Fast-Moving Covid-19 Escapes Traditional Workplace Data Tracking

Workplace health experts are scrambling to collect reliable information on how the coronavirus is affecting workers in all industries.

Other than efforts to gather details on health-care worker illnesses and deaths, numbers for other industries are, at best, incomplete.

The numbers are needed for health specialists and employers to identify which groups of workers are at risk and spot outbreaks in industries that previously had been shut down.

“I don’t think we have a system out there right now that’s really going to give us accurate numbers,” said Dr. Kenneth Rosenman, a Michigan State University medical professor and co-lead of the Council of State and Territorial Epidemiologists’ occupational health section.

‘A Real Challenge’

In normal times, occupational safety and health specialists depend on the Bureau of Labor Statistics, part of the Department of Labor, for data on workplace fatalities and illnesses. That information can take more than a year to release and may miss many illnesses.

Without one clearinghouse source collecting this employment data, the task falls on overworked local health departments, funeral directors, or hospital staff interviewing often-distraught family members or friends.

“It has been a real challenge to track cases of Covid-19 among workers because it’s hard to track with the traditional occupational health surveillance systems. It’s very difficult to determine which cases are work-related,” said Dr. Sara Luckhaupt, a medical officer with the National Institute for Occupational Safety and Health, a division of the Centers for Disease Control and Prevention.

The BLS maintains fatality and illness databases and issues two annual reports typically released in December that cover the prior year. This December’s reports will analyze 2019 cases.

The national Census of Fatal Occupational Injuries uses several sources, such as death certificates and newspaper accounts, to track on-the-job deaths from traumatic incidents such as traffic accidents or falling off a roof. The census doesn’t track deaths from diseases.

A BLS spokesman said that although the bureau already is gathering 2020 data, the lack of uniform information on Covid-19 cases from documents “will prevent consistent coding and measurement of these cases.”

The Survey of Occupational Injuries and Illnesses uses Occupational Safety and Health Administration-mandated reports from employers to estimate the number of nonfatal illnesses that were serious enough to require medical care that went beyond first aid or led to an employee missing a day or more from work.

The survey would include coronavirus cases that employers determined to be work-related. But since March, the Occupational Safety and Health Administration has issued three different opinions on which type of employers need to determine if a virus case is job-related.

Questions and Answers

In place of BLS data, occupational illness researchers are turning to CDC agencies and local and state health departments to gather and release infection information.

Even before the pandemic, fatality information on death certificates should have included the deceased’s occupation, said Shawna Webster, executive director of the National Association for Public Health Statistics and Information Systems.

The person who interviews a relative or friend to gather the employment information often is a funeral director or hospital staff member, Webster said.

With the high priority for tracking Covid-19 deaths, the death certificate information is often getting reviewed by local and state officials for completeness and accuracy before it’s forwarded to the CDC’s National Center for Health Statistics, Webster said.

There’s also a push to collect employment information from people who test positive for the coronavirus.

On May 5, the CDC released a revised model form for local health-care staffs to use when interviewing people who have tested positive, regardless of whether the patient is at home or admitted to a hospital, Luckhaupt said.

The new form asks if the patient in the 14 days prior to becoming ill had left home for a job and what the workplace setting was, for example, a grocery store or construction site.

The patient answers are eventually added to a database at the CDC’s Center for Surveillance, Epidemiology, and Laboratory Services.

While the information can’t show that a case was work-related, identifying at-risk jobs and industries is important.

Rosenman said he’d like to have additional information on the patient’s job and employer, especially as more businesses reopen. Getting information from the patient is important because health departments might otherwise be unaware of new hot spots since employers may not notify local health officials about infections.

“Wherever other facilities open up and you put lots of people together, you’re going to potentially have clusters of infection,” Rosenman said.

However, asking too many questions may lead to getting less information.

“I’d say there is a big challenge, because the volume of cases is so high, it’s a little overwhelming to some of the state and local health departments to be able to collect information on every case,” Luckhaupt said.