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Trends in Major Occupational Injuries in Different Industrial Divisions in Taiwan During 1983-1993

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Trends in Major Occupational Injuries in Different Industrial Divisions in Taiwan During 1983-1993 Trends in Major Occupational Injuries in Different Industrial Divisions in Taiwan during 1983-1993 Yu-Chen CHANG1, 2 and Jung-Der WANG2 'Department of Family Medicine , Tainan Municipal Hospital and 2Center for Research of Environmental and Occupational Diseases, Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health Abstract: Trends in Major Occupational Injuries in quency and severity rates in the aspect of human Different Industrial Divisions in Taiwan during capital loss. There was a consistently improved 1983-1993: Yu-Chen CHANG,et aL Department of trend in occupational injuries in Taiwan during 1983 Family Medicine, Tainan Municipal Hospital-Ob- -93 . jectives: The purpose of this study was to examine (J Occup Health 1997; 39: 295-301) the time trend in occupational injuries in main indus- trial divisions in Taiwan from 1983 through 1993 Key words: Occupational injury, Cumulative injury with newly developed quantification methods. rate, Severity index, Proportion of potential work- Methods: Data concerning deaths and permanent days lost, Human capital disabilities caused by occupational injuries were retrieved from the computer files of Taiwan's Labor Accidents have been the third leading cause of Insurance Bureau and statistical analyses were deaths in Taiwan since 19761). There have been performed by using the indices of the cumulative more than 1,500 cases of occupation-related deaths injury rate for from 15 to 64 years of age (CIR15-64), and more than 5,000 cases of permanent disabilities modified severity index (MSI), proportion of potential in recent years 2). Among the figures of deaths and workdays lost (PPWDL) and foregone earnings lost. disabilities are the precious lives lost and the func- Results: Mining and quarrying was the most risky in- tionally disabled individuals that have emerged, dustry, when expressed in both frequency and sever- ity. The mean rates over the 1 1 year period were as which has brought enormous grief and economic follows: disabling frequency rate, 24.0; incidence burden to the injured victims, as well as to their rate, 0.012 (yr 1); CIR15_64,0.491 ; disabling severity families and Taiwanese society as a whole3'4) rate, 7,591.7; modified severity index, 22.5; and the Efforts made to prevent the occupational injuries PPWDL, 3.72 (10-3). In terms of frequency, inci- are usually monitored by valid indicators. The dis- dence rate and CIR15_64,manufacturing was second abling frequency and severity rates have been used and agriculture third. With regard to severity, MSI worldwide since 1967 in order to quantify how and PPWDL, agriculture ranked second and con- many occupation-related injuries occur and how se- struction ranked third. The overall trend in occupa- rious they are to a firm 5), but when extending these tional injuries in Taiwan has steadily improved in the indicators from the level of the firm to that of an past decade. All indicators of human capital loss in industry or even a country, these two indicators 1993 were nearly down to one third of those have some drawbacks which limit their application. reported in 1983. The estimated potential salary lost in all industries of 1993 was 584.6 million US For example, the disabling frequency rate cannot be dollars. Conclusions: Mining and quarrying was still interpreted as the lifetime risk of an occupational ranked the most risky industry during 1983-93. We injury for a worker, nor does it take into account have demonstrated that CIR15-64, MSI, PPWDL and the difference in age distribution among industrial foregone earnings lost supplemented disabling fre- divisions. The disabling severity rate incorporates the fixed numbers of days disabled charged to a Received Sept 24, 1996; Accepted Feb 21, 1997 particular condition of disability from a standard Correspondence to: J.-D. Wang, Center for Research of En- table, which does not consider the actual loss in vironmental and Occupational Diseases, Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University workdays for the disability, nor can it be used to College of Public Health No. 1, Section 1, Jen-Ai Road, Taipei, crudely estimate the economic cost of occupational Taiwan, R. O. C. 10016 injuries. Moreover, companies with less than 30 employees are not legally required to report their reports of statistical data for the Taiwan-Fukein occupational injuries in Taiwan. Even if the firm area Labor Insurance 2). These data also include the size might not necessarily correlated inversely with workers' mean salary for each industrial division. the frequency and/or severity of occupational The methods used to quantify the occupational jnjuries6). The statistics accumulated by govern- injuries came from two aspects of measurements, mental agencies in Taiwan may underestimate the the frequency and the severity. The frequency indi- real problems of occupational injuries because large cators included the incidence rate and CIR1s_64• companies generally can afford to invest more on The severity indicators included the severity index, occupational safety and health, which usually pres- PPWDL and potential salary lost. Details of ad- ents us with a less frequent and severe figure for vantages and limitations were given in our previous occupational injuries. We have therefore proposed report', but there are modifications of the indices a cumulative injury rate from 15 to 64 years of age should be taken care of here. In our proposed (CIR15-64),severity index, proportion of potential model of potential workdays lost, we derived the workdays lost (PPWDL) and potential salary lost figure for lost workdays based on three main as complementary indicators to show the loss in categories of outcomes of occupational injuries, human capital?. The CIR1564 is supposed to be an cases of premature death, permanent disability and alternative index to the disabling frequency rate temporary dysfunction. But the category of both for its inherent adjustments of uneven age dis- tempopary dysfunction was omitted from this study tribution for assessinga worker's lifetime risk of ac- because the computer files from Labor Insurance quiring occupational injury in a specific contained only cases of deaths and permanent dis- industry-10). The concept of potential workdays abilities. In addition, the severity index was also lost involves the estimation of the potential work- modified by substituting the "total number of days a worker would lose if he died or was on sick person-hours worked" for "total number of person- leave due to occupational injuries. The total poten- years worked" in the denominator while the numer- tial workdays lost can be directly interpreted as a ator remained the same (potential workdays lost), quantitative loss of human resources to society and because of the limitation of data available from the converted into a monetary value. The severity computer file. This quotient we named the index, PPWDL and potential salary lost were modified severity index (MSI) to distinguish it developed to quantify the severity aspect of occupa- from the original severity index. tional injury of specific industries. They were also The cost of an occupational injury usually in- used as indicators supplemental to the disabling se- cluded the direct and indirect costs3). The potential verity rate, introducing the concept of standardiza- salary lost, or foregone earnings, was estimated tion in epidemiology and the concept of human cap- from the potential workdays lost which were multi- ital in economics7°11~. In this study, we use these plied with age, gender and industry specific daily new indicators to analyze and to compare the time salary2). From an economic point of view, such trend in occupational injuries for different industri- approaches are practical supplements which can be al sectors of Taiwan for comparison during 1983- directly used to count the human capital cost of oc- 93. cupational injuries, and they are usually considered Subjects and Methods as the lower bound of the costs estimated from the method of willingness-to-pay'12). Workers in every industrial company which The disabling frequency and severity rates for employs more than five persons have been required nine main industrial divisions during 1983-93 were to register with Taiwan's Labor Insurance Bureau taken directly from the annually published data since 1951. All subjects suffering from occupation- from the Council of Labor Affairs of Taiwan') , al injuries, either death or permanent disabilities, which included not only occupational mortality, were compensated and thus further data registered, total and partial permanent disabilities, but also for example injury date, kind of injury, grade of temporary disability compiled from the registration permanent disability (15 grades are used in Taiwan) reports of companies with more than 30 employees. and personal industrial code number, etc. These We compared the results for disabling frequency data from paper documents have been transformed and severity rates from the publishing document) into computer files since 1983. We have retrieved with the indicators, CIR1s_64' MSI, PPWDL and all of the computerized data files from 1983-93 potential salary lost which were calculated from the from the Labor Insurance Bureau of Taiwan Pro- computer file. Although the sources of data dif- vincial Government for this analysis. The data re- fered from each other, it is interesting to compare garding population at risk came from the annual the trend in these indicators, and readers should look with caution at the tables and figures because pational injuries in manufacturing and commerce of the difference between data sources. industries were 34.1 and 33.7 years respectively, According to the standard classifications of in- which were relatively young. Manufacturing in- dustry and occupation in Taiwan, there are nine dustries recruited a large proportion of the total main industrial divisions13), which is the same as the working population in Taiwan, 2,664 (X 103), definition from the International Labor Office whereas the mining and public utilities had the (ILO).
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