Underreporting Work Absences for Nontraumatic Work-Related Musculoskeletal Disorders to Workers’ Compensation: Results of a 2007–2008 Survey of the Québec Working Population

摘要

Objectives. We examined underestimation of nontraumatic work-related musculoskeletal disorders (WMSDs) stemming from underreporting to workers’ compensation (WC). Methods. In data from the 2007 to 2008 Québec Survey on Working and Employment Conditions and Occupational Health and Safety we estimated, among nonmanagement salaried employees (NMSEs) (1) the prevalence of WMSDs and resulting work absence, (2) the proportion with WMSD-associated work absence who filed a WC claim, and (3) among those who did not file a claim, the proportion who received no replacement income. We modeled factors associated with not filing with multivariate logistic regression. Results. Eighteen percent of NMSEs reported a WMSD, among whom 22.3% were absent from work. More than 80% of those absent did not file a WC claim, and 31.4% had no replacement income. Factors associated with not filing were higher personal income, higher seniority, shorter work absence, and not being unionized. Conclusions. The high level of WMSD underreporting highlights the limits of WC data for surveillance and prevention. Without WC benefits, injured workers may have reduced job protection and access to rehabilitation. Musculoskeletal disorders (MSDs) are the main cause of disability in most industrialized countries and represent a considerable human and economic burden. 1–4 Workers perceive a high proportion of their MSDs to be work related: nearly three quarters of workers in the province of Québec who had experienced musculoskeletal pain in 2007 to 2008 attributed it to work. 5 The term work-related musculoskeletal disorders (WMSDs) refers to nontraumatic inflammatory or degenerative disorders of the musculoskeletal structures of the neck, back, or upper or lower extremities that usually develop over time as a result of cumulative microtrauma, arising from biomechanical and other work exposures, that surpasses the adaptive and repair capacities of affected structures. 6,7 Nontraumatic WMSDs are distinguished in etiology and prevention from MSDs caused by acute accidental traumatic injuries. Although one of the most common sources of data used to measure the incidence of work-related disorders is workers’ compensation (WC) data, several studies have suggested that such data underestimate the prevalence of occupational disorders, including MSDs. 8–12 Few of these studies have specifically looked at nontraumatic WMSDs. We estimated, among nonmanagement salaried employees (NMSEs), (1) the 1-year prevalence of nontraumatic WMSDs and resulting work absence, (2) the proportion with WMSD-associated work absence who filed a WC claim, and (3) among those who did not file a claim, the proportion who lacked replacement income during their work absence.