Abstract
Background: Occupational health and safety surveillance in the US relies primarily on federal and state administrative data sources which all have limitations created by underreporting and different sampling frames. To begin closing data gaps, in 2019 the federal Occupational Health and Safety Administration began requiring many US business establishments to submit injury and illness data to the Injury Tracking Application (ITA). We present an example use of these data by characterizing injuries in the California warehousing industry. Methods: Yearly ITA data for 2018-2023 were obtained and cleaned to exclude invalid records, resulting in 3717 records from California General Warehousing and Storage (GWS, NAICS 493110) establishments. Annual rates of total reportable injuries and cases of injuries requiring days of job transfer or restriction (DJTR) were calculated. Results: Total injury rates peaked in 2021, with 5.87 injuries per 100 workers. While total injury rates subsequently declined, 2023 DJTR rates remained elevated over 2018 rates (3.21 vs. 1.84 per 100 workers). The primary analytical limitations were potential bias due to underreporting, and difficulty in identifying warehouse establishments. The ITA data are a valuable addition to existing administrative data sources, with several limitations similar to those in other administrative datasets. The findings of consistently elevated total and DJTR injury rates in California's warehousing industry are consistent with previous research and indicate that outreach and enforcement efforts should be expanded to protect the health and safety of warehouse workers. A major ongoing challenge of applied occupational injury and illness research and prevention is a lack of comprehensive data on rates and patterns of work-related injuries and illness necessary to understand causation and risk factors, identify and estimate the scale of new problems, and allot limited public health funding and resources accordingly. Most administrative data sets fail to capture one or more piece of critical information. Records of health care utilization and vital records rarely contain data elements needed to ascertain work-relatedness, and occupational health regulatory enforcement and Workers Compensation insurance data are subject to limitations including underreporting that may differ systematically by industry. In addition, these data sources typically lack specificity on occupation, industry, and nature of injury or illness. Survey data sources based on statistical samples of employers or workers are difficult to compare due to differing sampling frames. In effort to create a more comprehensive electronic recordkeeping system for workplace injury and illness, the US Department of Labor promulgated a rule in 2016 requiring certain business establishments to electronically submit injury and illness logs (Logs 300, 300A, and 301). An establishment is defined as a single physical business location [1] , and an employer may have one or more establishments. These logs were required by previous Occupational Safety and Health Administration (OSHA) regulations to be maintained by most employers but had not been systematically gathered by the agency. In 2019, a modified final rule became effective requiring submission of 300 A log information only by many establishments (any with 250 or more employees, and those with 20-249 employees in industries with historically higher injury rates) [1] . These data report annual summary counts of selected injuries and illnesses and total employment but include identifying information of the establishment including name, street address, and the most detailed (six-digit) North American Industry Classification System (NAICS) code. The resulting Injury Tracking Application (ITA) makes these data freely and publicly available online for the years 2016 forward [2] . The ITA data appear to be infrequently utilized in research at present; a literature search identified two reports [3, 4] and one journal article [5] on worker health and safety outcomes, in addition to one published [6] and three preprint [7] [8] [9] econometric analyses and several dissertations. In this publication, we present the use of the ITA data in characterizing injury rates in California's warehouse industry during 2018-2023. The warehousing industry has expanded rapidly worldwide with the rising popularity of e-commerce, and California's warehouse industry has grown from 132,802 annual average employment in 2018 to 242,196 in 2022 [10] . The Inland Empire region of Southern California, encompassing Riverside and San Bernardino counties, has experienced particularly rapid expansion due to proximity to the ports of Long Beach and Los Angeles (the two largest seaports in the United States) and relatively inexpensive land for construction in inland desert regions. These areas are dominated by large e-commerce businesses and third-party logistics (3PL) contractors. Amazon Inc.'s largest warehouse, a four million square foot facility to be completed in 2024, is under construction in Ontario, California-a city that already has the largest warehouse footprint in the Inland Empire [11] . Previous studies and investigative reporting have identified widespread worker health and safety concerns in the warehouse industry including fatalities, severe injuries like amputations, chronic injuries and musculoskeletal disorders (MSDs), as well as job stress and mental health concerns. In an analysis of California Workers' Compensation insurance claims, Delp et al. found increasing rates of claims from warehouse industry employees from 2014 to 2018, the majority of which were for musculoskeletal injuries, but no OSHA citations for violation of California's Repetitive Motion Injuries prevention standard in that period [12] . Ergonomic assessments of warehouse and material handling tasks have shown evidence of risks for musculoskeletal injury including back and upper extremity [12] [13] [14] [15] [16] . Exposure to chemicals and extreme heat have also been identified as health hazards [17] [18] [19] . US warehouse workers are more likely to be Black or Latinx than the rest of the workforce [20] and Inland Empire warehouse workers are predominantly Latinx immigrants [21] . Based on this evidence for high injury rates and health disparities, California passed legislation effective in 2022 (AB701) which prohibits excessive production quotas in many warehouse distribution centers, requires employers to provide workers with information on quotas upon request, and requires strategic enforcement efforts by the California Department of Industrial Relations [22] .
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