Lessons and Conclusions

Costs of Workplace Disease and Injury | Lack of Information on Occupational Exposures | Lack of Information on Work-Related Disease and Injury

Work-related disease and injury is responsible for considerable morbidity and mortality in New Zealand.

For mortality, disease represents a considerably greater (10-fold) burden than does injury: about one-third of work-related deaths are due to cancer, and substantial proportions are due to respiratory disease and ischaemic heart disease.

On the other hand, work-related accidents and injuries represent a greater burden of morbidity.

Costs of Workplace Disease and Injury

One of the aims of this report was to assess the economic and social costs associated with work-related disease and injury in New Zealand. However, there is little information on this.

A joint Department of Labour/ACC project took a case study approach to a number of aspects of work-related injury and disease. The authors detailed a range of factors that result in costs to the employee, the employer and the community, which included:

costs to replace an injured employee (hiring, training)
rehabilitation costs
costs from lost production
costs to repair or replace damaged equipment
fines
increased compensation costs
legal costs
loss of goodwill from bad publicity
intangible costs such as loss of morale (and a presumed consequent drop in productivity).

They reported costs of $1.2 million for the 15 cases considered in the report, and projected costs, taking into account ongoing payments for some of the cases, of almost $4 million³.

The authors also cited an estimate of between $4.3 billion and $ 8.7 billion for work-related disease and injury for the year ending 31 March 2002, based on a percentage of Gross Domestic Product.

Claims to ACC between 1 July 2002 and 30 June 2003 for work-related injuries and some diseases amounted to $143,487,000 for new claims and $275,950,000 for ongoing claims.

Lack of Information on Occupational Exposures

There was little information available on occupational exposures in New Zealand, and what was available was rarely comprehensive. However, information was available on environmental tobacco smoke, lead and levels of shift work. In addition, routine data collections provide information on the number of people employed in particular occupations and industries, which can serve as proxy measures of various exposures.

An increased focus on exposures seems appropriate, especially given the problems raised by diseases of long latency that comprise many work-related disorders of concern in New Zealand (and elsewhere).

Lack of Information on Work-Related Disease and Injury

This report has been based on a combination of overseas and New Zealand data because New Zealand data alone is inadequate to document the size of the problem, let alone suggest and enable solutions.

The Department of Labour and other government agencies do not know how many people die from work-related causes each year. More than 80% of work-related deaths (most due to illness rather than injury) are not documented or reported, and are not investigated.

Occupational cancer is a good example. There are about 237–425 deaths from occupational cancer in New Zealand each year, and 325–773 incident cases. Why does NODS report only about 30 cases a year, of which only about two are for causes other than asbestos? Why does ACC compensate only about four cases a year, including those for asbestos?

The OSH Cancer Panel is currently investigating some specific work-related cancers in more depth (bladder cancer, non-Hodgkin’s lymphoma and leukaemia) and is producing estimates that are similar to those presented here. However, this has required intensive investigations rather than relying on voluntary reporting. Obtaining such estimates more generally should be a major priority.

It should be recognised that much of the relevant data is routinely collected by other agencies – for example, the New Zealand Health Information Service (NZHIS) of the Ministry of Health holds information on deaths and cancer registrations. There is no need to duplicate this function, but other crucial surveillance information can only be collected by OSH, and there is a need for specialist expertise in occupational epidemiology to integrate and analyse the data from different sources.

Most published research used in this report presented information only, or predominantly, on males. This must be taken into account, as the nature and extent of women’s involvement in the workforce are probably changing to a greater extent than those of men. This means the disorders of which they are at risk, and the associated risks, are probably changing more than they are for men⁷.

There is also a lack of detailed ethnicity information in much of the published research. The reasons for this are similar to those on the data for women. The issues are also similar, because Māori and Pacific Islanders have different employment distributions from Europeans, and so can be expected to have different exposures and risks.

There is very little New Zealand information on work-related effects on bystanders – people who are not working but sustain injury or disease as a result of exposure to occupational hazards. Bystanders are an important group to consider, especially in some specific work situations such as farming, where the occupational and non-occupational environments often overlap and where children are often affected; and on the roads, where there appears to be a high number of deaths (and so presumably also non-fatal injuries) each year as a result of traffic crashes involving working and non-working people.