Workers’ Compensation Costs Among Construction Workers: A Robust Regression Analysis

Characteristics of Work-related Fatal Injuries Among Aged Workers in Republic of Korea

Objectives

The present paper aimed to examine whether an aging workforce is associated with an increase in work-related fatal injuries and to explore the underlying reasons for this potential increase.

Material and methods

Aged workers were defined as those who were at least 55 years old. Work-related fatalities were assessed in aged and young workers who were registered with the workers' compensation system in 2021 in the Republic of Korea. Total waged workers, based on raw data from the Local Area Labor Force Survey in 2021, were used as the denominator to estimate the work-related fatality rates.

Results

Most work-related fatalities in the aged workers occurred among individuals working in the "construction sector" (58.9%), those with "elementary occupations (unskilled workers)" (46.1%), and those with the employment status of "daily worker" (60.8%). The estimated incidence (0.973/10,000) of work-related fatalities among aged workers was about four times higher than that (0.239/10,000) among younger workers. "Falling," "collision," "struck by an object," and "trip and slip" were more frequent types of work-related fatalities among aged workers relative to young workers. The category of "buildings, structures, and surfaces" was a more frequent cause of work-related fatalities among aged workers than among young workers.

Conclusions

Aged workers had a higher incidence of work-related fatalities than young workers. Frequent engagement in precarious employment and jobs, coupled with the greater physical vulnerability of aged workers, were likely causes of their higher level of work-related fatal injuries.

Factors affecting work-related non-fatal injuries among aged workers in South Korea

Introduction

The objective of this paper is to investigate whether an aging workforce is associated with an increase in work-related non-fatal injuries and to explore the underlying reasons for this potential increase.

Methods

Aged workers were defined as those who were at least 55-years-old. Work-related non-fatal injuries were assessed in aged and young workers who were registered with the workers' compensation system from 2017 to 2021 of South Korea.

Results

The mean estimated rate of work-related non-fatal injuries of aged workers (0.88/100) was about 2.5-times higher than that of younger workers (0.35/100). Most work-related non-fatal injuries in the older adults were in individuals working in the "construction sector" (36.0%), those with "elementary occupations (unskilled workers)" (45.0%), and those with employment status of "daily worker" (44.0%). "Trip & slip" (28.7%) and "falling" (19.6%) were more frequent types of work-related non-fatal injuries in aged workers relative to young workers. The category of "buildings, structures, and surfaces" was a more frequent cause of work-related non-fatal injuries in aged workers than young workers.

Discussion

The incidence of non-fatal work-related injuries is higher among aged workers compared to their younger counterparts. The increased occurrence of aged workers participating in precarious employment and jobs, along with the greater physical vulnerability, is likely the cause of their higher rate of work-related non-fatal injuries.

The Cost Burden of Safety Risk Incidents on Construction: A Probabilistic Quantification Method

The construction sector is vulnerable to safety risk incidents due to its dynamic nature. Although numerous research efforts and technological advancements have focused on addressing workplace injuries, most of the studies perform empirical and deterministic postimpact evaluations on construction project performance. The effective modeling of the safety risk impacts on project performance provides decisionmakers with a valuable tool toward incidents prevention and proper safety risk management. Therefore, this study collected Australian incident records from the construction industry from 2016 onwards and conducted discrete event simulation to quantitatively measure the impact of safety risk incidents on project cost performance. Moreover, this study investigated the correlation between safety risk incidents and the age of injured workers. The findings show a strong correlation between the middle-aged workforce and the severity of incidents on project cost overruns. The ex-ante, nondeterministic analysis of safety risk impacts on project performance provides insightful results that will advance safety management theory in the direction of achieving zero harm workplace environments.

Medical Cost of Workers' Compensation Claims Related to Patient Handling and Mobility Tasks Within Skilled Nursing Facilities, Continuing Care Retirement Communities and Assisted Living Facilities: An Exploratory Analysis

OBJECTIVE

Evaluate the medical costs related to patient handling & mobility (PH&M) claims.

METHODS

Closed medical only and indemnity workers' compensation claims were utilized for this exploratory study. In addition to the PH&M tasks, the claimants' gender, age, tenure, and the claim lag time were also analyzed.

RESULTS

Generalized linear models indicated that variables related to tasks, claims' number of open days and age of the claimants had meaningful effects on the adjusted medical costs for medical only claims. For indemnity claims, the number of open days of claims, age and tenure had meaningful effects. Gender had meaningful effects only for indemnity claims when classifying the claims by patient handling tasks versus non-patient handling tasks.

CONCLUSIONS

Results showed that factors, other than the type of injury; meaningfully influenced the adjusted medical costs of indemnity claims.

Twenty years of workers' compensation costs due to falls from height among union carpenters, Washington state

BACKGROUND

Falls from height (FFH) are a longstanding, serious problem in construction.

METHODS

We report workers' compensation (WC) payments associated with FFH among a cohort (n = 24,830; 1989-2008) of carpenters. Mean/median payments, cost rates, and adjusted rate ratios based on hours worked were calculated using negative-binomial regression.

RESULTS

Over the 20-year period FFH accounted for $66.6 million in WC payments or $700 per year for each full-time equivalent (2,000 hr of work). FFH were responsible for 5.5% of injuries but 15.1% of costs. Cost declines were observed, but not monotonically. Reductions were more pronounced for indemnity than medical care. Mean costs were 2.3 times greater among carpenters over 50 than those under 30; cost rates were only modestly higher.

CONCLUSIONS

Significant progress has been made in reducing WC payments associated with FFH in this cohort particularly through 1996; primary gains reflect reduction in frequency of falls. FFH that occur remain costly.

Characterizing the relationship between in-hospital measures and workers' compensation outcomes among severely injured construction workers using a data linkage strategy

BACKGROUND

To characterize the relationship between acute measures of severity and three important workers' compensation outcomes associated with a worker's ability to return to work and the cost of a work-related injury.

METHODS

Probabilistic data linkage of workers' compensation claims made by injured construction workers from 2000 to 2005 with two Illinois medical record registries. Multivariable robust regression models were built to assess the relationship between three in-hospital measures and three outcomes captured in the Workers' Compensation data.

RESULTS

In the final multivariable models, a categorical increase in injury severity was associated with an extra $7,830 (95% CI: $4,729-$10,930) of monetary compensation awarded, though not with temporary total disability (TTD) or permanent partial disability (PPD). Our models also predicted that every extra day spent in the hospital results in an increase of 0.51 (95% CI: 0.23-0.80) weeks of TTD and an extra $1,248 (95% CI: $810-$1,686) in monetary compensation. Discharge to an intermediate care facility following the initial hospitalization was associated with an increase of 8.15 (95% CI: 4.03-12.28) weeks of TTD and an increase of $23,440 (95% CI: $17,033-$29,847) in monetary compensation.

CONCLUSIONS

We were able to link data from the initial hospitalization for an injured worker with the final workers' compensation claims decision or settlement. The in-hospital measures of injury severity were associated with total monetary compensation as captured in the workers' compensation process.

Analysis of ethnic disparities in workers' compensation claims using data linkage

OBJECTIVE

The overall goal of this research project was to assess ethnic disparities in monetary compensation among construction workers injured on the job through the linkage of medical records and workers' compensation data.

METHODS

Probabilistic linkage of medical records with workers' compensation claim data.

RESULTS

In the final multivariable robust regression model, compensation was $5824 higher (P = 0.030; 95% confidence interval: 551 to 11,097) for white non-Hispanic workers than for other ethnic groups when controlling for injury severity, affected body region, type of injury, average weekly wage, weeks of temporary total disability, percent permanent partial disability, death, or attorney use.

CONCLUSIONS

The analysis indicates that white non-Hispanic construction workers are awarded higher monetary settlements despite the observation that for specific injuries the mean temporary total disability and permanent partial disability were equivalent to or lower than those in Hispanic and black construction workers.

Age in relation to worker compensation costs in the construction industry

BACKGROUND

A better understanding of how workers' compensation (WC) costs are affected by an aging US workforce is needed, especially for physically demanding industries, such as construction.

METHODS

The relationship between age and injury type on claim costs was evaluated using a database of 107,064 Colorado WC claims filed between 1998 and 2008 among construction workers.

RESULTS

Mean WC costs increased with increasing age for total cost (P < 0.0001), medical costs (P < 0.0001), and indemnity costs (P < 0.0001). For each one-year increase in age, indemnity, and medical costs increased by 3.5% and 1.1%, respectively. For specific injury types, such as strains and contusions, the association between age and indemnity costs was higher among claimants aged ≥65 compared to claimants aged 18-24.

CONCLUSIONS

Our findings suggest that specific injury types may be partially responsible for the higher indemnity costs among older construction workers, compared with their younger coworkers.

An aging workforce and injury in the construction industry

The relatively large birth cohort between 1946 and 1964, combined with the economic recession in the first decade of the 21st century, have led to an increase in the proportion of older workers in the US workplace. Understanding the health and safety needs of an aging workforce will be critical, especially in the construction industry, where physical job demands are high. This paper reviews the epidemiologic literature on the impact of age on injury among workers in the construction industry in terms of cause, type, and cost. PubMed was searched by using the following terms: older workers, construction, construction industry, injury, and age. The available studies reported that, among the construction industry workforce, older age at injury was related to higher injury costs but not to number of injuries. The higher injury costs associated with worker age are likely due in part to the severity of the injuries sustained by older workers. Identification of injury trends and subsequent analytical research efforts designed to ascertain factors associated with injury among older construction workers are needed for employers to effectively manage a health and safety program that addresses the needs of the aging worker.

The relevance of occupational medicine to primary care in the 21st century

The relatively infrequent incidence of dramatic outbreaks of occupational disease, as occurred in the past, along with economic downturns, have lowered the medical altitude of the workplace as a risk factor for or determinant of disease and disability. However, in 2007 alone, there were more than 4 million nonfatal occupational illnesses in the United States. Equally relevant is the explosion in 2010 at a coal mine in West Virginia that left 29 workers dead. Not to be overlooked are the ongoing challenges to medical practitioners of managing workers' compensation cases. At the same time, the convergence of demographic changes, changes in the workplace structure, and emerging technologies are reinforcing the views of occupational medicine clinicians and other practitioners that occupational health must be integrated into primary care systems and that total separation of work-caused and nonwork-caused care is counterproductive and arbitrary. Therefore, basic principles, concepts, and procedures of occupational medicine must be integrated into the substrate of information and experience upon which students must depend on entering a medical career.

Application of handheld devices to field research among underserved construction worker populations: a workplace health assessment pilot study

BACKGROUND

Novel low-cost approaches for conducting rapid health assessments and health promotion interventions among underserved worker groups are needed. Recruitment and participation of construction workers is particularly challenging due to their often transient periods of work at any one construction site, and their limited time during work to participate in such studies. In the present methodology report, we discuss the experience, advantages and disadvantages of using touch screen handheld devices for the collection of field data from a largely underserved worker population.

METHODS

In March 2010, a workplace-centered pilot study to examine the feasibility of using a handheld personal device for the rapid health assessment of construction workers in two South Florida Construction sites was undertaken. A 45-item survey instrument, including health-related questions on tobacco exposure, workplace safety practices, musculoskeletal disorders and health symptoms, was programmed onto Apple iPod Touch® devices. Language sensitive (English and Spanish) recruitment scripts, verbal consent forms, and survey questions were all preloaded onto the handheld devices. The experience (time to survey administration and capital cost) of the handheld administration method was recorded and compared to approaches available in the extant literature.

RESULTS

Construction workers were very receptive to the recruitment, interview and assessment processes conducted through the handheld devices. Some workers even welcomed the opportunity to complete the questionnaire themselves using the touch screen handheld device. A list of advantages and disadvantages emerged from this experience that may be useful in the rapid health assessment of underserved populations working in a variety of environmental and occupational health settings.

CONCLUSIONS

Handheld devices, which are relatively inexpensive, minimize survey response error, and allow for easy storage of data. These technological research modalities are useful in the collection and assessment of environmental and occupational research data.