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Injuries tally staggering personal and economic costs

The health industry is responsible for more injuries than construction and mining combined.

By Susan J. Landers, amednews staff. May 8, 2006.

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Washington -- Injuries take a tremendous toll on the health of the population as well as on the nation's economy. A wide variety of injuries that occur at home and at work bring many patients to their physicians' offices.

The Centers for Disease Control and Prevention recently tallied the lifetime cost of such injuries and found that it tops $400 billion per year in medical expenses and productivity losses.

About $80 billion is attributed to medical expenses, and the remaining $326 billion is estimated in lost wages, fringe benefits and the ability to perform normal household responsibilities. This amount was calculated from the approximately 50 million injuries that required medical treatment in 2000. The costs begin to mount when the injuries occur and are then spread over each injured person's lifetime. The data were compiled in the book The Incidence and Economic Burden of Injuries in the United States, released by the CDC April 18.

Among its findings:

• Males account for about 70% of the total costs of injuries, largely due to their higher rates of fatal injury and the magnitude of their lost wages.
• People ages 25 to 44 represent 30% of the U.S. population and 40% of the total costs of injuries.
• Motor vehicle crashes account for 22% and falls account for 20% of the total cost of injuries.

"Many of the nearly 50 million injuries that occur each year in the United States are preventable," said Ileana Arias, PhD, director of CDC's National Center of Injury Prevention. "To accomplish that, though, we need greater recognition of the value of our prevention efforts."

The book was released as several hundred experts on work-related injuries and illnesses gathered for a symposium in Washington, D.C., in mid-April to share ideas gleaned from prevention research.

Sponsored by the CDC, the National Institute for Occupational Safety and Health, and the National Safety Council, the event marked the 10th anniversary of the National Occupational Research Agenda, or NORA, which was developed to carry out research projects that could most effectively reduce occupational injuries, illness and deaths.

In addressing the group, CDC Director Julie Gerberding, MD, MPH, stressed the ongoing need to solve health problems both in the workplace and in the home. "Not only because it is the right and humanitarian thing to do or because it might save some money but as an economy we aren't going to remain a viable global competitor if we don't deal effectively with worker safety and health."

The research approach taken by NIOSH is one that the CDC strives to emulate, she said. "It is not a clone of the NIH research portfolio, it is a unique brand that works for this setting, but I think it will work in other public health settings, and that's why we are plagiarizing it."

The approach entails gathering an often very large and diverse group of stakeholders to work toward resolving common problems.

Watch your step

Since the health care sector is the nation's top private employer with more than 10 million people, it's not surprising that it's also the source for many worker injuries. In 2002 it accounted for more injured workers than the construction and mining industries combined, one researcher said.

Two NIOSH-led research teams tackled hospital safety issues and received top awards at the NORA symposium. One team addressed falls in health care settings -- currently the No. 1 reason for worker compensation claims in the industry. The other examined the hazards of handling a variety of drugs, including lifesaving yet dangerous chemotherapy drugs.

Reducing the number of slips, trips and falls taken by health care workers required assembling a 40-member team that represented hospitals, universities, health care workers, the government, insurance and construction companies, and shoe, flooring and floor wax manufacturers.

After much discussion, the group created a list of "best practices," which, if followed, could do the trick. The groups' members were awarded a top 2006 NORA Partnering Award for Worker Safety.

Among the best practices are the selection of shoes with non-slip bottoms, the use of beepers to report dangerous spills immediately and the prompt and thorough removal of ice and snow from outside walks. A guidance document is now in the works.

Many of the same group members teamed up in 2003 to resolve what then was the No. 1 source of injuries among health care workers: overexertion from lifting patients. By following the group's recommendations that various mechanical lifts be substituted for worker's backs, the number of lifting injuries declined.

Another prize-winning research team worked for four years to devise ways to improve the health and safety of some 5.5 million health care workers exposed to hazardous drugs. Federal and state agencies, pharmaceutical manufacturers, labor unions, protective equipment manufacturers and oncology centers were all represented on the project.

The result was a NIOSH alert that summarizes the known health risks associated with handling these agents and provides guidance for safe administration. Tear-out checklists also provide case studies that present real-world scenarios of hazardous drug exposures and their consequences.

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