Although Declining, Cost of Union Carpenters’ Work-Related Back Problems Still Staggering

A construction site often attracts attention from public onlookers.  Those spectators would likely be equally awed by the cost of work-related back injuries/disorders sustained by carpenters: nearly a dollar for each hour of work according to a recent state of Washington retrospective study covering a 15 year period.  When standardized to 2006 monies, the total cost of medical care, time-loss, and permanent impairment for this work injury/disorder category from 1989 to 2003 was $128,358,522.

The study involved 15,768 union carpenters who reported 4,138 workers’ compensation back claims. Overexertion (i.e., lifting, pushing, pulling) was the cause of 3,042 cases while acute trauma (i.e., falling, struck by) was related to 1,096 cases. Overexertion mechanisms led to higher total claim costs ($77,902,170) when compared to acute trauma ($50,456,351).  However, acute trauma mechanisms, when compared to overexertion, produced much higher mean ($46,037 versus $25,608, respectively) and median ($2,497 versus $1,669, respectively) total costs.

Further analysis revealed the following cost breakdown:

• Medical – overexertion 35.3 percent, acute 36.2 percent
• Time lost indemnity – overexertion 55.6 percent, acute 53.1 percent
• Impairment – overexertion 9.1 percent, acute 10.7 percent

A positive finding revealed by this study involved payment rate (dollars spent per hour of carpenter work) which decreased from $1.61 in 1990 to $0.39 in 2003 – a drop of over 75 percent.  This reduction is due to lower costs relative to acute back injuries and a decrease in overexertion injury rates.

The Bottom Line – How This Applies To Ergonomists

Back injuries among carpenters continue to be a significant business cost.  A worksite ergonomic risk study among this group should focus on both overexertion and trauma as potential injury/disorder mechanisms.  Effective worksite modification to return a disabled employee to work, especially after the first or second injury, could dramatically reduce current and future claim costs.

Other Key Points

Time lost indemnity produced the highest percent of claim cost on a yearly basis.

Older age was associated with higher claim cost.  The greater the number of back injuries experienced by the carpenter (up to the third injury), the higher the claim cost.

Cost estimates for work-related back injuries among this group may be underestimated because the carpenters are also covered by a private health insurance that has fewer impediments when acquiring treatment.  Further, carpenters in this study reported that their work opportunities may be compromised if too many work-related injuries are claimed. 

Research Procedure

The Carpenters Trusts of Western Washington was used to identify a group of carpenters who worked from 1989 to 2003 in the State of Washington.  Information collected included birth date, gender, initial date of union work, and hours of union work.

Workers’ compensation data was gleaned from Washington State Department of Labor and Industries records.  Information included standard claim descriptors (date of injury, body part injured, injury nature, type of event) and claim costs (medical care, time-loss, and impairment).  Self-insured companies that covered workers who were in the study cohort supplied information limited to workers who experienced time-loss.

To offset the impact of cost variation for the same service given at different time periods of the 15 year study, two steps were taken to produce a constant dollar value as of the year 2006.  The national consumer price index was applied to all costs and once calculated, medical costs were discounted by 3 percent per year.  All costs were categorized into the year of injury occurrence.

Analysis of costs created from acute trauma cases were performed separate from overexertion injuries. 

Access
This position paper can be acquired at:
http://www3.interscience.wiley.com/journal/122443673/abstract

Article Title: Compensation Costs of Work-Related Back Disorders Among Union Carpenters, Washington State 1989-2003

Publication: American Journal of Industrial Medicine, 52:587-595, 2009

Authors: H J Lipscomb, J M Dement, B Silverstein, W Cameron, and J E Glazner 

This article originally appeared in The Ergonomics Report™ on 2009-07-15.