computed for each of the construction trades and
the construction industry. Each annual rate was computed using
the annual CFOI fatality count as the numerator, and the corre-
sponding FTE estimate as the denominator, per 100,000 full-time
equivalent workers.
 Appendix B Data and Analysis Methods

Nonfatal Injury and Illness Rates to class of worker questions. Some self-employed workers are in
establishments with payroll, in which case they are the owner or
The calculation of nonfatal injury and illness rates was similar in partner.
methods to those employed for fatal injury rates. Numerators for
the rate computations were taken from the BLS Annual Survey of For further information, contact
Occupational Injuries and Illnesses using counts of cases involving Janie Gittleman, Ph.D., M.R.P.
days away from work for the same three-digit occupation codes Associate Director, Safety and Health Research
noted above. FTEs for the self-employed were excluded from the Center to Protect Workers Rights
computation. Rates were computed as above, but expressed per Suite 1000
10,000 full-time equivalent workers. 8484 Georgia Avenue
Silver Spring, MD 20910
Ph: 3015788500, extension 107
Hispanic Construction Workers
Cell: 2023021340
Hispanic origin or ethnicity, as defined in CFOI and the CPS, Fax: 3015788572
includes a diverse population of all races. Hispanics include U.S.- email: jgittleman@cpwr.com
and foreign-born. In the CPS, individuals identify themselves or
are identified as Hispanic by proxy respondents. In CFOI, multiple
data sources, such as news accounts and death certificates, may be Mine Safety and Health
evaluated and serve to document Hispanic ethnicity or other racial
characteristics. Research Data Analysis
Methods
Establishments
Commodity Differences for Type of Employer
Information about establishments or employers was obtained from
the most recent Economic Census. Large construction employers (Mine Operators versus Independent
may include more than one establishment if they have more than Contractors)
one payroll office. The Economic Census produces information
about the number of employees, location, industry code for prin- The five commodity groups of coal (anthracite and bituminous),
cipal activity, and other data for establishments with payrolls. The metal, nonmetallic minerals (nonmetal), stone, and sand and grav-
group of nonemployers, or establishments with zero employees el are based on a slight modification of the Mine Safety and Health
reported, was excluded from these calculations. These nonemploy- Administrations (MSHA) six canvass classes, which are general
ers or establishments with zero employees for the month of March product classifications based on the Standard Industrial Classifica-
are not the same as self-employed workers. The workforce of self- tion (SIC) [OMB 1987]. The only modification combines anthra-
employed is assessed based on the CPS household survey responses cite and bituminous into one coal category. Because independent

315
 Appendix B Data and Analysis Methods
contractors may work at multiple mining operations associated
with a diversity of commodities, a canvass class is not designated
for independent contractors. Instead, independent contractors
report employment under two categories: (1) all coal locations
and (2) all metal, nonmetal, stone, and sand and gravel locations.
As a result of these reporting differences, fatality and injury rates
for independent contractors can only be computed for coal and
metal/nonmetal locations.
Work Location
Employment and injuries reported within the underground opera-
tional subunit are designated as underground work locations. All
other operational subunits (surface areas at underground mines,
strip/open pit operations, culm banks, auger mining, dredging
operations, other surface mines, independent shops, coal prepara-
tion plants or mills) are combined under surface work locations
with the exception of the office subunit, which is excluded from all
analyses.
Selection Criteria for Fatalities
The number of fatalities used for the analyses varies slightly from the
number reported in the publicly released MSHA accident/injury/
illness database because of the following: (1) injuries to nonemploy-
ees have been excluded from analysis; and (2) injuries identified by
MSHA after the files were closed out are not included.
Employment Size of Mining Operations
The annual average number of employees (excluding office
employees) reported by mining operations was used to categorize
these operations by employment size. Employee hours used to
316
compute fatality rates within categories of employment size also
excluded employee hours reported for these office workers.
Selection Criteria for Lost-Workday Cases
Lost-workday cases include only those cases that resulted in total
or partial permanent disabilities, actual days away from work, and
days of restricted work activity (i.e., MSHA degree of injury codes 2
through 5). The number of lost workdays was computed by adding
the days away from work and days of restricted work activity, with
one exception. MSHA assigns scheduled lost-workday charges for
permanent partial disabilities as a means to determine the relative
severity of certain injuries regardless of the days lost [MSHA 2002].
For injuries resulting in total or partial permanent disabilities, lost
workdays were the statutory days charged to the incident whenever
the statutory days exceeded the lost workdays reported or when lost
workdays were unreported.
Calculation of Rates
Injury rates were computed using employment estimates derived
from total hours worked (excluding office employees). Full-time
equivalent workers were calculated by dividing total hours by 2,000
hours per worker. Nonfatal injury rates were calculated per 100 full-
time equivalent workers, and fatal injury rates were calculated per
100,000 full-time equivalent workers, excluding office workers.
Injury/Illness and Mining Experience Data
Inclusion Criteria
Counts within categories of total years of mining experience includ-
ed all reported injuries and illnesses (i.e., MSHA degree of injury
codes 1 through 7) for the years 1991 through 2000 (Figures 416
and 417). Excluded were cases for which total mining experience
was not reported.
 Appendix B Data and Analysis Methods

Determining the Type of Incident Associated or

with the Injury Surveillance, Statistics, and Research Support Activity
Spokane Research Laboratory
MSHAs accident/injury/illness classification scheme, which iden- National Institute for Occupational Safety and Health
tifies the circumstances contributing most directly to the fatal or 315 E. Montgomery Avenue, MSP11
nonfatal injury, was used to establish the type of incident associated Spokane, WA 99207
with a fatal or nonfatal injury [MSHA 2002]. The type of incident is
Telephone: 5093548065
identical to MSHAs accident/injury/illness classification with two
exceptions:
For more detailed information about mining employment and
fatal and nonfatal injuries, please visit www.cdc.gov/niosh/mining/
Both fatal and nonfatal cases classified as a fall of highwall topics/data/default.htm.
or rib (accident/injury/illness code = 06) or as a fall
of roof or back (accident/injury/illness code = 07) are

National Electronic Injury

reported as a fall of ground incident.

Nonfatal injury cases occurring underground and classified

under machinery (accident/injury/illness code = 17) were Surveillance System (NEISS)
reclassified as a fall of ground if the source of the injury
Case Definition
was caving rock, ore, etc. (MSHA source of injury code
= 90). This reclassification is consistent with the way in Cases are defined as follows:
which MSHA classifies similar incidents that resulted in a
Medical: Nonfatal injuries and illnesses treated in an
fatal injury. Typically, the victim is operating a roof bolter
emergency department
or continuous miner and is struck by caving rock from the
mine roof or rib. Population: Civilian, noninstitutionalized workers

Work: Doing work for pay or other compensation

For further information, contact
(including arriving at or leaving work, but on the
Surveillance and Research Support Branch
Pittsburgh Research Laboratory employers premises); being transported between
National Institute for Occupational Safety and Health locations as a part of the job (excluding commuting to
P.O. Box 18070 or from home); engaging in agricultural production
Pittsburgh, PA 15236 activities; or working as a volunteer for an organized
Telephone: 4123866613 group (e.g., volunteer fire department)

317
 Appendix B Data and Analysis Methods
Demographics: All workers without restriction by age,
type of employer or industry (e.g., self-employed, private
industry, or government), or employer size
Case Exclusions
The following types of cases are excluded:
Injuries or illnesses to active duty military, national guard,
and State militia
Injuries or illnesses to institutionalized persons including
prisoners or mental health patients
Common illnesses (e.g., colds and flu)
Routine drug and alcohol screening
Revisits to the same emergency department for a
previously treated injury or illness
For the purposes of this Chartbook, injuries and illnesses to workers
under age 15 were excluded in all graphs.
Case Identification
Work-related cases are identified from admissions information and
emergency department chart review by hospital coders. A workers
compensation claim is not required for inclusion.
Injury and Illness Estimates
NEISS is designed to produce national estimates and is not suitable
for regional, State, or local injury and illness estimates. A national
estimate is obtained by extrapolating the number of cases seen in
the approximately 67 hospitals by using the statistical weight of
318
each case. The statistical weight varies depending on the size of the
hospital and the number of patients typically treated in their emer-
gency department. Each case captured in a sample hospital may
represent 20 to more than 100 cases seen in other U.S. hospitals. By
adding the weights for similar cases, a national estimate is obtained
for a demographic group, type of injury, injury circumstances, or
all injuries and illnesses. The public may access NEISS work-related
injury and illness data through the NIOSH online Work-Related
Injury Statistics Query System (Work-RISQS at www2a.cdc.gov/
risqs). At Work-RISQS, national estimates are expressed in thousands
of injuries and illnesses for a given year. For example in 1999, an
estimated 3,930.9 thousand or 3,930,900 occupational injuries and
illnesses were treated in U.S. hospital emergency departments for
workers who were aged 15 and older. Other surveillance systems
may produce different estimates.
Injury and Illness Estimate Confidence Bounds
Because the NEISS system is a sample of all U.S. hospitals and does
not count every injury or illness treated in all hospitals, the national
estimates may be in error. However, because the sample was statisti-
cally selected, we can calculate what the error due to sampling is
likely to be. Each estimate produced for NEISS data through Work-
RISQS has confidence bounds listed. The error estimates are based
on the 95% confidence interval and are expressed as a value that
should be subtracted from the estimate to get the lower confidence
bound and added to it to get the upper bound. For example, in
1999, there were an estimated 3,930.9 thousand work-related inju-
ries and illnesses with 95% confidence bounds of 793.7 thousand
cases for workers aged 15 and older. In other words, we expect the
true value from this system is likely to be in the range of 3,137,200
to 4,724,600 injuries and illnesses. Simply putabout 3 to 5 million
nonfatal occupational injuries and illnesses were treated in U.S.
emergency departments in 1999.

The confidence bounds do not account for biases (nonsampling
error) in the estimates that arise from the way in which data are
collected or defined, ability to identify all work-related cases, or
mistakes in data collection or coding.
The 95% confidence bounds are an approximation based on the
classical formula for variance of a total from a stratified sample.
These confidence bounds are an approximation of the general
magnitude of error about an estimate and are not precise values.
Worker Population
The employment estimates used by NIOSH with NEISS data and
Work-RISQS are derived from the U.S. Bureau of Labor Statistics
Current Population Survey (CPS) of civilian noninstitutionalized
workers. Employment estimates are calculated for Work-RISQS as
full-time equivalent workers (FTE), where one FTE equals 2,000
hours worked per year. The FTE estimates account for hours
worked in all jobs reported to CPS. At Work-RISQS, FTE estimates
may be obtained by month, quarter, or year for workers aged 15
and older. FTE estimates may be obtained by age group or sex.
Volunteer workers are not included in CPS estimates, although they
are included in the NEISS and Work-RISQS injury/illness counts.
This creates a small but insignificant bias in rate estimates.
Approximate standard errors are calculated for CPS employment
estimates by using parameters for selected demographic character-
istics in a generalized variance function provided by the Bureau
of Labor Statistics (see BLS [2001]). Parameters are independent
of the time period selected within a given year, although they may
change from year to year. In the calculation of error in the employ-
ment estimate, the selection of the variance parameters for the
year are chosen based on the appropriate employment character-
istics. When multiple characteristics apply for subsets of sex or age
Appendix B Data and Analysis Methods
groups, the parameters are chosen to provide the most conservative
error estimate (i.e., the largest error estimate). The errors gener-
ally decrease with longer time periods and when a selected sex or
age group spans fewer than 20 years. However, the errors resulting
from these calculations are only an approximation of the true sam-
pling error and do not account for systematic biases in the data.
Injury and Illness Rate Estimates
In workplace safety, the injury/illness rate is commonly calculated
as the frequency of injuries divided by the number of workers or
the number of hours worked within a time period. Work-RISQS
only provides rates as the number of injuries and illnesses per
200,000 hours worked (i.e., 100 FTEs) for time periods of a month,
quarter, or year. A rate estimate query at Work-RISQS produces a
table that includes the number of injuries and illnesses treated in
an emergency department (the rate numerator), the FTE (the rate
denominator), the rate per 100 FTEs, and the confidence bounds
expressed as a value to be added and subtracted from the rate
value.
Minimum Reporting Requirements
NEISS data reported through Work-RISQS have three criteria to
determine whether a national estimate is reportable. First, esti-
mates must be based on at least 40 cases among the small sample
of U.S. hospitals within NEISS. This means that on average, a type
of injury was treated at least once in about two-thirds of the 67
hospitals. Second, the national estimate must be greater than or
equal to 2,500 injuries/illnesses. Third, the error associated with an
estimate must be small enough to indicate that the estimate would
be reasonably reproducible (i.e., the coefficient of variation is less
than or equal to 33%).
319
 Appendix B Data and Analysis Methods
Selected Data Elements
Sex
Definition: The distinction between male and female. A workers
sex is indicated as male, female, or not stated. In any given years
data, the number of cases with sex listed as not stated is very small
(e.g., typically < 0.01% of all cases).
Age group
Definition: Inclusive range of ages of patients (in years). Injured
or ill workers are grouped by age ranges (typically a 5-year range).
One or more age groups may be selected. No age restrictions exist
for cases captured in NEISS provided they meet the definition of a
work-related case. However, injury rates are not available for youths
under age 15 because data on hours worked are not available. Age
is unknown for a small proportion of cases.
Race/Ethnicity
Definition: Construct for classifying people with similar biological,
social, and cultural heritage into four race groups (White, Black,
American Indian/Alaska Native, and Asian/Pacific Islander) and
one ethnicity group (Hispanic or Latino) as recorded on the emer-
gency department chart.
Within the original NEISS data, race and ethnicity of an injured
worker are collected as a two-part question. In the first part, race
is coded as white, black, other, or not stated. In the second part
which is free text, other races may be described such as Asian or
American Indian, or ethnicity may be entered such as Hispanic or
Latino. Because NEISS hospitals do not collect race and ethnic-
ity uniformly (if they collect or report it at all) and because of the
two-part nature of the NEISS race/ethnicity question, consistent
320
reporting of race and ethnicity is not always achieved. For example,
a Hispanic patient might be indicated as (1) white or black with the
free text blank (only race reported); (2) white or black with His-
panic entered into the free text (both race and ethnicity reported);
and (3) other, with Hispanic in the free text field (only ethnicity
reported).
Within Work-RISQS, race and ethnicity were recoded under a
single combined data structure where Hispanic ethnicity was indi-
cated preferentially as opposed to white or black race. Thus, for
the purposes of estimating injuries and illnesses, workers who were
identified as white or black and Hispanic or Latino were counted
under their Hispanic ethnicity. If originally race was listed as other,
and the free text contained a country of origin or ancestry, those
cases were recoded to the race or ethnicity category predominant
for the region (e.g., Chinese was recoded as Asian and Mexican was
recoded as Hispanic). Race was recoded as not stated if the free text
listed Indian without an indication that the patient was American
Indian or Native American. However, Indian was recoded to Ameri-
can Indian if the NEISS hospital where the case was seen generally
treated a large population of American Indians.
Note: Because of these and other problems in collecting race and
ethnicity information and missing information for approximately
20% of cases, Work-RISQS estimates for specific race or Hispanic
worker populations should be used with caution.
Data Objectives and Limitations
The primary objective of NEISS data collection and the online
Work-RISQS is to provide public access to occupational injury and
illness data for use in workplace safety and injury prevention activi-
ties for which understanding the general magnitude of injuries,
worker characteristics, and injury events are important (e.g., esti-
mating the number of falls from elevation). Use of these data for

other purposes should be done with caution. NEISS is not suitable
for examining rare events or events involving very detailed specifi-
cation of the incident characteristics, workplace setting, personal
protective equipment, or tools, machinery, or objects that were
associated with the injury (e.g., estimating the number of falls from
Type IA aluminum extension ladders made by XYZ Manufacturing
or the number injured workers wearing fall protection).
Occupational Respiratory
Disease
Number of Deaths
In this report, the number of deaths for each occupational respira-
tory condition is the number of decedents for which the condition
was coded as either an underlying or contributing cause of death.
For the years 19681998, these numbers were tabulated from the
record axis of the National Center for Health Statistics (NCHS)
multiple-cause-of-death data files. Beginning with the 1999 data,
these numbers were tabulated from the entity axis and the under-
lying cause of death of the multiple-cause-of-death data files. A
small number of deaths in 1999 with underlying cause code J65
(pneumoconiosis associated with tuberculosis) were included in
tabulations of the underlying cause of death for each type of pneu-
moconiosis. Similarly, deaths in 1999 with underlying cause code
J92.0 (pleural plaque with asbestos) were included in tabulations
with asbestosis as the underlying cause of death. The number of
deaths by condition is reported both annually and for selected time
periods. Reported deaths are restricted to U.S. residents aged 15
or older based on State of residence at death. Race was classified as
white, black, and all others.
Appendix B Data and Analysis Methods
Industry and Occupation Codes and Titles
Since 1993, the 1990 U.S. Census Bureau occupation and industry
titles and three-digit codes [Census 1992] have been used for cod-
ing death certificate information in the NCHS multiple-cause-of-
death data files (see Technical Appendix for 1995 at www.cdc.gov/
nchs/about/major/dvs/mcd/1998mcd.htm). Occupation and
industry mortality data for 19841992 were based on the 1980 Cen-
sus Bureau occupation and industry classifications [Census 1982].
Most codes and titles in the 1990 system do not differ from the 1980
system. The primary industries associated with silicosis and work-
related asthma cases in the SENSOR sections of this report are
grouped by the 1987 SIC system. However, the primary occupations
are grouped by the 1990 Census Bureau classification system.
Age-Adjusted Mortality Rates
Age-adjusted mortality rates presented in this report were based
on deaths with the condition of interest mentioned as an underly-
ing or contributing cause of death. Rates were calculated annually
for each specified condition from 1968 through 1999, as well as
for selected periods. For a given year, the age-adjusted rates rep-
resent the rates that would have been observed if the age-specific
rates for specified age groups had occurred in a population with
the same age distribution as the standard population. To conform
with current NCHS guidelines, the year 2000 standard population
[Anderson and Rosenberg 1998] was used as the standard. The
age intervals used were 1524, 2534, 3544, 4554, 5564, 6574,
7584, and 85 years and older. Rates for the entire U.S. population
and for each sex-race group were age-adjusted separately, using the
same standard population.
Age-adjusted rates were computed by the direct method. First, the
annual age-specific rates for the population were calculated. The
product of the age-specific rates and the number in the comparable
321
 Appendix B Data and Analysis Methods
age-specific group in the standard population equals the expected
number of deaths per million population for each age group. The
total expected numbers of deaths were then obtained by adding
all age groups. The total expected number of deaths was divided
by the sum of the standard population and the resulting quotient
was multiplied by 1,000,000 to produce the age-adjusted rate (per
million).
Age-adjusted rates were computed at the national and State level for
the period 19901999. Rates also were computed at the county level
either for two 15-year periods and one 30-year period (19701984,
19851999, and 19701999) or for a single 20-year period (1980
1999), depending on whether the condition was discretely classi-
fied during those time periods. Rates for malignant mesothelioma
were computed for 1999 only. For each time period (19701984,
19701999, 19801999, 19851999, and 19901999), age-specific
rates were first computed by dividing the average annual number of
deaths in each age group by the corresponding age-grouped, mid-
year population (1977, 1985, 1990, 1992, and 1995, respectively)
in the comparable geopolitical unit. Age-adjusted rates then were
computed as described above.
Proportionate Mortality Ratio (PMR)
The data used for PMR analyses are a subset of the NCHS multiple-
cause-of-death files for which usual industry and occupation codes
are available and meet quality criteria set by NCHS. The PMR is
defined as the observed number of deaths with the condition of
interest (mentioned as either underlying or contributing) in an
industry/occupation from selected States and years, divided by
the expected number of deaths with that condition. The expected
number of deaths is the total number of deaths in the industry or
occupation classification of interest multiplied by a proportion.
This proportion is defined as the number of cause-specific deaths
for the condition of interest in all industries/occupations divided
322
by the total number of deaths in all industries/occupations. The
PMRs in this report have been internally adjusted by 5-year age
groups (i.e., 1519, 2024, , 110114, and 115 years and over),
sex, and race (i.e., white, black, and all other). Confidence intervals
were calculated assuming Poisson distribution of the data.
A PMR greater than 1.0 indicates that more deaths were associated
with the condition in an occupation or industry than expected.
This report includes only those industries/occupations with 5 or
more decedents with the condition and a lower 95% confidence
limit exceeding 1.0.
For further information, contact
Public Health Surveillance Team
Surveillance Branch
Division of Respiratory Disease Studies
National Institute for Occupational Safety and Health
1095 Willowdale Road
Morgantown, WV 265052888
Telephone: 3042856115
Survey of Occupational Injuries
and Illnesses (SOII)
Survey Measures
The number of injuries and illnesses are reported nationwide and
by industry for three basic types of cases:
Lost-workday cases
Cases involving days away from work
Nonfatal cases without lost workdays

Lost-workday cases may include (1) cases involving days away from
work, or (2) cases involving restricted work activity only, or (3)
both. For cases involving days away from work, the survey presents
numeric and percent distributions by occupation and by the work-
er demographic traits and case characteristics, such as the part of
body involved, the nature of the injury or illness, the source of the
injury or illness, and the event or exposure in which the injury or
illness was produced or inflicted. In addition, the survey includes
two measures of severity for lost work-time cases: median number
of workdays lost and a percent distribution of days-away-from-work
cases by their duration. The latter measures are presented nation-
wide by industry and for the aforementioned worker and case char-
acteristics.
In addition to injury and illness counts, the survey also reports
on the frequency (incidence rate) of such cases. Incidence rates
permit comparison among industries and establishments of vary-
ing sizes. They express various measures of injuries and illnesses in
terms of a constant, i.e., exposure hours in the work environment
(for example, 200,000 employee hours or the equivalent of 100
FTE employees working for 1 year), thus allowing for a common
statistical base across industries regardless of employment size of
establishments.
Incidence rates also are useful in evaluating the safety performance
of an industry over time or in comparing State-to-State variations
in an industrys safety record. Such comparisons are possible using
the total case rate or the rate for lost-workday cases, days-away-from-
work cases, or nonfatal cases that do not involve lost workdays.
These measures are available for injuries only and for injuries and
illnesses combined. For illnesses, rates are available for total cases
and separately for the seven illness categories (see Chapters 1 and
3). Rates for days-away-from-work injuries and illnesses are also
available for the various categories of the four case characteristics
Appendix B Data and Analysis Methods
studied, for example, the incidence rates associated with carpal tun-
nel syndrome, back cases, injuries inflicted by health care patients,
or disabling falls to a lower level.
Incidence Rate Calculation
Incidence rates are calculated using the total obtained through
BLS weighting and benchmarking procedures [BLS 2003]. The
adjusted estimates for a particular characteristic, for example injury
and illness cases involving days away from work, are aggregated to
the appropriate level of industry detail. The total is multiplied by
200,000 (the base number of hours worked by 100 full-time employ-
ees for one year). The product is then divided by the weighted and
benchmarked estimate of hours worked as reported in the survey
for the industry segment.
The formula for calculating the incidence rate at the lowest level of
industry detail is
(Sum of characteristic reported) 200,000
Incidence rate = ----------
(Sum of the number of hours worked)
Incidence rates for higher levels of industry detail are produced
using aggregated weighted and benchmarked totals. Rates may be
computed by industry, employment size, geographic area, extent or
outcome of case, and case characteristic category. Rates for illnesses
and rates for case characteristic categories are published per 10,000
full-time employees using 20,000,000 hours instead of 200,000
hours in the formula shown above. Rates per 10,000 workers can be
converted to rates per 100 workers by moving the decimal point left
two places and rounding the resulting rate to the nearest tenth.
323
 Appendix B Data and Analysis Methods

State Participation The benchmark factor for the industry is less than 0.90 or
greater than 1.49.
Federal grants covering portions of the operating costs permit
States to develop estimates of occupational injuries and illnesses
Publication might disclose confidential information.
and to provide the data from which BLS produces national results.
National data for selected States that do not have operational Data for an unpublished industry are included in the total for the
grants are collected directly by BLS. The participating State agen- broader industry level. In addition, selected items of data are sup-
cies collect and process the data and prepare estimates using stan- pressed for publishable industries if the sampling error for the esti-
dardized procedures established by BLS to insure uniformity and
mate exceeds a specified limit, typically 60% at the national level.
consistency among the States. To further insure comparability and
reliability, BLS designs and identifies the survey sample for each
For the case characteristics and demographic data, items of data
State. Through its regional offices, BLS validates the survey results
and provides technical assistance to the State agencies on a con- are suppressed at the national level if one of the following situa-
tinuing basis. tions occurred:

The number of cases is fewer than five.

Publication Guidelines
The number of cases is greater than 5 and fewer than
The estimating procedure generates occupational injury and ill-
ness estimates for approximately 900 SIC codes. Industry estimates or equal to 20 and the sampling error for the estimate is
are not published if one of the following situations occurs: greater than 60%.

Estimates for the industry are based on reports from fewer The number of cases is greater than 20 and the sampling
than three companies; the industry had fewer than six error is greater than 40%.
employees; or, if three or more companies report data
for the industry, one firm employs more than 60% of the For further information, contact
workers. U.S. Bureau of Labor Statistics
OCWC/OSHSuite 3180
Average employment for the industry was fewer than
2 Massachusetts Avenue, NE
10,000 in the survey year. However, data for an industry
Washington, DC 202120001
with an annual average employment of less than 10,000
Nonfatal summary information: 2026916179
can be published if most of the employment was reported
Nonfatal case and demographic information: 2026916170
in the survey.
Fax: 2026916196
The relative standard error on total lost-workday cases for Nonfatal injuries and illnesses questions: oshstaff@bls.gov
the industry exceeds a specified limit. www.bls.gov/iif/

324

References
Anderson RN, Rosenberg HM [1998]. Age standardization of
death rates: implementation of the year 2000 standard. Natl
Vital Stat Rep 47(3). [www.cdc.gov/nchs/data/nvsr/nvsr47/nvs47_
03.pdf]
BLS (Bureau of Labor Statistics) [2001]. Employment and earn-
ings 48(1):246251.
BLS [2002]. Personal communication from staff of the U.S. Depart-
ment of Labor, Bureau of Labor Statistics, Census of Fatal Occupa-
tional Injuries (CFOI), September 17, 2002.
BLS [2003a]. Current population survey. Washington, DC: U.S.
Department of Labor, Bureau of Labor Statistics. [www.bls.gov/
news.release/pdf/empsit.pdf] Date accessed: June 2003.
BLS [2003b]. BLS handbook of methods. Chapter 9. Occupa-
tional safety and health statistics. Part 1. Estimation procedures.
Appendix B Data and Analysis Methods
[www.bls.gov/opub/hom/pdf/homch9.pdf] (Also, see HTML ver-
sion on the BLS Web site. [www.bls.gov/opub/hom/homch9_h.ht
m#Estimation%20Procedures])
Census [1982]. 1980 census of population: alphabetical index
of industries and occupations. Washington, DC: U.S. Census
Bureau.
Census [1992]. 1990 census of population and housing: alphabeti-
cal index of industries and occupations. Washington, DC: U.S. Cen-
sus Bureau, GPO Publication CPH-R3.
MSHA [2002]. Part 50 data users handbook. Denver, CO: U.S.
Department of Labor, Mine Safety and Health Administration,
Program Evaluation and Information Resources. [www.msha.gov/
STATS/PART50/P50Y2K/P50Y2KHB.PDF]
OMB [1987]. Standard industrial classification manual. Washing-
ton, DC: Office of Management and Budget.
325
T he bibliography provides the user with a variety of reference
materials from the public domain, including data tables, report
forms and documentation, government news releases, and research ar-
ticles. This information is organized by program or agency. Electronic
files [text (*.txt) or Adobe Acrobat (*.pdf)] are available on the Web
at www.cdc.gov/niosh/docs/chartbook/ and on CDROM [DHHS
(NIOSH) Publication No. 2004146C]. This Appendix provides the
user with the file name at the end of the citation (name.extension),
which is followed by an internet link, if available.
Adult Blood Lead Epidemiology
and Surveillance (ABLES)
Program
CDC (Centers for Disease Control and Prevention) [2002]. Adult
blood lead epidemiology and surveillanceUnited States, 1998
2001. MMWR 51(SS11):110 (SS5111.pdf). [www.cdc.gov/mmwr/
PDF/SS/SS5111.pdf]
Bureau of the Census (CENSUS)
Census [2003]. Census 2000 special equal employment opportu-
nity (EEO) tabulation. Subject matter descriptions of variable on
the Special EEO Tabulation. Washington, DC: U.S. Department
of Commerce, Economics and Statistics Administration, U.S. Bureau
of the Census, Housing and Household Economic Statistics Division
(descrvar.pdf). [www.census.gov/hhes/www/eeoindex/descrvar.pdf]
Census [2003]. County business patternsUnited States: 2001.
Washington, DC: U.S. Department of Commerce, Economics and
Statistics Administration, U.S. Bureau of the Census (cbp01-1.pdf).
[www.census.gov/prod/2003pubs/01cbp/cbp01-1.pdf]
Census of Fatal Occupational
Injuries (CFOI)
BLS [2002]. National census of fatal occupational injuries in 2001.
USDL 02541. September 25, 2002. Washington, DC: U.S. Department
of Labor, Bureau of Labor Statistics, Safety and Health Statistics Program
(cfnr0008.pdf). [www.bls.gov/iif/oshwc/cfoi/cfnr0008.pdf]
BLS [2003]. National census of fatal occupational injuries in 2002.
USDL 03488. September 17, 2003. Washington, DC: U.S. Department
of Labor, Bureau of Labor Statistics, Safety and Health Statistics
Program (cfoi.pdf). [www.bls.gov/news.release/pdf/cfoi.pdf]
327
Appendix C Bibliography
BLS [2003]. Census of fatal occupational injuries. Special tabu-
lationFatal occupational injuries to younger workers (17-)
by selected characteristics, 19922002. Washington, DC: U.S.
Department of Labor, Bureau of Labor Statistics, Safety and Health
Statistics Program (Fatal occupational injuries to younger workers
(17-), 1992-2002.pdf).
BLS [2003]. Census of fatal occupational injuries. Special tabula-
tionFatal occupational injuries to all workers by selected charac-
teristics, 19922002. Washington, DC: U.S. Department of Labor,
Bureau of Labor Statistics, Safety and Health Statistics Program
(Fatal occupational injuries to all workers, 1992-2002.pdf).
BLS [2003]. Census of fatal occupational injuries. Special tabula-
tionFatal occupational injuries to older workers (55+) by selected
characteristics, 19922002. Washington, DC: U.S. Department of
Labor, Bureau of Labor Statistics, Safety and Health Statistics
Program (Fatal occupational injuries to older workers, 1992-
2002.pdf).
BLS [2003]. Census of fatal occupational injuries. Special tabulation
Fatal occupational injuries to Hispanic workers by selected character-
istics, 19922002. Washington, DC: U.S. Department of Labor, Bureau
of Labor Statistics, Safety and Health Statistics Program (Fatal occupa-
tional injuries to Hispanic workers, 1992-2002.pdf).
Center to Protect Workers
Rights (CPWR)
Pollack ES, Chowdhury RT [2001]. Trends in work-related
deaths and injury rates among U.S. construction workers, 1992
1998. Washington, DC: The Center to Protect Workers Rights
(krdeaths.pdf). [www.cpwr.com/krdeaths.pdf]
328
Current Population Survey (CPS)
BLS [1997]. BLS handbook of methods. Chapter 1. Labor force
data derived from the Current Population Survey (homch1.pdf).
[www.bls.gov/opub/hom/pdf/homch1.pdf]
BLS [2001]. 2001 household data annual averages, Tables 149.
Current population survey. Washington, DC: U.S. Department
of Labor, Bureau of Labor Statistics (cpsa2001.pdf). [ftp://
ftp.bls.gov/pub/special.requests/lf/aa2001/pdf/cpsa2001.pdf]
BLS [2002]. Current population survey. BLS releases new 2000
2010 employment projections. Washington, DC: U.S. Department
of Labor, Bureau of Labor Statistics, Office of Occupational Statistics
and Employment Projections (ecopro.txt). [ftp://ftp.bls.gov/pub/
news.release/History/ecopro.12032001.news]
BLS [2003]. Current population survey. State and regional unem-
ployment, 2002 annual averages. Washington, DC: Department of
Labor, Bureau of Labor Statistics (srgune.pdf). [www.bls.gov/lau/
srgune.pdf]
Fullerton FN, Toossi M [2001]. Labor force projections to 2010: steady
growth and changing composition. Mon Labor Rev 124(11):2138
(Art2full.pdf). [www.bls.gov/opub/mlr/2001/11/art2full.pdf]
Hecker DE [2001]. Occupational employment projections to 2010. Mon
Labor Rev 124(11):5784 (Art4full.pdf). [www.bls.gov/opub/mlr/2001/
11/art4full.pdf]
Mine Safety and Health
Administration (MSHA)
MSHA [1986]. Report on 30 CFR Part 50. Washington, DC: U.S.
Department of Labor, Mine Safety and Health Administration
(rptonpart50.pdf). [www.msha.gov/stats/part50/rptonpart50.pdf]

MSHA [2002]. Part 50diskette users handbook. Coding manual.
Washington, DC: U.S. Department of Labor, Mine Safety and Health
Administration (d_aicodes.pdf). [www.msha.gov/stats/part50/p50y2k/
p50y2khb.pdf] and [www.cdc.gov/niosh/mining/topics/data/images-
pdfs/codes.pdf]
MSHA [2004]. Mine accident, injury, and illness report. Washington,
DC: U.S. Department of Labor, Mine Safety and Health Administration.
(7000-1.pdf). [www.msha.gov/forms/elawsforms/7000-1.htm] and
[www.msha.gov/FORMS/7000-1.pdf]
MSHA [2004]. Quarterly mine employment and coal production
report. Washington, DC: U.S. Department of Labor, Mine Safety
and Health Administration (7000-2.pdf). [www.msha.gov/forms/
forms.htm] and [www.msha.gov/forms/7000-2.pdf].
National Agricultural Workers
Survey (NAWS)
DOL [2000]. Findings from the National Agricultural Workers
Survey (NAWS) 19971998: a demographic and employment profile
of United States farm workers. Research Report No. 8. Washington,
DC: U.S. Department of Labor, Office of the Assistant Secretary for
Policy. March 2000 (report_8.pdf). [www.dol.gov/asp/programs/
agworker/report_8.pdf]
NIOSH Reports
Adekoya N, Pratt SG [2001]. Fatal unintentional farm injuries
among persons less than 20 years of age in the United States: geo-
graphic profiles. Cincinnati, OH: U.S. Department of Health and
Human Services, Public Health Service, Centers for Disease Control
Appendix C Bibliography
and Prevention, National Institute for Occupational Safety and
Health, DHHS (NIOSH) Publication No. 2001131 (childag2.pdf).
[www.cdc.gov/niosh/childag/pdfs/Childag2.pdf]
Myers JR, Hendricks KJ [2001]. Injuries among youth on farms in
the United States, 1998. U.S. Department of Health and Human
Services, Public Health Service, Centers for Disease Control
and Prevention, National Institute for Occupational Safety and
Health, DHHS (NIOSH) Publication No. 2001154 (2001154.pdf).
[www.cdc.gov/niosh/childag/pdfs/2001154.pdf]
NIOSH [2000]. Worker health chartbook, 2000. Cincinnati, OH:
U.S. Department of Health and Human Services, Public Health
Service, Centers for Disease Control and Prevention, National
Institute for Occupational Safety and Health, DHHS (NIOSH)
Publication No. 2001127 (2000-127.pdf). [www.cdc.gov/niosh/
pdfs/2000-127.pdf]
NIOSH [2000]. Injuries, illnesses, and hazardous exposures in the
mining industry, 19861995: a surveillance report. Cincinnati, OH:
U.S. Department of Health and Human Services, Public Health
Service, Centers for Disease Control and Prevention, National
Institute for Occupational Safety and Health, DHHS (NIOSH)
Publication No. 2000117 (iiahe.pdf). [www.cdc.gov/niosh/mining/
pubs/pdfs/iiahe.pdf]
NIOSH [2001]. Fatal injuries to civilian workers in the United States,
19801995 (National Profile). Cincinnati, OH: U.S. Department
of Health and Human Services, Public Health Service, Centers
for Disease Control and Prevention, National Institute for
Occupational Safety and Health, DHHS (NIOSH) Publication No.
2001129 (ntof2fbc.pdf). [www.cdc.gov/niosh/NTOF2000/pdfs/
ntof2fbc.pdf]
NIOSH [2001]. Tracking occupational injuries, illnesses, and haz-
ards: the NIOSH surveillance strategic plan. Cincinnati, OH: U.S.
329
Appendix C Bibliography
Department of Health and Human Services, Public Health Service,
Centers for Disease Control and Prevention, National Institute for
Occupational Safety and Health, DHHS (NIOSH) Publication No.
2001118 (2001-118.pdf). [www.cdc.gov/niosh/pdfs/2001-118.pdf]
NIOSH [2003]. Work-related lung disease surveillance report, 2002.
Cincinnati, OH: U.S. Department of Health and Human Services,
Public Health Service, Centers for Disease Control and Prevention,
National Institute for Occupational Safety and Health, DHHS
(NIOSH) Publication No. 2003111 (2003-111.pdf). [www.cdc.gov/
niosh/docs/2003-111/pdfs/2003-111.pdf]
Sentinel Event Notification
System for Occupational Risk
(SENSOR)
Rosenman KD, Reilly MJ, Simms A, Panasuk B [2002]. 2001
Annual report on occupational noise-induced hearing loss in
Michigan. Joint reportMichigan State University, Department
of Medicine, and the Michigan Department of Consumer and
Industry Services, Occupational Health Division (01NIHL_all.pdf).
[www.chm.msu.edu/oem/hearing/01NIHL_all.pdf]
Massachusetts Department of Public Health [2000]. Work re-
lated injuries to teens in Massachusetts surveillance update:
19931999. Teens at work: injury surveillance and intervention
project. Massachusetts Department of Public Health. Bureau of
Health Statistics, Research, and Evaluation, Occupational Health
Surveillance Program (Twispp.pdf). [www.state.ma.us/dph/bhsre/
ohsp/teens/teeninj.htm]
330
Survey of Occupational Injuries
and Illnesses (SOII)
Documentation
BLS [1997]. BLS handbook of methods. Chapter 9. Occupational
safety and health statistics. Washington, DC: U.S. Department of
Labor, Bureau of Labor Statistics (homch9.pdf). [www.bls.gov/
opub/hom/pdf/homch9.pdf]
BLS [2003]. Occupational injuries and illnesses: counts, rates,
and characteristics, 2001. Appendix E. Survey report form and
instructions. Washington, DC: U.S. Department of Labor, Bureau
of Labor Statistics, Safety and Health Statistics Program, Bulletin
2560 (Appendix E - Survey Report Form and Instructions.pdf).
[www.bls.gov/iif/oshsum.htm]
DOL [2000]. Report on the youth labor force. Chapter 6. Occupa-
tional injuries, illnesses, and fatalities. Washington, DC: U.S.
Department of Labor (ryl2000.pdf). [www.bls.gov/opub/rylf/pdf/
rylf2000.pdf]
OSHA [2002]. OSHA No. 101. Supplementary record of occupa-
tional injuries and illnesses. Washington, DC: U.S. Department of
Labor (osha101.pdf).
OSHA [2002]. OSHA No. 200. Log and summary of occupational
injuries and illnesses. Washington, DC: U.S. Department of Labor,
(osha200form-all-in-1.pdf).
News Releases
BLS [2002]. Workplace injuries and illnesses in 2001. News,
December 19, 2002; USDL 02687. Washington, DC: U.S.
Department of Labor, Bureau of Labor Statistics, Safety and Health

Statistics Program (osnr0016.pdf). [www.bls.gov/iif/oshwc/osh/os/
osnr0016.pdf]
BLS [2003]. Lost worktime injuries and illnesses: characteristics
and resulting days away from work, 2001. News, March 27, 2003;
USDL 03138. Washington, DC: U.S. Department of Labor,
Bureau of Labor Statistics, Safety and Health Statistics Program
(osnr0017.pdf). [www.bls.gov/iif/oshwc/osh/case/osnr0017.pdf]
Selected Tables
BLS [1997]. Survey of occupational injuries and illnesses. Nonfatal
(OSHA recordable) injuries and illnesses. Nonfatal occupa-
tional illnesses by category of illness, private industry, 19921996.
Washington, DC: U.S. Department of Labor, Bureau of Labor
Statistics, Safety and Health Statistics Program (ostb0523.pdf).
[www.bls.gov/iif/oshwc/osh/os/ostb0523.pdf]
BLS [1998]. Survey of occupational injuries and illnesses. Nonfatal
(OSHA recordable) injuries and illnesses. Nonfatal occupa-
tional illnesses by category of illness, private industry, 19931997.
Washington, DC: U.S. Department of Labor, Bureau of Labor
Statistics, Safety and Health Statistics Program (ostb0628.pdf).
[www.bls.gov/iif/oshwc/osh/os/ostb0628.pdf]
BLS [1999]. Survey of occupational injuries and illnesses. Nonfatal
(OSHA recordable) injuries and illnesses. Nonfatal occupa-
tional illnesses by category of illness, private industry, 19941998.
Washington, DC: U.S. Department of Labor, Bureau of Labor
Statistics, Safety and Health Statistics Program (ostb0746.pdf).
[www.bls.gov/iif/oshwc/osh/os/ostb0746.pdf]
BLS [2000]. Survey of occupational injuries and illnesses. Nonfatal
(OSHA recordable) injuries and illnesses. Supplemental Table
S08. Nonfatal occupational illnesses by category of illness, private
industry, 19951999. Washington, DC: U.S. Department of Labor,
Appendix C Bibliography
Bureau of Labor Statistics, Safety and Health Statistics Program
(ostb0874.pdf). [www.bls.gov/iif/oshwc/osh/os/ostb0874.pdf]
BLS [2001]. Survey of occupational injuries and illnesses. Nonfatal
(OSHA recordable) injuries and illnesses. Supplemental Table
S08. Nonfatal occupational illnesses by category of illness, private
industry, 19962000. Washington, DC: U.S. Department of Labor,
Bureau of Labor Statistics, Safety and Health Statistics Program
(ostb0995). [www.bls.gov/iif/oshwc/osh/os/ostb0995.pdf]
BLS [2002]. Survey of occupational injuries and illnesses. Nonfatal
(OSHA recordable) injuries and illnesses. Supplemental Table
S08. Nonfatal occupational illnesses by category of illness, private
industry, 19972001. Washington, DC: U.S. Department of Labor,
Bureau of Labor Statistics, Safety and Health Statistics Program
(ostb1118.pdf). [www.bls.gov/iif/oshwc/osh/os/ostb1118.pdf]
BLS [2002]. Survey of occupational injuries and illnesses. Nonfatal
(OSHA recordable) injuries and illnesses. Supplemental Table
S19. Nonfatal occupational injury and illness incidence rates per
100 full-time workers, private industry, 2001. Washington, DC: U.S.
Department of Labor, Bureau of Labor Statistics, Safety and Health
Statistics Program (ostb1143.pdf). [www.bls.gov/iif/oshwc/osh/
os/ostb1143.pdf]
BLS [2002]. Survey of occupational injuries and illnesses. Nonfatal
(OSHA recordable) injuries and illnesses. Supplemental Table
S20. Number of nonfatal occupational injury and illness, pri-
vate industry, 2001. Washington, DC: U.S. Department of Labor,
Bureau of Labor Statistics, Safety and Health Statistics Program
(ostb1144.pdf). [www.bls.gov/iif/oshwc/osh/os/ostb1144.pdf]
BLS [2003]. Survey of occupational injuries and illnesses. Nonfatal
(OSHA recordable) injuries and illnesses. Table 11. Number of
331
Appendix C Bibliography
nonfatal occupational injuries and illnesses with days away from work
involving musculoskeletal disorders by selected worker and case char-
acteristics, 2001. Washington, DC: U.S. Department of Labor, Bureau
of Labor Statistics, Safety and Health Statistics Program (ostb1154.pdf).
[www.bls.gov/iif/oshwc/osh/case/ostb1154.pdf]
BLS [2003]. Survey of occupational injuries and illnesses. Nonfatal
(OSHA recordable) injuries and illnesses. Table R37. Number
of nonfatal injuries and illnesses involving days away from work
by industry and age of worker, 2001. Washington, DC: U.S.
Department of Labor, Bureau of Labor Statistics, Safety and
Health Statistics Program (ostb1192.pdf). [www.bls.gov/iif/oshwc/
osh/case/ostb1192.pdf]
BLS [2003]. Survey of occupational injuries and illnesses. Nonfatal
(OSHA recordable) injuries and illnesses. Table 38. Number of
nonfatal injuries and illnesses involving days away from work by in-
dustry and race or ethnic origin of worker, 2001. Washington, DC:
U.S. Department of Labor, Bureau of Labor Statistics, Safety and
Health Statistics Program (ostb1193.pdf). [www.bls.gov/iif/oshwc/
osh/case/ostb1193.pdf]
BLS [2003]. Survey of occupational injuries and illnesses. Nonfatal
(OSHA recordable) injuries and illnesses. Table R39. Number of
nonfatal injuries and illnesses involving days away from work by in-
dustry, sex, and length of service with employer, 2001. Washington,
DC: U.S. Department of Labor, Bureau of Labor Statistics, Safety
and Health Statistics Program (ostb1194.pdf). [www.bls.gov/iif/
oshwc/osh/case/ostb1194.pdf]
BLS [2003]. Survey of occupational injuries and illnesses. Nonfatal
(OSHA recordable) injuries and illnesses. Table 41. Number
of nonfatal injuries and illnesses involving days away from work
by occupation and age of worker, 2001. Washington, DC: U.S.
Department of Labor, Bureau of Labor Statistics, Safety and Health
332
Statistics Program (ostb1196.pdf). [www.bls.gov/iif/oshwc/osh/
case/ostb1196.pdf].
BLS [2003]. Survey of occupational injuries and illnesses. Nonfatal
(OSHA recordable) injuries and illnesses. Table R42. Number of
nonfatal injuries and illnesses involving days away from work by oc-
cupation and race or ethnic origin of worker, 2001. Washington,
DC: U.S. Department of Labor, Bureau of Labor Statistics, Safety
and Health Statistics Program (ostb1197.pdf). [www.bls.gov/iif/
oshwc/osh/case/ostb1197.pdf]
BLS [2003]. Survey of occupational injuries and illnesses. Nonfatal
(OSHA recordable) injuries and illnesses. Table R43. Number
of nonfatal injuries and illnesses involving days away from work
by occupation, sex, and length of service with employer, 2001.
Washington, DC: U.S. Department of Labor, Bureau of Labor
Statistics, Safety and Health Statistics Program (ostb1198.pdf).
[www.bls.gov/iif/oshwc/osh/case/ostb1198.pdf]
BLS [2003]. Survey of occupational injuries and illnesses. Nonfatal
(OSHA recordable) injuries and illnesses. Table R45. Number of
nonfatal injuries and illnesses involving days away from work by na-
ture of injury or illness and age of worker, 2001. Washington, DC:
U.S. Department of Labor, Bureau of Labor Statistics, Safety and
Health Statistics Program (ostb1200.pdf). [www.bls.gov/iif/oshwc/
osh/case/ostb1200.pdf]
BLS [2003]. Survey of occupational injuries and illnesses. Nonfatal
(OSHA recordable) injuries and illnesses. Table R66. Number and
percent distribution of nonfatal injuries and illnesses involving days
away from work by occupation and number of days away from work,
2001. Washington, DC: U.S. Department of Labor, Bureau of Labor
Statistics, Safety and Health Statistics Program (ostb1221.pdf).
[www.bls.gov/iif/oshwc/osh/case/ostb1221.pdf]

BLS [2003]. Survey of occupational injuries and illnesses. Nonfatal
(OSHA recordable) injuries and illnesses. Table R67. Number and
percent distribution of nonfatal injuries and illnesses involving days
away from work by nature of injury or illness and number of days
away from work, 2001. Washington, DC: U.S. Department of Labor,
Bureau of Labor Statistics, Safety and Health Statistics Program
(ostb1222.pdf). [www.bls.gov/iif/oshwc/osh/case/ostb1222.pdf]
BLS [2003]. Survey of occupational injuries and illnesses. Nonfatal
(OSHA recordable) injuries and illnesses. Table R68. Number and
percent distribution of nonfatal injuries and illnesses involving
days away from work by part of body affected and number of days
away from work, 2001. Washington, DC: U.S. Department of Labor,
Bureau of Labor Statistics, Safety and Health Statistics Program
(ostb1223.pdf). [www.bls.gov/iif/oshwc/osh/case/ostb1223.pdf]
BLS [2003]. Survey of occupational injuries and illnesses. Nonfatal
(OSHA recordable) injuries and illnesses. Table R69. Number and
percent distribution of nonfatal injuries and illnesses involving days
away from work by source of injury or illness and number of days
Appendix C Bibliography
away from work, 2001. Washington, DC: U.S. Department of Labor,
Bureau of Labor Statistics, Safety and Health Statistics Program
(ostb1224.pdf). [www.bls.gov/iif/oshwc/osh/case/ostb1224.pdf]
BLS [2003]. Survey of occupational injuries and illnesses. Nonfatal
(OSHA recordable) injuries and illnesses. Table R70. Number and
percent distribution of nonfatal injuries and illnesses involving days
away from work by event or exposure leading to injury or illness
and number of days away from work, 2001. Washington, DC: U.S.
Department of Labor, Bureau of Labor Statistics, Safety and Health
Statistics Program (ostb1225.pdf). [www.bls.gov/iif/oshwc/osh/
case/ostb1225.pdf]
BLS [2003]. Survey of occupational injuries and illnesses. Nonfatal
(OSHA recordable) injuries and illnesses. Table R71. Number of
injuries and illnesses involving days away from work by selected
worker characteristics and number of days away from work, 2001.
Washington, DC: U.S. Department of Labor, Bureau of Labor
Statistics, Safety and Health Statistics Program (ostb1226.pdf).
[www.bls.gov/iif/oshwc/osh/case/ostb1226.pdf]
333
T he following index is provided for readers of the Chartbook to
locate information in figures or tables by page number. To
enhance the use of this information, the HTML version of the
214215, 233, 238, 242,
263265, 267, 275, 285
age-adjusted mortality rates . . . . . . . . . . . 149, 155, 158, 162, 170,
index provides a hyperlink to each figure or table.
239

Keyword . . . . . . . . . . . . . . . . . . . . . Page number agent, agent categories . . . . . . . . . . . . . . 141, 144

abdomen . . . . . . . . . . . . . . . . . . . . . . . . . . 29 agriculture . . . . . . . . . . . . . . . . . . . . . . . . 9, 15, 17, 26, 3839, 50,
54, 63, 6869, 7980,
ABLES . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5657
8486, 9293, 9899,
accidents (see transportation) 104105, 111112, 117
118, 124125, 130131,
acetylcholinesterase inhibitors . . . . . . . . 141
139140, 187188, 195
AChE inhibitors (see acetylcholinesterase inhibitors) 200, 202204, 207211,
213214, 216219, 224,
administrative, administrators . . . . . . . . . 8, 10, 25, 38, 49, 63, 68,
263, 269, 273, 280, 282,
71, 79, 92, 98, 104, 111,
286, 289
117, 124, 130, 143, 187,
269, 272, 279, 282, 286, AIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
289
support . . . . . . . . . . . . . . . . . . . . . . . . 8 air transportation . . . . . . . . . . . . . . . . . . . 16, 198

adolescents . . . . . . . . . . . . . . . . . . . . . . . . 275276 aircraft . . . . . . . . . . . . . . . . . . . . . . . . . . . 50, 280, 287

age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5, 23, 36, 47, 53, 61, 66, 77, Alabama . . . . . . . . . . . . . . . . . . . . . . . . . . 57

83, 89, 96, 102, 108, 115,
Alaska . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13, 46, 60, 149, 199, 203
121, 128, 139, 185, 196,
199200, 203, 205207, Alaska Native . . . . . . . . . . . . . . . . . . . . . . 24, 37, 48, 67, 78, 186,

335
Index
196, 207208, 265, 268,
279, 284, 287
algaecide (see algicide)
algicide . . . . . . . . . . . . . . . . . . . . . . . . . . . 141
all-terrain vehicles . . . . . . . . . . . . . . . . . . 209, 211
American Indian . . . . . . . . . . . . . . . . . . . 24, 37, 48, 67, 78, 186,
196, 207208, 265, 268,
279, 284, 287
amputations . . . . . . . . . . . . . . . . . . . . . . . 2728, 8893
animals . . . . . . . . . . . . . . . . . . . . . . . . . . . 197, 200
anxiety . . . . . . . . . . . . . . . . . . . . . . . . . . . 3539
Appalachian, Appalachian States . . . . . . 162, 165
Arizona . . . . . . . . . . . . . . . . . . . . . . . . . . . 57, 203
arm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
asbestosis . . . . . . . . . . . . . . . . . . . . . . . . . . 152153, 155156
Asian . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7, 24, 37, 48, 67, 78, 186,
196, 207208, 265, 268,
279, 284, 287
assaults . . . . . . . . . . . . . . . . . . . . . . . . . . . 30, 5051, 270, 280, 287
assemblers . . . . . . . . . . . . . . . . . . . . . . . . . 26
asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143144
attendants . . . . . . . . . . . . . . . . . . . . . . . . . 26
ATVs (see all-terrain vehicles)
back, back pain . . . . . . . . . . . . . . . . . . . . 2829, 59, 9599
bakeries (retail) . . . . . . . . . . . . . . . . . . . . 276
336
belting . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156
bending . . . . . . . . . . . . . . . . . . . . . . . . . . 246
black
lung . . . . . . . . . . . . . . . . . . . . . . . . . . . 161163, 165, 239
workers . . . . . . . . . . . . . . . . . . . . . . . . 69, 24, 37, 48, 62, 67, 78,
84, 91, 97, 103, 110, 116,
123, 129, 147, 150, 153,
186, 196, 207208, 238,
265, 268, 279, 284, 287
bloodborne . . . . . . . . . . . . . . . . . . . . . . . . 4142
boat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 197
building . . . . . . . . . . . . . . . . . . . . . . . . 156
repair . . . . . . . . . . . . . . . . . . . . . . . . . . 156
bodily
exertion . . . . . . . . . . . . . . . . . . . . . . . . 30
reaction . . . . . . . . . . . . . . . . . . . . . . . . 30
body
part . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
systems . . . . . . . . . . . . . . . . . . . . . . . . 2829
boilermakers . . . . . . . . . . . . . . . . . . . . . . . 156
bricklayers, brickmasons . . . . . . . . . . . . . 242243, 245, 247
bruise, bruises . . . . . . . . . . . . . . . . . . . . . 2728, 101105, 276
bullets . . . . . . . . . . . . . . . . . . . . . . . . . . . . 197
burns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2728, 107112, 276
bus drivers . . . . . . . . . . . . . . . . . . . . . . . . 26
business . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
byssinosis . . . . . . . . . . . . . . . . . . . . . . . . . . 152153, 158159
 Index

California . . . . . . . . . . . . . . . . . . . . . . . . . 21, 46, 60, 71, 74, 134, clarifying machine operators . . . . . . . . . 156
137, 174, 177, 182, 198,
cleaners . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
203
cleaning materials . . . . . . . . . . . . . . . . . . 144
carpal tunnel syndrome . . . . . . . . . . . . . . 2728, 59, 6569, 71
clerks, clerical . . . . . . . . . . . . . . . . . . . . . . 10
carpenters . . . . . . . . . . . . . . . . . . . . . . . . . 26, 242243, 245, 248
climbing . . . . . . . . . . . . . . . . . . . . . . . . . . 246
cash grain . . . . . . . . . . . . . . . . . . . . . . . . . 204
clinicians . . . . . . . . . . . . . . . . . . . . . . . . . . 5354
cashier, cashiers . . . . . . . . . . . . . . . . . . . . 10, 71
coal, coal mining . . . . . . . . . . . . . . . . . . . 163, 166, 226229, 231234,
casting machine operators . . . . . . . . . . . 171
237, 239
category
coal workers pneumoconiosis . . . . . . . . 152153, 161163, 165,
1/0 . . . . . . . . . . . . . . . . . . . . . . . . . . . 161
239
2/1 . . . . . . . . . . . . . . . . . . . . . . . . . . . 161
Colorado . . . . . . . . . . . . . . . . . . . . . . . . . . 170, 203
cattle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204
commodity . . . . . . . . . . . . . . . . . . . . . . . . 226, 228229, 231234
caught in . . . . . . . . . . . . . . . . . . . . . . . . . . 198
equipment . . . . . . . . . . . . . . . . . . . . . 30 communication analyst . . . . . . . . . . . . . . 10
object . . . . . . . . . . . . . . . . . . . . . . . . . 30
communications . . . . . . . . . . . . . . . . . . . . 9
causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49, 149, 198, 200
company, companies . . . . . . . . . . . . . . . . 5354
caving rock . . . . . . . . . . . . . . . . . . . . . . . . 230
computer
(from in place) . . . . . . . . . . . . . . . . . . 234
administrators . . . . . . . . . . . . . . . . . . . 10
checking . . . . . . . . . . . . . . . . . . . . . . . . . . 71 engineers . . . . . . . . . . . . . . . . . . . . . . 10
managers . . . . . . . . . . . . . . . . . . . . . . . 10
chemical
specialists . . . . . . . . . . . . . . . . . . . . . . 10
burns . . . . . . . . . . . . . . . . . . . . . . . . . . 2728
support . . . . . . . . . . . . . . . . . . . . . . . . 10
class . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141 system managers . . . . . . . . . . . . . . . . . 10
products . . . . . . . . . . . . . . . . . . . . . . . 29 systems . . . . . . . . . . . . . . . . . . . . . . . . 10
systems analysts . . . . . . . . . . . . . . . . . . 10
chemicals . . . . . . . . . . . . . . . . . . . . . . . . . 29, 156
miscellaneous . . . . . . . . . . . . . . . . . . . 144, 150, 156 computing . . . . . . . . . . . . . . . . . . . . . . . . 71
chest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 condition . . . . . . . . . . . . . . . . . . . . . . . . . 216218
cholinesterase inhibitor (see acetylcholinesterase inhibitors) connective tissue . . . . . . . . . . . . . . . . . . . 59

337
Index
construction . . . . . . . . . . . . . . . . . . . . . . . 89, 15, 17, 2526, 3839,
50, 54, 63, 6869, 7980,
8486, 9293, 9899, 104
105, 111112, 117118,
124125, 130131, 140,
150, 169, 187188, 224,
242, 244, 263, 269, 273,
280, 282, 286, 289
industry . . . . . . . . . . . . . . . . . . . . . . . . 242243, 245, 247258
laborers . . . . . . . . . . . . . . . . . . . . . . . . 26, 242243, 245, 252
materials . . . . . . . . . . . . . . . . . . . . . . . 156
trades . . . . . . . . . . . . . . . . . . . . . . . . . . 242
workers . . . . . . . . . . . . . . . . . . . . . . . . 246
contact with
electric current . . . . . . . . . . . . . . . . . . 244
equipment . . . . . . . . . . . . . . . . . . . . . 30
objects . . . . . . . . . . . . . . . . . . . . . . . . . 30, 5051
contacts . . . . . . . . . . . . . . . . . . . . . . . . . . . 270, 280, 287
containers . . . . . . . . . . . . . . . . . . . . . . . . . 29
contractor (mining) . . . . . . . . . . . . . . . . 226, 228229, 231237
contributing cause of death . . . . . . . . . . 146, 149, 152, 155, 158,
162, 165, 169
contusion, contusions . . . . . . . . . . . . . . . 2728, 101105, 276
courier services . . . . . . . . . . . . . . . . . . . . . 16
craft . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8, 25, 38, 49, 63, 68, 71,
79, 92, 98, 104, 111, 117,
124, 130, 143, 168, 187,
269, 272, 279, 282, 286,
289
crawling . . . . . . . . . . . . . . . . . . . . . . . . . . 246
338
crop . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204, 217219
crude rate . . . . . . . . . . . . . . . . . . . . . . . . . 239
crushing . . . . . . . . . . . . . . . . . . . . . . . . . . 276
crushing machine operators . . . . . . . . . . 171
CTS (see carpal tunnel syndrome)
current (see electric current)
customer service representatives . . . . . . . 10
customer services . . . . . . . . . . . . . . . . . . . 71
cut, cuts . . . . . . . . . . . . . . . . . . . . . . . . . . . 2728, 114118, 276
cutters . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166, 242243, 245, 258
CWP (see coal workers pneumoconiosis)
dairy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204
data
communication analyst . . . . . . . . . . . 10
entry . . . . . . . . . . . . . . . . . . . . . . . . . . 71
sources . . . . . . . . . . . . . . . . . . . . . . . . 53, 143, 168, 275
database administrators . . . . . . . . . . . . . . 10
days away from work . . . . . . . . . . . . . . . . 15, 18, 2330, 3539,
5963, 6569, 7680, 82,
8893, 9599, 101105,
107112, 114118, 120
125, 127131, 184188,
245258, 264265, 270
273, 281282, 287289
death certificate . . . . . . . . . . . . . . . . . . . . 149, 155, 168
deaths . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146, 150, 195200, 239

Delaware . . . . . . . . . . . . . . . . . . . . . . . . . . 134, 155
department stores . . . . . . . . . . . . . . . . . . 16, 276
dermatitis . . . . . . . . . . . . . . . . . . . . . . . . . 184188, 216218
desktop publishers . . . . . . . . . . . . . . . . . . 10
disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1921, 7374, 133134,
136137, 173174, 176
177, 179, 181182
disinfectant . . . . . . . . . . . . . . . . . . . . . . . . 141
disorder, disorders . . . . . . . . . . . . . . . . . . 1920, 3539, 5963, 73
74, 133134, 181182
dredge . . . . . . . . . . . . . . . . . . . . . . . . . . . . 229, 231
drinking places . . . . . . . . . . . . . . . . . . . . . 16
drivers . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
drowning . . . . . . . . . . . . . . . . . . . . . . . . . 198, 200
drywall installers . . . . . . . . . . . . . . . . . . . . 242243, 245, 249
durable goods (manufacturing) . . . . . . . 9, 15, 17, 26, 263, 273,
282, 289
dust, dust disease . . . . . . . . . . . . . . . . . . . 1920, 173174, 230
eastern seaboard . . . . . . . . . . . . . . . . . . . 149
eating places . . . . . . . . . . . . . . . . . . . . . . . 16
electric, electrical . . . . . . . . . . . . . . . . . . . 230, 233234, 244
current . . . . . . . . . . . . . . . . . . . . . . . . 200, 244
lights . . . . . . . . . . . . . . . . . . . . . . . . . . 150
power . . . . . . . . . . . . . . . . . . . . . . . . . 150
electricians . . . . . . . . . . . . . . . . . . . . . . . . 26, 150, 166, 242243, 245,
250
Index
electrocution, electrocutions . . . . . . . . . 49, 198
elementary school teachers . . . . . . . . . . . 150
emergency departments . . . . . . . . . . . . . 8384, 8990, 108109,
121122, 275276
employed . . . . . . . . . . . . . . . . . . . . . . . . . 59, 47, 263
employer type (mining) . . . . . . . . . . . . . 226229, 231235, 237
employment . . . . . . . . . . . . . . . . . . . . . . . 59, 16, 24, 27, 47, 161,
226, 242, 244, 263
size (see size)
engineer, engineers . . . . . . . . . . . . . . . . . 10, 242243, 245, 253
environment, environments . . . . . . . . . . 198, 200, 270, 280, 287
equipment . . . . . . . . . . . . . . . . . . . . . . . . 29, 5051, 270, 280, 287
manufacturing . . . . . . . . . . . . . . . . . . 16
operators . . . . . . . . . . . . . . . . . . . . . . . 163
ergonomic . . . . . . . . . . . . . . . . . . . . . . . . 246
establishment . . . . . . . . . . . . . . . . . . . . . . 244
size (see size)
ethnicity . . . . . . . . . . . . . . . . . . . . . . . . . . 79, 24, 37, 48, 62, 67,
78, 84, 91, 97, 103, 110,
116, 123, 129, 186, 197,
210211, 214, 243, 265,
268, 279, 284289
event . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30, 5051, 244, 246, 270,
280, 287
exertion . . . . . . . . . . . . . . . . . . . . . . . . . . 30
experience . . . . . . . . . . . . . . . . . . . . . . . . 213, 216218, 228, 235
237
339
Index

explosion, explosions . . . . . . . . . . . . . . . 30, 5051, 198, 230, 270, Farmington coal mine explosion . . . . . . 227
280, 287
fatal, fatality, fatalities . . . . . . . . . . . . . . . 13, 4551, 197200, 224,
exposed, exposure . . . . . . . . . . . . . . . . . . 30, 5051, 141, 144, 238, 227, 229230, 239, 242
244, 246, 270, 280, 287 245, 247258, 264, 267
to harmful substances . . . . . . . . . . . . 30 270, 278280, 284287
extraction . . . . . . . . . . . . . . . . . . . . . . . . . 8 female, females . . . . . . . . . . . . . . . . . . . . 6, 89, 24, 36, 47, 51, 61,
66, 77, 83, 90, 96, 102,
extractive occupations . . . . . . . . . . . . . . . 163, 166 109, 115, 122, 128, 139,
eye . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2829 147, 150, 152, 185, 214,
fabric mill . . . . . . . . . . . . . . . . . . . . . . 159 234, 268, 275, 278, 285
fabricators . . . . . . . . . . . . . . . . . . . . . . 8, 25, 38, 49, 63, 68, 71, field crop . . . . . . . . . . . . . . . . . . . . . . . . . 204, 217219
79, 92, 98, 104, 111, 117,
124, 130, 143, 168, 187, filtering machine operators . . . . . . . . . . 156
269, 272, 279, 282, 286, finance, financial . . . . . . . . . . . . . . . . . . . 89, 15, 26, 3839, 50, 54,
289 63, 6869, 7980, 8486,
fall, falls, falling . . . . . . . . . . . . . . . . . . . . 30, 4951, 198, 200, 230, 9293, 9899, 104105,
233234, 245, 270, 280, 111112, 117118, 124
287 125, 130131, 187188,
of ground . . . . . . . . . . . . . . . . . . . . . . 233234 224, 263, 269, 273, 280,
to same level . . . . . . . . . . . . . . . . . . . . 30 282, 286, 289
to lower level . . . . . . . . . . . . . . . . . . . . 244 fine motor tasks . . . . . . . . . . . . . . . . . . . . 71
farm, farming . . . . . . . . . . . . . . . . . . . . . . 8, 25, 38, 4950, 63, 68, finger . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
71, 79, 92, 98, 104, 111,
117, 124, 130, 187, 204 fire, fires . . . . . . . . . . . . . . . . . . . . . . . . . . 30, 5051, 198, 200, 227,
205, 207211, 269270, 270, 280, 287
272, 279280, 282, 286 firearms . . . . . . . . . . . . . . . . . . . . . . . . . . . 200
287, 289
fishing . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89, 15, 17, 2526, 3839,
tractor (see tractor)
4950, 54, 63, 6869, 71,
type . . . . . . . . . . . . . . . . . . . . . . . . . . . 204
7980, 8486, 9293,
workers . . . . . . . . . . . . . . . . . . . . . . . . 26, 140, 213219
9899, 104105, 111
youths . . . . . . . . . . . . . . . . . . . . . . . . . 205207
112, 117118, 124125,
farmer (also see agriculture) . . . . . . . . . . 140 130131, 187188, 195

340

199, 202, 224, 263, 269,
272273, 279280, 282,
286, 289
boat . . . . . . . . . . . . . . . . . . . . . . . . . . . 197
fixtures . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
flame . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 200
floor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Florida . . . . . . . . . . . . . . . . . . . . . . . . . . . 46, 182, 198
follow-the-crop . . . . . . . . . . . . . . . . . . . . . 213
food
preparation . . . . . . . . . . . . . . . . . . . . . 10
service . . . . . . . . . . . . . . . . . . . . . . . . . 10
foot . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
footwear . . . . . . . . . . . . . . . . . . . . . . . . . . 156
forestry . . . . . . . . . . . . . . . . . . . . . . . . . . . 89, 15, 17, 2526, 3839,
4950, 54, 63, 6869, 71,
7980, 8486, 9293,
9899, 104105, 111112,
117118, 124125, 130
131, 187188, 195199,
202, 224, 263, 269, 272
273, 279280, 282, 286,
289
foundries . . . . . . . . . . . . . . . . . . . . . . . . . 171
fracture, fractures . . . . . . . . . . . . . . . . . . 2728, 120125, 276
frequency . . . . . . . . . . . . . . . . . . . . . . . . . 238
fruit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204, 217219
fumigant . . . . . . . . . . . . . . . . . . . . . . . . . . 141
Index
fungicide . . . . . . . . . . . . . . . . . . . . . . . . . . 141
furniture . . . . . . . . . . . . . . . . . . . . . . . . . . 29
gas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 230
gastrointestinal . . . . . . . . . . . . . . . . . . . . . 216
gender (see sex)
geographic distribution . . . . . . . . . . . . . . 13, 1718, 21, 46, 57, 60,
74, 134, 137, 146, 149,
155, 158, 162, 165, 170,
174, 177, 182, 198200,
203
Georgia . . . . . . . . . . . . . . . . . . . . . . . . . . . 158
glass, glass products . . . . . . . . . . . . . . . . . 42, 166
glues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144
goods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
government . . . . . . . . . . . . . . . . . . . . . . . 224
grader . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140
gravel (mining) . . . . . . . . . . . . . . . . . . . . 226, 228229, 231234,
238
grinding machine operators . . . . . . . . . . 171
grocery stores . . . . . . . . . . . . . . . . . . . . . . 16, 276
ground, ground surfaces . . . . . . . . . . . . . 29, 197
guns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 200
hand . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
molders . . . . . . . . . . . . . . . . . . . . . . . . 171
shapers . . . . . . . . . . . . . . . . . . . . . . . . 171
tools . . . . . . . . . . . . . . . . . . . . . . . . . . . 29, 205, 230, 233234
341
Index
handling materials . . . . . . . . . . . . . . . . . . 233234
handwriting . . . . . . . . . . . . . . . . . . . . . . . 71
harmful
environments . . . . . . . . . . . . . . . . . . . 5051, 270, 280, 287
substances . . . . . . . . . . . . . . . . . . . . . . 30, 270, 280, 287
harvesting machine . . . . . . . . . . . . . . . . . 197
hazard . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209, 211
head . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2829
health . . . . . . . . . . . . . . . . . . . . . . . . . . . . 216219
health care . . . . . . . . . . . . . . . . . . . . . . . . 4142, 143
patient . . . . . . . . . . . . . . . . . . . . . . . . . 29
professionals . . . . . . . . . . . . . . . . . . . . 168
workers . . . . . . . . . . . . . . . . . . . . . . . . 179
health information . . . . . . . . . . . . . . . . . . 10
health professionals . . . . . . . . . . . . . . . . . 53
hearing
conservation . . . . . . . . . . . . . . . . . . . . 54
loss . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5354, 238
tests . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
heat burns . . . . . . . . . . . . . . . . . . . . . . . . . 2728, 107112, 276
hepatitis B . . . . . . . . . . . . . . . . . . . . . . . . . 41
herbicide . . . . . . . . . . . . . . . . . . . . . . . . . 141
hernia . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
highway . . . . . . . . . . . . . . . . . . . . . . . . . . . 5051, 270, 280, 287
accident . . . . . . . . . . . . . . . . . . . . . . . . 244
hired worker . . . . . . . . . . . . . . . . . . . . . . . 205206, 208210
342
Hispanic workers . . . . . . . . . . . . . . . . . . . 68, 24, 37, 48, 62, 67,
78, 84, 91, 97, 103, 110,
116, 123, 129, 186, 197,
210211, 214, 243, 265,
268, 279, 284289
historical events . . . . . . . . . . . . . . . . . . . . 227
HIV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
hog . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204
hollow-bore needle . . . . . . . . . . . . . . . . . 4243
home care aides . . . . . . . . . . . . . . . . . . . . 10
homicide . . . . . . . . . . . . . . . . . . . . . . . . . . 49, 51, 198
horses . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209, 211
horticulture . . . . . . . . . . . . . . . . . . . . . . . 217219
hospital, hospitals . . . . . . . . . . . . . . . . . . 16, 53, 143, 168
workers . . . . . . . . . . . . . . . . . . . . . . . . 4243
hours worked . . . . . . . . . . . . . . . . . . . . . . 2324
household . . . . . . . . . . . . . . . . . . . . . . . . . 205206, 208211
housekeeping . . . . . . . . . . . . . . . . . . . . . . 42
HP (see hypersensitivity pneumonitis)
human service assistants . . . . . . . . . . . . . 10
hydrocarbons . . . . . . . . . . . . . . . . . . . . . . 144
hypersensitivity pneumonitis . . . . . . . . . . 146147
hypodermic needle . . . . . . . . . . . . . . . . . 42
Idaho . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
ignition . . . . . . . . . . . . . . . . . . . . . . . . . . . 230

Illinois . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21, 46, 74, 134, 137, 174
illness, illnesses . . . . . . . . . . . . . . . . . . . . . 1415, 1721, 2330, 3539,
5963, 6569, 71, 7374, information managers . . . . . . . . . . . . . . . 10
7680, 133134, 136137, injection . . . . . . . . . . . . . . . . . . . . . . . . . . 43
141, 173174, 176177,
181182, 184188, 224,
236237, 245258, 264
265, 270273, 281282,
287289
source . . . . . . . . . . . . . . . . . . . . . . . . . 29
incidence . . . . . . . . . . . . . . . . . . . . . . . . . 179
incident type . . . . . . . . . . . . . . . . . . . . . . . 230, 233234
incidents (see transportation)
independent contractor (mining) . . . . . 226, 228229, 231234,
236237
Indiana . . . . . . . . . . . . . . . . . . . . . . . . . . . 134, 137
indoor air pollution . . . . . . . . . . . . . . . . . 144
industrial . . . . . . . . . . . . . . . . . . . . . . . . . 26
chemicals . . . . . . . . . . . . . . . . . . . . . . 150, 156
machinery repair . . . . . . . . . . . . . . . . 159
premises . . . . . . . . . . . . . . . . . . . . . . . 50, 270, 280, 287
industry . . . . . . . . . . . . . . . . . . . . . . . . . . . 9, 1415, 17, 26, 3839,
50, 54, 63, 6869, 7980,
8486, 9293, 9899,
104105, 111112, 117
118, 124125, 130131,
139140, 144, 150, 156,
159, 163, 166, 169, 171,
187188, 224, 226, 228
230, 232239, 242258,
Index
263, 269, 273, 276, 280,
282, 286, 289
injury, injuries . . . . . . . . . . . . . . . . . . . . . 1319, 2330, 3539, 42,
4551, 5963, 6569, 71,
7680, 8286, 8893, 95
99, 101105, 107112,
114118, 120125, 127
131, 184188, 197198,
202211, 215, 224, 227
228, 231237, 242258,
264265, 267273, 275
276, 278282, 284289
source . . . . . . . . . . . . . . . . . . . . . . . . . 29
inorganic dusts . . . . . . . . . . . . . . . . . . . . . 144
insecticide . . . . . . . . . . . . . . . . . . . . . . . . . 141
installation . . . . . . . . . . . . . . . . . . . . . . . . 8
instruments . . . . . . . . . . . . . . . . . . . . . . . . 29
insulation worker . . . . . . . . . . . . . . . . . . . 156
insurance . . . . . . . . . . . . . . . . . . . . . . . . . 9, 15, 26, 3839, 50, 54,
63, 6869, 7980, 8486,
9293, 9899, 104105,
111112, 117118, 124
125, 130131, 187188,
224, 263, 269, 273, 280,
282, 286, 289
interviews . . . . . . . . . . . . . . . . . . . . . . . . . 54
intravenous line (access, insert) . . . . . . . 43
343
Index
Iowa . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 200, 203
iron . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171
ironworkers . . . . . . . . . . . . . . . . . . . . . . . 242243, 245, 251
isocyanates . . . . . . . . . . . . . . . . . . . . . . . . 144
IV (see intravenous)
janitors . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
job activity . . . . . . . . . . . . . . . . . . . . . . . . . 71
joint . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 216217
Kansas . . . . . . . . . . . . . . . . . . . . . . . . . . . . 182
Kentucky . . . . . . . . . . . . . . . . . . . . . . . . . . 198199
kilohertz . . . . . . . . . . . . . . . . . . . . . . . . . . 238
knee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
kneeling . . . . . . . . . . . . . . . . . . . . . . . . . . 233234
on object . . . . . . . . . . . . . . . . . . . . . . . 234
lab workers . . . . . . . . . . . . . . . . . . . . . . . . 42
labor force . . . . . . . . . . . . . . . . . . . . . . . . 59, 47, 242, 263
laborers . . . . . . . . . . . . . . . . . . . . . . . . . . . 8, 2526, 38, 49, 63, 68,
71, 79, 92, 98, 104, 111,
117, 124, 130, 143, 168,
187, 242243, 245, 252,
269, 272, 279, 282, 286,
289
lacerations . . . . . . . . . . . . . . . . . . . . . . . . 2728, 114118, 276
Latino (see Hispanic workers)
lead toxicity . . . . . . . . . . . . . . . . . . . . . . . 5657
344
leg . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
length of service . . . . . . . . . . . . . . . . . . . . 27
level . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 238
lifting . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30, 71
livestock . . . . . . . . . . . . . . . . . . . . . . . . . . 204205
loading . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
location (mining) . . . . . . . . . . . . . . . . . . 229231, 233
locomotive operating occupations . . . . . 163
logs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 197
loss of balance . . . . . . . . . . . . . . . . . . . . . 30
lost workday, lost workdays . . . . . . . . . . . 1415, 18, 82, 85, 231
235
lost-time . . . . . . . . . . . . . . . . . . . . . . . . . . 232235
Louisiana . . . . . . . . . . . . . . . . . . . . . . . . . 177
lower extremities . . . . . . . . . . . . . . . . . . . 28
lumber material . . . . . . . . . . . . . . . . . . . . 156
lung . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173174
disease . . . . . . . . . . . . . . . . . . . . . . . . . 1920
machine, machinery, machines . . . . . . . . 26, 29, 49, 197198, 200,
205, 230, 233234
operators . . . . . . . . . . . . . . . . . . . . . . . 156, 159, 163, 166, 171
repair . . . . . . . . . . . . . . . . . . . . . . . . . . 159
magnitude . . . . . . . . . . . . . . . . . . . . . . . . 1315, 1921, 28, 35, 41
43, 45, 59, 65, 71, 73, 76,
82, 88, 95, 101, 107, 114,
120, 127, 133134, 136,

143144, 146, 149, 152,
155, 158, 162, 165, 169,
173, 176177, 179, 181,
184, 195200, 202203,
205211, 213219, 224,
227, 230235, 239, 242
258, 267268, 270271,
278, 281, 284
Maine . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21, 74, 137, 149, 177
maintenance . . . . . . . . . . . . . . . . . . . . . . . 8, 42
male, males . . . . . . . . . . . . . . . . . . . . . . . . 6, 24, 36, 47, 51, 61, 66,
77, 83, 90, 96, 102, 109,
115, 122, 128, 139, 147,
150, 152, 185, 214, 234,
268, 275, 278, 285
management, manager, managerial . . . . 8, 10, 25, 38, 49, 63, 68,
71, 79, 92, 98, 104, 111,
117, 124, 130, 143, 187,
269, 272, 279, 282, 286,
289
manufacturing . . . . . . . . . . . . . . . . . . . . . 9, 15, 17, 26, 3839, 50,
54, 63, 6869, 7980,
8486, 9293, 9899,
104105, 111112, 117
118, 124125, 130131,
140, 144, 169, 187188,
224, 263, 269, 273, 280,
282, 286, 289
Massachusetts . . . . . . . . . . . . . . . . . . . . . . 275276
materials, material moving . . . . . . . . . . . 8, 29
equipment operators . . . . . . . . . . . . . 163
Index
mechanical suffocation . . . . . . . . . . . . . . 200
medical assistants . . . . . . . . . . . . . . . . . . . 10
medical devices . . . . . . . . . . . . . . . . . . . . 42
mesothelioma (malignant) . . . . . . . . . . . 149150
metal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 226229, 231236
mining . . . . . . . . . . . . . . . . . . . . . . . . . . . 163, 166, 171
processing machine operatives . . . . . 171
Michigan . . . . . . . . . . . . . . . . . . . . . . . . . . 21, 5354, 74, 134, 137,
177, 182
Mid-Atlantic . . . . . . . . . . . . . . . . . . . . . . . 182
Midwest . . . . . . . . . . . . . . . . . . . . . . . . . . . 21, 146, 206207
migrant farmworker . . . . . . . . . . . . . . . . . 213214, 216219
mills . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159, 229, 231
mine, miners . . . . . . . . . . . . . . . . . . . . . . 161, 235238
mineral
dusts . . . . . . . . . . . . . . . . . . . . . . . . . . 144
products . . . . . . . . . . . . . . . . . . . . . . . 171
mining . . . . . . . . . . . . . . . . . . . . . . . . . . . 9, 15, 17, 26, 3839, 50,
54, 63, 6869, 7980,
8486, 9293, 9899,
104105, 111112, 117
118, 124125, 130131,
161, 169, 171, 187188,
224, 226239, 263, 269,
273, 280, 282, 286, 289
machine operators . . . . . . . . . . . . . . . . . . 163, 166, 171
occupations . . . . . . . . . . . . . . . . . . . . . 163
345
Index
Minnesota . . . . . . . . . . . . . . . . . . . . . . . . . 203
minority . . . . . . . . . . . . . . . . . . . . . . . . . . 207209, 211
Mississippi, Mississippi Delta . . . . . . . . . . 18, 46, 203
Missouri . . . . . . . . . . . . . . . . . . . . . . . . . . 137, 200
mobile equipment . . . . . . . . . . . . . . . . . . 50, 270, 280, 287
molding machine operators . . . . . . . . . . 171
Montana . . . . . . . . . . . . . . . . . . . . . . . . . . 13, 46
mortality . . . . . . . . . . . . . . . . . . . . . . . . . . 146147, 149150, 152
153, 155156, 158159,
162163, 165166, 169
171, 239
rate . . . . . . . . . . . . . . . . . . . . . . . . . . . 239
ratios . . . . . . . . . . . . . . . . . . . . . . . . . . 150
motion . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
motor vehicles . . . . . . . . . . . . . . . . . . . . . 49, 198
manufacturing . . . . . . . . . . . . . . . . . . . . . 16
mountain States . . . . . . . . . . . . . . . . . . . . 146
moving . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
mowing machines . . . . . . . . . . . . . . . . . . 197
MSDs (see musculoskeletal disorders)
multiple
injuries . . . . . . . . . . . . . . . . . . . . . . . . 2728
parts . . . . . . . . . . . . . . . . . . . . . . . . . . 2829
muscle pain . . . . . . . . . . . . . . . . . . . . . . . 216217
musculoskeletal . . . . . . . . . . . . . . . . . . . . 59, 63, 216217, 246
disorders . . . . . . . . . . . . . . . . . . . . . . . 5963
346
nature . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2728, 198, 200
Nebraska . . . . . . . . . . . . . . . . . . . . . . . . . . 134
neck . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2829
needlestick injuries (see percutaneous injuries)
NEISS . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8384, 8990, 108109,
121122
network
administrators . . . . . . . . . . . . . . . . . . . 10
systems analyst . . . . . . . . . . . . . . . . . . 10
neurotic disorder . . . . . . . . . . . . . . . . . . . 3539
New England . . . . . . . . . . . . . . . . . . . . . . 146
New Hampshire . . . . . . . . . . . . . . . . . . . . 57
New Mexico . . . . . . . . . . . . . . . . . . . . . . . 21, 74, 170, 182
New York . . . . . . . . . . . . . . . . . . . . . . . . . . 46, 60, 174, 177
newcomer . . . . . . . . . . . . . . . . . . . . . . . . . 213
N-methyl carbamate . . . . . . . . . . . . . . . . . 141
noise . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5354, 238
nondurable goods (manufacturing) . . . 9, 15, 17, 26, 263, 273,
282, 289
nonfatal . . . . . . . . . . . . . . . . . . . . . . . . . . 1618, 2330, 3539, 59
63, 6569, 71, 7680, 8286,
8893, 9599, 101105,
107112, 114118, 120125,
127131, 184188, 202211,
215, 224, 228, 231238,
245258, 264265, 270273,
281282, 287289

nonhighway . . . . . . . . . . . . . . . . . . . . . . . 50, 270, 280, 287
nonmetal . . . . . . . . . . . . . . . . . . . . . . . . . 226229, 231236
nonmetallic . . . . . . . . . . . . . . . . . . . . . 171
mineral products . . . . . . . . . . . . . . . . 156
mining . . . . . . . . . . . . . . . . . . . . . . . . . 171
nonpassenger . . . . . . . . . . . . . . . . . . . . . . 244
North Carolina . . . . . . . . . . . . . . . . . . . . . 57, 137, 158, 177
northeast . . . . . . . . . . . . . . . . . . . . . . . . . . 206207
northern plains States . . . . . . . . . . . . . . . 146
NTOF . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4546, 49
nursery . . . . . . . . . . . . . . . . . . . . . . . . . . . 204
worker . . . . . . . . . . . . . . . . . . . . . . . . . 140
nurses . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
registered . . . . . . . . . . . . . . . . . . . . . . 10
nursing
aides . . . . . . . . . . . . . . . . . . . . . . . . . . 25
care . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
homes . . . . . . . . . . . . . . . . . . . . . . . . . 276
nuts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204, 217219
objects . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5051, 270, 280, 287
occupation, occupational . . . . . . . . . . . . 8, 10, 2526, 38, 42, 49,
63, 68, 71, 79, 92, 98,
104, 111, 117, 124, 130,
140, 143, 150, 156, 159,
163, 166, 168, 171, 187,
197198, 205207, 215,
242243, 245, 247258,
269, 272, 279, 282, 289
Index
odors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144
office
clerks . . . . . . . . . . . . . . . . . . . . . . . . . . 10
support . . . . . . . . . . . . . . . . . . . . . . . . 8
Ohio . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46, 203
Oklahoma . . . . . . . . . . . . . . . . . . . . . . . . . 174
older, older worker . . . . . . . . . . . . . . . . . 238, 263265, 278282
on-farm . . . . . . . . . . . . . . . . . . . . . . . . . . . 199200, 203, 205207
open pit (mine) . . . . . . . . . . . . . . . . . . . . 229, 231
operating engineers . . . . . . . . . . . . . . . . . 242243, 245, 253
operator, operators . . . . . . . . . . . . . . . . . 8, 25, 38, 49, 63, 68, 71,
79, 92, 98, 104, 111, 117,
124, 130, 143, 159, 163,
166, 168, 171, 187, 226
229, 231237, 269, 272,
279, 282, 286, 289
orderlies . . . . . . . . . . . . . . . . . . . . . . . . . . 25
organochlorine . . . . . . . . . . . . . . . . . . . . 141
organophosphorus . . . . . . . . . . . . . . . . . . 141
other causes . . . . . . . . . . . . . . . . . . . . . . . 198, 200
other private sector . . . . . . . . . . . . . . . . . 195
overexertion . . . . . . . . . . . . . . . . . . . . . . . 30, 246
Pacific Islander . . . . . . . . . . . . . . . . . . . . . 24, 37, 48, 67, 78, 186,
196, 207208, 265, 268,
279, 284, 287
pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
painters . . . . . . . . . . . . . . . . . . . . . . . . . . . 242243, 245, 254
347
Index
part of body . . . . . . . . . . . . . . . . . . . . . . . 28
parts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
passenger . . . . . . . . . . . . . . . . . . . . . . . . . 244
patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29, 54
pedestrian . . . . . . . . . . . . . . . . . . . . . . . . . 244
Pennsylvania . . . . . . . . . . . . . . . . . . . . . . . 46, 57, 170, 198, 200
percutaneous
exposure . . . . . . . . . . . . . . . . . . . . . . . 42
injuries . . . . . . . . . . . . . . . . . . . . . . . . 4243
perfumes . . . . . . . . . . . . . . . . . . . . . . . . . . 144
peritoneum . . . . . . . . . . . . . . . . . . . . . . . . 149
personal care . . . . . . . . . . . . . . . . . . . . . . 16
aide . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
pest control . . . . . . . . . . . . . . . . . . . . . . . 140
pesticide . . . . . . . . . . . . . . . . . . . . . . . . . . 139141
physical agents . . . . . . . . . . . . . . . . . . . . . 1920, 133134
physician, physicians . . . . . . . . . . . . . . . . 42
assistants . . . . . . . . . . . . . . . . . . . . . . . 10
pipefitters . . . . . . . . . . . . . . . . . . . . . . . . . 26, 150, 156
plants . . . . . . . . . . . . . . . . . . . . . . . . . . . . 229, 231
plastics . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156
processing machine operatives . . . . . . . . 171
pleura . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149
plumbers . . . . . . . . . . . . . . . . . . . . . . . . . . 26, 150, 156, 242243,
245, 255
PMR (see proportionate mortality ratio)
348
pneumoconiosis . . . . . . . . . . . . . . . . . . . . 152153, 161163, 165
166, 239
unspecified/other . . . . . . . . . . . . . . . 152153, 165166
poisoning . . . . . . . . . . . . . . . . . . . . . . . . . 1920, 5657, 136137,
139141, 198, 200
polymers . . . . . . . . . . . . . . . . . . . . . . . . . . 144
position . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
pottery . . . . . . . . . . . . . . . . . . . . . . . . . . . 171
poultry . . . . . . . . . . . . . . . . . . . . . . . . . . . 204
powered haulage . . . . . . . . . . . . . . . . . . . 230, 233234
precision production . . . . . . . . . . . . . . . . 8, 25, 38, 49, 63, 68, 71,
79, 92, 98, 104, 111, 117,
124, 130, 143, 168, 187,
269, 272, 279, 282, 286,
289
prevalence . . . . . . . . . . . . . . . . . . . . . . . . 161
private sector . . . . . . . . . . . . . . . . . . . . . . 195197, 202, 224
procedure . . . . . . . . . . . . . . . . . . . . . . . . . 43
production . . . . . . . . . . . . . . . . . . . . . . . . 8
professional . . . . . . . . . . . . . . . . . . . . . . . 8, 25, 38, 49, 63, 68, 71,
79, 92, 98, 104, 111, 117,
124, 130, 143, 187, 269,
272, 279, 282, 286, 289
proportionate mortality ratio . . . . . . . . . 150, 156, 159, 163, 166,
171
proprietors . . . . . . . . . . . . . . . . . . . . . . . . 26
public administration . . . . . . . . . . . . . . . 9, 54, 140, 144

public utilities . . . . . . . . . . . . . . . . . . . . . . 9, 15, 17, 26, 3839, 50, 63,
6869, 7980, 8486, 92 reaching . . . . . . . . . . . . . . . . . . . . . . . . . . 71, 246
93, 9899, 104105, 111
112, 117118, 124125,
130131, 140, 187188,
224, 263, 269, 273, 280,
282, 286, 289
punctures . . . . . . . . . . . . . . . . . . . . . . . . . 276
pyrethrins, pyrethroid . . . . . . . . . . . . . . . 141
pyrolysis products . . . . . . . . . . . . . . . . . . . 144
quarry, quarrying . . . . . . . . . . . . . . . . 171, 229, 231
race . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79, 24, 37, 48, 62, 78, 84,
91, 97, 103, 110, 116, 123,
129, 147, 150, 153, 186,
196, 207209, 238, 265,
268, 279, 284, 287
railway . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50, 270, 280, 287
rate, rates . . . . . . . . . . . . . . . . . . . . . . . . . 1318, 2021, 35, 3839,
41, 4546, 48, 57, 60, 65,
69, 7374, 76, 7980,
8286, 8890, 9293, 95,
9899, 101, 104105, 107
109, 111112, 114, 117
118, 120122, 124125,
127, 130131, 133134,
136137, 146, 149, 156,
158, 170, 173174, 176
177, 179, 181182, 184,
187188, 195197, 199,
202211, 215, 224, 227,
229233, 239, 242258,
267, 278, 284
Index
ratios . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163, 166, 171
real estate . . . . . . . . . . . . . . . . . . . . . . . . . 9, 15, 26, 3839, 50, 63,
6869, 7980, 8486,
9293, 9899, 104105,
111112, 117118, 124
125, 130131, 187188,
224, 263, 269, 273, 280,
282, 286, 289
regional (see Appalachian, Appalachian States, eastern seaboard,
Mid-Atlantic, Midwest, Mississippi Delta, mountain States, New
England, northeast, northern plains States, south, southeast,
southern, southern coastal, southwest, southwestern, west, west-
ern, western coal mining, western mining States, western moun-
tain, western States)
relatives . . . . . . . . . . . . . . . . . . . . . . . . . . . 208211
repair, repairers . . . . . . . . . . . . . . . . . . . . 8, 2526, 38, 49, 63, 68,
71, 79, 92, 98, 104, 111,
117, 124, 130, 143, 168,
187, 269, 272, 279, 282,
286, 289
repeated trauma . . . . . . . . . . . . . . . . . . . . 1920, 7374
repetitive motion . . . . . . . . . . . . . . . . . . . 30, 246
reporting source . . . . . . . . . . . . . . . . . . . 168
reports . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
respiratory
disease . . . . . . . . . . . . . . . . . . . . . . . . . 1920, 143144, 146
147, 149150, 152153,
155156, 158159, 161
163, 165166, 168171,
173174, 176177, 179
349
Index

symptoms . . . . . . . . . . . . . . . . . . . . . . 216, 218219 separating machine operators . . . . . . . . . 156

restaurants . . . . . . . . . . . . . . . . . . . . . . . . 276 seroconversion . . . . . . . . . . . . . . . . . . . . . 42
restricted work activity . . . . . . . . . . . . . . . 15, 82, 86 service (occupation) . . . . . . . . . . . . . . . . 8, 14, 25, 38, 49, 63, 68,
71, 79, 92, 98, 104, 111,
retail
117, 124, 130, 143, 187,
representatives . . . . . . . . . . . . . . . . . . . . . 10 269, 272, 279, 282, 286,
trade . . . . . . . . . . . . . . . . . . . . . . . . . . 9, 15, 26, 3839, 50, 54, 63, 289
6869, 7980, 8486, 92 representatives . . . . . . . . . . . . . . . . . . 10
93, 9899, 104105, 111
112, 117118, 124125, services (industry) . . . . . . . . . . . . . . . . . . 9, 15, 26, 3839, 50, 54,
130131, 140, 187188, 63, 6869, 7980, 8486,
224, 263, 269, 273, 280, 9293, 9899, 104105,
282, 286, 289 111112, 117118, 124
125, 130131, 140, 144,
Rhode Island . . . . . . . . . . . . . . . . . . . . . . 46 187188, 224, 263, 269,
rolling . . . . . . . . . . . . . . . . . . . . . . . . . . . . 230 273, 280, 282, 286, 289

roofers . . . . . . . . . . . . . . . . . . . . . . . . . . . . 242243, 245, 256 settled . . . . . . . . . . . . . . . . . . . . . . . . . . . . 213

rubber products . . . . . . . . . . . . . . . . . . . . 156 severity . . . . . . . . . . . . . . . . . . . . . . . . . . . 23, 26, 2830, 37, 62, 67,
sales . . . . . . . . . . . . . . . . . . . . . . . . . . . 8, 38, 49, 63, 68, 71, 79, 78, 91, 97, 103, 110, 116,
92, 98, 104, 111, 117, 124, 123, 129, 186, 234, 265,
130, 143, 187, 269, 272, 272, 281, 288
279, 282, 286, 289 sex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6, 89, 24, 36, 47, 51, 61,
representatives . . . . . . . . . . . . . . . . . . . . . 10, 25 66, 77, 83, 90, 96, 102,
109, 115, 122, 128, 139,
sand . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 226, 228229, 231234, 147, 150, 152, 185, 214,
238
234, 268, 275, 278, 285
scalds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107112, 276
sheep . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204
scalpel . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
sheet metal workers . . . . . . . . . . . . . . . . . 156
security guards . . . . . . . . . . . . . . . . . . . . . 10
ship
SENSOR . . . . . . . . . . . . . . . . . . . . . . . . . . 5354, 71, 139141, 143 building . . . . . . . . . . . . . . . . . . . . . . . . 156
144, 168169 repair . . . . . . . . . . . . . . . . . . . . . . . . . . 156

350

shoulder . . . . . . . . . . . . . . . . . . . . . . . . . . 29
shuttle . . . . . . . . . . . . . . . . . . . . . . . . . . . . 213
silicosis . . . . . . . . . . . . . . . . . . . . . . . . . . . 152153, 168171
size (employment, establishment) . . . . . 16, 230, 244
skin disease, disorder . . . . . . . . . . . . . . . . 1920, 181182
sliding
material . . . . . . . . . . . . . . . . . . . . . . . . 230
rock . . . . . . . . . . . . . . . . . . . . . . . . . . . 230
slip, slips . . . . . . . . . . . . . . . . . . . . . . . . . . 30, 230, 233234
social service assistants . . . . . . . . . . . . . . . 10
software engineers . . . . . . . . . . . . . . . . . . 10
solvents . . . . . . . . . . . . . . . . . . . . . . . . . . . 144
soreness . . . . . . . . . . . . . . . . . . . . . . . . . . 59
sorter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140
source . . . . . . . . . . . . . . . . . . . . . . . . . . . . 197, 205
of reports . . . . . . . . . . . . . . . . . . . . . . 143
south . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1718, 21, 174, 206207
South Carolina . . . . . . . . . . . . . . . . . . . . . 158
southeast . . . . . . . . . . . . . . . . . . . . . . . . . . 158
southern . . . . . . . . . . . . . . . . . . . . . . . . . . 177
southern coastal . . . . . . . . . . . . . . . . . . . . 1718, 21
southwest . . . . . . . . . . . . . . . . . . . . . . . . . 1718, 74, 174, 182
southwestern . . . . . . . . . . . . . . . . . . . . . . 177
spinal cord, spine . . . . . . . . . . . . . . . . . . . 9599
Index
sprains . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2728, 59, 127131, 276
States . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13, 1718, 21, 46, 57, 60,
74, 134, 137, 146, 149,
155, 158, 162, 165, 170,
174, 177, 182, 198200,
203
steamfitters . . . . . . . . . . . . . . . . . . . . . . . . 26, 150, 156
steel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171
stepping, stepping on object . . . . . . . . . . 233234
stone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 226, 228229, 231234
products . . . . . . . . . . . . . . . . . . . . . . . 156, 171
stores . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 276
strains . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2728, 59, 127131, 276
stress . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3539
strip mine . . . . . . . . . . . . . . . . . . . . . . . . . 229, 231
struck . . . . . . . . . . . . . . . . . . . . . . . . . . . . 244
against . . . . . . . . . . . . . . . . . . . . . . . . . 200
against object . . . . . . . . . . . . . . . . . . . 30
by . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 200, 270, 280, 287
by falling . . . . . . . . . . . . . . . . . . . . . . . 198
by falling objects . . . . . . . . . . . . . . . . . 49
by flying . . . . . . . . . . . . . . . . . . . . . . . . 198
by mobile equipment . . . . . . . . . . . . . 244
by object . . . . . . . . . . . . . . . . . . . . . . . 30, 244
by vehicle . . . . . . . . . . . . . . . . . . . . . . 50, 244
suffocation . . . . . . . . . . . . . . . . . . . . . . . . 198, 200
Sunshine Silver Mine . . . . . . . . . . . . . . . . 227
supervisors . . . . . . . . . . . . . . . . . . . . . . . . 163, 166, 245
351
Index

support . . . . . . . . . . . . . . . . . . . . . . . . . . . 8, 25, 38, 49, 63, 68, 71,
79, 92, 98, 104, 111, 117,
124, 130, 143, 187, 269,
272, 279, 282, 286, 289
specialists . . . . . . . . . . . . . . . . . . . . . . . . . 10
surface (mines) . . . . . . . . . . . . . . . . . . . . 226, 229234
surgical technicians . . . . . . . . . . . . . . . . . 42
suture needle . . . . . . . . . . . . . . . . . . . . . . 42
system engineers . . . . . . . . . . . . . . . . . . . 10
TB (see tuberculosis)
teachers . . . . . . . . . . . . . . . . . . . . . . . . . . . 150
tear, tears . . . . . . . . . . . . . . . . . . . . . . . . . 127131, 276
technical . . . . . . . . . . . . . . . . . . . . . . . . . . 8, 25, 38, 49, 63, 68, 71,
79, 92, 98, 104, 111, 117,
124, 130, 143, 187, 269,
272, 279, 282, 286, 289
thread mill . . . . . . . . . . . . . . . . . . . . . . . . 159
threshold level . . . . . . . . . . . . . . . . . . . . . 238
toe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
tools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29, 205
toxic agents . . . . . . . . . . . . . . . . . . . . . . . . 1920, 176177
tractor . . . . . . . . . . . . . . . . . . . . . . . . . . . . 197, 205, 209, 211
trades . . . . . . . . . . . . . . . . . . . . . . . . . . . . 242
transportation . . . . . . . . . . . . . . . . . . . . . 89, 15, 17, 26, 30, 3839,
50, 54, 63, 6869, 7980,
8486, 9293, 9899,
104105, 111112, 117
118, 124125, 130131,
140, 187188, 224, 263,
269, 273, 280, 282, 286,
289
accidents . . . . . . . . . . . . . . . . . . . . . . . 30
incidents . . . . . . . . . . . . . . . . . . . . . . . 5051, 270, 280, 287

technicians . . . . . . . . . . . . . . . . . . . . . . . . 10 trees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 197

tendinitis (see tendonitis) trend, trends . . . . . . . . . . . . . . . . . . . . . . . 57, 1317, 1920, 25,

3536, 39, 41, 45, 4849,
tendonitis . . . . . . . . . . . . . . . . . . . . . . . . . 2728, 59, 7680 51, 56, 59, 65, 69, 71, 73,
Tennessee . . . . . . . . . . . . . . . . . . . . . . . . . 198199 7677, 80, 82, 8586, 88,
93, 95, 99, 101, 105, 107,
tenure (also see experience) . . . . . . . . . . 161, 213, 216218, 236 112, 114, 118, 120, 125,
237 127, 131, 133, 136, 146,
152, 155, 158, 161162,
Texas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21, 46, 60, 74, 137, 174,
165, 169, 173, 176, 179,
177, 182, 198, 200
181, 184, 188, 195, 202,
textile 224, 227, 232, 239, 243,
machine operator . . . . . . . . . . . . . . . . 159 247258, 267268, 270271,
producing States . . . . . . . . . . . . . . . . . 158 278, 281, 284285, 288

352
 Index

trips . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 Virginia . . . . . . . . . . . . . . . . . . . . . . . . . . . 174

truck drivers . . . . . . . . . . . . . . . . . . . . . . . 2526, 242243, 245, 257 visitors . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205206, 208211
trucking services . . . . . . . . . . . . . . . . . . . . 16 waiter, waitress . . . . . . . . . . . . . . . . . . . . . 10
trucks . . . . . . . . . . . . . . . . . . . . . . . . . . . . 197 walkways . . . . . . . . . . . . . . . . . . . . . . . . . . 29
trunk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 Washington . . . . . . . . . . . . . . . . . . . . . . . . 60, 174, 203

tuberculosis . . . . . . . . . . . . . . . . . . . . . . . 179 water . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 197

transport . . . . . . . . . . . . . . . . . . . . . . . 198
twisting . . . . . . . . . . . . . . . . . . . . . . . . . . . 71, 246 vehicle . . . . . . . . . . . . . . . . . . . . . . . . . 50, 270, 280, 287
machine operator . . . . . . . . . . . . . . . . 159
underground (mines) . . . . . . . . . . . . 161, 226227, 229234 welders . . . . . . . . . . . . . . . . . . . . . . . . . . . 166, 242243, 245, 258

underlying cause of death . . . . . . . . . . . . 146, 149, 152, 155, 158, welding . . . . . . . . . . . . . . . . . . . . . . . . . . . 144
162, 165, 169 west . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74, 149, 174, 182, 206
unexposed . . . . . . . . . . . . . . . . . . . . . . . . 238 207

unintentional . . . . . . . . . . . . . . . . . . . . . . 199200 West Virginia . . . . . . . . . . . . . . . . . . . . . . 46, 60, 155, 162, 165, 170,
174, 227
unknown . . . . . . . . . . . . . . . . . . . . . . . . . . 198
western . . . . . . . . . . . . . . . . . . . . . . . . . . . 177
unspecified type (mesothelioma) . . . . . . 149 coal mining . . . . . . . . . . . . . . . . . . . . . 162
unspecified/other pneumoconiosis (see pneumoconiosis) mining States . . . . . . . . . . . . . . . . . . . 165
mountain . . . . . . . . . . . . . . . . . . . . . . 18
upper extremities . . . . . . . . . . . . . . . . . . . 28 States . . . . . . . . . . . . . . . . . . . . . . . . . . 170
Utah . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170 wheezing . . . . . . . . . . . . . . . . . . . . . . . . . . 218
vegetable, vegetables . . . . . . . . . . . . . . . . 204, 217219 white workers . . . . . . . . . . . . . . . . . . . . . . 67, 24, 37, 48, 62, 67, 78,
84, 91, 97, 103, 110, 116,
vehicle, vehicles . . . . . . . . . . . . . . . . . . . . 29, 270, 280, 287
123, 129, 147, 150, 153,
venipuncture . . . . . . . . . . . . . . . . . . . . . . 43 186, 196, 207, 238, 265,
268, 279, 284, 287
Vermont . . . . . . . . . . . . . . . . . . . . . . . . . . 170
wholesale trade . . . . . . . . . . . . . . . . . . . . . 9, 15, 26, 3839, 50, 54,
violent acts . . . . . . . . . . . . . . . . . . . . . . . . 30, 5051, 270, 280, 287
63, 6869, 7980, 8486,
viral infections . . . . . . . . . . . . . . . . . . . . . 4142 9293, 9899, 104105,

353
Index

111112, 117118, 124 workers compensation . . . . . . . . . . . . . . 53, 275276

125, 130131, 140, 187
188, 224, 263, 269, 273,
280, 282, 286, 289
winding machine operator . . . . . . . . . . . 159
winged steel needle . . . . . . . . . . . . . . . . . 42
Wisconsin . . . . . . . . . . . . . . . . . . . . . . . . . 134, 200, 203
women . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209, 211
location . . . . . . . . . . . . . . . . . . . . . . . . 229231, 233
loss . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23, 2630, 37, 62, 67, 78,
91, 97, 103, 110, 116, 123,
129, 186, 265, 272, 281,
288
worker, workers . . . . . . . . . . . . . . . . . . . . 16, 226
motion . . . . . . . . . . . . . . . . . . . . . . . . 29
position . . . . . . . . . . . . . . . . . . . . . . . . 29
data . . . . . . . . . . . . . . . . . . . . . . . . . . . 168
working surfaces . . . . . . . . . . . . . . . . . . . 205
work-related . . . . . . . . . . . . . . . . . . . . . . . 195199, 202, 206211,
242, 247258
asthma . . . . . . . . . . . . . . . . . . . . . . . . . 143144
WRA (see work-related asthma)
wrist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Wyoming . . . . . . . . . . . . . . . . . . . . . . . . . . 13, 46
X-ray . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161
yarn mill . . . . . . . . . . . . . . . . . . . . . . . . . . 159
years worked . . . . . . . . . . . . . . . . . . . . . . . 161
younger worker . . . . . . . . . . . . . . . . . . . . 139, 263265, 267273,
275276
youth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 199200, 203, 205211

354