Looking for good workplace injury stats? Try the emergency department

Workers’ compensation data is typically used to track the performance of workplace health and safety. A recent study from the Institute for Work & Health suggests emergency department records can provide an independent source of reliable information on job-related injuries and illnesses.

Published: May 19, 2011

An accurate picture of the number and types of workplace injuries and illnesses is critical to an effective occupational health and safety (OHS) system. This information helps determine where to focus prevention and enforcement efforts, and then assess how well these efforts are working.

That being the case, the use of workers’ compensation records by OHS authorities causes concern for many. They wonder just how reliable workers’ compensation administrative data is as a source of information on the incidence of work injuries and illness.

A recent study by the Institute for Work & Health (IWH) suggests another source of information is available in Ontario: emergency department records. These records can be used to track the performance of the OHS system and to assess the reliability of workers’ compensation data on acute injuries.

In order to improve health and safety, we need to know where we stand, and that means having high quality surveillance information, says IWH President and Senior Scientist Dr. Cam Mustard. Emergency department records in Ontario are a valid source of information on the incidence of work-related disorders and should be incorporated by OHS authorities into the routine surveillance of the health of workers.

Researchers find areas of agreement

Mustard led a team of researchers comparing accepted workers’ compensation lost-time claims from 2004 to 2008 to emergency department visits attributed to a work-related cause during the same period. These numbered just over 435,000 and just under 700,000, respectively.

(Researchers expected the higher number of emergency department visits. Emergency departments treat patients who file lost-time claims and no-lost-time claims. As well, a number of emergency department patients with work-related injuries will not file a claim, will have their claim denied or be ineligible to file a claim at all, given that 30 per cent of Ontario’s labour force is not covered by workers’ compensation.)

The study found strong agreement between emergency department and WSIB records in a number of areas:

  • The frequency of work-related emergency department visits relative to the frequency of accepted lost-time WSIB claims remained constant over the five-year period – at about 60 per cent greater.
  • There was a 17.3 per cent reduction in work-related emergency department visits, and a 17.8 per cent reduction in lost-time compensation claims from 2004 to 2008.
  • The incidence of serious injuries resulting in concussion or fracture (by age group and gender) was generally the same in emergency department and WSIB records.

The accuracy of hospital reporting on emergency department visits is understood to be very high. Therefore, the strong agreement of emergency department data with WSIB data regarding the reduction in lost-time claims over the five-year period and the incidence of concussions and fractures is noteworthy. We can have more confidence in the view of the world presented by WSIB lost-time claims data, particularly with respect to trends over time and the incidence of serious injuries, Mustard says.

Emergency room data can help fill void

Perhaps most important is the finding that emergency room data offer a good source of information on the incidence of acute workplace injuries. The December 2010 report of the Expert Advisory Panel on Occupational Health and Safety commissioned by the Ontario Ministry of Labour called on the system partners to improve the reliability and validity of OHS data currently collected for the purposes of performance measurement.

Emergency department information can help fulfil this recommendation, says Mustard. Because it offers population-based, year-over-year and consistent measures of work-related injuries, it meets the definition of high quality surveillance information. What’s more, because it’s completely independent of workers’ compensation information, it can give us insight into the accuracy of administrative data reported by the WSIB.

The study by Mustard and his team, titled “Comparison of data sources for the surveillance of work injury,” has been submitted for publication. An executive summary is available at: www.iwh.on.ca/other-reports.