Review of estimates of the global burden of injury and illness due to occupational exposures

Background Over the last decade, there have been several attempts to estimate the global burden of ill health due to work-activity. The most recent of these is the Comparative Risk Assessment (CRA) project of the World Health Organization. Methods Published estimates of global burden of injury and disease due to occupational factors were summarized, compared, and contrasted with the aim of putting the CRA estimates into context, identifying the most reliable and appropriate estimate for total burden due to occupational risks, and making recommendations regarding future work. Results The best estimate of global work-related deaths of workers is approximately two million per year, with disease responsible for the vast majority of these, but even this is likely to be a considerable underestimate of the true number of deaths because of shortcomings in the available data. Conclusions The CRA estimates of burden due to individual risk factors appear appropriate for the limited number of exposures and conditions included, but are a major underestimate of the overall number of work-related deaths at a global level due to exclusion of risk factors because of data limitations. Improvements in global estimates are likely to come from the use of different methodologies and improvements in the availability and use of local data. Am. J. Ind. Med. 48:491-502, 2005. (c) 2005 Wiley-Liss, Inc.