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Adjustment for race is discouraged in lung-function testing, but the implications of adopting race-neutral equations have not been comprehensively quantified. We obtained longitudinal data from 369,077 participants in the National Health and Nutrition Examination Survey, U.K. Biobank, the Multi-Ethnic Study of Atherosclerosis, and the Organ Procurement and Transplantation Network. Using these data, we compared the race-based 2012 Global Lung Function Initiative (GLI-2012) equations with race-neutral equations introduced in 2022 (GLI-Global). Evaluated outcomes included national projections of clinical, occupational, and financial reclassifications; individual lung-allocation scores for transplantation priority; and concordance statistics (C statistics) for clinical prediction tasks. Among the 249 million persons in the United States between 6 and 79 years of age who are able to produce high-quality spirometric results, the use of GLI-Global equations may reclassify ventilatory impairment for 12.5 million persons, medical impairment ratings for 8.16 million, occupational eligibility for 2.28 million, grading of chronic obstructive pulmonary disease for 2.05 million, and military disability compensation for 413,000. These potential changes differed according to race; for example, classifications of nonobstructive ventilatory impairment may change dramatically, increasing 141% (95% confidence interval [CI], 113 to 169) among Black persons and decreasing 69% (95% CI, 63 to 74) among White persons. Annual disability payments may increase by more than $1 billion among Black veterans and decrease by $0.5 billion among White veterans. GLI-2012 and GLI-Global equations had similar discriminative accuracy with regard to respiratory symptoms, health care utilization, new-onset disease, death from any cause, death related to respiratory disease, and death among persons on a transplant waiting list, with differences in C statistics ranging from -0.008 to 0.011. The use of race-based and race-neutral equations generated similarly accurate predictions of respiratory outcomes but assigned different disease classifications, occupational eligibility, and disability compensation for millions of persons, with effects diverging according to race. (Funded by the National Heart Lung and Blood Institute and the National Institute of Environmental Health Sciences.).

Context: The allocation of scarce health care resources requires a knowledge of disease costs. Whereas many studies of a variety of diseases are available, few focus on job-related injuries and illnesses. This article provides estimates of the national costs of occupational injury and illness among civilians in the United States for 2007. Methods: This study provides estimates of both the incidence of fatal and nonfatal injuries and nonfatal illnesses and the prevalence of fatal diseases as well as both medical and indirect (productivity) costs. To generate the estimates, I combined primary and secondary data sources with parameters from the literature and model assumptions. My primary sources were injury, disease, employment, and inflation data from the U.S. Bureau of Labor Statistics (BLS) and the Centers for Disease Control and Prevention (CDC) as well as costs data from the National Council on Compensation Insurance and the Healthcare Cost and Utilization Project. My secondary sources were the National Academy of Social Insurance, literature estimates of Attributable Fractions (AF) of diseases with occupational components, and national estimates for all health care costs. Critical model assumptions were applied to the underreporting of injuries, wage-replacement rates, and AFs. Total costs were calculated by multiplying the number of cases by the average cost per case. A sensitivity analysis tested for the effects of the most consequential assumptions. Numerous improvements over earlier studies included reliance on BLS data for government workers and ten specific cancer sites rather than only one broad cancer category. Findings: The number of fatal and nonfatal injuries in 2007 was estimated to be more than 5,600 and almost 8,559,000, respectively, at a cost of $6 billion and $186 billion. The number of fatal and nonfatal illnesses was estimated at more than 53,000 and nearly 427,000, respectively, with cost estimates of $46 billion and $12 billion. For injuries and diseases combined, medical cost estimates were $67 billion (27% of the total), and indirect costs were almost $183 billion (73%). Injuries comprised 77 percent of the total, and diseases accounted for 23 percent. The total estimated costs were approximately $250 billion, compared with the inflation-adjusted cost of $217 billion for 1992. Conclusions: The medical and indirect costs of occupational injuries and illnesses are sizable, at least as large as the cost of cancer. Workers' compensation covers less than 25 percent of these costs, so all members of society share the burden. The contributions of job-related injuries and illnesses to the overall cost of medical care and ill health are greater than generally assumed.

The true burden (morbidity, mortality, disability, cost, pain, distress) of occupational and work-related diseases and injuries is unknown, and what is reported as burden is significantly underestimated. This underestimation affects the way decision-makers view investments in research and worker protection, which in turn has a substantial impact on national welfare and public health. To better describe the societal and individual burdens of occupational and work-related diseases and injuries, we propose an approach to gauge what is known about burden and where new assessments may be made. This approach consists of 4 elements to consider in burden assessments: (1) utilizing multiple domains, including the individual worker, the worker’s family, the community in which the workplace is located, the employer, and society as a whole; (2) taking a broader view of the work-relatedness of disease and injury; (3) assessing the impact of the entire working-life continuum; and (4) applying the comprehensive concept of “well-being” as an indicator in addressing contemporary changes in the nature of work, the workplace, and the workforce. Further research on burden and enhanced surveillance is needed to develop these elements.

Purpose The objective of this systematic review was to synthesize evidence on the effectiveness of workplace-based return-to-work (RTW) interventions and work disability management (DM) interventions that assist workers with musculoskeletal (MSK) and pain-related conditions and mental health (MH) conditions with RTW. Methods We followed a systematic review process developed by the Institute for Work & Health and an adapted best evidence synthesis that ranked evidence as strong, moderate, limited, or insufficient. Results Seven electronic databases were searched from January 1990 until April 2015, yielding 8898 non-duplicate references. Evidence from 36 medium and high quality studies were synthesized on 12 different intervention categories across three broad domains: health-focused, service coordination, and work modification interventions. There was strong evidence that duration away from work from both MSK or pain-related conditions and MH conditions were significantly reduced by multi-domain interventions encompassing at least two of the three domains. There was moderate evidence that these multi-domain interventions had a positive impact on cost outcomes. There was strong evidence that cognitive behavioural therapy interventions that do not also include workplace modifications or service coordination components are not effective in helping workers with MH conditions in RTW. Evidence for the effectiveness of other single-domain interventions was mixed, with some studies reporting positive effects and others reporting no effects on lost time and work functioning. Conclusions While there is substantial research literature focused on RTW, there are only a small number of quality workplace-based RTW intervention studies that involve workers with MSK or pain-related conditions and MH conditions. We recommend implementing multi-domain interventions (i.e. with healthcare provision, service coordination, and work accommodation components) to help reduce lost time for MSK or pain-related conditions and MH conditions. Practitioners should also consider implementing these programs to help improve work functioning and reduce costs associated with work disability.

In order to study the relationship between China's safety production indicators and economic and social indicators, the development trend of indicator data in the past 20 years was statistically analyzed, and qualitative and quantitative research was conducted using grey relational analysis and multiple linear regression analysis methods. In the past two decades, there has been a significant improvement in the number of deaths, work-related injuries, and occupational patients in China's safety production, and the country's three categories of 14 economic and social indicators have achieved rapid development. Using the grey relation analysis method, the grey correlation degree between the number of deaths, work-related injuries, and occupational patients in China over the past twenty years and 14 economic and social indicators was obtained. The ranking of economic and social indicators that affect the number of deaths, work-related injuries, and occupational patients varies greatly. A multiple linear regression model was established for the number of deaths, work-related injuries, occupational diseases, and 14 economic and social indicators. The rationality of the model was verified from four aspects: R 2 , F-value, P-value, and deviation between actual and fitted values. Provide guidance for the development of safety production indicators and economic and social indicators in China through research.

ObjectivesIn the Netherlands, a new regulation has been adopted for recognition and compensation of serious substance-related occupational diseases. A national advisory committee has a key task of providing advice on the protocols for operationalisation of individual causality assessment in this new context.MethodsProtocol development involves gathering the best available population-level evidence on causality and using this evidence to determine individual causality. Here, the presumably plausible principle was adopted, which stipulates that uncertainties in individual causality should be weighed in favour of a fast and transparent one-time compensation for (ex-)workers.ResultsIn monocausal diseases, a limited workplace exposure assessment is considered sufficient to determine whether individual causality is presumably plausible in the Dutch context. For multicausal occupational diseases, individual causality assessment is more complicated. Modelling of existing data on the exposure–response relation helps establish the probability of causation, that is, the risk of the disease attributable to a work-related exposure. This operationalisation, applied in some protocols, makes use of the probability of causation, while being prudent in establishing exposure limits. An example from asbestos and lung cancer is provided in this short report.ConclusionsWe propose a pragmatic approach to individual causality assessment of substance-related occupational diseases, considering statistical and diagnostic uncertainties. This approach substantiates protocols towards a one-time financial compensation without long-winding recognition procedures.

Purpose: The aim of this retrospective study was to analyse the compensation procedures concerning patients presenting with work-related lung cancer (LC), hospitalised in a French university hospital, and to assess the benefit of systematic specialised occupational disease (OD) consultations in improving procedures for reporting and recognising OD. Methods: Patient exposure to occupational lung carcinogens was assessed via an analysis of a standardised questionnaire, completed between 1 January 2009 and 24 April 2023. Among the 2024 patients who completed the questionnaire, 621 patients with probable exposure to occupational lung carcinogens were included. Among these patients, two groups were compiled: group 1, consisting of the 392 subjects who did not benefit from specialised OD consultations, and group 2, consisting of the 229 subjects who benefited from such consultations since 2014 and to whom a medical certificate to claim for compensation was issued by a physician. During the second phase of our study, we determined the outcome of the compensation procedure for OD. Uni- and multivariate logistic regressions were performed according to descending logistic regression methods. Results: Multivariate analyses, including smoking status, sex, age and claim for compensation, confirm the significant relationship between specialised OD consultation and claim for compensation (OR 18.13, 95% CI [11.47–28.64]). Furthermore, the rate of occupational disease recognition has multiplied by 1.5 since 2014. Conclusion: This study confirms the importance of specialised OD consultations in helping patients with LC to obtain compensation and to reduce under-recognition.

Suicide and non-fatal suicide behavior (NFSB) are significant problems faced by most countries. The objective of this research is to quantify the economic cost of suicide and NFSB in the Australian workforce and to examine the potential impact of introducing a workplace suicide prevention intervention to reduce this burden. The analysis used the best available suicide data, a well-established costing methodology, and a proven workplace intervention. In 2014, 903 workers died by suicide, 2303 workers harmed themselves resulting in full incapacity, and 11,242 workers harmed themselves resulting in a short absence from work. The present value of the economic cost of suicide and NFSB is estimated at$6.73 billion. Our analysis suggests the economic benefit of implementing a universal workplace strategy would considerably outweigh the cost of the strategy. For every one dollar invested, the benefits would be in excess of $ 1.50 ( $1.11–$ 3.07), representing a positive economic investment. All variations of the key parameter hold the positive benefit-cost ratio. Rates of suicide and NFSB are far too high in Australia and elsewhere. More needs to be done to reduce this burden. Although workplace strategies are appropriate for those employed, these interventions must be used within a multifaceted approach that reflects the complex nature of self-harming behavior.

Introduction This study investigated the association between the financial performance of workplaces and the incidence of occupational injuries and diseases using the Workplace Panel Survey, a workplace-related national statistical survey in South Korea. Methods The dependent variables were those related to the incidence of occupational injuries and diseases. The independent variables were those related to the financial performance of each workplace. Multilevel Poisson regression (or logistic regression) and linear regression analyses were used. Results For the number of victims, the average number of workers, interest income, interest expenses, and value-added per person were associated with a significantly increased relative risk (RR). In contrast, lease expense2, depreciation and amortization, and initial/ending industrial property rights were associated with a significant decrease in RR. For the existence of occupational injuries/diseases, taxes and duties1, and welfare/benefits expenses were associated with a significant increase in the odds ratio (OR). In contrast, severance pay2, depreciation/amortization, and average number of workers were associated with a significant decrease in OR. Discussion As the financial status of workplaces worsened, the incidence of occupational injuries and diseases increased. In contrast, as the operating profit and amount of tangible assets (subject to depreciation and amortization) of workplaces increased, the incidence of occupational injuries and diseases decreased. As the number of workers increased, the number of occupational injuries and diseases also increased; however, the odds of occupational injury or disease decreased. The decreasing number of occupationally injured or diseased workers, along with the increasing number of transport devices, might have resulted from special consignment subcontracts between cargo truck owners and shipping companies in South Korea.

The importance of goldmining to Ghana's development cannot be overestimated. However, the associated morbidities and mortalities resulting from occupational exposure to health hazards and the general cost associated with it is critical. In managing occupational health, a simple comprehension of the main determinants of the problem is required. A cross-sectional survey of 504 goldminers was fitted to a nested binary logistic regression model to evaluate the independent effect of subsector departments, compositional attributes, contextual factors and working conditions on goldminers' likelihood of experiencing occupational related health problems. Subsector department was robust and persisted in predicting experiencing occupational related health problems in all three models. Goldminers who were in artisanal small scale (ASM) non-production, large scale (LSM) production and LSM non-production were less likely to experience occupational related health problems as compared to their counterparts in ASM production. For the compositional factors, female goldminers were more likely to experience occupational related health problems as compared to their male co-workers. Goldminers who were married and also older miners were more likely to experience occupational related health problems as compared to the unmarried and the relatively younger goldminers. At the contextual level, miners who worked on shift-based schedule and also miners who lived close to mine sites were more likely to experience occupational related health problems. Among the working conditions, goldminers who worked in good health conditions were less likely to experience occupational related health problems. Surprisingly, goldminers who rated their safety conditions as good were more likely to experience occupational related health problems. Gold miners are exposed to different health risk scenarios across subsectors and departments. These conditions need critical attention and action from industry stakeholders. Programs that promote self-care culture should be promoted, especially in the ASM subsector. PPE's could be relied on for protection in the mining industry but they should be the last line of defense and not to replace preventive measures and actions.