New research on doctor visits hints at new areas of OHS research

The Institute for Safety, Compensation and Recovery Research (ISCRR) is drawing considerable attention to a recent research report into the actions of patients after medical practitioners ( a general practitioner or GP in Australian parlance) have identified a work-related illness. The research is unique and instructive and indicates areas that require more analysis.

According to the media release on the research:

“ISCRR’s Chief Research Officer, Dr Alex Collie, who conceived the research, said that over 22 per cent of workers didn’t make compensation claims even though their GP had determined that the illness was work-related.” (link added)

Dr Collie continues:

“There are a number of reasons we are seeing work-related conditions not being claimed..

“It could be that workers are less willing to claim for psychological conditions compared with physical conditions because of potential for stigma in the workplace. Workers’ may also be unaware they can make a workers’ compensation claim.”

This quote changes from the definitive to the possible illustrating uncertainty but the equivocations hint at an important avenue for further research – “the potential for stigma in the workplace”.  More analysis, if available, on the occupations of the patients may have been useful.

Collie’s research conducted with Ying Pan, Helena Britt and Joan Henderson, has added weight from the size of the survey sample, an impressive

“486,400 general practitioner (GP) consultations around Australia recorded in the BEACH (Bettering the Evaluation and Care of Health) research program between April 2004 and March 2009.”

But the data appears from the above to be secondhand, probably through necessity than choice but how does the research help the management of workplace safety?

Safety Impacts

Firstly, the research provides further evidence of the underestimation of workplace illnesses and injuries in Australia.  Preventative strategies and the magnitude of safety costs are almost always based on workers compensation data.  Dr Collie has found over 100,000 additional workplace injuries or illnesses that were absent from five years’ data – around 20,000 each year.*

Secondly, as the recognition of workplace psychosocial hazards emerges from its infancy in Australia, this research indicates that we still do not know quite what to do with mental health issues.

Although the heading of the media release (WORKERS MAKE FEWER CLAIMS FOR PSYCHOLOGICAL ILLNESSES) and the first paragraph mention psychological illnesses, the body of the release is less informative on that part of the research.

The results of the research report itself states

“Of all work-related GP encounters 77.4% were claimed through workers’ compensation.  Problems most commonly managed at claimed encounters were musculoskeletal, followed by skin, psychological and general/unspecified problems.  Musculoskeletal problems were the most common work related problems managed at unclaimed encounters; however, they were managed significantly less often.  In contrast, psychological, general, circulatory, respiratory, social and ear related problems were managed significantly more often at unclaimed encounters.  Encounters occurring in major cities and inner regional areas were significantly more likely to be claimed  through workers’ compensation than those in outer regional and remote regions.”

Numerical data

Table 3 in the report (page 6) provides some numerical data and lists depression as the seventh ranked, and only, psychological condition claimed on workers’ compensation (around 3.7 per 100 encounters).  For those conditions not claimed on workers compensation there are three psychological health conditions:

• Acute stress reaction (ranked 2)   7.1 per 100 encounters
• Depression (ranked 3)                       6.4 per 100 encounters
• Anxiety (ranked 6)                             4.7 per 100 encounters.

These seems to be the figures supporting the headline but the differentiation of these three psychological conditions is beyond the interpretation of this author.  However the figures generate a more practical safety question and one that should be actively pursued – why are workers so hesitant to lodge a workers’ compensation claim for a work-related psychological condition?

This question is crucial to determining control measures and these control measures are likely to gain less governmental support because there is a substantial number of psychologically injured workers hidden from the data that government uses to prioritise spending.

This data still would not have been on the agenda of Australia’s recent inquiry into mental health but, although workplace bullying is not mentioned in the research report, the current Parliamentary inquiry into workplace bullying should not these statistical findings speculate on what generated these workplace psychological issues.

Dr Collie and researchers acknowledge that this seems to be the first report of its type and they should be congratulated on this different perspective on workplace illnesses, injuries, and workers’ compensation.  The report hints at many areas of relevance to safety management but remains shy of any practical application in that area.  We will need to wait for the next set of researchers that will surely come.

Kevin Jones

* always check my calculations as Arts graduates are not know for accurate counting.  Maybe I should have said almost a quarter of the survey sample did not claim workers compensation.