Economic Burden of Occupational Fatal Injuries in the United States Based on the Census of Fatal Occupational Injuries, 2003-2010

Since 1992, the Bureau of Labor Statistics’ CFOI program has been collecting information on the magnitude and characteristics of workplace fatal injuries in the United States. Now considered the “gold standard,” CFOI produces comprehensive, accurate, and timely counts of fatal work injuries. CFOI is a Federal-State cooperative program that has been implemented in all 50 States and the District of Columbia since 1992. Approximately 30 data elements are collected, coded, and tabulated, including information about the worker, the fatal incident, and the machinery or equipment involved.  To compile counts that are as complete as possible, the census uses multiple sources to identify, verify, and profile fatal worker injuries. Information about each workplace fatality–occupation and other worker characteristics, equipment involved, and circumstances of the event–is obtained by combining the source records, such as death certificates, workers’ compensation reports, and Federal and State agency administrative reports. To ensure that fatalities are work-related, cases are substantiated with two or more independent source documents, or a source document and a follow-up questionnaire. See BLS 2012 for more detailed information about the Census of Fatal Occupational Injuries.³

Costs of fatal occupational injuries were estimated using a model developed by the Division of Safety Research within the National Institute for Occupational Safety and Health; more extensive information on the methods and derivation of the model is provided in Biddle (2004)⁴.  Estimated costs by year of death; state of injury; sex, race, age, and occupation of the worker; event or exposure, source of injury, and industry groups in which the worker was employed are presented in Tables 1-51.  Each table reports the total cost, mean and median costs, to various groups. The focus on the costs of injury provides actionable information on the costs to various constituencies, industries and occupations.

The cost-of-illness method, which combines direct and indirect costs, was employed to derive the societal cost of fatal occupational injuries. It calculates incidence-based costs, the lifetime cost of all fatal occupational injuries occurring in a given year regardless of what year the costs are accrued, rather than prevalence-based costs; information on the basic methodology is available at RTI (2006)⁵.  Base information for each decedent was obtained through CFOI.  Decedents who were identified as members of the U.S. military as well as decedents less than 16 years of age were not included in the cost calculations.  Worker and case characteristics used in the cost calculations included: age, sex, occupation, and race of the worker; employer industry; and year of death.  Although not necessary for the calculations, event or exposure, source of injury, and State of injury were obtained from CFOI to present societal costs for these groups. The direct and indirect costs of each occupational fatal injury reported by CFOI were calculated independently.  Costs for all individual fatal occupational injuries were then summed for each characteristic or group of characteristics of interest.

The cost model used to compile these tables produces a conservative estimate for lifetime economic costs of fatal occupational injuries.  Moreover, it should be made clear that these estimates are not exact and precise; they are, instead, estimations, and are based on many factors.  Estimates are subject to limitations of the model specification and the limitations associated with the level of detail and quality of data systems used in the calculations.

The model specification is most significantly limited by not producing a “complete” economic cost of occupational fatalities, in that intangible losses that are associated with premature death are not included.  While it may be intuitively appealing to provide some quantitative measure of these costs, rather than simply disregard them in determining the overall burden of the fatal injury, it is inescapable that the nature of the losses—pain, suffering, loss of consort and loss of traditional role, as well as emotional harm to the injured and the family—involve a subjective and personal component that is difficult to measure, if not immeasurable.  It is for this reason that the intangible dimension is not considered in these calculations. Such a consideration would impose additional complexity and theoretical requirements on a model that is designed to provide a straightforward calculation of well-defined measures of costs associated with fatal occupational injury.  This measure has great value in itself, and this measure should not be lessened by its failure to incorporate a measure that has confounded numerous authorities with advanced knowledge.

Despite the acknowledged limitations of the estimates contained in these findings, the estimates themselves have substantial practical value, providing additional information about how injuries affect society and providing necessary information for decision-makers on relevant costs of fatal occupational injuries in relation to costs and selection of prevention programs.  These cost outcomes additionally represent income that is not received and medical expenses incurred because of fatal injuries, and thus have direct bearing on State, regional and national economic measures of goods and services production, such as Gross Domestic Product (GDP) and other national income measures. These estimates can be further used to plan, augment and prioritize occupational injury prevention and control programs, policy analysis, evaluation of safety and health interventions, and advocacy for a safer work environment.

The cost model and data sources used combine to form an effective mechanism for determining the cost of fatal occupational injury.  These cost estimates can be used to determine the specific burden of injury to particular demographic groups, as well as the circumstances of injury. This can be extremely useful in determining the cost to various constituencies—to the Nation, to States and Census regions, to various groups, industries, and occupations. In addition, this report provides the frequency of these events to indicate the extent of the occupational health problem.  The more extended nature of the extent of the occupational health problem includes a component that is not considered here, the cost of suffering and loss of role, but the contribution of these data tables, in identifying the financial cost of fatal occupational injury, constitutes a major component in delimiting the scope of this injury.  The use of economic losses, such as those calculated using this model, provides an additional measure to existing societal measures of frequency and rate of injury, to assist in defining the overall dimensions of traumatic workplace fatalities.