文章基本信息

标题：Occupational Injury and Illness Surveillance: Conceptual Filters Explain Underreporting
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作者：Lenore S. Azaroff ; Charles Levenstein ; David H. Wegman 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2002
卷号：92
期号：9
页码：1421-1429
语种：English
出版社：American Public Health Association
摘要：Occupational health surveillance data are key to effective intervention. However, the US Bureau of Labor Statistics survey significantly underestimates the incidence of work-related injuries and illnesses. Researchers supplement these statistics with data from other systems not designed for surveillance. The authors apply the filter model of Webb et al. to underreporting by the Bureau of Labor Statistics, workers’ compensation wage-replacement documents, physician reporting systems, and medical records of treatment charged to workers’ compensation. Mechanisms are described for the loss of cases at successive steps of documentation. Empirical findings indicate that workers repeatedly risk adverse consequences for attempting to complete these steps, while systems for ensuring their completion are weak or absent. The United States does not have a comprehensive national surveillance system for occupational injuries and illnesses. Lacking this system, major sources of US occupational health data include the Bureau of Labor Statistics (BLS) annual survey of occupational injuries and illnesses, workers’ compensation records, and physician reporting systems. Data produced by these systems have been described as fragmentary, unreliable, and inconsistent. Moreover, they have been shown to underestimate the incidence of workrelated injuries, illnesses, and even fatalities by as much as several hundred percent. 1– 13 Following a 1987 National Academy of Sciences report on the shortcomings of surveillance systems, 9 the BLS redesigned its annual survey 10, 14 and introduced new programs to improve documentation of occupational fatalities. 15 However, the problem of underreporting remains unresolved. Here we adapt the filter model developed by Webb et al. 16, 17 to describe the documentation of work-related injuries and illnesses in Australia. Filter models are applied to the BLS and physician-based surveillance systems. Because data from other systems not designed for surveillance are nonetheless used to inform research and public policy, the discussion includes workers’ compensation wagereplacement data and medical records. This last source provides data to individual research projects as well as the National Hospital Ambulatory Medical Care Survey and related programs. 18