Occupational Injuries in Pakistan: Incidences and Economic ... · Dr. Shujaat Farooq Dr. Mahmood Khalid , 2015 . Introduction Inception of thindustrial revolution in 20 century precipitated

Occupational Injuries in Pakistan:

Incidences and Economic Impact

Presented By:

Faisal Mushtaq (MS Health Economics)

Supervisors:

Dr. Shujaat Farooq

Dr. Mahmood Khalid

, 2015

Introduction

Inception of industrial revolution in 20th century precipitated the

concept of labour force.

The use of machinery with less safety measures resulted in the

problems of injuries.

Employees/employers are not properly trained to use machinery

and cope with mishaps.

The term 'injury' derived from the Latin word 'in+jus' meaning 'not

right', (Baker et al., 1987).

Introduction (Count…)

Injuries contribute to disturb living standard and fabricate economic

and financial problems for labourers (Ghaffar et al., 2004; Waehrer,

2007).

Injuries are the leading cause of global burden of disability and

death for all working age groups (WHO, 2012).

According to report of Australian Industrial Commission (AIC), for

every $1 of direct costs of injury estimates, $3 to $5 of indirect

costs is also incurred (Commons, 2008–09).

Occupational Injuries in Pakistan

Globally Pakistan was ranked 9th populated country in 2010, with

the total labour force of 54.9 million (Government of Pakistan,

2013).

Every year, in occupational injury/ incidences, 41 workers out of

1000 receive injury [Nasrullah and Xiang (2008), (NISP)]

In Pakistan most of the unskilled labourers are unaware to use the

protective equipment, precautionary and safety measures.

Objective of the Study

Following three specific objectives

• To investigate the possible injury rate by socio-economic and

regional variables.

• To analyze the reasons that caused occupational injury

• To estimate the indirect economic cost of injured workers (on the

bases of available data of injury).

Rational of the Study

It would contribute in the literature by highlighting the influential

characteristics of injury i.e. age, education, gender, region

occupation and industrial sector.

This study estimated the Indirect cost of occupational injury by

using LFS data set.

This study also analysis the reason of occupational injury in the

form of unsafe acts at work place.

Literature Review

Author Period Data Country Methodology Findings

Determinants of Injury

Hamalainen et al 2006 ILO, Central

intelligence

agency (CIA)

175

Countries

Descriptive

statistics

About average 350,000 people receive fatal

occupational incidents and the number of

non-fatal incidents was about 240 million.

Adane et al 2013 Primary data Ethiopia Multiple Logistic

Regression

There are about 38.7 present incidences in

the preceding year. Out of which 68.4

present were the males while the rest stated

by female workers.

Broucke at al 2011 Primary data Belgium Logistic Regression

Technique

Prominent differences in case of gender,

age, employee quantity and the contact

among education and age were found.

Reasons of Injury

Khalid 2012 LFS (2010-11) Pakistan Binary Logistic

Regression

Lots of problems occur when one gets

injured; this gives birth to many problems

like socio-economical, psychological and

many others.

Gumber 1997 NSSO (1986-

87)and

WDR (1993)

India Descriptive States During the past few decades number of

injuries increased due to modernisation in

technology and economic development.

Literature Review (Count…)

Author Period Data Country Methodology Findings

Ghaffar et al 1999 BS, NTRC, MoH Pakistan Epidemiological

estimates and the

WHO motorization

index.

The rising time trend in all injuries and the

significant loss of life from injuries has a

critical impact on the national economy.

Economic Cost of Injury

Corso et al 2006 National, state

and other sources.

United States Approach by

Lawrence et al

More than 50 million Americans

experienced a medically treated injury in

2000, which resulting in lifetime costs of

406 billion dollar out of which 80 billion

dollar was from medical treatment and 326

billion dollar was for most productivity.

Fuente et al 2012 National Institute

of safety and

Hygiene at Work

(INSHT)

Spain Human capital

method

Occupational injuries in Spain affected the

current economic crisis, which has

triggered a sharp fall in both the number of

accidents and the probability of having one

Leigh et al 1992 United states Human capital

method

841 deaths and 512,539 non-fatal injuries

were estimated for 1992. The cost of

occupational injuries in agricultural sector

was estimated as $4.57 billion in 1992,

whereas direct and indirect cost was

estimated as $1.66 billion and $ 2.93 billion

respectively.

Data

Pakistan Labor Force Survey (2012-13)

Methodology

Unit of Analysis: Employed Labour force (age =10 year and

above)

• Dependent variable: Work place Injury/ Occupational injury

Occupational injury is analyzed into four different categories:

– Descriptive analysis among key variables

– Reasons of injury

– Determinants of injury (age, gender, education, occupation, industry

nature of employment, region and province)

– Economic impact of injury

Descriptive analysis among the key variables:

• Injury rate = 𝑡𝑜𝑡𝑎𝑙 𝑛𝑢𝑚𝑏𝑒𝑟 𝑜𝑓 𝑖𝑛𝑗𝑢𝑟𝑒𝑑 𝑒𝑚𝑝𝑙𝑜𝑦𝑒𝑑

𝑡𝑜𝑡𝑎𝑙 𝑛𝑢𝑚𝑏𝑒𝑟 𝑜𝑓 𝑒𝑚𝑝𝑙𝑜𝑦𝑒𝑑 𝑝𝑒𝑟𝑠𝑜𝑛∗ 100

Methodology (Count….)

• Male injury rate=𝑡𝑜𝑡𝑎𝑙 𝑛𝑢𝑚𝑏𝑒𝑟 𝑜𝑓 𝑚𝑎𝑙𝑒 𝑖𝑛𝑗𝑢𝑟𝑒𝑑 𝑒𝑚𝑝𝑙𝑜𝑦𝑒𝑑

𝑡𝑜𝑡𝑎𝑙 𝑛𝑢𝑚𝑏𝑒𝑟 𝑜𝑓 𝑚𝑎𝑙𝑒 𝑒𝑚𝑝𝑙𝑜𝑦𝑒𝑑∗ 100

• Female injury rate=𝑡𝑜𝑡𝑎𝑙 𝑛𝑢𝑚𝑏𝑒𝑟 𝑜𝑓 𝑓𝑒𝑚𝑎𝑙𝑒 𝑖𝑛𝑗𝑢𝑟𝑒𝑑 𝑒𝑚𝑝𝑙𝑜𝑦𝑒𝑑

𝑡𝑜𝑡𝑎𝑙 𝑛𝑢𝑚𝑏𝑒𝑟 𝑜𝑓 𝑓𝑒𝑚𝑎𝑙𝑒 𝑒𝑚𝑝𝑙𝑜𝑦𝑒𝑑∗ 10

Reasons of injury:

• Reason of injury are narrated as the unsafe acts at work place i.e. Failure

to use safety devices, wrong order by supervisor etc.

• Cross tabulation method is used based on the Bivariate analysis to

describe the injury rates among unsafe acts at work place.

Determinants of injury:

• Logistic regression model is used to find out the relationship between

binary dependent variable and independent explanatory variables.

• 𝐼𝑆𝑖=𝛽𝑜 + 𝛽1𝑆𝑖 + 𝛽2𝐴𝑖 + 𝛽3𝐴𝑖2 + 𝛽4𝐸𝑖 + 𝛽5𝐺𝑖 + 𝛽6𝑂𝑖 + 𝛽7𝑃𝑖+∈𝑖

Methodology (Count….)

Variables:

IS= Injury status with binary outcomes 1 means employed worker

is injured and 0 mean not injured.

S=Gender of worker P= Province

A=Age of employed respondent A^2= Age square

E= Represent different levels of education

G= Geographical locality(Rural=1 Urban =0).

O= Occupation of respondent.

Methodology (Contd….)

Indirect cost of Injury

Temporary work loss (till one year and above)

• Average Per day income =average monthly income

26days (working days in a month)

• Cost of injury = estimated work loss days*average per day income

(Shalini (2008; Waehrer (2007).

Permanent work loss ( worker didn’t resume back to work for the rest of his

working age that is 65 years).

• 𝑃𝑉𝑁𝑛=R[1−(1/1+𝑖)𝑛]

𝑖

• PVN is stands for the present value of an annuity, R is the periodic receipt

(or payment), and n is the length of annuity means numbers of years, i is

the average annual discount rate of that particular year 2012-13 that is

about 9.5 percent according to International Financial Statistics (IFS)

2014.

Estimation of Injury Rates Among the Key Variables

Injury rate by personal Characteristics Table 1: Injury rate by Gender (%)

Status of Injuries

Gender

Male Female Overall

Injured 4.7 2.5 4.2

Not injured 95.3 97.5 96

Total 100 100 100

N 50,927 14,657 65,584

Source: Author’s calculation from Micro Dataset LFS 2012-2013

Figure 1: Injury Rate by Age Groups (%)

Figure 2: Injury Rate by Education of Employed Worker (%)


3.2

3.4

3.6

3.8

4

4.2

4.4

(10-24) (25-39) (40-49) 50 and above

3.7%

4.2%

4.4%

3.8%

0

1

2

3

4

5

6

No formal Primary Middle Matric Intermediate Graduate +

4.5%

5.1%

3.9% 3.2%

1.5 % 1%

Injury Rate by Labour market Characteristics

• Labour market is divided into four parts i.e. is occupation, sector of employment (industry),

type of employment (formal and informal) and nature of employment.

Figure 3: Injury Rate by Occupation (%)


0

2

4

6

8

0.5% 1.3% 1.1% 0.7%

1.9%

4.5%

6.9%

4.2% 5.1%

4.2%

Figure 4: Injury Rate by Type of Employment (%)


3.7

3.75

3.8

3.85

3.9

3.95

4

4.05

4.1

4.15

4.2

4.25

Formal sector Infromal sector overall

3.8%

4.4%

4.2%

Reported Reason of Occupational Injury

• There are 14 reported reasons of injury at work place, which are further

narrow down to 7 on the basis of their resemblance (LFS, 2012-13)

Reasons of Injury by Socio-economic and Labor market Related

Characteristics

Table 2: Reason of Injury by Gender (%)

Reasons of Injury Females Males Overall

Operating without Instructions 3.3 2.7 2.8

Excess Speed 16.0 27.6 26.1

Failure to Use Safety Devices 7.6 11.9 11.3

Using Equipment Unsafely 47.2 45.8 46.0

Wrong Order of Supervisor 21.3 4.7 6.9

Unsafe Act by Fellow and Outsider 0.4 2.2 1.9

Others 4.2 5.1 5.0

Total 100.0 100.0 100.0


Table 3: Reasons of injury by Educational Groups (%)

Reasons of Injuries No

Formal

Education

Till

Primary

Six to

Matric

Intermediate

and above

Overall

Operating without Instructions 2.9 2.3 3.2 2.4 2.8

Excess Speed 21.9 27.7 30.6 45.4 26.1

Failure to Use Safety Devices 12.3 11.7 9.8 5.0 11.3

Using Equipment Unsafely 48.2 45.1 43.2 38.8 46.0

Wrong Order of Supervisor 8.6 6.0 5.0 1.2 6.9

Unsafe Act by Fellow and

Outsider

1.4 2.0 2.6 5.5 2

Others 4.8 5.2 5.7 1.7 5

Total 100 100 100 100 100


Table 4: Reason of injury by occupation (%)

Reason of injury Highly Skilled Skilled Unskilled Over all

Operating without instructions 2.7 2 3.6 2.8

Excess speed 43.8 30.8 31.0 31.3

Failure to use safety devices 6.8 9.5 12.7 11.0

Using equipment unsafely 26.0 46.4 43.2 44.1

Wrong order of supervisor 1.4 6.4 3.3 4.7

Unsafe act by fellow and others 8.2 1.2 2.1 1.9

Others 10.9 3.7 4.2 4.2

Total 100 100 100 100


Determinants of Injury (Regression Results)

Table 6: The determinants of Occupational Injury/Disease-Binary Logistic

Regression. (Note*** denote significant at 1 percent, **denote significant at 5 percent, * denote significant at 10 percent)

Explanatory Variables Coeffi Std. Error Odds Ratio

Gender (Male=1) 1.095*** 0.075 2.990

Age (in years) 0.048*** 0.008 1.049

Age square -0.001*** 0.000 0.999

Educational Group (Graduates and above as ref)

No formal education 1.141*** 0.339 3.129

Primary 1.120*** 0.340 3.066

Middle 0.944*** 0.342 2.570

Matric 0.897*** 0.340 2.452

Intermediate 0.430 0.355 1.538

Occupation (Elementary Occupation as ref)

Legislator -1.582** 0.725 0.206

Professional -0.993*** 0.187 0.370

Technicians -1.212*** 0.212 0.298

Clerk -1.256*** 0.365 0.285

Regression Results (Count..…)

Table

Explanatory Variables Coeffi Std. Error Odds Ratio

Service worker 1.034*** 0.095 0.356

Agriculture 0.117* 0.062 0.889

Craft 0.458*** 0.075 1.582

Plants 0.063*** 0.075 1.065

Region(Rural=1) 0.451*** 0.054 1.570

Province (Baluchistan as ref)

KP 1.138*** 0.118 3.120

Punjab 1.429*** 0.109 4.174

Sindh 1.787*** 0.109 5.973

Constant 0.458*** 0.392 0.001

Total Number of observations 65584

Model Chi-square 1421.7

Model Significance 0

Log likelihood -9389.8

Pesudo R Square 0.07

Estimated Results of Indirect cost of Injury

• According to the study injuries are divided into two main categories one is the

temporary and the second is permanent work loss on the basis of data available in LFS.

Measuring Indicators of Temporary Injuries:

• The total cases in respondent sample of temporary work loss are 2,022 cases,

Figure 5:Cost of Occupational Injury in Temporary work loss:


professionals 5%

technicians and associates 2%

service workers 13%

agriculture 27%

craft 13%

plant and mechine assambler 19%

elementryoccupation 21%

Measuring Indicators of Permanent Injury

Investigating the permanent loss by taking the average monthly income of that worker.

Ordinary annuity is used calculate the permanent work loss cost and compute that loss

till the average expected life of work that is officially 65 year of a worker by using the

discount rate.

Table 7: Distribution of Indirect Economic Cost of Injury in Permanent Disability

Occupations Percentage of

injuries

Average cost per

case (000)

Total indirect cost in

(000)

Service workers 3.0 303.2 1213

Skilled Agriculture worker 71.0 421.3 45080.2

Craft related trade work 7.0 250.4 2503.8

Plant and machine assemblers 2.0 262.4 787.1

Elementary occupation 17.0 275.2 7156.3

Total 100 1512.5 56740.3

Average Cost per Case

Total 2,172 number of cases on the basis of which total cost is calculated that is about

69.1 million, including both the temporary and permanent occupational injury.

The estimated average cost per case among the occupational injury/incidence is 32,044

PKR, which is taken by dividing the total cost over the total number of cases.

Table 10: Estimated Economic cost of Occupational Injury

Occupation Percentage

Distribution Of Injury

Mean Indirect Cost

Of Case

Total Indirect Cost per

Occupation (000)

Legislators and manager 0.1 9250 18.5

Professionals 1.7 27064 97.4

Technicians and associates 1.1 17791 409.2

Clerk 0.3 5777 40.4

Service workers 6.9 13842 2090.1

Agriculture 38.6 59787 50100

Craft 15.7 12415 4233.5

Plant and machine assembler 15.6 8242 2785.7

Elementary occupation 20.1 20524 8948.7

Total 100 154167 69600.6

Total Population Estimates

The total estimated labour force is about 41 million.

The estimated total indirect cost of injury of year 2012-13 having

0.18 percent of the GDP.

Table 11: Total Indirect Economic Cost

Type of Cases Number of Cases

(million)

Indirect Cost

(billion)

Temporary Injury 1.7 10

Permanent Injury 0.086 33

Total 1.78 43


Conclusion

4.0 percent injury prevail in the total employed labour

About 43 PKR billion is the estimated total indirect cost of these

injured workers

Injured worker is unable to perform normal activity which also

affects his/her earnings

Industrial sector has been the leading cause of injury/accidents in

Pakistan, especially in agriculture, construction, manufacturing

and community services

Conclusion Count……

There is a need to monitor and evaluate the health and safety

standards in three main areas;

The first one is in occupation

The second one is in industrial level

The third one is in education/training.

But other factors like age, gender and locality also affect the rate

of injuries.

Proper training and education helps the workers to minimize the

unsafe acts at work station and ensure the casualty-free working

environment and it can also help to reduce the economic burden

of occupational injury/accident and time off-work.

Policy Implications

There is a sever need of health insurance.

Implementation of the Injury and illness prevention programs can reduce

injury rate.

Occupational Safety and Health Administration approach must be adopted.

Check and balance of the Labour inspector from the higher authorities.

Need to improve these areas by using the skill development and proper

technical training institutes.

There is need of strong awareness campaign to minimize the workplace

injuries and must accelerate the work safety habits.

References

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Occupational Injuries among Building Construction Workers in Gondar City, Ethiopia.

Occupational Medicine and Health Affairs.

• Baker. Susan P., Stephen P. Teret & Erich M Daub (1987), Injuries in Sol Levine and Abrahami

Lilienfeld (ed) Epidemiology and Health Policy, Tavistock Publications. New York. pp 177-206.

• Corso, P., Finkelstein, E., Miller, T., Fiebelkorn, I., & Zaloshnja, E. (2006). Incidence and

lifetime costs of injuries in the United States. Injury Prevention, 12 (4), 212-218.

• Campolieti, M., & Krashinsky, H. (2006). Disabled workers and wage losses: some evidence

from workers with occupational injuries. Industrial & Labor Relations Review, 60(1), 120-138.

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the Community: 2008–09.

• Fabiano B., Curro F., & Pastorino, R. (2001). Occupational injuries in Italy: risk factors and long

term trend (1951–98). Occupational and environmental medicine, 58(5), 330-338.

• Ghaffar, A., Hyder, A. A., Mastoor, M. I., & Shaikh, I. (1999). Injuries in Pakistan: directions for

future health policy. Health policy and planning, 14(1), 11-17.

• Ghaffar, A., Hyder, A., & Masud, T. I. (2004). The burden of road traffic injuries in developing

countries: the 1st national injury survey of Pakistan. Public health, 118(3), 211-217.

• Gumber, A., (1997). Burden of injury in India. Economic and Political Weekly, 1478-1491.

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Documents

Occupational Injuries in Pakistan: Incidences and Economic ... · Dr. Shujaat Farooq Dr. Mahmood Khalid , 2015 . Introduction Inception of thindustrial revolution in 20 century precipitated