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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 (%)
Source: Author’s calculation from Micro Dataset LFS 2012-2013
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 (%)
Source: Author’s calculation from Micro Dataset LFS 2012-2013
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 (%)
Source: Author’s calculation from Micro Dataset LFS 2012-2013
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
Source: Author’s calculation from Micro Dataset LFS 2012-2013
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
Source: Author’s calculation from Micro Dataset LFS 2012-2013
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
Source: Author’s calculation from Micro Dataset LFS 2012-2013
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:
Source: Author’s calculation from Micro Dataset LFS 2012-2013
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
Source: Author’s calculation from Micro Dataset LFS 2012-2013
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
• Adane, M. M., Gelaye, K. A., Beyera, G. K., Sharma, H. R., & Yalew, W. W. (2013).
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.
• Commons, C. The Cost of Work-related Injury and Illness for Australian Employers, Workers and
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.
• Krug, E. G., Sharma, G. K., & Lozano, R. (2000). The global burden of injuries. American
journal of public health, 90(4), 523.Public Services Research Institute.