IWH (Institute for Work & Health), 400 University Avenue, Suite 1800, Toronto, Ontario, M5G 1S5, Canada.
TNO (The Netherlands Organisation for Applied Scientific Research), Hague, Netherlands.
BMC Public Health. 2021 Jan 6;21(1):49. doi: 10.1186/s12889-020-10050-7.
Estimates of the economic burden of work injuries and diseases can help policymakers prioritize occupational health and safety policies and interventions in order to best allocate scarce resources. Several attempts have been made to estimate these economic burdens at the national level, but most have not included a comprehensive list of cost components, and none have attempted to implement a standard approach across several countries. The aim of our study is to develop a framework for estimating the economic burden of work injuries and diseases and implement it for selected European Union countries.
We develop an incidence cost framework using a bottom-up approach to estimate the societal burden of work injuries and diseases and implement it for five European Union countries. Three broad categories of costs are considered-direct healthcare, indirect productivity and intangible health-related quality of life costs. We begin with data on newly diagnosed work injuries and diseases from calendar year 2015. We consider lifetime costs for cases across all categories and incurred by all stakeholders. Sensitivity analysis is undertaken for key parameters.
Indirect costs are the largest part of the economic burden, then direct costs and intangible costs. As a percentage of GDP, the highest overall costs are for Poland (10.4%), then Italy (6.7%), The Netherlands (3.6%), Germany (3.3%) and Finland (2.7%). The Netherlands has the highest per case costs (€75,342), then Italy (€58,411), Germany (€44,919), Finland (€43,069) and Poland (€38,918). Costs per working-age population are highest for Italy (€4956), then The Netherlands (€2930), Poland (€2793), Germany (€2527) and Finland (€2331).
Our framework serves as a template for estimating the economic burden of work injuries and diseases across countries in the European Union and elsewhere. Results can assist policymakers with identifying health and safety priority areas based on the magnitude of components, particularly when stratified by key characteristics such as industry, injury/disease, age and sex. Case costing can serve as an input into the economic evaluation of prevention initiatives. Comparisons across countries provide insights into the relevant performance of health and safety systems.
估算工伤和职业病的经济负担有助于政策制定者优先考虑职业健康和安全政策和干预措施，以便最佳分配稀缺资源。已经有几次尝试在国家层面上估算这些经济负担，但大多数都没有包括成本构成的综合清单，也没有试图在几个国家实施标准方法。我们的研究目的是制定一个估算工伤和职业病经济负担的框架，并将其应用于选定的欧盟国家。
我们采用自下而上的方法开发一种发病率成本框架，以估算工伤和职业病的社会负担，并将其应用于五个欧盟国家。考虑了三大类成本：直接医疗保健、间接生产力和无形与健康相关的生活质量成本。我们从 2015 年新诊断的工伤和职业病数据开始。我们考虑了所有类别和所有利益相关者的终身成本。对关键参数进行了敏感性分析。
间接成本是经济负担的最大部分，其次是直接成本和无形成本。按 GDP 的百分比计算，波兰的总费用最高（10.4%），其次是意大利（6.7%）、荷兰（3.6%）、德国（3.3%）和芬兰（2.7%）。荷兰的每个病例成本最高（75342 欧元），其次是意大利（58411 欧元）、德国（44919 欧元）、芬兰（43069 欧元）和波兰（38918 欧元）。每劳动年龄人口的成本最高的是意大利（4956 欧元），其次是荷兰（2930 欧元）、波兰（2793 欧元）、德国（2527 欧元）和芬兰（2331 欧元）。
我们的框架可作为在欧盟及其他国家估算工伤和职业病经济负担的模板。结果可以帮助政策制定者根据各部分的重要性，特别是根据行业、伤害/疾病、年龄和性别等关键特征进行分层，确定健康和安全优先领域。病例成本核算可以作为预防措施经济评估的投入。国家间的比较可以深入了解健康和安全系统的相关绩效。
