Pattern and outcome of occupational Accidents reported to general organization for social insurance, Saudi Arabia for the period 1403-1416 A.H (1983-1996)

Abstract

Occupational accidents may cause serious injuries such as fractures, mangling, crushing, amputations, burns, dislocation or eye injuries, some of which might end in disability or death with all their serious outcomes. At the best injury may cause loss of productive person-years at the personal and decrease of economic development at the national levels. Millions of dollars are being paid by countries in the form of compensation, daily allowances, pension, and treatment. The Kingdom of Saudi Arabia (KSA) has succeeded in diversifying and developing its industry. According to the available data from the 1995 annual statistics of the Ministry of Industry and Electricity the number of factories increased at a rate of 163% over the past 13 years. That is from 850 factories in 1401 A.H. (1981) to 2234 by the end of 1414 A.H. (1994). This increase had naturally necessitated the hiring of more work force. Consequently, the exposure to the various potential occupational hazards became inevitable. Epidemiologic studies of occupational accidents and deaths are thus required to identify high-risk industries and labour groups as well as the pattern of accident to formulate and implement preventive strategies. The overall aim of this study was to determine the pattern of work-related injuries and deaths among the insured employees on a nation-wide basis in the K.S.A. since 1403 after the inception of the occupational hazards branch (1/7/1402). It was a retrospective search and analysis of computerized records of GOSI headquarter in Riyadh as well as a review of all annual GOSI reports from the year 1403 to 1416. The data so collected were analysed and categorized by industry, occupation, injury source, injury type, nationality, body part injured and other relevant variables. The accident incident rate was computed from the total number of accidents / year and the number of employees registered at GOSI in that year. The relative risk with the 95% confidence interval and the proportionate morbidity and mortality rates were calculated where appropriate. The occupational injury rate for the years 1413 and all occupational deaths data and nationality were derived from computerized files. The rest of the information was based on the annual GOSI statistical reports for the years 1403 through 1416. The occupational accident incidence rate during the last 14 years was, unfortunately, high and is on increase. During the financial years 1403 to 1416 the overall incidence rate increased from 14.4 accidents in 1403 to approximately 38.7 accidents / 1000 insured employees in 1415 but dropped slightly during 1416 to 38.1. When considering the last four years alone the rates increased in all regions except the Western. Fortunately the outcome (recovery rate) during the last 14 years was more than 95% in all regions, the highest being that for the Western region where it was 98.5%. Moreover, this region had the least case fatality rate, the highest was that reported from the Southern region followed by the Eastern region. Regarding the disability rate the Central region had more accidents that caused disability followed by the Eastern. The accident rates were highest during Saturdays and lowest over the weekend (Friday) and were more frequent during the warmer months of the year (May to October). Expatriates had high relative risks (RRs) than Saudis specially those from the Indian sub-continent. Employees from Indian sub-continent had a relative risk (RR) with The corresponding figures for the remaining three years were 1.80 (1.77 1.83), 2.23 (2.192.28), and 2.13 (2.09-2.17), respectively. The age-specific accident incidence rates showed that the general trend is a decline in the incidence with advancing age except for the years 1414 and 1415 where the rate for the age-group 15-19 years was less than for the second age category. However, the P values for all years approached zero. During the year 1413 the age-specific rate for the age group 15-19 was 11 times for those aged 60 years or more while the rate for the age group 20-29 was almost consistently in the region of nine times that for the age category 60 years and above The construction and manufacturing industries exhibited the highest incidence rates with significantly high relative risks. The construction industry group exhibited the highest incidence rates from the years 1413 to 1415 (63.7, 76.7, and 60.9 accidents / 1000 exposed employees, respectively) followed by manufacturing industry. The RRs (95% C.I.) for injury in the construction during the period of study were 2.62 (2.57- 2.66), 2.97 (2.92 -3.02), 2.38 (2.342.43), and 2.27 (2.222.31), respectively. When the manufacturing industry was excluded, the RR increased. The figures were 3.66 (3.58 - 3.74), 4.19 (4.10 4.27), 3.27 (3.203.34), 3.11 (3.053.18) for the years 1413, 1414, 1415, and 1416, respectively. The RRs (95% CI.) in the manufacturing industry relative to the rest of industry (construction included) was also high. The figures were 1.84 (1.80 1.88), 1.80 (1.761.84), 1.94 (1.891.98), and 1.97 (1.932.01). Exclusion of the construction industry increased the RR to 3.44 (3.35-3.54), 3.60 (3.51 -3.69), 3.25 (3.17-3.34), and 3.2 (3.12-3.28), respectively. This industry ranked first during the year 1416 (62.0 accidents/1000 employees) while construction came next in rank (60.0 accidents/1000 employees). Occupation wise the production related jobs, improvement for the purpose of having more detailed information and analysis to help industry reduce this high rate of accidents. The suggested areas for improvement are: 1. Accident distribution by establishment size. 2. The number of insured workers were neither distributed by gender nor according to occupational and industrial sub-groups. 3. Computer program adjustment is required to facilitate computing episodes of accidents occurring to the same worker. 4. Occupational accidents were categorized by age-groups but not by injury nature and source, accident type, and injured body parts. 5. Man-days lost were unavailable. Such information, if available, can be used as an index of case severity and economic impact on the employee and employer. 6. The terms unspecified (UNS), non-classifiable, and not elsewhere classified (NEC) often appear with large figures. These can be minimized with careful recording of the data at the source. 7. Accidents from the regions were not distributed by type and source, injury nature, injured body parts, occupation, and industry. The accidents data from the regions were not categorized by the age and experience of the injured. Further grouping of these two variables by nationality would be of value. 8. The nationalities of the injured employees were not distributed by industry or occupation 9. Mortality was not distributed by experience, age, gender, occupation, industry or nationality.