Compensation Claims Data Research Articles

Guideline adherence and lost workdays for acute low back pain in the California workers' compensation system.

ContextThe use of clinical-practice guidelines is a suggested method for improving health outcomes by the earlier provision of necessary and effective medical interventions.ObjectiveTo quantify the influence of adherence to guideline-recommended interventions in the first week of treatment for an initial low back pain (LBP) injury on lost workdays.MethodsIn a retrospective cohort of California’s workers’ compensation claims data from May 2009 to May 2018, 41 diagnostic and treatment interventions were abstracted from the medical claims for workers with acute LBP injuries and compared with guideline recommendations. Lost workdays within 1-year post-injury were compared by guideline adherence using quantile regressions.ResultsOf the 59,656 workers who met the study inclusion criteria, 66.1% were male and the average (SD) age was 41 (12) years. The median number (IQR) of lost workdays was 27 (6–146) days. In the first week of treatment, 14.2% of workers received only recommended interventions, 14.6% received only non-recommended interventions, and 51.1% received both recommended and non-recommended interventions. Opioid prescriptions fell 86% from 2009 to 2018. Workers who received only guideline-recommended interventions experienced significantly fewer lost workdays (11.5 days; 95% CI: -13.9, -9.1), a 29.3% reduction, than workers who received only non-recommended interventions. The percentage of workers receiving only recommended interventions increased from 10.3% to 18.2% over the 9 years.Conclusion and relevanceWhen workers received guideline-recommended interventions, they typically returned to work in fewer days. The majority of workers received at least one non-recommended intervention, demonstrating the need for adherence to guideline recommendations. Fewer lost workdays and improved quality care are outcomes that strongly benefit injured workers.

Collider Bias in Administrative Workers' Compensation Claims Data: A Challenge for Cross-Jurisdictional Research.

Workers' compensation claims consist of occupational injuries severe enough to meet a compensability threshold. Theoretically, systems with higher thresholds should have fewer claims but greater average severity. For research that relies on claims data, particularly cross-jurisdictional comparisons of compensation systems, this results in collider bias that can lead to spurious associations confounding analyses. In this study, I use real and simulated claims data to demonstrate collider bias and problems with methods used to account for it. Using Australian claims data, I used a linear regression to test the association between claim rate and mean disability durations across Statistical Areas. Analyses were repeated with nesting by state/territory to account for variations in compensability thresholds across compensation systems. Both analyses are repeated on left-censored data. Simulated claims data are analysed with Cox survival analyses to illustrate how left-censoring can reverse effects. The claim rate within a Statistical Area was inversely associated with disability duration. However, this reversed when Statistical Areas were nested by state/territory. Left-censoring resulted in an attenuation of the unnested association to non-significance, while the nested association remained significantly positive. Cox regressions with simulated claims data demonstrated how left-censoring can reverse effects. Collider bias can seriously confound work disability research, particularly cross-jurisdictional comparisons. Work disability researchers must grapple with this challenge by using appropriate study designs and analytical approaches, and considering how it affects the interpretation of results.

The impact of long-term workers' compensation benefit cessation on welfare and health service use: protocol for a longitudinal controlled data linkage study.

BackgroundIn 2012, the Australian state of New South Wales passed legislation that reformed its workers’ compensation system. Section 39 introduced a five-year limit on income replacement, with the first affected group having their benefits cease in December 2017. There is limited evidence on how this will affect their healthcare service use and where they will go for financial support.MethodsMultiple data sources will be linked: administrate workers’ compensation claims data from the State Insurance Regulatory Authority (SIRA), universal health insurance data from the Medical Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS), state hospital and emergency department data, and social welfare data from the Department of Social Services’ Data Over Multiple Individual Occurrences (DOMINO). An estimated 4,125 injured workers had their benefits cease due to Section 39. These will form the exposure group who will be compared to 1) a similar group of workers’ compensation claimants who have had at least two years of compensated time off work but whose benefits did not cease due to Section 39; and 2) a community comparison group drawn from state hospital and emergency department records.An accredited third party will link the data, which will be accessible only via secure virtual machine. Initial analyses will compare the prevalence and incidence of service use across groups in both the year before and year after benefit cessation; the community control will be assigned the median benefit cessation date in lieu of an actual date. To estimate the impact of benefit cessation due to Section 39, we will conduct time series analysis of the prevalence and incidence of service use.DiscussionThis study will provide much-needed evidence on the consequences of long-term benefit cessation, particularly on subsequent healthcare and welfare service use.

Incidence of mesothelioma and asbestosis by occupation in a diverse workforce.

We sought to characterize detailed patterns of mesothelioma and asbestosis incidence in the workforce as part of an occupational disease surveillance program in Ontario, Canada. The Occupational Disease Surveillance System (ODSS) cohort was established using workers' compensation claims data and includes 2.18 million workers employed from 1983 to 2014. Workers were followed for mesothelioma and asbestosis diagnoses in Ontario Cancer Registry, physician, hospital, and ambulatory care records through 2016. Trends in incidence rates were estimated over the study period. Cox proportional hazard models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). A total of 854 mesothelioma and 737 asbestosis cases were diagnosed during follow-up. Compared with all other workers in the ODSS, those employed in construction trades occupations had the greatest adjusted incidence rate of both mesothelioma (223 cases; HR, 2.38; 95% CI: 2.03-2.78) and asbestosis (261 cases; HR, 3.64; 95% CI: 3.11-4.25). Rates were particularly elevated for insulators, pipefitters and plumbers, and carpenters. Workers in welding and flame cutting, boiler making, and mechanic and machinery repair occupations, as well as those in industrial chemical and primary metal manufacturing industries, had strongly elevated rates of both diseases. Rates were greater than anticipated for workers in electrical utility occupations and education and related services. Results substantiate the risk of mesothelioma and asbestosis in occupation and industry groups in the Ontario workforce with known or suspected asbestos exposure. Sustained efforts to prevent the occurrence of additional cases of disease in high-risk groups are warranted.

Assessing disabling and non-disabling injuries and illnesses using accepted workers compensation claims data to prioritize industries of high risk for Oregon young workers

Introduction: Young workers are especially vulnerable to occupational injuries and illnesses. There is a continued need to investigate injury burden among young workers across demographics and industry to inform targeted interventions. Workers compensation (WC) claims are important for quantifying work-related injuries and illnesses, however published studies have focused on disabling claims. This study extended previous research on Oregon young workers by including the most recent WC claims data to identify patterns of injury and high risk industries. Methods: We obtained all accepted disabling claims (N = 13,360) and a significant portion of non-disabling claims (N = 24,660) on workers aged 24 years and under from 2013 to 2018. Claim count, rate and cost were calculated by year, age, gender, industry, and injury type. A prevention index (PI) method was used to rank industries in order to inform prevention efforts. Results: Average annual disabling and non-disabling claim rates were 111.6 and 401.3 per 10,000 young workers. Workers aged 19–21 (disabling: 119.0 per 10,000 and non-disabling: 429.3) and 22–24 years (115.7 and 396.4) and male workers (145.3 and 509.0) had higher claim rates than workers aged 14–18 (80.6 and 297.0) and female workers (79.8 and 282.9). The most frequent injury types were “struck by/against” (35.6%) and “work-related musculoskeletal disorders (WMSDs)” (19.5%). High risk industries included agriculture, construction, and manufacturing for both genders combined. For female young workers, the highest risk industry was healthcare. Conclusions: This study demonstrated the added value of non-disabling WC claims data. Using both disabling and non-disabling data and PI method, agriculture, construction, manufacturing and healthcare industries were identified as priority workplaces to prevent common and costly injuries among Oregon young workers. Practical Applications: While the industries identified are considered hazardous for all workers, findings in this study can guide targeted research and prevention efforts specific to young workers.

Occupational safety and health in marine aquaculture in Atlantic Canada: What can be learned from an analysis of provincial occupational injury compensation claims data?

BackgroundCommercial aquaculture employs roughly 19 million workers globally, yet research on aquaculture occupational safety and health is extremely limited, including in developed countries like Canada. Analyses of injury and fatality compensation claims data from Scandinavian countries, Australia, the United States, and Brazil reveal aquaculture is a high-risk industry, associated with multiple hazards and high injury and fatality rates. Marine aquaculture takes place on Canada's east and west coasts. It is expanding in Atlantic Canada where it consists mainly of salmon and shellfish production. This paper presents results from a descriptive analysis of data on accepted compensation claims for injured Atlantic Canada marine aquaculture workers. MethodsWorkers' compensation in Canada falls under provincial jurisdiction. Anonymous claims data between 1996 and 2017, provided by four Atlantic provincial compensation boards, captured injury claims broadly specific to the aquaculture industry, supporting a descriptive analysis of incidence rates and injury characteristics. ResultsAcross provinces, lost time injury rates among aquaculture workers fluctuated over time, but exceeded recent overall average provincial rates from 2010 to 2016. Consistent across provinces, almost half of all marine aquaculture injuries were caused by bodily reaction and (over)exertion (mean = 15.0%; SD = 6.4%), falls (14.4%; SD = 2.3%), or being struck by or against an object (mean = 13.7%; SD = 2.2%). Roughly half of the injuries were of three types: traumatic injuries to muscles, tendons, ligaments, and joints (mean = 33.0%; SD = 3.7%), open wounds (mean = 10.1%; SD = 2.5), and surface wounds and bruises (mean = 10.0%; SD = 5.2%). The back, including spine and spinal cord was the body part most commonly affected by workplace injuries (mean = 17.2%; SD = 1.4%), followed by leg(s) (mean = 10.8%; SD = 0.5%), and finger(s)/ fingernail(s) (mean = 10.4%, SD = 4.4%). ConclusionFindings indicate marine aquaculture workers are suffering from similar injuries (injury event, nature and source of injury, body parts) across provinces and these are similar to aquaculture sector injury claims patterns in Norway, Finland, Australia, and the United States. The high incidence rates are a strong signal that marine aquaculture in Canada, as elsewhere, is a hazardous sector. Compensation claims rates exceed overall provincial averages and have not declined. Ongoing surveillance, hazard assessments, and identification and implementation of prevention strategies could help this expanding industry reduce rates of injuries and illnesses.

Incidence of acute myocardial infarction in the workforce: Findings from the Occupational Disease Surveillance System.

Increased risks of acute myocardial infarction (AMI) may be attributable to the workplace, however, associations are not well-established. Using the Occupational Disease Surveillance System (ODSS), we sought to estimate associations between occupation and industry of employment and AMI risk among workers in Ontario, Canada. The study population was derived by linking provincial accepted lost-time workers' compensation claims data, to inpatient hospitalization records. Workers aged 15-65 years with an accepted non-AMI compensation claim were followed for an AMI event between 2007 and 2016. Adjusted Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for each industry and occupation group, compared to all other workers in the cohort. Sex-stratified analyses were also performed. In all, 24,514 incident cases of AMI were identified among 1,502,072 Ontario workers. Increased incidence rates of AMI were found across forestry (HR 1.37, 95% CI 1.19-1.58) and wood processing (HR 1.50, 1.27-1.77) job-titles. Elevated rates were also detected within industries and occupations both broadly related to mining and quarrying (HR 1.52, 1.17-1.97), trucking (HR 1.32, 1.27-1.38), construction (HR 1.32, 1.14-1.54), and the manufacturing and processing of metal (HR 1.41, 1.19-1.68), textile (HR 1.41, 1.07-1.88), non-metallic mineral (HR 1.30, 0.82-2.07), and rubber and plastic (HR 1.42, 1.27-1.60) products. Female food service workers also had elevated AMI rates (HR 1.36, 1.23-1.51). This study found occupational variation in AMI incidence. Future studies should examine work-related hazards possibly contributing to such excess risks, like noise, vibration, occupational physical activity, shift work, and chemical and particulate exposures.

The New Brunswick Act Respecting Research Three Years Later: A Data Trickle Turns into a Flood

IntroductionIn New Brunswick Canada (NB) in 2017, the Provincial Government passed a bill called the Act Respecting Research. This Act took the form of an omnibus bill modifying 20 pieces of legislation to define a legal authority for the New Brunswick Institute for Research, Data and Training (NB-IRDT) to receive prepared, linkable microdata from multiple public bodies in NB. This was followed in 2019 by a second Act Respecting Research that broadened the scope of the first. Together this legislation has helped to expand NB-IRDT’s data holdings from its first dataset – hospital records received in 2015 – to over 40 different linkable datasets as of March 2020. These datasets are underpinning ambitious research partnerships between NB-IRDT and the Provincial Government.
 Objectives and ApproachThis presentation will detail the rapid progress made since the first Act was passed in 2017 and presented at IPDLN-2018. It will outline enabling factors, including secured funding, the central role of the Department of Health, engagement with senior decisionmakers, and interaction with other provincial data centres and national networks including HDRN Canada. Ongoing and new challenges arising from the rapid increase in the scale of data collection and their resolution will be discussed.
 ResultsIn addition to a wide range of provincial health administrative and clinical datasets, recent datasets include school records (report cards, standardized testing, attendance), income support data, workers compensation claims data, higher education program and graduation data, court appearances, adult training/retraining programs and immigration landing records. All files are linkable at the individual level. Multi-year research projects to support program evaluation are underway, with departments now able to access other agency data through NB-IRDT.
 Conclusion / ImplicationsNB-IRDT and the experience in NB offer important lessons for other jurisdictions aiming to expand access to linkable multi-agency data for research and evaluation.

Cancer surveillance among workers in plastics and rubber manufacturing in Ontario, Canada

ObjectiveOccupational exposure to agents in plastics and rubber manufacturing has been associated with elevated risk of certain cancers. We sought to evaluate cancer risk among workers employed in occupations and...

Changes in early high-risk opioid prescribing practices after policy interventions in Washington State.

ObjectiveTo test associations between several opioid prescribing policy interventions and changes in early (acute/subacute) high‐risk opioid prescribing practices.Data SourcesPopulation‐based workers' compensation pharmacy billing and claims data, Washington State Department of Labor and Industries (January 2008‐June 2015).Study DesignWe used interrupted time series analysis to test associations between three policy intervention timepoints and monthly proportions of population‐based measures of high‐risk, low‐risk, and any workers’ compensation‐related opioid prescribing. We also tested associations between the policy intervention timepoints and five high‐risk opioid prescribing indicators among workers prescribed any opioids within 3 months after injury: (a) >7 cumulative (not necessarily consecutive) days‘ supply of opioids during the acute phase, (b) high‐dose opioids, (c) concurrent sedatives, (d) chronic opioids, and (e) a composite high‐risk opioid prescribing indicator.Principal FindingsWithin 3 months after injury, 9 percent of workers were exposed to high‐risk and 12 percent to low‐risk workers’ compensation‐related opioid prescribing; 79 percent filled no workers’ compensation‐related opioid prescription. Among workers prescribed any early (acute/subacute) opioids, the indicator for >7 days' supply of opioids during the acute phase was present for 30 percent, high‐dose opioids for 18 percent, concurrent sedatives for 3 percent, and chronic opioids for 2 percent. Beyond a general shift toward more infrequent and lower‐risk workers’ compensation‐related opioid prescribing, each policy intervention timepoint was significantly associated with reductions in specific acute/subacute high‐risk opioid prescribing indicators; each of the four specific high‐risk opioid prescribing indicators had significant reductions associated with at least one policy.ConclusionsSeveral state‐level opioid prescribing policies were significantly associated with safer workers’ compensation‐related opioid prescribing practices during the first 3 months after injury (acute/subacute phase), which should in turn reduce transition to chronic opioids and associated negative health outcomes.

Are foreign-born workers more likely to make multiple injury claims than native-born workers?

Several studies have explored the factors associated with repeat workers’ compensation claims, however, none investigated the impact of migration status on repeat claims among injured workers. Using South Australian workers’ compensation claims data from 2000 to 2014, generalized estimating equation models were used to compare the differences in repeat claims between foreign-born workers (FBW) and Australian-born workers. Time intervals between repeat claims, compensation costs, and working days lost by region of birth, as well as the change of severity between repeat claims were examined. Amongst 464,596 accepted compensation claims, repeat claims for FBW (50.5%) was lower than that of Australian-born workers (57.4%, incidence-rate ratio, IRR = 0.83, 95% CI 0.82–0.84). However, region-specific analysis showed that European-born migrant workers were 19% more likely to make repeat claims than Australian-born workers (IRR = 1.19, 95% CI 1.17–1.22), including burns, digestive diseases, fractures, infectious diseases, mental disorders, musculoskeletal diseases, and skin injuries. The time interval between repeat claims was shorter for FBW compared to Australian-born workers and compensation payments of repeat claims were higher. Regardless of birth region, time intervals between repeat claims showed a decreasing temporal trend, while it was the opposite in terms of injury severity. Foreign-born workers were generally less likely to make a repeat claim than Australian-born workers, but with birth region differences. This may be attributable to underreporting from some workers. Foreign-born workers were generally less likely to have time off work but the overall costs were higher. These differences should be considered in future injury prevention strategies.

The Impact of Adherence to Clinical Practice Guidelines on Medical Costs.

To examine the association between non-adherence to clinical practice guidelines (CPGs) and medical and indemnity spending among back and shoulder injury patients. Workers compensation claims data was used from a large, US insurer (1999 to 2010). Least square regression models were created to examine the association between spending and guideline-discordant care. Non-adherence to CPGs was associated with higher medical and indemnity spending for 11 of the 28 CPG indicators. Failure to adhere to the other CPGs did not increase medical or total spending. After covariate adjustment, non-adherence to these 11 CPGs was associated with spending increases that ranged from $16,000 for physical therapy (PT) to $114,000 for surgery. Our results demonstrate that failure to adhere to a subset of CPG indicators significantly predicts increased medical and indemnity spending for two important occupational injuries.

Characterising the Burden of Work-Related Injuries in South Australia: A 15-Year Data Analysis.

To characterise the burden of work-related injuries in South Australia, workers’ compensation claim data were obtained from SafeWork South Australia between 2000 and 2014. Descriptive analyses were performed to investigate the burden of work-related injuries by age, gender, occupation, industry, and nature and mechanism of injury. Dunn’s test was used to compare the injury costs and working days lost by industry and occupation. Ordinary linear regression was used to investigate the age-injury cost association. A total of 464,139 workers’ compensation claims were reported during the 15-year period in South Australia, with an overall rate of 4.6 claims per 100 employees, resulting in a total of 20,861,001 working days lost and AU$14.9 billion dollars of compensation payment. Between 2000 to 2014, the annual claim rates, compensation payments, working days lost, and number of work-related death reduced by 59.3, 73.8, 87.1, and 78.6 percent, respectively, while the median compensation payment increased by 67.3% from AU$968 to AU$1620. A 1-year increase in age was associated with a 2.1% (Rate Ratio, RR = 1.021, 95% CI: 1.020–1.022) increase in compensation costs and a 1.3% (RR = 1.013, 95% CI: 1.012–1.020) increase in working days lost. Work-related injury rates are declining in most sectors, however some workers, especially young male technicians and labourers in the community services industry, remain at higher risk. Challenges for workers’ health and safety include the aging labour force, vehicle incidents, and severe injuries among new and foreign-born workers.

Using Workers' Compensation Claims Data to Describe Nonfatal Injuries among Workers in Alaska.

BackgroundTo gain a better understanding of nonfatal injuries in Alaska, underutilized data sources such as workers’ compensation claims must be analyzed. The purpose of the current study was to utilize workers’ compensation claims data to estimate the risk of nonfatal, work-related injuries among occupations in Alaska, characterize injury patterns, and prioritize future research.MethodsA dataset with information on all submitted claims during 2014–2015 was provided for analysis. Claims were manually reviewed and coded. For inclusion in this study, claims had to represent incidents that resulted in a nonfatal acute traumatic injury, occurred in Alaska during 2014–2015, and were approved for compensation.ResultsConstruction workers had the highest number of injuries (2,220), but a rate lower than the overall rate (34 per 1,000 construction workers, compared to 40 per 1,000 workers overall). Fire fighters had the highest rate of injuries on the job, with 162 injuries per 1,000 workers, followed by law enforcement officers with 121 injuries per 1,000 workers. The most common types of injuries across all occupations were sprains/strains/tears, contusions, and lacerations.ConclusionThe successful use of Alaska workers’ compensation data demonstrates that the information provided in the claims dataset is meaningful for epidemiologic research. The predominance of sprains, strains, and tears among all occupations in Alaska indicates that ergonomic interventions to prevent overexertion are needed. These findings will be used to promote and guide future injury prevention research and interventions.

Heat related illness among workers in Washington State: A descriptive study using workers' compensation claims, 2006-2017.

Heat related illness (HRI) places a significant burden on the health and safety of working populations and its impacts will likely increase with climate change. The aim of this study was to characterize the demographic and occupational characteristics of Washington workers who suffered from HRI from 2006 to 2017 using workers' compensation claims data. We used Washington workers' compensation data linked to weather station data to identify cases of work-related HRI. We utilized Occupational Injury and Illness Classification System codes, International Classification of Diseases 9/10 codes, and medical review to identify accepted and rejected Washington State (WA) workers' compensation claims for HRI from 2006 to 2017. We estimated rates of HRI by industry and evaluated patterns by ambient temperature. We detected 918 confirmed Washington workers' compensation HRI claims from 2006 to 2017, 654 were accepted and 264 were rejected. Public Administration had the highest third quarter rate (131.3 per 100 000 full time employees [FTE]), followed by Agriculture, Forestry, Fishing, and Hunting (102.6 per 100 000 FTE). The median maximum daytime temperature was below the Washington heat rule threshold for 45% of the accepted HRI claims. Latinos were estimated to be overrepresented in HRI cases. The WA heat rule threshold may not be adequately protecting workers and racial disparities are present in occupational HRI. Employers should take additional precautions to prevent HRI depending on the intensity of heat exposure. States without heat rules and with large industry sectors disproportionately affected by HRI should consider regulations to protect outdoor workers in the face of more frequent and extreme heat waves.

The Impact of Morphine Equivalent Daily Dose Threshold Guidelines on Prescribed Dose in a Workers' Compensation Population.

Prescription opioid overdose has increased markedly and is of great concern among injured workers receiving workers' compensation insurance. Given the association between high daily dose of prescription opioids and negative health outcomes, state workers' compensation boards have disseminated Morphine Equivalent Daily Dose (MEDD) guidelines to discourage high-dose opioid prescribing. To evaluate the impact of MEDD guidelines among workers' compensation claimants on prescribed opioid dose. Workers' compensation claims data, 2010-2013 from 2 guideline states and 3 control states were utilized. The study design was an interrupted time series with comparison states and average monthly MEDD was the primary outcome. Policy variables were specified to allow for both instantaneous and gradual effects and additional stratified analyses examined evaluated the policies separately for individuals with and without acute pain, cancer, and high-dose baseline use to determine whether policies were being targeted as intended. After adjusting for covariates, state fixed-effects, and time trends, policy implementation was associated with a 9.26 mg decrease in MEDD (95% confidence interval, -13.96 to -4.56). Decreases in MEDD also became more pronounced over time and were larger in groups targeted by the policies. Passage of workers' compensation MEDD guidelines was associated with decreases in prescribed opioid dose among injured workers. Disseminating MEDD guidelines to doctors who treat workers' compensation cases may address an important risk factor for opioid-related mortality, while still allowing for autonomy in practice. Further research is needed to determine whether MEDD policies influence prescribing behavior and patient outcomes in other populations.

Occupational injuries among police workers: Patterns and contributing factors in an Australian jurisdiction

Police are regularly exposed to potentially traumatic events, which puts them at risk of physical and psychological injury. International evidence suggests that police have high injury rates relative to other occupations, however most research either focuses on specific situations (e.g., use of force); specific injury causes (e.g., weapons); or specific injury types (e.g. Post-traumatic Stress Disorder). Few studies have focused on understanding injury patterns across the workforce. Thus, the primary objective of this paper was to describe the rate, mechanisms, type and costs of occupational injuries experienced by police in one Australian jurisdiction.Using administrative workers’ compensation claims data, claims records of police were examined for the period 2003/04–2011/12. Descriptive analyses were conducted to characterise the distribution of first and subsequent claims, stratified by claim type (minor, medical and time loss). Rates were calculated using labour force statistics (per 1000 full-time equivalent workers).This study described a number of factors associated with the incidence of injury among police. Over the study period, there was a decrease in first claim rates and an increase in subsequent claim rates across all claim types. Key findings to inform prevention strategies included that younger males (in the 35–44 year age groups) made the most claims, and the greatest proportion of injuries for medical and time loss claims were caused by body stressing (e.g., lifting, carrying). Future research linking corporate statistics to operational/incident information would be beneficial to understand the specific incident factors that are important in outcomes.

Use of Neural Networks to Identify Safety Prevention Priorities in Agro-Manufacturing Operations within Commercial Grain Elevators

The grain handling industry plays a significant role in U.S. agriculture by storing, distributing, and processing a variety of agricultural commodities. Commercial grain elevators are hazardous agro-manufacturing work environments where workers are prone to severe injuries, due to the nature of the activities and workplace. Safety incidents in agro-manufacturing operations generally arise from a combination of factors, rather than a single cause, therefore, research on occupational incidents must look deeper into identifying the underlying causes, through the application of advanced analyses methods. In occupational safety, it is possible to estimate and predict probability of safety risks through developing artificial neural network predictive models. Due to the significance of safety risk assessment in the design and prioritization of effective prevention measures, this study aimed at classifying and predicting causes of occupational incidents in grain elevator agro-manufacturing operations in the Midwest region of the United States. Workers’ compensation claims data, from 2008 to 2016, were utilized for training multilayer perceptron (MLP) and radial basis function (RBF) neural networks. Both MLP and RBF models could predict the probability of safety risks with a high overall accuracy of 60%, 61%. Based on values of AUC (area under the curve) from the ROC (receiving operating charts), both models predicted the probability of individual safety risks with a high accuracy rate of between 71.5% and 99.2%. In addition, sensitivity analysis showed that nature of injury is the most significant determinant of safety risks probability, along with type of injury. The novelty of this study is the use of the artificial neural network methodology to analyze multi-level causes of occupational incidents as the sources of safety risks in bulk storage facilities. The results confirm that artificial neural networks are useful in safety risk estimation, and identifying the incidents’ risk factors. The implementation of safety measures in grain elevators can help in preventing occupational injuries, saving lives, and reducing the occurrence and severity of such incidents in industrial work environments.

Segmentation of Severe Occupational Incidents in Agribusiness Industries Using Latent Class Clustering

One of the principle objectives in occupational safety analysis is to identify the key factors that affect the severity of an incident. To identify risk groups of occupational incidents and the factors associated with them, statistical analysis of workers’ compensation claims data is performed using latent class clustering, for the segmentation of 1031 severe occupational incidents in agribusiness industries in the Midwest region of the United States between 2008–2016. In this study, severe incidents are those with workers’ compensation costs equal to or greater than $100,000 (USD). Based on the latent class clustering results, three risk groups are identified with injury nature as the most statistically distinctive classifier. The highest cost injuries include strain, tear, fracture, contusion, amputation, laceration, burn, concussion, and crushing. The most prevalent and statistically significant injury type is permanent partial disability. The study introduces a novel application of latent class clustering in the segmentation of high severity occupational incidents. The analytical approach and results of this study will aid safety practitioners in identifying occupational risk groups and analyzing injury patterns, and inform safety intervention plans to avoid the occurrence of similar incidents in agribusiness industries.

Characteristics of agricultural and occupational injuries by workers' compensation and other payer sources.

Workers' compensation claims data are routinely used to identify and describe work-related injury for public health surveillance and research, yet the proportion of work-related injuries covered by workers' compensation, especially in the agricultural industry, is unknown. Using data from the Iowa Trauma Registry, we determined the sensitivity and specificity of the use of workers' compensation as a payer source to ascertain work-related injuries requiring acute care comparing agriculture with other rural industries. The sensitivity of workers' compensation as a payer source to identify work-related agricultural injuries was 18.5%, suggesting that the large majority of occupational agricultural injuries would not be accurately identified through workers' compensation records. For rural nonagricultural, rural occupational injuries, the sensitivity was higher (64.2%). Work-related agricultural injuries were most frequently covered by private insurance (39.6%) and public insurance (21.4%), while rural nonagricultural injuries were most frequently covered by workers' compensation (65.2%). Workers' compensation claims data will not include the majority of work-related agricultural injuries.