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Occupational Injury and Illness

Of the illnesses reported to the Bureau of Labor Statistics, cumulative trauma disorders accounted for fifty-five percent of all occupational illnesses in Texas. C. High-risk workplaces Texas rural counties experience occupational injury fatalities at a rate eighty-two percent greater than urban counties.

  Construction remains the industry division in Texas with the highest fatality rate and the only industry not demonstrating declining rates since 1980. Data were not available by firm size or other company characteristics.

  Meat packing plant workers in Texas experience an extraordinarily high injury rate (37.4 per 100 full-time workers per year), which exceeds the already high U.S. rate by thirty-five percent. D. Special populations Based on Texas death certificates from 1980-1990, each year on average, eleven children were killed on the job in Texas. Further, in 1991, over 1,000 injuries and illnesses among children less than 18 years of age were reported to the Texas Workers' Compensation Commission.

  Several special studies of occupational injury and illness in Texas indicated a disproportionate representation of Hispanic workers. II. Economic Costs Economic projections suggest that workers' compensation payments in 1990 would have been over 41.2 percent below actual workers' compensation payments, implying that the enormous growth in the program in the 1980s was primarily due to factors other than changes in the work force size, industrial structure, national trends in injury and illness incidence rates, or wage rates. III. Potentially Hazardous Exposure An estimated fourteen percent of Texas private sector workers are potentially exposed to upper extremity cumulative trauma, six percent to crystalline silica, and five percent to noise (shown to be related to cumulative trauma disorders, silicosis, and noise-induced hearing loss, respectively).

  The service industries of various types also had risks of potential exposures in addition to traditionally hazardous industries.

    Direct data for measuring agricultural worker exposure to pesticides within Texas are not available.

  A large percentage of the Texas work force is estimated to work in indoor non-industrial environments in Texas at risk of health effects from indoor air pollution. However, no information on the prevalence of indoor air pollution is available in Texas.

  Even after several years of the Occupational Safety and Health Administration (OSHA) hazard communication standard being in place, the largest category for OSHA serious citations is hazard communication. IV. Human Resources In Texas, there is a shortage of comprehensively trained core occupational health professionals (physicians, nurses, industrial hygienists, and safety professionals).

  More than 150 additional occupational medicine physicians, 100 primary care practitioners with occupational medicine training, and 1,600 occupational health nurses are needed to meet current occupational health service demands in Texas. Although not quantifiable, there is a shortage of professionals in nearly all areas of industrial hygiene practice.

  Certain geographic areas, such as the Rio Grande Valley, are particularly affected by these shortages. This may be partially attributed to the minimal number of programs in Texas providing specialized training in occupational health.

  Fewer than half of the nurses who work for business and industry in Texas possess a baccalaureate degree. This degree is the minimum requirement for 1995 applications for professional certification.

  There is a lack of occupational health content in curricula in medical and nursing schools, as well as in training programs for other occupational health-related professional disciplines (occupational therapy, physical therapy, vocational rehabilitation specialists, and chiropractors). With prevention as the single overriding focus for prioritization, this study developed policy options to address the following three major areas which would improve occupational safety and health in Texas: occupational safety and health surveillance, programs, and professionals. The final chapter of this report (Chapter 7) provides a more comprehensive list of policy options and associated areas of needed research. Following are selected policy options for each area which merit strongest consideration:

OCCUPATIONAL SAFETY AND HEALTH SURVEILLANCE (a) Designate a lead agency to identify and coordinate the surveillance and prevention efforts across the multiple state agencies that play a role in occupational safety and health. Initiate surveillance and prevention efforts for minors lawfully working.

(b) Clarify and evaluate the role, purpose, and scope of Texas Workers' Compensation Commission claim data collection efforts in relation to occupational safety and health surveillance needs for the State.

(c) Systematically collect and analyze data on public employees in Texas. Continue participation of Texas in the federal Bureau of Labor Statistics Annual Survey of private employees.

(d) Support and expand Texas Department of Health's participation in the Sentinel Event Notification System for Occupational Risks (SENSOR), a program for identification and prevention of occupational diseases.

(e) Analyze and evaluate Bureau of Labor Statistics survey data on detailed characteristics of fatal and nonfatal injuries and illnesses using the newly redesigned occupational safety and health coding system (ROSH).

(f) Reinstate coding of usual occupation and industry on Texas death certificates.

(g) Evaluate employer adherence to reporting fatal occupational injuries to the Texas Workers' Compensation Commission. Increase inspections and safety consultations for the workplace fatalities that OSHA does not investigate.

(h) Designate a Texas agency to develop an index of relative exposure hazard among types of industries (not specific companies) that can be periodically updated.

(i) Increase the involvement of the insurance industry in efforts to collection occupational health and related medical cost data.

OCCUPATIONAL SAFETY AND HEALTH PROGRAMS (a) Target prevention and training programs based on leading causes of death (motor vehicle and homicide), leading types of injuries and illnesses (back injuries, cumulative trauma), high-risk workplaces (construction, meat packing plants, agriculture), and special populations (minority, migrant, child workers).

(b) Encourage and support widespread employer institution of comprehensive occupational safety and health programs.

(c) Encourage the establishment of occupational safety and health programs that meet OSHA's Voluntary Guidelines, which include four major elements: (1) management commitment and employee involvement; (2) worksite analysis of current or potential hazards; (3) hazard prevention and control; and (4) safety and health training.

OCCUPATIONAL SAFETY AND HEALTH PROFESSIONALS (a) Provide more opportunities for training of individuals to become occupational safety and health professionals in Texas.

(b) Provide a better distribution of professionals and services to the Rio Grande Valley area of Texas.

(c) Increase the quality and content of the occupational health curriculum in medical and nursing schools and training programs in related occupational safety and health professions. Increase awareness of the importance of controlling safety and health in the workplace as a business operation component by including relevant courses in business school curricula. Evaluate the content and availability of continuing education courses for these professionals.

PREFACE

Study Objectives

The University of Houston Health Law and Policy Institute was awarded a special line item from the Texas legislature to direct and implement the study, "Occupational Injury and Illness in Texas." This study was an interdepartmental and inter-institutional collaboration between the University of Houston Health Law and Policy Institute, the University of Houston Department of Economics, and The University of Texas School of Public Health at Houston (Southwest Center for Occupational and Environmental Health). The major objectives of the study were to document the magnitude and economic costs of occupational injury and illness in Texas, to describe occupational exposures, to evaluate human resources in occupational health and safety in Texas, to identify policy options for prevention of injury and illness, and to make recommendations for future study.

Organization of the Report

Chapter 1 of the report presents a history of general occupational safety and health activity in Texas, along with a brief history of surveillance of occupational injuries and illnesses in Texas. Chapter 2 presents estimates of the burden of occupational injury and illness for Texas. Chapter 3 describes the magnitude of specific injury and illness conditions and specific worker populations. Chapter 4 describes the population of workers in Texas, reviews the potential hazardous occupational exposures in Texas, and estimates the number of workers likely to be exposed to these hazards. Chapter 5 presents estimates of the economic consequences of occupational injuries and illnesses. Chapter 6 documents Texas resources available for the prevention and treatment of occupational injuries and illnesses. Chapter 7 discusses policy options and recommends areas for research.

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