Worker deaths in the United States from occupational diseases, primarily from toxic chemical exposures, are conservatively estimated by NIOSH and other researchers at 50,000 to 60,000 deaths annually.

Why does this monumental, continuing national disaster go virtually unnoticed, enabling the issue to be ignored?This is largely due to a range of factors that mask the true magnitude of occupational diseases in this country.  There is often a long latency period (significant lapse of time between the workplace exposure and manifestation of disease symptoms) – making it difficult to prove the occupational origin of the disease. Also occupational diseases are often not appropriately identified due to a general lack of medical knowledge and training in this field.  Meanwhile, the lack of a single, comprehensive national surveillance system has made it difficult to achieve the kind of data collection and monitoring that is so essential to improving recognition, diagnosis, treatment, and prevention of occupational diseases. The inadequacy of proper reporting methods among other issues is a continuing problem that conceals the widespread nature of occupational disease and its tragic toll on our workers.  We must raise awareness about the extent of the problem to galvanize the political will needed to achieve pro-worker change in our systems.

One appalling issue to consider in the context of occupational disease is the “bottom-line” approach many companies adopt when it comes to questions of worker health and safety. Worker deaths are often far cheaper for a corporation than identifying and correcting safety/health hazards at the workplace; and employers are virtually immune from prosecution for the depraved indifference that results in severe injury, toxic exposure, or death.  The Occupational Safety and Health Administration’s limited enforcement ability; the incredibly difficult political battles for enacting even the most basic regulatory standards; the ridiculously low fines levied in case of corporate wrongdoing; the low probability of inspection and  miniscule possibility of prosecution and conviction; the opportunities to  negotiate pro-industry agreements in the course of investigations of corporate wrongdoing; all this and more creates no incentive for employers to provide safe and healthy workplaces. It is tantamount to a license to kill workers with impunity. The criminal penalties for killing a worker are preposterously low compared to those for accounting fraud, or even minor drug use. It is a very sad commentary on how we, as a society, value worker lives.

Workers’ Compensation, the system meant to provide vital support for injured and ill workers, miserably fails the victims of occupational disease. Proving one’s illness is work related can be particularly difficult for many reasons, including the long latency period mentioned above. The system misses over 90% of occupational disease deaths, and at least   80% of the medical costs for occupational diseases. 

Occupational disease can destroy a workers’ health – but due to the failures of workers’ compensation, occupational diseases can also bankrupt workers.  The comp system puts employers and their insurers in charge of diagnosis and treatment – the very same players whose focus is to reduce their costs by any means and who often, in an effort to contain costs, aggressively contest injured/ill worker claims. This leads to outright denial of legitimate claims or long delays. In this way employers and the insurance companies conveniently shift costs and the economic burden for occupational illness, injury, and death falls heavily and unfairly on workers, families and taxpayers. The predominant payer for the over $300 billion annual cost of occupational illnesses and injuries is the federal government; primarily through Social Security Disability (SSDI), Medicare and Medicaid. 

Experts recommend that the dysfunctional state-by-state workers’ compensation systems as well as federal workers’ compensation needs to be replaced by a single national system with uniform coverage and benefits, independent of insurance and industry control. I believe that this would make the system more efficient and pro-worker by taking profit considerations and a skewed power balance out of the equation. We must take action now to address the devastation that occupational disease is causing in this country.

To read a detailed analysis of this issue of occupational illness, read Patrice Woeppel’s article: Occupational Diseases in the United States: Workers’ Compensation and OSHA, Our Failed Systems in Need of Overhaul. Click here to access the article.

References:

Leigh, J. Paul; Markowitz, Steven; Fahs, Marianne; Landrigan, Philip. Costs of Occupational Injuries and Illnesses. University of Michigan Press, 2000.
Steenland, Kyle; Burnett, Carol; Lalich, Nina; et al.Dying for Work: The Magnitude of US Mortality From Selected Causes of Death Associated With Occupation, American Journal of Industrial Medicine, Vol 43, pp 461-482, 2003.
LaDou, J. Workers’ Compensation in the United States: Cost Shifting and Inequities in a Dysfunctional System. New Solutions, Vol 20(3) 291-302, 2010.
Davis, Devra. The Secret History of the War on Cancer. Basic Books, New York, 2007, pp.104-105.
Leigh, J. P., Robbins, J. Occupational Disease and Workers’ Compensation: Coverage, Costs, and Consequences. Millbank Quarterly, 82 (4), 689-721, 2004.

Patrice Woeppel is a retired hospital and healthcare executive and former hospital board officer. Dr. Woeppel is also the author of Depraved Indifference: the Workers’ Compensation System.