Fatal Occupational Injuries in Massachusetts 1991-1999

Acknowledgements

This report was prepared by Tsegaye M. Bekele, MPH, Michael A. Fiore, MS, and Letitia K. Davis, ScD, of the Occupational Health Surveillance Program (OHSP). Special thanks go to Susan Shepherd, Richard Campbell, and Niko Philips-Dias, who collected much of the data on which this report is based and worked on earlier drafts of the document. Also we wish to thank the Massachusetts Registry of Vital Records, the Occupational Safety and Health Administration (OSHA) Region I Office, the Massachusetts Department of Industrial Accidents, the Massachusetts Fatal Accident Reporting System, the U.S. Coast Guard, and the medical examiners, city and town clerks, police departments, and fire departments of Massachusetts for providing data on fatal occupational injuries to OHSP. We also appreciate the contribution of the U.S. Department of Labor, Bureau of Labor Statistics, Boston Region Office.

This work was funded in part through cooperative agreements with the Bureau of Labor Statistics (W9J281252Q) and the National Institute for Occupational Safety and Health (U60/CCU108704).

To obtain additional copies of this report, contact:

Massachusetts Department of Public Health
Bureau of Health Statistics, Research and Evaluation
Occupational Health Surveillance Program
250 Washington Street, 6th floor
Boston, MA 02108
617-624-5632


Preface

It is not possible to issue a report on work-related fatalities at this time without acknowledging the overwhelming number of people who died at work in the recent terrorists attacks. The events of September 11th have brought a heightened and painful awareness of the tragedy wrought when loved ones leave for work never to return home. These and the subsequent fatalities of media and postal workers due to anthrax exposures in the workplace have fostered new appreciation for the contribution of workers in all walks of life.

This report tells the less dramatic but likewise painful story of individuals who have been fatally injured on the job – not in a single event but in events that occur day in and day out. It is the story of workers who have died trying to get their jobs done – of fishers who provide us with the food we eat, of carpenters who build the homes we live in, of convenience store workers who work through the night, of firefighters, police, and other first responders who routinely put their lives on the line for the greater public good. The hazards faced by these workers should not simply be accepted as part of the job. The more we know about the circumstances under which workers have been fatally injured, the better able we are to prevent similar fatalities in the future.

Contents

Executive Summary
Introduction
Methods

1. Fatal Occupational Injuries in Massachusetts

1.1 Overview
1.2 Gender
1.3 Age
1.4 Race and Hispanic Origin
1.5 Events/Exposures
1.6 Industry
1.7 Occupation
1.8 Government-employed Workers
1.9 Self-employed Workers
1.10 Foreign-born Workers
1.11 Establishment Size
1.12 Distribution of Occupational Fatalities by County
1.13 Fatal Occupational Injuries Inspected by OSHA

2. Comparison of Massachusetts and the U.S.

2.1 Fatal Occupational Injury Rates
2.2 Fatal Events
2.3 Age, Gender, Race and Ethnicity

3. Special Topics

3.1 Fatal Falls to Lower Levels
3.2 Work-related Homicide
3.3 Commercial Fishing

4. Appendices



Executive Summary

Work-related fatalities are a significant public health problem in Massachusetts, as they are in the United States. Information about the occupations, industries and circumstances in which these fatalities occur is essential to guide efforts to prevent future fatalities. Since 1991, the Massachusetts Department of Public health has collected information on all fatal occupational injuries in the Commonwealth as part of the national Census of Fatal Occupational Injuries, conducted in cooperation with the Bureau of Labor Statistics in the U.S. Department of Labor. This report provides a comprehensive overview of fatal occupational injuries in Massachusetts during 1991-1999. It includes a comparison of the occupational fatality experience in Massachusetts with that of the nation as a whole. It also includes more detailed findings on three specific topics: falls to lower levels, workrelated homicides, and fishing-related fatalities. Findings are intended to guide the many players – government agencies, employers, unions, safety professionals, advocacy organizations, researchers, job trainers, and equipment design engineers - who have important roles to play in preventing fatal injuries at work.

Key findings:

Overview

• A total of 633 workers died as a result of fatal occupational injuries sustained in Massachusetts during 1991-1999 – an average of between one and two workers each week.
  
• The annual average fatality rate was 2.3 fatalities per 100,000 workers. There was no clear-cut trend in fatality rates over the nine-year period (Chart 1).

Gender, Age, Race, and Hispanic Origin

• The great majority of victims (93%) were male, and male workers had a much higher rate of fatal occupational injury than female workers (Chart 2).
• The rate of fatal occupational injury increased markedly with the age of the workers (Chart 3).
• Workers of Hispanic origin (regardless of race) had a high rate of fatal occupational injury compared to black and white workers (Chart 4).
• Foreign-born workers accounted for a high proportion of fatal injuries among workers of color and made up a disproportionate share of the victims of workplace homicide.

Industries, Occupations, and Fatal Events

• Agriculture (excluding Fishing and Forestry) had the highest fatal occupational injury rate, more
  than five times the average rate for all industry divisions (Chart 5). Two thirds of the 35 fatalities in
  this industry division involved workers employed in landscaping and horticultural services.
  
• The Construction industry division had both a high number of fatal injuries (136) and the second
  highest fatal occupational injury rate. More than half of the construction workers fatally injured on
  the job died as a result of falls.
  
• The Farming, Forestry and Fishing occupation group had the highest fatality rate, more than
  thirteen times the average rate for all occupations. Most of the workers in this group (57 of 95)
  were fishers. Commercial fishing claimed more lives than any other single occupation (Chart 6).
  
• Fatal occupational injuries due to transportation-related incidents - including land, water, and air
  transport incidents - lead all event categories. Within this category, highway motor vehicle
  incidents and water vehicle incidents were the most frequent events resulting in 84 and 51
  fatalities respectively.
  
• Falls to lower levels was the leading single fatal event in Massachusetts, accounting for 118
  fatalities (Table1).

Sector, Establishment Size and Investigations by the Occupational Safety and Health Administration

• A total of 69 government employees died on the job.
  
• Self-employed workers had a higher occupational fatality rate (more than twice) than wage and salary workers.
  
• Small establishments (with 19 or fewer employees) had a high fatal occupational injury rate, more than one and a half times the average rate for establishments of all sizes (Chart 7).
  
• More than 60% of the occupational fatalities were not inspected by OSHA because; a) they did not fall under OHSA’s jurisdiction; or b) they resulted from events that are not routinely investigated by the agency; or c) death occurred more than 30 days after the injury (Chart 8).

Falls to Lower Levels

• Most fatal falls to lower levels (61%, 72 fatalities) occurred in the construction industry division and two-thirds of these occurred in small establishments with 10 or fewer employees (Chart 11).
  
• The fatal fall rate in construction was as high as sixteen times the average fatal fall rate for all industries (Table 6).
  
• Older workers had a six-fold increased risk of fatal falls to lower levels compared to workers of all age groups (Chart 13).

Work-related Homicides

• Work-related homicide was the third leading fatal event, accounting for 82 fatalities.
  
• Work-related homicides were concentrated in a small number of industries and occupations (Chart 14).
  
• Male workers had a higher rate of workplace homicide than female workers.
  
• Homicide was the leading fatal event among black and Hispanic workers.
  
• Robbery was the leading precipitating circumstance, where motive was known, of work-related homicides (Chart 15).
  
• Workplace homicides are more likely to result from shooting than non-workplace homicide.

Fishing

• Most work-related fishing fatalities occurred as a result of sinking or capsizing of fishing vessels (Chart 16).
• Most (61%) fishing fatalities occurred during fall and winter seasons (Chart 17).

Comparison with national occupational fatality experience

• Massachusetts had lower annual fatal occupational injury rates than the nation for each year of the period under consideration (Chart 9). The rate difference was in part explained by the difference in the occupation composition and industry mix of the labor force between Massachusetts and the nation. Low homicide and motor vehicle related death rates in Massachusetts have also contributed to the low fatal injury rate of the state.
  
• Falls accounted for a much higher proportion (21%) of work-related fatal injuries in Massachusetts than in the nation (11%) (Appendix 2).

Introduction

Although the risk of dying on the job in the United States has declined since 1980¹, fatal occupational injuries continue to be a significant public health problem in Massachusetts as they are in the country as a whole. From 1991 through 1999, 633 workers died as a result of injuries sustained while at work in the Commonwealth. These fatalities were all the more tragic because they were largely preventable. Information about the circumstances in which workers were fatally injured on the job is essential to design and target efforts to prevent future fatalities.

This report provides a comprehensive overview of fatal occupational injuries in Massachusetts from 1991 to 1999. Although the Massachusetts Department of Public Health published an annual report on fatal injuries at work each year during this period, the numbers from these individual years were too small for meaningful analysis of categories of interest. Nine years of data, however, allow for a more detailed understanding of the factors associated with workplace fatalities in Massachusetts.

This report is based on data collected under two separate but complementary federal programs. The comprehensive surveillance of all fatal occupational injuries sustained in Massachusetts is conducted as part of the national Census of Fatal Occupational Injuries (CFOI), supported by the U.S. Department of Labor, Bureau of Labor Statistics. On-site investigations of selected fatalities are carried out as part of the Fatality Assessment and Control Evaluation (FACE) program sponsored by the National Institute for Occupational Safety and Health. Both of these programs are carried out in Massachusetts by the Occupational Health Surveillance Program of the Massachusetts Department of Public Health.

Section I of this report provides an overview of work-related fatalities in Massachusetts during the nine-year period. Section II compares the occupational fatality experience in Massachusetts with that of the nation. Section III includes more detailed findings on three special topics: falls to lower levels, homicides, and fishingrelated fatalities. Case examples based on FACE investigations are included throughout the report. This resource document is intended to guide the many parties - government agencies, employers, unions, safety professionals and advocacy organizations, researchers, job trainers, product design engineers, and architects – who have a role to play in preventing fatal injuries at work.

Methods

Definition of Fatal Occupational Injuries

A fatal occupational injury is defined as a death resulting from traumatic injury or other external cause that occurred while the person was at work. This definition includes fatalities due to acute exposure to toxic chemicals or physical agents as well as lack of such essentials as heat or oxygen. Examples include those events traditionally linked with factors in the work environment such as falls, electrocutions, and crushings, as well as homicides and suicides at work and motor vehicle fatalities that occur while travelling on the job. The CFOI and FACE programs do not include injuries that occur while commuting to or from work. Deaths caused by occupational illness and most fatal heart attacks are also excluded.

Included in this report are all fatal occupational injuries that occurred in Massachusetts while the victims were working or traveling for work in the state regardless of their state of residence, state of death, or state of origin of travel. The count does not include, however, fatal injuries that occurred in other states but death occurred in Massachusetts.

Fatal occupational injuries that occurred in the ocean are included in the count if (according to the CFOI criteria), either the injury occurred within the 200-miles offshore economic zone of the United States and is more proximal to Massachusetts than other states or a death certificate was issued by the state of Massachusetts. Fatal injuries that occurred beyond the 200-mile offshore economic zone of the U.S. are excluded.

Definition of Work-relatedness

For an injury to be considered work-related, the victim must have been working at the time of the event (or traveling as part of his employment) and engaged in a legal activity. Victims may have been either employed by others or self-employed, and they may have been employed for wage and salary compensation or have been volunteers working without pay or other compensation.

Sources of Data

Data on fatal occupational injuries in Massachusetts are from the Census of Fatal Occupational Injuries (CFOI) carried out by the Occupational Health Surveillance Program (OHSP) in the Massachusetts Department of Public Health. The Department has collected occupational fatality data under the CFOI program since 1991. Data on occupational fatalities throughout the United States are from the national CFOI reports published by the U.S. Bureau of Labor Statistics (BLS).

CFOI uses multiple data sources to identify and document work-related fatalities. The main sources are death certificates, Workers’ Compensation records, newspapers, FARS (Fatality Accident Reporting System) reports, OSHA records, and Coast Guard reports. Other available federal and state administrative records are also used. In some cases, employers are contacted through follow-up questionnaires to obtain additional information. These records are used to compile a complete and accurate count of fatal injuries at work in a given year. For assurance of an accurate count of fatal occupational injuries, CFOI requires that the work relationship be substantiated by two or more independent sources.

Coding

Information on each fatal occupational injury is coded for different variables using different coding systems. Categorical analyses of fatal injuries by industry, occupation and event are based on the classifications of these coding systems.

Industry: Industry is the type of establishment or business in which a fatally-injured worker was employed at the time of the injury. Information is obtained from different source documents and is coded according to the Standard Industrial Classification Manual, Office of Management and Budget 1987 (Appendix 8).

Occupation: Occupation is the type of occupation that a fatally-injured worker assumed at the time of his/her injury. It is coded according to the Occupational Injuries and Illnesses Occupation Coding Manual (Adopted from the Bureau of Census 1990 Alphabetical Index of Industries and Occupations), 1993, Bureau of Labor Statistics, U.S. Department of Labor (Appendix 9).

Event/Exposure, Nature of Injury, Body Part Affected and Source of Injury: were coded according to Occupational Injury and Illness Classification Manual, 1992, BLS (Appendix 10).

Other variables: Other variables such as age, race, gender, establishment size, and ownership are coded according to the BLS, Census of Fatal Occupational Injuries State Operating Manual, March 1996.

Fatality Rates

Fatality rates are defined as the number of fatalities due to traumatic occupational injuries per 100,000 Massachusetts workers. Unless otherwise noted in this document, the average annual fatality rates for the nine-year period are reported. These were computed as: (a) the sum of the number of fatalities over the nine-year period, divided by (b) the sum of the number of workers employed in Massachusetts each year over the nine-year period, multiplied by (c) 100,000. For some rates, employment data from 1995 (the midyear of the study period) were used as the denominator. Information about the number of workers was obtained from the Current Population Survey (CPS) conducted by the Bureau of Labor Statistics, except where noted. Fatalities involving youth less than 16 years old were excluded from all rate calculations because employment data from the CPS are limited to workers 16 years and older. Due to lack of industry-specific data for self-employed workers, fatalities among self-employed workers (except for Agriculture) were excluded from industry-specific rate computations. Some of the rates presented in this report are based on small numbers of fatalities and should be interpreted with caution.

Rates indicate the probability or risk of a worker being fatally injured on the job within a year. Numbers are the count of workers who die from work-related injuries. In a large industry, many workers may be fatally injured but the rate may be low. Conversely, in a small but high-risk industry, the number of workers fatally injured may be small but the rate or risk may be high. Both rates and numbers should be taken into account when targeting prevention efforts.