The Burden of Occupational Disease and Injury in New Zealand: Technical Report
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6. Lessons for Surveillance and Research
6.1 OVERVIEW OF TYPE AND YEAR OF PUBLICATION OF ARTICLES
Introduction
The basis of this report is the published literature relevant to work-related disease and injury in New Zealand. The focus was articles published from 1984 onwards, with all articles included if published up to and including June 2004 (2004 references were only included if they were already accessible via standard literature databases). Articles were included if the focus of the article was New Zealand, or New Zealand data were included in the data set on which the paper was based (as occurred with some international collaborative studies).
The body of the report is based on a detailed analysis of these articles. However, there is also benefit to be gained by a high-level content analysis of the articles. This can help to identify the areas well covered and poorly covered by research activity, and allows an assessment of changes in research activity over time.
Approach used
Government reports were not included in this total. A high-level content analysis of the papers was performed to provide an insight into the areas that were the focus of research interest and to monitor the intensity of research activity in New Zealand in the last two decades.
The papers were categorised as original studies (involving data collection and analysis), letters to the editor published in a journal, review articles, opinion articles (covering areas such as approaches to coding or surveillance of work-related disorders), and case reports. Each article was classified as being focused on injury, disease, both or on a more general topic related to injury or disease. They were separately classified as to whether the focus was on injury or disease, on exposures, on prevention or on ACC or other aspects of compensation directly related to an injury or disease. Articles focused only on legal aspects or on the overall design of ACC were not included. Articles focusing on disease were categorised as to the disorder that was the focus of the study. Injury articles were categorised as to whether they were focused on fatal, non-fatal or all injuries. Finally, the year of publication was coded. This allowed an assessment of research activity over time. The assessment is focused on the research activity rather than the period of time being considered, as it is based on the year of publication rather than the year(s) that was covered by the study.
Other aspects of the publications could also have been examined (such as sex, ethnicity and age), but the aspects that have been included in the presented analysis appeared to be the ones that would prove the most useful.
Findings
There were 246 articles that met the criteria (i.e. published from 1984 onwards and focused on New Zealand and/or including New Zealand data) published in the general peer-reviewed literature in the last 20 years. Seventy-one per cent of these were focused on disease, 20% on injury, 7% on both disease and injury and 2% were focused on general topics relevant to disease and injury.
Seventy-four per cent of the articles were original studies, 18% letters to the editor, 4% review articles, 3% opinion articles and 1% case reports. This percentage breakdown was similar between disease and injury articles.
Disease and injury
The number of articles varied considerably over time, with peaks in the late 1980s and around 2000 and 2001 (Figure 6.1). Not surprisingly, given the much higher number of disease articles compared to injury articles, these peaks were dominated by disease publications. However, injury publications were most common around the time of the disease publication peaks. Disease publications were much more common than injury publications for all years except 1990 (Figure 6.2).
Exposures relevant to disease and injury were the main focus of 10% of the publications, with ACC the focus of 9% and prevention the focus of 6%.
Disease
The main topics covered in disease publications were cancer, infection, respiratory diseases, general topics (i.e. more than one disease) and chemical poisoning. Other topics relevant to occupational disease were the subject of limited research activity (Table 6.1).
| DISEASE | NUMBER | PER CENT |
|---|---|---|
| Cancer | 45 | 23.4 |
| Infection | 28 | 14.6 |
| Respiratory | 27 | 14.1 |
| General | 22 | 11.5 |
| Musculoskeletal | 21 | 10.9 |
| Chemical poisoning | 15 | 7.8 |
| Psychiatric | 7 | 3.7 |
| Skin | 7 | 3.7 |
| Environmental tobacco smoke | 7 | 3.7 |
| Neurology | 3 | 1.6 |
| Noise-induced hearing loss | 3 | 1.6 |
| Shift work | 2 | 1.0 |
| Job strain | 2 | 1.0 |
| Vascular | 1 | 1.0 |
| Vibration | 1 | 1.0 |
| Structural change | 1 | 1.0 |
| Total | 192 | 100.0 |
The focus of the research changed considerably over time. Just over half the cancer publications were published before 1990, and another 22% from 2000 onwards. Publications on infection also were most common in the 1980s, with 50% published before 1990, and publications fairly evenly spread since then. In contrast, respiratory publications have been more recent, with 52% published since 1998. Musculoskeletal publications were more common in the 1990s, with 62% of the musculoskeletal publications occurring in the eight years from 1993 to 2000. Chemical publications were spread throughout the two decades (Figure 6.3).
Exposures relevant to disease were the main focus of 11% of the disease publications, with ACC the focus of 10% and prevention the focus of only 3%.
Injury
Of the publications focused on injury, 32% considered fatal injury, 41% considered non-fatal injury, and 27% considered both types of injury. Fatal injury publications were clustered from 1989 to 1995 and around 2001. These years coincide approximately with the years following the completion of the two major fatalities studies in New Zealand (1987 and 2001). Non-fatal injury publications were spread more evenly, but were more common in the 1990s (Figure 6.4).
