Occupational disease in New York State: a comprehensive examination.

In order to obtain information on the current magnitude of occupational disease in New York State, four data sources were reviewed: Workers' Compensation records, disease registries maintained by the state department of health, data from the Bureau of Labor Statistics (BLS), and data from the California's physician reporting system. A proportionate attributable risk approach is used to develop estimates of mortality due to occupational diseases. The distribution of occupational hazards was assessed using data from the Occupational Safety and Health Administration (OSHA), the National Institute for Occupational Safety and Health (NIOSH), and the New York State Department of Environmental Conservation (NYDEC). Finally, econometric estimates of the direct and indirect costs of occupational illness were developed. The best available data indicate that 5,000 to 7,000 deaths are caused each year in New York State by work-related illnesses, and at least 35,000 new cases of occupational illness develop each year in the State. It is also estimated that between 150,000 and 750,000 workers in New York State are employed in the 50 most hazardous industries. OSHA standards regulating exposure to selected chemicals were found to have been violated frequently. The annual costs of occupational disease in New York State are approximately $600,000,000; only a small fraction is covered by workers' compensation insurance. Of the 52,000 physicians in New York State, only 73 are board-certified in occupational medicine. Most of these are involved in administrative, teaching, and research aspects of occupational medicine. Of the 300 industrial hygenists in New York State, two-thirds are employed by major corporations. Recommendations are described to improve the recognition of occupational disease in New York State and to reduce the burden of this disease. A statewide network of occupational health clinical services is proposed and has been funded by the New York State Legislature. Other recommendations are also given.