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Profiles of Occupational Injuries and Diseases in Michigan

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June 2004 Division of Environmental and Occupational Epidemiology Michigan Department of Community Health Profiles of Occupational Injuries and Diseases in Michigan State of Michigan Governor - Jennifer M. Granholm, JD Michigan Department of Community Health Director - Janet D. Olszewski, MSW Surgeon General - Kimberlydawn Wisdom, MD, MS Public Health Administration Chief Administrative Officer - Jean Chabut, BSN, MPH Bureau of Epidemiology Director - Matthew Boulton, MD, MPH Division of Environmental and Occupational Epidemiology Director - David R. Wade, PhD Authors Division of Environmental and Occupational Epidemiology Martha Stanbury, MSPH Thomas W. Largo, MPH Jill Granger, MPH Lorraine Cameron, PhD Michigan State University Kenneth Rosenman, MD Contributors Michigan Department of Community Health Glenn Copeland, MBA Robert Scott, PhD Robert Wahl, DVM, MPH Michigan State University Mary Jo Reilly, MS Amy Sims, BS Editing and Design Shevon Desai, BA Publication Date June 2004 Permission is granted for the reproduction of this publication, in limited quantity, provided the reproductions contain appropriate reference to the source. This publication was supported by grant number 5 U01 OH007306 from the U.S. Centers for Disease Control and Prevention - National Institute for Occupational Safety and Health (CDC- NIOSH). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of CDC-NIOSH. The Michigan Department of Community Health is an Equal Opportunity Employer, Services, and Programs Provider. ii Table of Contents Summary and Recommendations v Chapter 1 Introduction, Organization and Data Systems 1 Chapter 2 Fatal Work-Related Injuries 7 Chapter 3 Non-Fatal Work-Related Injuries 15 Chapter 4 Work-Related Asthma 27 Chapter 5 Occupational Lead Poisoning and Elevated Blood Lead Levels 33 Chapter 6 Silicosis and Other Pneumoconiosis 41 Chapter 7 Acute Occupational Pesticide Poisoning 49 Chapter 8 Occupational Noise-Induced Hearing Loss 55 Chapter 9 Occupationally-Acquired Communicable Diseases 61 Chapter 10 Work-Related Musculoskeletal Disorders 67 Chapter 11 Occupational Cancer 77 Chapter 12 Occupational Skin Diseases 83 iii Summary and Recommendations S Summary and Recommendations ore than 4.8 million individuals work in the state of Michigan, and some risk of illness or injury M attends virtually every job held. Work-related injuries and illnesses cost 1.5 billion dollars annually in workers’ compensation claims in Michigan, and the indirect costs of these conditions may be as much as five times greater (7.5 billion dollars). Yet, work-related injuries and illnesses are preventable. Equipment design, ventilation systems, use of personal protective equipment, work practices and many other factors contribute to the control or elimination of workplace hazards. Since the passage of the federal Occupational Safety and Health Act thirty-five years ago and its adoption in Michigan, workplaces have become safer. The overall decline in occupational injury and illness rates in Michigan and nationally can be attributed to many factors, including strong enforcement of health and safety standards, increased awareness, and support from the private sector. Identification, quantification and tracking of adverse health outcomes are essential for understanding and preventing occupational injuries and illnesses. Data on the magnitude and trends in occupational injury and illness in Michigan are available from a number of sources. To make these data more accessible, they have been compiled into this single report. The report uses the available data to profile all occupational injuries and diseases and some specific occupational conditions of public health importance in Michigan. Examination of the data has led to the identification of some recommended actions, which could result in significant improvements in occupational health and safety. The key findings of this report and related recommendations are noted below. Occupational injuries Findings • There were 175 fatal occupational injuries in Michigan in 2001; on average, one worker died nearly every two days of an acute, work-related injury. Michigan's fatal injury rate has remained below the federal rate for the 10 years these data have been collected. • Michigan's non-fatal injury rate declined 32% between 1992 and 2001, from a high of 9.4 per 100 full time workers to 6.4 in 2001. Michigan's rate for private sector employees exceeded the national rate throughout this timeframe, particularly in the manufacturing sector (12.5 per 100 in Michigan; 10.4 in the U.S. in 2001.) Recommendations • The Michigan Occupational Safety and Health Administration (MIOSHA) has maintained strong enforcement and education and training programs to ensure effective recordkeeping and reporting of occupational injuries and illnesses by employers, and this may account for the differences between federal and state rates. Additional investigation would help determine how much of the difference is due to better reporting by Michigan employers. v Summary and Recommendations Toxic exposures Findings • Over 33,000 adults were tested for blood lead levels between 1998 and 2001; 1,907 of these individuals were exposed to lead at work and had a blood lead level equal or greater than 10 micrograms per deciliter of blood (an indication of exposure to lead greater than background levels). The number of individuals with higher blood lead levels has decreased steadily since 1998. • Seventy percent of interviewed individuals with elevated blood lead levels experienced symptoms at blood lead levels allowed by the current workplace safety regulations. • One-third of the interviewed individuals reporting having young children living in their home, who were potentially at risk of exposure to lead taken home on the clothing of the worker. Despite the risk, only 24% of these children had been tested for lead exposure. Of those tested, almost half had an elevated blood lead level. • Surveillance of occupational lead exposure is effective because laboratories must report all blood lead test results (in children and adults), and because regulations under the Michigan Occupational Safety and Health Act (MIOSHA) require ongoing blood lead monitoring of lead- exposed workers. Recommendations • The MIOSHA health standards for lead in general industry and construction should be reassessed in light of evidence that adverse health effects are being experienced even among workers with blood lead levels considered acceptable by these standards. • Additional efforts are needed to ensure that the children of lead-exposed workers are being tested for lead exposure and are being protected from "take-home" lead. • Given the effectiveness of the laboratory-based surveillance system for lead, and given concerns in Michigan for exposure to other heavy metals at work and in the environment, consideration should be given to mandating laboratory reporting of mercury, arsenic, and cadmium blood and urine test results. Occupational diseases Findings • Michigan's occupational asthma surveillance system identified over 1,780 individuals with work-related asthma from 1988 through 2001, for an average annual incidence of 3.4 cases per 100,000 workers. The leading causes of occupational asthma were exposures to isocyanates and metalworking fluids. vi Summary and Recommendations • Michigan's silicosis surveillance system confirmed silicosis in 857 individuals during the 14- year period from 1988 through 2001. Seventy-seven percent worked in foundries where they were exposed to the silica dust that causes this disabling lung disease. Occupational exposure to mineral dusts other than silica caused pneumoconiosis in 14,148 individuals reported by health care providers and employers between 1992 and 2001. Ninety-one percent of these individuals were reported to have asbestosis, the type of pneumoconiosis caused by asbestos exposure. Because pneumoconioses are diseases of long latency, most individuals currently diagnosed with these conditions were exposed to the causative mineral dusts many years ago. • Seventy-seven individuals with work-related pesticide poisoning were reported to the occupational pesticide poisoning surveillance system that began in 2001. • The Michigan work-related noise-induced hearing loss surveillance system, established in 1992, identified 20,731 cases through 2001. These individuals worked in many types of industries but predominantly manufacturing, construction and agriculture. Reduction of noise- induced hearing loss is a goal of MIOSHA's current strategic plan. • On average, there were about 20 cases annually of work-related infectious diseases in each of the five data systems where these data were available. The amount of overlap between data systems is unknown. More than one-quarter of the cases were for work-related tuberculosis. The number of reported cases is very small given the number of workers potentially exposed in Michigan. • From 1992-2001, the incidence of disorders due to repeated trauma in the workplace in Michigan was more than double the incidence rate in the United States, although rates for cases associated with days away from work were similar to national rates. The incidence of musculoskeletal disorders declined over that time period, paralleling a decline in the U.S. Reduction of work-related musculoskeletal disorders is a goal of MIOSHA’s current strategic plan. • Mandatory reporting of work-related diseases to the state of Michigan included 706 individuals
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