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Lenore S. Azaroff, ScD, Charles Levenstein, PhD, MOH and David H. Wegman, MD, MPH

The authors are with the Department of Work Environment, University of Massachusetts, Lowell.

Correspondence: Requests for reprints should be sent to Lenore S. Azaroff, ScD, University of Massachusetts Lowell Work Environment Department, One University Ave, Lowell, MA 01854 (e-mail: lenore_azaroff{at}uml.edu).

Occupational health surveillance data are key to effective intervention. However, the US Bureau of Labor Statistics survey significantly underestimates the incidence of work-related injuries and illnesses. Researchers supplement these statistics with data from other systems not designed for surveillance.

The authors apply the filter model of Webb et al. to underreporting by the Bureau of Labor Statistics, workers’ compensation wage-replacement documents, physician reporting systems, and medical records of treatment charged to workers’ compensation. Mechanisms are described for the loss of cases at successive steps of documentation. Empirical findings indicate that workers repeatedly risk adverse consequences for attempting to complete these steps, while systems for ensuring their completion are weak or absent.

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