Main results and prospects

Transcription

1 Occupational health Maladies chroniques et traumatismes Development of national surveillance indicators for work-related traffic accidents Exploratory study from data recorded by social insurance workers compensation funds June 2014 Julien Brière, Sabira Smaïli Occupational health department (DST), French Institute for Public Health Surveillance (InVS) Main results and prospects This report rectifies an exploratory work which was intended to focus on and test the development of national indicators needed for the national epidemiological surveillance of work-related traffic accidents. The data used are derived from workers compensation data about work-related accidents recorded by the two main social security funds in France, the private sector employees fund ( Régime général de sécurite sociale ) and the agricultural employees fund ( Mutualite sociale agricole ). I Figure 1 I Transportation Two main points which have to be learned from this exploratory work will be detailed here: 1) the acquired indicators highlight differences particularly based on age and economic sector at a very detailed level; 2) the implementation of a data collection for workrelated accidents in the near future will allow a regular production of updated indicators on this occupational hazard. A traffic accident is defined by the Road Safety Authority as an accident causing at least one victim, occurring on a road open to public transportation and involving at least one vehicle. There are two categories of work-related traffic accidents. These are accidents occurring during a work-related trip (also known as an accident on a mission for the employer), and accidents which occur while commuting. First cause of fatal accidents at work Work-related traffic accidents are the leading causes of fatal accidents at workplace, with nearly 44% of the deaths from accidents recognized by the general social security fund in 2012 (including accidents which occurred while commuting) [1]. An increase in the exposure to the risk of traffic related accidents while commuting in recent years should be noted with an increase in frequency and size of the distance covered daily in this category of travels [2]. Work-related traffic accidents: very incomplete data However, very little data are available both at the national level and in international literature to describe the magnitude of the phenomenon of work-related traffic accidents, the Joseph Cortes/ victims` profiles, circumstances leading to the occurrence of these accidents and their effects on health. A few descriptive studies have been conducted on fatal accidents [3,4], but very little on the non-fatal ones. Data from social insurance workers compensation funds in France constitute the main source of information on this category of accidents. However, these data have some limitations. Accidents that have not been reported to the social security funds as work-related accidents have, in fact, been excluded. Accidents declared as work-related but not recognized by the social security funds cannot be analyzed without any recorded descriptive information (some of the non-recognized accidents are not work-related traffic accidents while others, on the other hand, are not recognized solely for administrative reasons). Finally, statistics from various social security fundss are disparate. They rely on heterogeneous nomenclature according to social security funds, and they do not always directly separate traffic-related accidents. Development of national surveillance indicators for work-related traffic accidents French Institute for Public Health Surveillance / p. 1

2 Note The data used in this exploratory work dates back to It is the data acquired between 2007 and 2009 (according to the social security funds) in a feasibility study (published in 2011 [5]) on setting up of a national mechanism of centralization and statistics analysis on work-related accidents and occupational diseases; a mission entrusted to the InVS by the public health policy Act of August 9 th As a result, indicators produced and described here do not necessarily reflect the current situation, although it is likely that the trends that emerge are still relevant. These indicators must first and foremost be seen as examples of indicators that will be produced in this field in the future and as types of differences which still existed recently and whose development will be possible to follow. The acquired indicators highlight differences, particularly based on age and economic sector at a very detailed level Among the 16.3 million employees insured by the Régime général and the agricultural employees fund in 2004, 102,000 were victims of work-related traffic accidents recognized as work-related accidents, about two-thirds of which were accidents occurring while commuting (73,000 accidents), and one-third while on business trips (29,000 accidents). Among these victims were 627 deaths, 462 of whom were commuting and 165 on a business trip. Work related traffic accidents accounted for a small portion of work-related accidents (including travel accidents) (8.0%), but a significant proportion of deaths (53%). Differences according to the victim`s age As for all traffic related accidents (private trips and work), the frequency of work-related traffic accidents decreased with age for business trips and for commuting (figure 2). The gap between the frequency index of the younger workers (less than 30 years old) and the older ones (over 50 years old) was more pronounced with regards to commuting than business trips. With regards to business trips, the frequency of traffic accidents was higher among men than among women. On the other hand, a difference in frequency of commuting accidents was not observed on a gender basis Mortality rate (figure 3) decreased with age for commuting, a phenomenon also observed in all deaths involving traffic accidents for any type of travel. On the other hand, for business travels, there was a slight increase in mortality rates with age among males and stability among women. Differences according to economic sector Frequency of work-related traffic accidents varied little between the 16 sectors of Economic Nomenclature Synthesis (NES) of the National Institute of Statistics and Economic Studies (Insee), with the exception of the transport sector among men where, as expected, the frequency index for business travels was three times higher than the overall index (figure 4). On the other hand, looking at this index in more detailoriented economic sectors (Nomenclature of French Activity (NAF) of Insee in 712 levels), large disparities were observed. For example, for business trips (table 1), the frequency and the number of traffic- accidents were high: -- among men and women in the postal and ambulances sectors; -- among men in transportation of goods to short distances, intercity transportation of goods and the fast-food industry. As for commuting, the economic sectors distinguishable by a frequency and a high number of accidents, were not the same. Methodological frame: frequency index Frequency index is the ratio between the number of victims and the size of the population of employees insured by the Régime général fund and the agricultural employees fund for the year under review. It can not be seen as a "risk assessment" of being a victim of a work-related traffic accident in the sense of a probability of an accident occuring during a workrelated trip, which should be based on the duration of workers exposure to road hazards (index denominator). This type of information on the employees insured by the Régime général fund and the agricultural employees fund does not exist. This frequency index reflects the burden of injuries emanating from work-related traffic accidents among different groups of employees and allows their comparison. p. 2 / French Institute for Public Health Surveillance Development of national surveillance indicators for work-related traffic accidents

3 I Figure 2 I Frequency index for 1,000 employees according to the type of accident, gender and age Index frequency /1, Business trips Aged less than Aged 50 and over Age groups Index frequency /1, Commuting Aged less than Aged 50 and over Age groups Development of national surveillance indicators for work-related traffic accidents French Institute for Public Health Surveillance / p. 3

4 I Figure 3 I Mortality rate for 100,000 employees according to the type of accident, gender and age Mortality rate /100,000 Mortality rate /100, Business trips Aged less than Aged 50 and over Age groups Commuting Aged less than Aged 50 and over Age groups p. 4 / French Institute for Public Health Surveillance Development of national surveillance indicators for work-related traffic accidents

5 I Figure 4 I Business trips, number of victims and frequency index for 1,000 employees according to economic sector in 16 levels and gender A - Agriculture forestry and fishing B - Agriculture and food industry C - Consumer goods industry D - Automobile industry E - Equipment industries F - Intermediate goods industries G - Energy H - Construction J - Trade K - Transportation L - Financial activities M - Real estate business N - Business services P - Personal services Q - Educ. health and social services R - Administration A - Agriculture forestry and fishing B - Agriculture and food industries C - Consumer goods industry D - Automobile industry E - Equipment Industry F - Intermediate goods industries G - Energy H - Construction J - Trade K - Transportation L - Financial activities M - Real estate business N - Business services P - Personal services Q - Educ. health and social services R - Administartion 2,407 3,389 3,870 4,419 1, , Index frequency all sectors = 2.2 Number Index frequency for 1,000 employees 2,683 1,967 1, Index frequency all sectors = 1.3 Number Index frequency for 1,000 employees 0.7 Development of national surveillance indicators for work-related traffic accidents French Institute for Public Health Surveillance / p. 5

6 I Table 1 I Business trips, number of victims and frequency index for 1,000 employees according to economic sector and gender (economic sectors with higher or equal to 3 times the index frequency of all sectors) a) Among men Aggregated economic sector (NES 16 posts) Economic sector (NAF 712 posts) Number of accidents Population of employees Index frequency /1,000 B - Agriculture and food industry 158B - Cooking of bread products 103 3, G - Energy 401C - Electricity transmission G - Energy 103Z - Extraction and agglomeration of peat G - Energy 401E - Distribution and trade of electricity 29 3, G - Energy 402A - Production of gaseous fuel J - Trade 504Z - Trade and repair of motocycles 165 9, J - Trade 526G - Door-to-door-sales 33 3, J - Trade 511T - Non specialized trade intermediaires 23 3, J - Trade 512E - Wholesale of live animals 27 3, J - Trade 513V - Wholesale of frozen products 55 8, K - Transportation 602E - Journeys by taxi 101 6, K - Transportation 602L - Transportation of goods to short distances 1,019 82, K - Transportation 602P - Rental of trucks with a driver , K - Transportation 602M - Intercity transportation of goods 1, , K - Transportation 631A - Handling at ports 35 5, N - Business services 641C - Other postal activities 249 4, N - Business services 641A - National postal agency , N - Business services 711A - Car rentals for a short duration 56 6, N - Business services 900B - Removal and treatment of household trash , N - Business services 748G - Routing 59 8, P - Personal services 553B - Fast-food industry , P - Personal services 555D - Catering and organization of receptions 118 8, Q - Educ. health and social services 851J - Ambulances , Q - Educ. health and social services 804A - Driving school 106 8,157 1 Q - Educ. health and social services 851G - Activities of healthcare assitants R - Administration 752A - Foreign affairs b) Among women B- Agricultural and food industries 154A - Manufacture of oils and raw fats B - Agricultural and food industries 155B - Manufacture of butter B - Agricultural and Food Industries 159T - Manufacture of beverages 5 1, C - Consumer goods industries 221J - Other publishing activities 4 1, J - Trade 513L - Wholesale tobacco trade J - Trade 526G - Door-to-door sales 31 5, J - Trade 511T - Non specialized trade intermediaries 11 2, J - Trade 526H - Sales automata 8 1, K - Transportation 602E - Journey by taxis 41 2, K - Transportation 601Z - Railway transportation K - Transportation 602G - Other forms of road transportations 19 2, K - Transportation 602B - Regular highway travellers 73 10, K - Transportation 602A - Urban transportation of travellers 40 6, K - Transportation 602L - Transportation of goods to short distances 54 9, K - Transportation 602P - Rental of trucks with a driver 6 1, p. 6 / French Institute for Public Health Surveillance Development of national surveillance indicators for work-related traffic accidents

7 N - Business services 641A - National postal agency 1,431 59, N - Business services 641C - Other postal activities N - Business services 711A - Car rentals cars for a short duration 22 4, N - Business services 748G - Routing 27 5, N - Business services 744A - Advertising management 74 18, P - Personal services 930G - Care for the dead P - Personal services 925E - Management of natural heritage Q - Educ. health and social services 851J - Ambulances , Q - Educ. Health and Social services 804A - Driving school 95 6, Q - Educ. health and social services 851G - Activities of healthcare assistants 45 8, Q - Educ. Health and social services 853J - Home-help/domestic servant , R - Administration 752A - Foreign affairs Frequency index of an economic sector must be interpreted with caution when it is based on a low number of accidents. NES: Economic Nomenclature Synthesis of Insee. NAF: Nomenclature of French Activity of Insee. Other indicators Other indicators that can highlight differences which are potentially useful for prevention, were calculated (depending on the type of vehicle involved in the accident and according to the time of occurrence of the accident). Indicators measuring effects of accidents on health have also been developed. They describe the nature of lesions, the part of body affected, the severity of injuries measured according to several criteria and the distribution of the duration of leaves of absence. What are the new things brought by these indicators? They bring a new insight on occupational road risk. Aggregated results of several social security funds (aggregation of two funds for the moment). These results allow a better assessment of the magnitude of this occupational hazard at the national level. Aggregated indicators in the economic sectors which are characterized by a high proportion of employees in several social security funds (for example the food industry). These indicators are essential for the health surveillance and prevention of accidents, and it is impossible to produce them by adding existing statistics which are based on heterogeneous nomenclatures of activity. Separate results among men and women. These results are not currently available as the statistics of social security funds were not established on the basis of gender. Indicators according to economic sector at a very detailed level (nomenclature in 712 categories) common to all funds. These indicators are not available today. An analysis of the consequences of accidents in terms of the duration of leaves of absence and the rate of disability among men and women. These results are not currently available. Development of national surveillance indicators for work-related traffic accidents French Institute for Public Health Surveillance / p. 7

8 Implementation of a routinely data collection for work-related accidents to regularly produce updated indicators on this occupational hazard The regular production of national indicators on work-related traffic accidents is essential for health surveillance and prevention of this occupational hazard. Indicators which were tested in the year 2004 highlight the differences of situation according to different factors of interest. Their follow-up will henceforth enable to have long series which are necessary for the temporal surveillance of this hazard to workers. To make data on occupational injuries available each year from the main social security funds, that will allow the development of indicators on different categories of occupational injuries, including traffic-related accidents, the InVS has recommended the establishment of a national centralization of compensation data for occupational injuries and occupational diseases from all French social insurance funds (see the conclusions of the feasibility study of InVS supra). Pending decisions on the modalities of implementation and funding for this system, a device for collection and analysis of data limited to three of the main social security funds ( Régime général, agricultural employees fund and the civil servants in local governments and hospitals fund) is being put in place, in collaboration with the Directorate for Research, Studies, and Statistics (Dares) of the Ministry of Labor. This scaled-down device, compared with the central mechanism, will collect raw data currently kept in each of the three recognized social security funds on an annual basis. This monitoring will still have some limitations. Data from social security funds will cover only workers registered with them. Those particularly excluded are craftsmen, retailers and self-employed who are not insured against any occupational hazards in their social security fund. Furthermore, the social security funds record very little descriptive information on the circumstances leading to traffic accidents. To reinforce the epidemiological surveillance of this occupational hazard, it has been planned to test the use of a second source of data, in order to develop complementary indicators to those from social security funds. It is the data collected by the French police in the event of work-related traffic accident. When police investigate a road accident, they fill an analysis report of injury in the traffic accident (Baac), which includes an item type of trip (filled for drivers and pedestrians only but not passengers) identifying commuting, professional use and private use. This second exploratory work, currently underway, is a collaboration between InVS and the joint unit of epidemiological research and surveillance in transport, occupation and environment (Umrestte), which has been using these data for several years. References [1] CnamTS, Direction des risques professionnels. Rapport de gestion [2] Talbot J. Les déplacements domicile-travail, De plus en plus d actifs travaillent loin de chez eux [3] Briere J, Chevalier A, Imbernon E. Surveillance of fatal occupational injuries in France: Am J Ind Med 2010;53 (11): [4] Occupational highway transportation deaths, United States, MMWR Morb Mortal Wkly Rep 2011;60 (16): [5] Chevalier A, Briere J, Feurprier M, et al. Construction d un outil centralisateur des données de réparation issues des régimes de Sécurité sociale. Synthèse de l étude de faisabilité et recommandations. Saint-Maurice: Institut de veille sanitaire 2011:-12. Keywords: traffic accident, commuting accident, occupational injury, compensation claims, indicator Suggested citation: Brière J, Smaïli S. Development of national surveillance indicators for work-related traffic accidents. Exploratory study from data recorded by social insurance workers compensation funds. Saint-Maurice: French Institute for Public Health Surveillance; p. Available at the following URL: French Institute for Public Health Surveillance, 12 rue du Val d Osne Saint-Maurice Cedex France Tel. : 33 (0) Fax : 33 (0) ISSN: ISBN-NET: Produced by: Service communication Legal deposition: juin 2014