Occupational illness cases, private industry, 1976-95

600 F
500
400
300
200
100 L
0

1976 1978 1980 1982 1984 1986 1988 1990 1992 1994

NOTE: Data for 1992-1995 exclude work-related fatalities. ~

65. Compensation and Working Conditions Summer 1997


Table 3. Industries with the highest number of nonfatal iliness cases of disorders associated with repeated trauma, private

industry, 1995,
and number of cases in thousands)
Annual
Industry! sic ‘Number incidence:

code? empioyment | of cases rate
96,886.0 308.2 37.8
371 967.6 49.5 496.5,
201 470.5 7 TI20
372 449.0 64 143.7
232 251.9 62 ~ 2716
806 3,742.9 64 20.4
308 709.5 59 82.7
346 251.5 5.2 201.8
541 2,983.2 5.4 24.0
481 886.6 46 53.0
367 581.4 43 73.0
363 120.4 42 360.6
225 196.7 41 * 2128
358 201.6 40 198.9
369 156.2 39 248.1
596 329.4 28 100.3
531 2,327.4 27 16.3
737 1,084.0 27 26.4
384 263.8 27 104.1
373 158.3 26 168.7
382 286.2 26 91.1
251 280.4 25 93.4
239 227 25 118.2
275 560.4 25 45.7
Cutlery, handtools, and 342 128.0 24 190.6
Offices and clinics of medical doctors 801 1,609.9 24 17.8
Iron and stee! foundries. 332 130.2 24 173.6
Commercial banks ... 602 1,461.1 23 176
Computer and office equipment 357 350.0 23 67.5
‘Newspapers . 271 445.7 23 62.5

Fire, marine, and casualty insurance .. 633 530.8 2.3
Miscellaneous food and kindred products 209 180.4 24 123.1
Women's and misses’ outerwear 233 276.0 24 82.3
Electrical industrial apparatus 2 157.4 24 134.5,
Miscellaneous fabricated metal prod 349 252.0 21 81.2
Bakery products ... 205 211.4 241 101.0
Air transportation, scheduled . 451 626.3 20 36.2

+ Industries with the highest number of iliness cases of disorders
associated with repeated trauma were determined by analysis of the
number of cases at the 3-digit SIC code level. The analysis included
those 3-digit industries which reported at least 2,000 cases of disor-
ders associated with repeated trauma.

2 Standard Industrial Classification Manual, 1987 Edition.

3 Employment is expressed as an annual average and is derived
primarily from the BLS Current Employment Statistics program.

4 Incidence rates represent the number of illness cases of disor-
ders associated with repeated trauma per 10,000 full-time workers

and were calculated as: (N/EH) X 20,000,000, where
N = number of iliness cases of disorders associated
with repeated trauma
EH = total hours worked by all employees during the

year
20,000,000 = base for 10,000 equivalent futl-time workers:
(working 40 hours per week, 50 weeks per year).

5 Excludes farms with fewer than 11 employees.
nec. = not elsewhere classified

‘Compensation and Working Conditions Summer 1997 64


Safety and Health

Have Disorders
Associated with
Repeated Trauma

Stopped Increasing?

BY DINO DRUDI

In 1995, there were 494,800 newly-reported work-re-
lated illnesses in the American private sector.’ Occupa-
tional illnesses are any abnormal conditions or disorders,
caused by long-term or repeated exposure to factors associ-
ated with employment and are distinct from occupational
injuries, which result from a single work-related event or a
single instantaneous exposure in the work environment.

Repeated trauma disorders account for over three-fifths
of these newly-reported occupational illness cases. The
308,200 new disorders associated with repeated trauma in
1995 include conditions due to repeated motion, vibration,
or pressure.’ Conditions such as sprains, which are usually
classified as occupational injuries, are considered occupa-
tional illnesses involving repeated trauma when they arise
from cumulative traumatic exposure over time.

Repeated trauma disorders for many years have been the
fastest growing category of occupational illness reported in
the BLS survey. They rose steadily from 22,600 cases in
1982 to 332,100 cases in 1994, an increase of over 1,000
percent in 12 years, before dropping to 308,200 in 1995
(see chart). During this time the corresponding incidence
rates grew from 3.6 cases per 10,000 full-time workers in
1982 to 41.1 cases in 1994, before dropping to 37.8 cases
in 1995,

In 1986, disorders associated with repeated trauma be-
came the leading occupational illness category, surpassing
skin diseases and disorders such as occupational dermatitis
as the leading occupational illness. By 1989, disorders as-
sociated with repeated trauma outnumbered all other occu-
pational disease categories combined (see chart), Table 1
presents the number of cases and incidence rates for disor-

Dino Drudiis an economist in the Office of Safety, Health, and Working
Conditions, Bureau of Labor Statistics. Telephone (202) 606-6175.

61 Compensation and Working Conditions Summer 1997

Table 1. Number and incidence rates for nonfatal disorders
associated with repeated trauma, private industry, 1976-95

Disorders associated with
repeated trauma
Number i 1
(thousands) Incidence rates’
23.0 44
23.4 40
20.2 3.3
21.9 3.4
23.2 36
23.0 3.5
226 36
26.7 42
7 51
37.0 5.3
45.5 64
729 10.0
115.3 15.4
146.9 19.2
185.4 24.4
223.6 29.7
281.8 8
302.4 38.3
332.1 41.1
08.2 378

* Incidence rates represent the number of iliness cases of disor-
ders associated with repeated trauma per 10,000 full-time workers
and were calculated as: (N/EH) X 20,000,000, where

N= number of iliness cases of disorders associated
with repeated trauma
EH = total hours worked by all employees during the
calendar year
20,000,000 = base for 10,000 equivalent fulltime workers

(working 40 hours per week, 50 weeks per year).
NOTE: Exctudes farms with fewer than 11 employees.


ders associated with repeated trauma from 1976 to 1995.

Work-related repeated trauma disorder cases arise in a
variety of ways. Most are caused, however, by free bodily
motion which imposes stress or strain upon some part of
the body due to a task’s repetitive character. These cases
are classified by BLS as occupational illnesses, meaning
they arise from non-instantaneous exposures often span-
ning an extended period of time. Repeated trauma disor-
der is one of several terms used to describe these condi-
tions. Other terms used include cumulative trauma disorder
and repetitive stress disorder.

The most common repetitive task associated with re-
peated trauma disorders, according to BLS survey data, is
placing, grasping, or moving objects other than tools (for
example, scanning groceries at the checkout counter). Other
work activities, such as typing or key entry, and repetitive
use of tools also produce large numbers of repeated trauma
disorder cases.

Background of the survey

The Survey of Occupational Injuries and Illnesses is a
Federal/State program in which employer reports are col-
lected from about 250,000 private industry establishments
and processed by State agencies cooperating with BLS.
Occupational injury and illness data for coal, metal, and
nonmetal mining and for railroad activities are provided by
the Department of Labor’s Mine Safety and Health Admin-
istration and the Department of ‘Transportation’s Federal.
Railroad Administration. The survey, which measures non-
fatal injuries and illnesses only, excludes the self-employed;
farms with fewer than 11 employees; private households;
and employees in Federal, State, and local government agen-
cies?

Industry experience
Disorders associated with repeated trauma tend to con-
centrate in manufacturing industries. The 25 private sec-

tor industries with the highest nonfatal illness incidence
rates of disorders associated with repeated trauma in 1995
were all in manufacturing. (See table 2.) Of the 36 private
sector industries (3-digit level) with 2,000 or more disor-
ders associated with repeated trauma cases, 10 were out-
side of manufacturing. (See table 3.)

Meat packing plants, SIC 2011, have the highest inci-
dence rate with 1,206.2 cases per 10,000 full-time workers.
This was over a third higher than the next category, motor
vehicles and car bodies, SIC 3711, with 885 cases per 10,000
full-time workers, and over 30 times the all private indus-
try rate.

Employment—and thus exposure hours—in motor ve-
hicles and equipment, SIC 371, which includes motor ve-
hicles and car bodies, is twice that of meat products, SIC
2011, which includes meat packing plants. Consequently,
even though the incidence rate for meat products is consid-
erably greater than the incidence rate for motor vehicles
and equipment manufacturing, motor vehicles and equip-
ment manufacturing nevertheless accounts for more cases
of disorders associated with repeated trauma than meat prod-
ucts. These two industries together account for over a quar-
ter of repeated trauma disorder cases.

Conclusion

The 7-percent drop in the number of disorders associ-
ated with repeated trauma cases, from 332,100 in 1994 to
308,200 in 1995—and the 8-percent drop in the incidence
rate from 41.1 cases per 10,000 full-time workers in 1994
to 37.8 in 1995—is a significant 1-year decline. But con-
clusions about future trends cannot be based on a single
year’s data. It is still too early to determine whether the
drop in the number and rate of disorders associated with
repeated trauma cases represents a leveling off after over a
decade of increase, or a reversal of the trend consequent to
ergonomic improvements, or an anomaly.

—ENDNOTES—

* Data are from the 1995 BLS Survey of Occupational Injuries and Il-
nesses.

? Includes, among others, carpal tunnel syndrome, noise-induced hearing
loss, synovitis, tenosynovitis, bursitis, and Raynaud’s

3 The annual survey provides estimates of the number and frequency (in-
cidence rates) of workplace injuries and illnesses based on logs kept by pri-
vate industry employers during the year. These records reflect not only the
year’s injury and illness experience, but also the employer's understanding of
which cases are work related under current U.S. Department of Labor
recordkeeping guidelines... The number of injuries and illnesses reported in
any given year also can be influenced by changes in the level of economic
activity, working conditions and work practices, worker experience and train-
ing, and the number of hours worked.

‘The survey measures the number of new work-related illness cases which
are recognized, diagnosed, and reported during the year. Some conditions
(eg., long-term latent illnesses caused by exposure to carcinogens) often are

difficult to relate to the workplace and are not adequately recognized and
reported. These long-term latent illnesses are believed to be understated in
the survey’s illness measures. The overwhelming majority of the reported
new illnesses are those which are easier to directly relate to workplace activ-
ity (¢.g., contact dermatitis or carpal tunnel syndrome).

‘The survey estimates of occupational injuries and illnesses are based on a
scientifically selected probability sample, rather than a census of the entire popu-
lation. These sample-based estimates may differ from the results which would
be obtained from a census of the population. The sample used was one of many
possible samples, cach of which could have produced different estimates.

The data also are subject to nonsampling error. The inability to obtain
information about all cases in the sample, mistakes in recording or coding the
data, and definitional difficulties are examples of nonsampling error in the
survey. Nonsampling errors are not measured. However, BLS has imple-
mented quality assurance procedures to minimize nonsampling error in the
survey.

Compensation and Working Conditions Summer 1997 62


‘Table 2. industries with the highest nonfatal illness incidence rates of disorders associated with repeated trauma,
private industry, 1995
(Employment and number of cases in thousands)

1995
Industry" sic Annual Incidence Numper
code? average rate* cases
96,866.0 37.8 308.2
Meat packing plants ... 2011 143.5 1,206.2 18.4
Motor vehicles and car bodies a 358.9 885.0 31.7
2254 224 786.3 16
2015 235.5 | 623.5 14.4
3633 16.7 592.4 9
2322 244 469.0 10
2013 91.5 426.1 3.9
3632 20.7 388.2 14
Engine electrical equipment..... 3694 706 384.6 28
Men's and boys’ trousers and slacks 2325 73 383.7 27
3751 20.8 371.5 8
3465 115.3 352.0 42
2531 427 3473 14
2326 40.6 341.8 1.2
3639 13.4 329.8 A
3211 15.3 325.5 5
3586 5.5 316.5 2
3714 511.9 3046 16.5
2006 35.4 296.4 14
Men's footwear, except athletic 3143 254 2678 6
Women's footwear, except athletic .. 3144 16.9 262.3 4
Household cooking equipment 3631 214 255.3 5
271 27.6 251.8 6
* 3585 139.0 245.4 34
3114 13.7 244.4 3
, High rate industries wore those having the 26 highest incidence and were calculated as: (N/EH) X 20,000,000, where
rates for iliness cases of disorders associated with repeated trauma
at the most detailed or lowest SIC level at which rates are calculated N = number of iliness cases of disorders associat
and published. Generally, manufacturing industries were calculated with repeated trauma
at the 4-digit code level and the remaining industries at the 3-digit level £H = total hours worked by all employees during th:
based on the Standard industrial Classification Manual, 1967 Edition. calendar year
2 Standard industrial Classification Manual, 1987 Edition. 20,000,000 = base for 10,000 equivalent full-time workers
2 Employment is is expressed as an annual average and is derived (working 40 hours per week, 50 weeks per yea
primarily from the BLS Current Employment Statistics program.
4 Incidence rates represent the number of iliness cases of disor- * Exchxdes forms with fewer han 74 employes.
ders associated with repeated trauma per 10,000 full-time workers n.e.c. = not elsewhere classi

63 Compensation and Working Conditions Summer 1997