Chief State Medical Examiner

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Occupational Health Surveillance

New Jersey Occupational Health Indicators 2000-2019

NOTE: Statistics are based on most recent available information.

New Jersey Occupational Health Indicators are calculated annually to measure the health status of New Jersey’s working population. Characterizing the populations most at risk for work-related illness and injury helps assess occupational health needs. The New Jersey Occupational Health Indicator (OHI) data are formatted and calculated based on the Council of State and Territorial Epidemiologists (CSTE) and the National Institute for Occupational Safety and Health (NIOSH) guide “Occupational Health Indicators: A Guide for Tracking Occupational Health Conditions and their Determinants."


Highlights: 2000 - 2019
  • There were over 3,000 work-related hospitalizations per year.
  • A total of 1,987 workers died from fatal injuries.
  • A total of 1,110 hospitalizations were due to work-related burns.
  • 92% of pneumoconiosis hospitalizations were due to exposure to asbestos and asbestosis was the leading cause of mortality from or with pneumoconiosis (93%).
  • New Jersey annual death rates of malignant mesothelioma (11.7-21.8 cases per million residents) were higher than U.S. rates (11.1-14.0 cases per million residents).
  • Annual total workers’ compensation benefits paid exceeded 30 billion dollars. The average workers’ compensation award paid per worker was $495.
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Employment Profile

Percentage of Workers Employed in Industries at High Risk for Occupational Morbidity

The most effective way to prevent injuries and illness is to control the occupational hazards. To help prioritize limited resources it is vital to concentrate on high risk industries for non-fatal injuries and illnesses.

Percentage of Workers Employed in Occupations at High Risk for Occupational Morbidity

Workers employed in occupations at high risk for occupational morbidity in New Jersey increased from 197,938 in 2000 to 498,092 in 2019. 

Percentage of Workers Employed in Industries and Occupations at High Risk for Occupational Mortality

The percentage of workers employed in occupations at high risk for occupational mortality has increased slightly from 2000-2019 for both New Jersey and the US while the percentage of workers employed in industries at high risk for occupational mortality has remained consistent. A fatal injury is considered work-related if the event leading to the injury occurred while the employee was working, either on or off the employer’s premises. In 2019, there were over 495,000 workers employed in occupations at high risk for occupational mortality in New Jersey, which is 11% of the employed population.

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Work-Related Injuries and Illnesses

Nonfatal Work-Related Injuries and Illnesses Reported by Employers

There have been over 1.8 million non-fatal work-related injuries in New Jersey from 2000-2019. The estimated annual total incidence rate for cases involving days away from work in New Jersey was 1,000 per 100,000 full-time equivalent workers in 2019, which has slightly decreased from 1,800 per 100,000 full-time equivalent workers in 2000. Non-fatal work-related injuries occurred more frequently in service-providing industries and occupations in 2019. The back and hand were the parts of the body that were most affected; and sprains, strains, and tears were the most common nature of injury or illness.

N.B. -- Caution should be taken when comparing data to other states or with national estimates due to differences in industry concentration and sample size.

Musculoskeletal Disorders

Musculoskeletal disorders (MSDs) are some of the most common and preventable work-related injuries. MSDs are injuries or disorders of the muscles, tendons, nerves, ligaments, joints, or spinal discs that are caused by or aggravated by work activities. Of the 195,688 cases of MSDs reported in New Jersey from 2000-2019, 48% were MSDs of the back; 27% were MSDs of the neck, shoulders, and upper extremities; and 1% were carpel tunnel syndrome.

N.B. -- Caution should be taken when comparing data to other states or with national estimates due to differences in industry concentration and sample size.

Amputations Reported by Employers

In New Jersey, the rate of work-related amputations was 5.0 amputations per 100,000 full-time employees in 2019.

N.B. -- Caution should be taken when comparing data to other states or with national estimates due to differences in industry concentration and sample size.

Fatal Work-Related Injuries

Work-related fatal injuries are a serious public health concern which are preventable through occupational health surveillance efforts. Even though occupational injuries are largely preventable, there have been 1,987 fatal occupational injuries from 2000-2019. Ongoing surveillance of occupational fatalities can help public health and other governmental agencies track and prevent future work-related fatal injuries.

Asthma Among Adults Caused or Made Worse by Work (data collection began in 2011)

Work-related asthma (WRA) is a debilitating and sometimes fatal disease. According to the CDC, asthma is a chronic inflammatory disease of the airways that affects millions of adults in the US. More than 300 substances used in the workplace are known to either cause asthma in healthy workers or aggravate asthma in those who already have the condition. WRA can be prevented. New Jersey law requires physicians, physician assistants, and advanced practice nurses to report WRA cases for the appropriate public health follow-up.

Data are obtained from the New Jersey Asthma Call Back Survey (ACBS) which is conducted with Behavioral Risk Factor Surveillance System Survey (BRFSS) respondents who report an asthma diagnosis.

In 2017, there were 293,333 individuals in New Jersey who reported that their asthma was caused or made worse by exposures at work, which has slightly decreased from 307,641 in 2011.

Malignant Mesothelioma

Malignant mesothelioma is a rare but highly fatal cancer of the thin membranes surrounding the chest cavity (pleura) or abdominal cavity (peritoneum). Exposure to asbestos fibers is a well-established risk factor for mesothelioma. There were over 20,000 hospitalizations due to asbestosis from 2000-2019.

Mortality from or with Pneumoconiosis

Pneumoconiosis is a class of non-malignant lung diseases which are usually incurable and may lead to death. Pneumoconiosis includes silicosis, asbestosis, coal workers’ pneumoconiosis, and other and unspecified pneumoconiosis. In New Jersey, asbestosis resulted in the greatest number of deaths, over 1,000 from 2000-2018.

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Work-Related Hospitalizations

Individuals hospitalized with work-related injury and illnesses have some of the more serious and costly work-related adverse health outcomes. In New Jersey alone there have been over 85,000 work-related hospitalizations from 2000-2019.

Hospitalizations for Work-Related Burns

Burns can be the most expensive work-related injuries to treat, result in large amounts of lost work time, and can be extremely painful. In New Jersey, there have been 1,110 work-related burn hospitalizations from 2000-2019.

In 2019, there were a total of 32 work-related hospitalizations due to burns. Of these cases 29 (91%) were male and the average age was 39. Nine (28%) were White; 5 (16%) were Black; and 17 (53%) were of Hispanic origin. Twenty-eight percent of the burns were to the lower limb, except ankle and foot; 22% were to the head, face, and trunk; and 19% to the shoulder and upper limb, except wrist and hand.

N.B. -- Caution should be taken when comparing data to other states or with national estimates due to workers’ compensation (WC) eligibility criteria and availability of data from WC programs varying among states. Effective October 1, 2015 healthcare organizations and providers were required to start using ICD-10-CM codes. The transition in classification from ICD-9-CM to ICD-10-CM may not be a one-to-one match, therefore caution should be taken when comparing data before and after the transition.

Hospitalizations from or with Pneumoconiosis

Most cases of pneumoconiosis are diagnosed in older individuals, are often incurable and may result in death. The annual rate of asbestosis from 2000-2019 in New Jersey was 66-277 hospitalizations/million residents. Rates of asbestosis in New Jersey may be high because the production of asbestos products and use of asbestos, especially in New Jersey’s many shipyards were extensive in the state. Several New Jersey studies have documented excess lung cancer among New Jersey workers in industries with asbestos exposure, including New Jersey’s most well-known asbestos products manufacturer, the Manville Corporation in Somerset County. NJDOH has estimated that as many as 500,000 New Jersey workers may have been exposed since 1940.

N.B. -- Caution should be taken when comparing data to other states or with national estimates due to workers’ compensation (WC) eligibility criteria and availability of data from WC programs varying among states. Effective October 1, 2015 healthcare organizations and providers were required to start using ICD-10-CM codes. The transition in classification from ICD-9-CM to ICD-10-CM may not be a one-to-one match, therefore caution should be taken when comparing data before and after the transition.

Work-Related Lower Back Disorder Hospitalizations (data collection began in 2008)

Hospitalizations for work-related low back disorders have serious and costly effects including high direct medical costs, significant functional impairment and disability, high absenteeism, reduced work performance, and lost productivity. Well-recognized prevention efforts can be implemented for high-risk job activities and reduce the burden of work-related low back disorders

N.B. -- Caution should be taken when comparing data to other states or with national estimates due to workers’ compensation (WC) eligibility criteria and availability of data from WC programs varying among states. Effective October 1, 2015 healthcare organizations and providers were required to start using ICD-10-CM codes. The transition in classification from ICD-9-CM to ICD-10-CM may not be a one-to-one match, ICD-codes for low-back disorders are still in the process of being validated. Therefore, data for 2016-2019 have not been collected on the state and national level.

Hospitalizations for Work-Related Severe Traumatic Injury (data collection began in 2012)

Acute work-related trauma is a leading cause of death and disability among U.S. workers. Severe traumatic injury can lead to long-term pain and disability and is very costly for workers’ compensation systems and for society as a whole. Accurate characterization of injury trends is critical to understanding how we are doing as a nation with regards to occupational injury prevention.

In 2015, 421 work-related inpatient hospitalizations for severe traumatic injury for persons age 16 years or older occurred. The annual crude rate of work-related inpatient hospitalizations in 2015 for person 16 years or older was 9.9 severe traumatic injuries/100,000 employed person.

N.B. -- Caution should be taken when comparing data to other states or with national estimates due to workers’ compensation (WC) eligibility criteria and availability of data from WC programs varying among states. Effective October 1, 2015 healthcare organizations and providers were required to start using ICD-10-CM codes. ICD-codes for severe traumatic injuries are still in the process of being validated. Therefore, data for 2016-2019 have not been collected on the state and national level.

Hospitalizations for or with Occupational Eye Injuries (data collection began in 2016)

Occupational eye injuries are common yet preventable. In severe cases, ocular trauma can lead to lifetime disability. Although protective eyewear can reduce the risk of eye injury, identifying additional risk factors for eye injuries is integral to preventing them. Estimating the burden of occupational eye injuries and associated risk factors can help target prevention activities.

In 2019, 39 work-related inpatient hospitalizations for occupational eye injuries for persons age 16 years or older occurred. The annual crude rate of work-related inpatient hospitalizations in 2019 for person 16 years or older was 0.9 per 100,000 employed persons.

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Work-Related Emergency Department Visits

Heat-Related Emergency Department Visits (data collection began in 2013)

Exposure to environmental heat is a clear recognized hazard for many occupations where individuals are not able to maintain thermal equilibrium due to their work environment (e.g., hot and humid), required clothing type, and usage of protective equipment.

N.B. -- Caution should be taken when comparing data to other states or with national estimates due to workers’ compensation (WC) eligibility criteria and availability of data from WC programs varying among states. Effective October 1, 2015 healthcare organizations and providers were required to start using ICD-10-CM codes. The transition in classification from ICD-9-CM to ICD-10-CM may not be a one-to-one match, therefore caution should be taken when comparing data before and after the transition.

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Toxic Exposures

Acute Work-Related Pesticide Poisonings Reported to Poison Control Centers

Workers (agricultural and pesticide applicators) who handle pesticides are at greatest risk for pesticide poisoning. In New Jersey, there were over 700 cases of pesticide-associated illnesses reported from 2000-2017. New Jersey annual rates (0.7-1.3 poisonings/100,000 employed persons) were below the U.S. rates (1.5-2.1 poisonings/100,000 employed persons) from 2000-2017. 

Elevated Blood Lead Levels Among Adults

Adult lead poisoning usually occurs as a result of occupational exposure and can affect multiple organ systems and cause permanent damage. Anemia, nervous system dysfunction, and kidney damage may result from lead exposure. Workers can be exposed to lead through inhalation of fumes and dusts and through ingestion due to lead contaminated hands, food, clothing, etc. Employers are required by OSHA to offer annual medical exams to workers who have BLLs ≥ 40 µg/dL.

The NJDOH routinely finds elevated blood lead values ≥ 25µg/dL in workers employed in certain industries despite a trend that indicates decreasing blood lead levels in adults over time. This downward trend should be interpreted cautiously for a variety of reasons including the closing of a large lead acid battery manufacturing facility, an overall decrease in manufacturing in New Jersey, and the implementation of an electronic reporting system which more efficiently collects, and de-duplicates reported lead cases.

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Occupational Health and Safety Professionals

Work-related injuries and illnesses are preventable. It is important to assess the availability of trained occupational health professionals that can identify the hazard and implement preventative services in the workplace.

N.B. -- Due to the difficulty obtaining consistent, reliable data, the CSTE Occupational Health Subcommittee voted to discontinue national data collection for this indicator following publication of the 2015 data.

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OSHA Enforcement Activities

In 1970, Congress established the Occupational Safety and Health Administration (OSHA). OSHA’s mission is to "assure so far as possible every working man and woman in the nation safe and healthful working conditions." This mandate involves the application of a set of tools by OSHA (e.g., standards development, enforcement, compliance assistance). OSHA conducts both referral and non-referral inspections on worksites. Investigations are inspections that are triggered by three events: fatality, catastrophe, or referral (including outside health/safety agency or media). The measures of frequency for this indicator may approximate the added health and safety benefits and protection felt by workers as a result of their worksites being inspected.

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Influenza Vaccination Coverage Among Healthcare Personnel

Influenza is a significant cause of morbidity and mortality. Healthcare personnel (HCP) can serve as vectors for influenza transmission because they can acquire it from patients and transmit it to other patients and workers. The seasonal influenza vaccine is highly effective in healthy, younger adults, which includes many HCP. The CDC, and other professional organizations, recommends that all HCP receive the vaccine annually.

 

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Workers’ Compensation Awards

Workers’ compensation awards are reviewed to establish whether the reported medical condition is work-related. Accepted awards represent known work-related injuries and illnesses, and often more severe cases. In 2018, a total of $2,418,577,000 was awarded to injured New Jersey workers, which is an average of $605 per injured worker. 

N.B. -- Caution should be taken when comparing data to other states or with national estimates due to workers’ compensation (WC) eligibility criteria and availability of data from WC programs varying among states.

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Last Reviewed: 8/31/2021