Missed reporting of nonfatal occupational injuries: estimation using the International Labor Organization datasets.

Introduction: Most previous studies about missed reporting of nonfatal occupational injuries have four limitations: (i) mostly qualitative methods, (ii) arbitrary fraction used to estimate missed nonfatal occupational injuries based on subjective opinions, (iii) use of datasets derived from only one country, and (iv) use of a relatively simple estimation method. In contrast, (i) using quantitative approaches, this study will calculate the (ii) objective estimates on (iii) a multinational scale. (iv) A newly devised logical approach for estimation will be applied. Through this study, the fraction of missed reports of nonfatal occupational injuries will be estimated in a new way.

Methods: Four International Labor Organization (ILO) datasets were analyzed in this study: (i) fatal occupational injuries per 100,000 workers by sex and migrant status, (ii) nonfatal occupational injuries per 100,000 workers by sex and migrant status, (iii) inspectors per 10,000 employed persons, and (iv) labor inspection visits per inspector. The ratification status of 27 ILO conventions, classified into 12 categories, was used for the analyses. The GDP dataset from the World Bank Open Data was also used. In addition to basic descriptive analyses, a multilevel Poisson regression method was applied. The primary outcome was the risk ratio of the above-mentioned four selected measures when an ILO convention was ratified compared to when the convention was not ratified. Finally, for the estimation of the fraction of missed reports of nonfatal occupational injuries, a newly devised estimation method was applied. This method was devised based on a unique characteristic of reporting systems for fatal occupational injuries (duplicate reporting through multiple reporting systems).

Results: The ratio of discovered nonfatal occupational injuries to total estimated nonfatal occupational injuries ranged from 0.13 (95% CI 0.13-0.14) to 0.89 (95% CI 0.84-0.95). In other words, the minimum estimate of the percentage of missed injury reports is 11% (1-0.89 = 0.11) and the maximum is 87% (1-0.13 = 0.87). The mean value of the ratios of discovered nonfatal occupational injuries to total estimated nonfatal occupational injuries was 0.52. In other words, the most likely estimate for the fraction of missed injury reports is 48% (1-0.52 = 0.48).

Discussion: Underreporting of nonfatal occupational injuries could hinder the efforts of governments to address and improve the occupational safety and health status of the country. Accurate assessment of the current status of nonfatal occupational injuries is important for devising effective strategies to reduce this type of injury.