Under-reporting of non-fatal occupational injuries among precarious and non-precarious workers in Sweden

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  • Kreshpaj, Bertina
  • Theo Bodin
  • David H Wegman
  • Nuria Matilla-Santander
  • Bo Burstrom
  • Katarina Kjellberg
  • Letitia Davis
  • Tomas Hemmingsson
  • Johanna Jonsson
  • Carin Håkansta
  • Cecilia Orellana

BACKGROUND: Under-reporting of occupational injuries (OIs) among precariously employed workers in Sweden challenges effective surveillance of OIs and targeted preventive measures.

OBJECTIVE: To estimate the magnitude of under-reporting of OIs among precarious and non-precarious workers in Sweden in 2013.

METHODS: Capture-recapture methods were applied using the national OIs register and records from a labour market insurance company. Employed workers 18-65 resident in Sweden in 2013 were included in the study (n=82 949 OIs). Precarious employment was operationalised using the national labour market register, while injury severity was constructed from the National Patient Register. Under-reporting estimates were computed stratifying by OIs severity and by sociodemographic characteristics, occupations and precarious employment.

RESULTS: Under-reporting of OIs followed a dose-response pattern according to the levels of precariousness (the higher the precarious level, the higher the under-reporting) being for the precarious group (22.6%, 95% CI 21.3% to 23.8%), followed by the borderline precarious (17.6%, 95% CI 17.1% to 18.2%) and lastly the non-precarious (15.0%, 95% CI 14.7% to 15.3%). Under-reporting of OIs, decreased as the injury severity increased and was higher with highest level of precariousness in all groups of severity. We also observed higher under-reporting estimates among all occupations in the precarious and borderline precarious groups as compared with the non-precarious ones.

CONCLUSIONS: This is the first register-based study to empirically demonstrate in Sweden that under-reporting of OIs is 50% higher among precariously employed workers. OIs under-reporting may represent unrecognised injuries that especially burden precariously employed workers as financial, health and social consequences shift from the employer to the employee.

Original languageEnglish
JournalOccupational and Environmental Medicine
Issue number1
Pages (from-to)3-9
Number of pages7
Publication statusPublished - 2022
Externally publishedYes

Bibliographical note

© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.

    Research areas

  • Adult, Data Collection/methods, Employment/statistics & numerical data, Female, Humans, Insurance Claim Reporting, Male, Middle Aged, Occupational Injuries/statistics & numerical data, Patient Acuity, Registries, Socioeconomic Factors, Sweden/epidemiology

ID: 327061457