Capture-recapture estimation of unreported work-related musculoskeletal disorders in Connecticut

Background Estimates of the extent of musculoskeletal disorders (MSD) are usually based upon workers' compensation reports, although recent reports indicate that there may be widespread under-reporting of MSD. Methods An estimate of the incidence of ann and hand work-related MSD was made using capture-recapture analysis of the overlap between state workers' compensation reports and physician reports in Connecticut for 1995. The resulting estimate was compared to a population-based survey of MSD. Results There was very small overlap between the two state injury reporting systems: 6.7% of 793 reported workers' compensation cases, or 8% of 661 physician's reports. The estimate for MSD not captured by either system was 13,285 resulting in 14, 686 (95% CI: 9,733-18,453) total reported and non-reported cases. This compares to an estimate of 13, 775 cases (95% CI: 8,800-18,800) based on a phone survey. Conclusions This analysis points to substantial under-reporting of MSD in Connecticut: estimates of unreported cases exceed those officially, reported by a factor of 11:1. The findings have an important bearing on injury prevention programs and policy making. Am. J. Ind. Med. 39:636-642, 2001. (C) 2001 Wiley-Liss, Inc.