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The Impact of Law No. 6331 on Work-Related Incidents in Türkiye (2007–2023): Standardization Analysis of City-Level Data for Compulsory Insured Workers

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Abstract
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Objective: This study examined the effects of the occupational health and safety (OHS) Law No. 6331, enacted in Türkiye in 2013. It analyzed the rates of work-related accidents (WrAs), occupational diseases (ODs), and work-related mortalities (WrMs) among compulsory insured workers from 2007 to 2023. Additionally, it aimed to reveal the situation prior to the introduction of compulsory OHS services for public institutions and low-risk workplaces with fewer than 50 workers in 2025. Methods: Using data from Türkiye’s Social Security Institution (SSI), trends across 81 cities were examined through an epidemiological, observational, and descriptive design. Indirect standardization was applied to adjust for variations in the number of “4-1/a compulsory insured” workers, allowing for comparisons of standardized (s) WrA, sOD, and sWrM ratios between cities. Results: The number of insured workers in Türkiye nearly doubled during the study period. Regional disparities became evident, with sWrA ratios higher in western provinces and sWrM ratios elevated in the east. Zonguldak, Bilecik, Kütahya, Manisa, Bartın, Karabük, and Kocaeli consistently showed the highest standardized ratios. After the law’s implementation, sWrA rose in the Black Sea region, while a modest rise in sOD was detected in Marmara. Peaks in sWrM occurred in various cities, with clustering observed in the Eastern Black Sea. Conclusion: This study highlights systemic weaknesses and regional inequalities in Türkiye’s OHS landscape. The upcoming 2025 expansion of Law No. 6331 provides an opportunity for improvement; however, persistent underreporting, limited diagnostic capacity for occupational diseases, and uneven implementation across regions suggest that significant structural gaps remain.

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