New York State Occupational Health Clinic Network Report – Key Updates
2004 - 2012
The New York State (NYS) Occupational Health Clinic Network (OHCN) is unique in the United
States as a partially-funded, statewide, public health-based network offering clinical and preventive
occupational disease services. There are 11 clinics located throughout NYS including a Clinic
specializing in agricultural safety and health. Since 1988, the OHCN has contributed to maintaining a
healthy workforce in New York. Utilizing a public health approach, regionally-based clinics diagnose
and treat occupational diseases and help improve working environments in New York State. The
clinics also assist in meeting the goal in the NYS Department of Health Prevention Agenda 2013-2017
of reducing occupational injury and illness.
This report represents an update of a selected subset of figures from the initial NYS Occupational
Health Clinic Report (1988-2003) to include data from 2004 through 2012. The initial report included
detailed descriptions of patient demographics, types of diagnoses and likely etiologic agents
responsible for causing or exacerbating medical conditions, as well as the types of industries and
occupations of the patients seen with occupational exposures.
The current report provides updated data to better reflect current trends in diagnoses and exposures, and
a more detailed description of data found in the original report. Properly identifying workplace hazards
can be used to improve treatment and management of occupational diseases as well as prevent them
from occurring. Data in this report will assist in identifying current occupational health needs in NYS
as well as those being met by the OHCN.
Overview:


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Between 2004 and 2012, 28,090 new patients were seen in 110,376 visits.
Patients were seen from all counties in New York State, with most people residing in counties
with large metropolitan areas.
There has been a shift in the occupations of the patients from the original report with a much
higher percentage employed in public administration (31% vs. 22% previously), the services
industry (27% vs. 23% previously), and fewer in construction trades (13% vs. 22%, previously).
These shifts do not reflect changes seen in the New York State workforce.
Patients were primarily seen for diseases of the musculoskeletal system, respiratory system, and
injuries and poisonings.
An increasing percentage of the patients were seen for ergonomic exposures (31% vs. 25%
previously), including keyboard use and repetitive motion.
A quarter of the patients were evaluated for exposure to mineral and inorganic dusts, including
asbestos, silica and non-specified dusts.
Patient Characteristics
Patient Population
Figure 2.1. Number of new NYS OHCN patients seen, by year. From 2004 through 2012, 28,090
new patients were seen in the NYS Occupational Health Clinic Network (OHCN) in 110,376 visits.
These patients were roughly equally divided between group screening patients* and symptomatic
patients. The number of new patients decreased almost every year from 4,421 in 2004, to 2,436 in
2012. Overall, the total number of patients seen each year by the NYS OHCN has also decreased over
the years, from 7,870 patients in 2004 to 2,479 patients in 2012 (data not shown). This decline is
primarily due to patients who were seen for exposures at the World Trade Center moving to specialized
World Trade Center clinics.
*The Clinics offer screening services for groups of exposed workers. Because these patients are usually
not experiencing symptoms and are not seeking diagnostic services, per se, they are classified
separately in the database as group screening patients.
Number of New Patients
Figure 2.1. Number of New NYS OHCN Patients Seen,
by Year, 2004-2012*
5000
4500
4000
3500
3000
2500
2000
1500
1000
500
0
Symptomatic Patients
2004
2005
2006
Group Screening Patients
2007
2008
Year
2009
All Clinic Patients
2010
2011
2012
Figure 2.2. Percentage of NYS OHCN patients, by type seen. Overall, 95% (32,150) of patients
were seen for occupational exposures. Occupational patients had exposures from either their present or
past occupations. The small percentage of environmental patients were seen for non-occupational
exposures to such places as landfills, home mold-related problems, and a variety of other exposures. In
addition, some patients were family members of workers seen for possible health effects related to
take-home exposures.
In general, there were a much higher percentage of females (data not shown) among the environmental
(66%) and family (73%) patients, compared to the occupational patients (29%).
Figure 2.2. Percentage of NYS OHCN Patients, by
Type Seen, 2004-2012
1,403 (4.16%)
190 (0.56%)
Environmental
Family
Occupational
32,150 (95.28%)
County of Residence
Figure 2.3. Residence of NYS OHCN patients, by county. Patients were seen from all counties in
NYS, with large percentages residing in counties with large metropolitan areas such as the five counties
of New York City (NYC), Albany, Erie and Monroe counties. Otsego and Suffolk Counties had the
highest percentages of patients. There were substantially fewer patients from areas of New York with
lower populations such as the Adirondack Park.
Figure 2.3. Residence of NYS OHCN Patients, by County
Figure 2.4. Percentage of NYS OHCN patients, by geographic region. There were 32,137 patients
who resided in New York State (NYS); 26,951 (80%) outside of New York City (NYC) and 5,186
(15%) in NYC. There were 1,593 (4%) patients who were not NYS residents. Place of residence was
unknown for 13 patients.
Figure 2.4. Percentage of NYS OHCN Patients, by
Geographic Region, 2004-2012
Out of NYS
4%
NYC
15%
NYS w/o NYC
80%
Sex of Patient Population-Females
Figure 2.5. Percentage of female NYS OHCN patients, by geographic region. Females accounted
for 31% (n=10,477) of the patient population. Women made up a higher percentage of the patients seen
in NYC (40%) as opposed to NYS outside of NYC (28%). Overall, the percentage of patients who
were female has remained relatively stable. Ninety percent of the females were seen for occupational
conditions, while 98% of the males were seen for occupational conditions (data not shown).
Figure 2.5. Percentage of Female NYS OHCN Patients
by Geographic Region, 2004-2012
50
NYS w/o NYC
NYC
NYS
Percentage of Female Patients
45
40
35
30
25
20
15
10
5
0
2004
2005
2006
2007
2008
Year
2009
2010
2011
2012
Group Screening Patients
Overall, 14,294 (50%) patients were seen in the NYS OHCN as part of a group screening. Among those
seen, 7,032 (44%) were part of a respirator certification program, 1,260 (11%) were followed-up for
asbestos exposure, and 2,999 (16%) were general occupational health examinations due to on-the-job
exposures. Many of the group screening patients were seen due to potential exposures to hazardous
agents including screenings for Lyme disease, skin cancer, Hepatitis, lead and hearing loss. Patients
were also screened as part of pre-placement and termination examinations.
Figure 2.6. Percentage of NYS OHCN patients, by sex, geographic region and patient type.
Among all of the patients seen in NYS outside of NYC (26,951), 4,336 (16%) were female patients
seen as part of a sick visit (symptomatic) and 3,617 (13%) were females seen as part of group
screenings; 7,628 (28%) were symptomatic male patients, and 11,370 (42%) were males seen as part of
group screenings. A greater percentage of women were seen as symptomatic patients in NYC (33%) as
opposed to being part of group screenings (6%). A higher percentage of males in NYC were also seen
as symptomatic patients (38%) compared to the percentage seen as part of group screenings (21%).
Figure 2.6. Percentage of NYS OHCN Patients, by Sex,
Geographic Region and Patient Type, 2004-2012
Male
Female
NYS w/o NYC
45
40
40
35
30
25
20
16.0
15
NYS w/o NYC
NYC
42.0
38.0
35
33.0
Percentage of Patients
Percentage of Patients
NYC
45
13.0
10
6.0
5
30
28.0
25
21.0
20
15
10
5
0
Symptomatic
Group Screening
0
Symptomatic
Group Screening
Age of Patient Population
Figure 2.7. Percentage of NYS OHCN patients, by age. The mean age of the patients during their
first visits to the NYS OHCN was 44 years (data not shown), with over 70% of the patients between 31
and 60 years of age. Over 1,461 patients were under 20 years of age when first seen and 3,610 patients
were over 60 years of age during their first visits to the Clinic. This is consistent with the NYS
workforce.
Percentage of Patients
Figure 2.7. Percentage of NYS OHCN Patients, by
Age, 2004-2012
27.8
30
25
21.9
20.1
20
15.1
15
8.3
10
5
4.3
2.0
0.4
0
<20
21-30
31-40
41-50
51-60
Age at First Visit
61-70
71-80
81+
Figure 2.8. Percentage of NYS OHCN patients, by type and age. The majority of occupational
patients were between 21 and 60 years of age (86%). A substantially higher percentage of the family
patients were 61 years and older (36% vs. 20% environmental and 10% occupational).
Figure 2.8. Percentage of NYS OHCN Patients, by
Type and Age, 2004-2012
85.5
90
75.8
Percentage of Patients
80
70
60.0
60
50
Family
30
19.9
Occupational
20
10
Environmental
35.8
40
10.1
4.3
4.2
4.3
0
<20
21-60
Age at First Visit
61+
Ethnicity of Patient Population
Figure 2.9. Percentage of NYS OHCN patients, by ethnicity and geographic region. Of the patients
seen statewide, 26,709 (79%) were White, 2,965 (9%) were African-American, 2,523 (7%) were
Hispanic, and 594 (2%) were Asian. Again, these percentages varied by whether the patients were from
NYS outside of NYC, where 86% of the Clinic patients were White, versus NYC where only 43% of
the Clinic patients were White. The ethnicity of the patients also varied by whether they were
symptomatic or group screening patients - with a higher percentage of non-Whites seen as symptomatic
patients (data not shown).
Figure 2.9. Percentage of NYS OHCN Patients,
by Ethnicity and Geographic Region, 2004-2012
Other
2.0%
Asian
1.1%
NYS w/o NYC
African
American
6.4%
Other
3.9%
Hispanic
3.7%
NYC
Asian
4.9%
African
American
21.6%
White
86.4%
White
43.0%
Hispanic
26.2%
Figure 2.10. Percentage of NYS OHCN patients, by ethnicity, geographic region and year. From
2004 through 2012, the percentages of patients by ethnicity have remained relatively constant, although
from 2008 to 2009 the percentage of White patients from NYC decreased by about 12% and the
percentages of the other ethnicities, except Asians, increased slightly.
Figure 2.10. Percentage of NYS OHCN Patients, by Ethnicity,
Geographic Region and Year, 2004-2012
100.0
NYS w/o NYC
Percentage of Patients
90.0
80.0
70.0
60.0
50.0
40.0
30.0
20.0
10.0
0.0
2004
Asian
2005
2006
2007
African American
2008
Year
Hispanic
100
2009
2010
2011
Other/Unknown
2012
White
NYC
90
Percentage of Patients
80
70
60
50
40
30
20
10
0
2004
Asian
2005
2006
African American
2007
2008
Year
Hispanic
2009
2010
Other/Unknown
2011
2012
White
Source of Payment for Services
Figure 2.11. Percentage of NYS OHCN patients, by source of payment and patient type. Among
group screening patients, the employer was primarily responsible for payment for clinical services
(79% vs. 10% of symptomatic patients). Overall, employers were billed for 45% of the Clinic patients'
services. Among those patients seen for symptoms, the Clinics expected Worker's Compensation to
cover payment of services for 48% of the patients, while this payment source was expected for less
than 1% of the group screening patients.
Figure 2.11. Percentage of NYS OHCN Patients, by
Source of Payment and Patient Type, 2004-2012
Other
Self
Other Ins.
HMO
BC/BS
Medicaid
Medicare
Workers Comp
Employer
Union
21.2
Patient Type
Group Screening
Symptomatic
3.5
7.3
2.9
4.7
1.4
1.5
48.3
10.1
3.1
9.0
0.4
0.4
0.2
0.2
0.0
0.1
0.8
78.9
9.6
0
10
20
30
40
50
Percentage of Patients
60
70
80
90
Source of Patient Referral
Figure 2.12. Percentage of NYS OHCN patients, by referral source and patient type. The Clinics
are primarily centers of referral, not primary care clinics. The majority of patients were referred to the
Clinics by either their employer or their union (59%), regardless of patient type. Approximately 90% of
the group screening patients and 27% of the symptomatic patients were referred by one of these two
sources.
Figure 2.12. Percentage of NYS OHCN Patients, by
Referral Source and Patient Type, 2004-2010
Employer
Physician
Lawyer
Other
Union
76.0
80.0
Percentage of Patients
Self
70.0
60.0
50.0
40.0
30.0
20.0
16.5
21.3
12.6 15.1 14.6 15.1
13.8
10.0
1.7
0.4
3.9
2.8
0.0
Symptomatic
Group Screening
Figure 2.13. Percentage of NYS OHCN patients, by referral source and geographic region. Clinics
located in NYC received over 24% of their referrals from unions and 24% from employers; while in
NYS, outside of NYC, about 11% of referrals were from unions and 53% from employers.
Figure 2.13. Percentage of NYS OHCN Patients,
by Referral Source and Geographic Region,
2004-2010
Percentage of Patients
Employer
60
Physician
Lawyer
Self
Other
Union
52.6
50
40
30
20
10
29.2
23.7
10.8
5.3
11.0
9.8
10.5
6.6
8.3
7.5
0
NYS w/o NYC
NYC
24.7
Occupations of Clinic Patients
Figure 2.14. Percentage of occupational NYS OHCN patients, by major occupational group and
patient type. Examining the job titles among the occupational Clinic patients showed that 10,444
(43%) were employed in technical, sales and administrative support occupations; followed by 5,779
(24%) in precision production occupations, and 3,598 (15%) as operators, fabricators and laborers (data
not shown). Among the symptomatic patients, 3,745 (34%) worked in technical, sales and
administrative support occupations, 2,768 (25%) in precision production, 2,002 (18%) as operators and
laborers, and 1,180 (11%) as managers and professionals. Among the group screening patients, 6,699
(50%) worked in technical, sales and administrative support occupations, 3,011 (23%) worked in
precision production, and 1,656 (12%) as operators and laborers. This does not reflect the distribution
of occupations in NYS.
Figure 2.14. Percentage of Occupational NYS OHCN
Patients, by Major Occupational Group and Patient
Type, 2004-2012
Group Screening
Symptomatic
8.0
Managerial & Professional Specialty
10.6
50.0
Technical, Sales & Administrative Support
34.0
6.7
Services
10.1
0.6
2.2
Farming, Forestry & Fishing
22.5
Precision Production, Craft & Repair
25.0
12.0
Operators, Fabricators & Laborers
17.9
0.3
0.2
Military
0
10
20
30
40
Percentage of Patients
50
60
Figure 2.14a. Percentage of occupational NYS OHCN patients in services occupations, by type of
service occupation and patient type. Examining the types of jobs among those in the services group
showed that 1,285 (65%) were employed in cleaning and maintenance occupations, 438 (22%) in food
services, and 268 (13%) as personal care workers (data not shown). Among both symptomatic and
group screening patients, the largest percentage of patients was from the cleaning and maintenance
occupations (53% and 78%).
Figure 2.14a. Percentage of Occupational NYS OHCN
Patients in Services Occupations, by Type of Service
Occupation and Patient Type, 2004-2012
Group Screening
Symptomatic
7.0
Personal Care Workers
18.7
78.0
Cleaning and Maintenance
53.5
14.9
Food Services
27.8
0
10
20
30
40
50
60
Percentage of Occupational Patients
70
80
90
Table 2.14b. Top five most common occupations of NYS OHCN patients in services occupations,
by patient type. Among symptomatic patients in services occupations, 348 (31%) were employed as
janitors or building cleaners, 110 (10%) as maids or housekeepers and 104 (9%) as grounds
maintenance workers. Among the group screening patients in services occupations, 576 (64%) were
employed as janitors or building cleaners, and 63 (7%) as non-restaurant food servers.
Table 2.14b. Top Five Most Common Occupations of NYS OHCN Patients
in Services Occupations, by Patient Type, 2004-2012 (In Order)
1.
2.
3.
4.
5.
Symptomatic
Janitors and Building Cleaners (31%)
Maids and Housekeeping (10%)
Grounds Maintenance Workers (9%)
Cooks (7%)
Food Preparation Workers (4%)
1.
2.
3.
4.
5.
Group Screening
Janitors and Building Cleaners (64%)
Non-restaurant Food Servers (7%)
Grounds Maintenance Workers (7%)
Maids and Housekeeping (3%)
Nonfarm Animal Caretakers (3%)
Figure 2.15. Percentage of occupational NYS OHCN patients, by major occupational group and
geographic region. The largest percentage of Clinic patients in NYC were employed in precision
production, craft and repair occupations and in technical, sales and administrative support occupations
(approximately 28% each). The largest percentage of Clinic patients outside of NYC were employed in
technical, sales and administrative support occupations (46%) followed by employment in precision
production, craft and repair occupations (22%). In NYC, 628 (19%) were employed in services
occupations compared to 1,261 (6%) in the rest of NYS. Similarly, there were more people employed
in farming, forestry and fishing outside of NYC (42 in NYC vs. 250 in the rest of NYS).
Figure 2.15. Percentage of Occupational NYS OHCN
Patients, by Major Occupational Group and
Geographic Region, 2004-2012
NYC
NYS w/o NYC
Managerial & Professional Specialty
14.1
8.1
27.6
Technical, Sales & Administrative Support
Services
46.3
18.7
6.3
1.2
1.3
Farming, Forestry & Fishing
Precision Production, Craft & Repair
22.3
10.2
Operators, Fabricators & Laborers
28.4
15.5
0.0
0.3
Military
0
5
10
15
20
25
30
35
40
Percentage of Occupational Patients
45
50
Service Occupations
Figure 2.15a. Percentage of occupational NYS OHCN patients in services occupations, by type of
service occupation and geographic region. Examining the types of jobs among those in the services
group showed that 1,285 (65%) were employed in cleaning and maintenance occupations, 438 (22%) in
food services, and 268 (13%) as personal care workers (data not shown). The largest percentage of
Clinic patients were employed in cleaning and maintenance occupations in both NYC (75%) and the
remainder of NYS (59%).
Figure 2.15a. Percentage of Occupational NYS OHCN
Patients in Services Occupations, by Type of Service
Occupation and Geographic Region, 2004-2012
NYC
NYS w/o NYC
8.8
Personal Care Workers
15.8
74.5
Cleaning and Maintenance
58.9
16.7
Food Services
25.3
0
10
20
30
40
50
60
Percentage of Occupational Patients
70
80
Figure 2.15b. Top five most common occupations of NYS OHCN patients in services industry, by
geographic region. The largest percentage of Clinic patients in services occupations were employed as
janitors and building cleaners in both NYC (59%) and the remainder of NYS (38%). In NYC, the next
largest percentage were employed as grounds or maintenance workers (5%) while for the remainder of
NYS, maids and housekeeping made up the second largest percentage (6%).
Table 2.15b. Top Five Most Common Occupations of NYS OHCN Patients
in Services Occupations, by Geographic Region, 2004-2010 (In Order)
1.
2.
3.
4.
5.
NYS w/o NYC
Janitors and Building Cleaners (38%)
Grounds Maintenance Workers (11%)
Non-restaurant Food Servers (7%)
Maids and Housekeeping (6%)
Cooks (5%)
1.
2.
3.
4.
5.
NYC
Janitors and Building Cleaners (63%)
Maids and Housekeeping (9%)
Grounds Maintenance Workers (4%)
Cooks (4%)
Waiters and Waitresses /
Transportation Attendants (3%)
Industries of Clinic Patients
Figure 2.16. Percentage of occupational NYS OHCN patients, by major industrial group and
patient type. Among those patients seen for occupational exposures, 10,030 (31%) were employed in
public administration; followed by 8,839 (27%) in the services industry and 4,279 (13%) in
construction at the time of their first visit to the Clinic (data not shown). Variability among the type of
industry also occurred when the patient was seen as part of a group screening. Among those seen in the
Clinics as part of a group screening, 6,724 (42%) worked in public administration and 3,598 (22%)
worked in the services industry; while among the symptomatic patients, 5,241 (32%) worked in the
services industry and 3,306 (20%) worked in public administration.
Figure 2.16. Percentage of Occupational NYS OHCN
Patients, by Major Industrial Group and Patient Type,
2004-2012
Group Screening
Agriculture
1.1
Symptomatic
3.0
0.0
0.4
Mining
14.0
12.3
Construction
8.7
Manufacturing
15.9
7.4
Transportation
9.3
0.8
1.8
Wholesale
1.3
Retail
4.8
0.6
1.8
Finance, Insurance, Real Estate
22.2
Services
32.0
41.5
Public Administration
20.2
0.5
0.4
Other
0
5
10
15
20
25
30
35
Percentage of Occupational Patients
40
45
Figure 2.16a. Percentage of occupational NYS OHCN patients, in the services industry, by type of
work and patient type. The largest percentage of Clinic patients working in the services industry were
employed in health services occupations for both symptomatic patients (39%) and group screening
patients (47%), followed by those in educational services (21% for symptomatic and 29% for group
screening).
Figure 2.16a. Percentage of Occupational NYS OHCN
Patients in the Services Industry, by Type of Work and
Patient Type, 2004-2012
Group Screening
Symptomatic
Misc. Services
1.0
1.1
Private Households
0.6
0.3
Engineering, Accounting, Research, Management
and Related Services
4.0
3.3
2.6
3.2
Membership organizations
Museums/Art Galleries, and Botanical/Zoological
Gardens
0.4
0.5
Social Services
0.8
8.1
29.4
Educational Services
20.8
0.1
2.1
Legal Services
47.4
Health Services
39.2
5.1
Amusement and Recreation
2.0
0.0
0.2
Motion Pictures
0.3
0.8
Misc. Repair
1.4
2.1
Automotive Repair and Parking
3.2
Business Services
11.8
0.3
2.3
Personal Services
3.5
2.2
Hotels and Lodging
0
10
20
30
40
Percentage of Occupational Patients
50
Figure 2.17. Percentage of occupational NYS OHCN patients, by major industrial group and
geographic region. In NYC, 2,120 (44%) of occupational patients were employed in the services
industry, compared to 6,207 (24%) in the rest of NYS. In contrast, 933 (20%) were employed in public
administration in NYC, compared to 8,911 (34%) in NYS.
Figure 2.17. Percentage of Occupational NYS OHCN
Patients, by Major Industrial Group and Geographic
Region, 2004-2012
NYC
Agriculture
0.1
Mining
0.2
0.2
NYS w/o NYC
2.3
13.0
12.8
Construction
9.1
Manufacturing
12.7
6.9
Transportation
8.6
1.9
1.1
Wholesale
2.0
3.3
Retail
2.1
1.0
Finance, Insurance, Real Estate
44.4
Services
23.6
19.5
Public Administration
33.9
0.7
0.3
Other
0
10
20
30
Percentage of Occupational Patients
40
50
Figure 2.17a. Percentage of occupational NYS OHCN patients in the services industry, by type of
work and geographic region. In NYC, 638 (30%) of the occupational patients were employed in
educational services followed by 523 (25%) in health services. In the remainder of NYS, 3,050 (50%)
were employed in health services and 1,361(22%) in educational services.
Figure 2.17a. Percentage of Occupational NYS OHCN
Patients in the Services Industry, by Type of Work and
Geographic Region, 2004-2012
NYC
NYS w/o NYC
Misc. Services
1.1
0.9
Private Households
1.3
0.1
Engineering, Accounting, Research, Management
and Related Services
2.5
3.8
5.8
Membership organizations
2.0
Museums/Art Galleries, and Botanical/Zoological
Gardens
0.8
0.4
2.5
Social Services
6.2
30.4
Educational Services
22.3
3.7
Legal Services
0.5
24.9
Health Services
50.0
2.4
2.6
Amusement and Recreation
Motion Pictures
0.4
0.0
Misc. Repair
0.7
0.5
0.6
2.3
Automotive Repair and Parking
13.4
Business Services
6.1
2.6
1.1
Personal Services
6.9
Hotels and Lodging
1.1
0
10
20
30
40
50
Percentage of Occupational Patients
60
Diagnoses, Selected Illnesses and Conditions of Patients
Figure 3.1. Number of diagnoses in NYS OHCN patients, by main ICD-9-CM diagnostic
categories and sex. Overall, there were 65,903 diagnoses made for the 26,821 patients seen by the
Clinic Network between 2004 and 2012. Males were seen primarily for diseases of the musculoskeletal
system (n=4,589), respiratory system (n=4,154), injuries and poisonings (n=3,864) and for symptoms
and signs (n=2,483). Females were seen primarily for diseases of the musculoskeletal system
(n=7,152), injuries and poisonings (n=2,929), and for diseases of the respiratory system (n=2,519).
There were 27,009 NYS OHCN diagnoses with V-codes (data not shown). These were patients who
were not currently sick but visited the NYS OHCN for some specific purpose, such as to receive
prophylactic vaccinations or to be screened for conditions for which the patients were at high risk.
Figure 3.1. Number of Diagnoses in NYS OHCN
Patients, by Main ICD-9-CM Diagnostic Categories
and Sex, 2004-2012
Male
Female
235
120
Infectious Diseases
159
38
Neoplasms
479
137
Endocrine Diseases
Mental Disorders
848
1,299
1,933
1,640
Nervous System
Circulatory System
165
832
Respiratory System
2,519
Digestive System
372
4,154
881
288
203
Skin Diseases
4,589
Musculoskeletal System
Symptoms & Signs
1,313
Injury & Poisonings
2,483
2,929
0
1,000
2,000
7,152
3,864
3,000
4,000
5,000
Number of Diagnoses
6,000
7,000
8,000
Diseases of the Nervous System and Sense Organs
(ICD-9-CM Codes 320-389)
Figure 3.10. Number of diagnoses of diseases of the nervous system and sense organs in NYS
OHCN patients, by year and work-relatedness. There were 3,573 diagnoses of diseases in this
category, of which 74% were work-related and 18% were possibly work-related. The majority of the
diagnoses in this category were carpal tunnel syndrome (n=864) of which 87% were work-related;
noise-induced hearing loss (n=494) of which 65% were work-related; cubital tunnel syndrome (n=486)
of which 85% were work-related; peripheral nervous system disorders (n=390) of which 75% were
work-related while another 17% were possibly work-related; and disorders of the eye (n=158) of which
63% were work-related (data not shown).
Figure 3.10. Number of Diagnoses of Diseases of the
Nervous System and Sense Organs in NYS OHCN
Patients, by Year and Work-relatedness, 2004-2010
Work-related
Not Work-related
Maybe Work-related
400
350
Number of Diagnoses
300
250
200
150
100
50
0
2004
2005
2006
2007
Year
2008
2009
2010
Figure 3.11. Percentage of diagnoses of diseases of the nervous system and sense organs in NYS
OHCN patients, by type of disease and sex. An almost even number of diagnoses of diseases within
this category occurred among males (n=1,436) and females (n=1,392). A third (34%) of the diagnoses
among males were noise-induced hearing loss (NIHL), while nearly half (43%) of the diagnoses among
females were carpal tunnel syndrome. Among the NIHL diagnoses, 95% resided in NYS outside of
NYC (data not shown).
Figure 3.11. Percentage of Diagnoses of Diseases of the Nervous
System and Sense Organs in NYS OHCN Patients, by Type of
Disease and Sex, 2004-2010
Female
9.0%
2.3%
4.2%
Male
3.1%
4.3% 2.4%
3.5%
3.1%
2.5%
11.4%
16.3%
33.5%
23.4%
18.9%
9.4%
42.7%
7.0%
11.2%
Inflammatory, hereditary and
Toxic encephalopathy
Other CNS Disorders
degenerative disorders of the
CNS
Figure11.
Percent of Diagnoses of Diseases of the Nervous System and Sense Organs
Peripheral
nervous system
Carpal tunnel syndrome
Cubital tunnel syndrome
NYS
disorders
, by Type of Disease and Sex, 2004-2009
Disorders of the eye
Disorders of the ear
NIHL
in
Diseases of the Respiratory System
(ICD-9-CM Codes 460-519)
Figure 3.15. Number of respiratory system disease diagnoses in NYS OHCN patients, by year and
World Trade Center (WTC) status. There were 6,673 diagnoses of a disease of the respiratory
system. Of these diagnoses, 63% were work-related and another 23% were possible work-related.
There were 2,603 (40%) respiratory system disease diagnoses related to the WTC disaster. As of 2005,
the majority of individuals with WTC exposures were seen in clinics specializing in monitoring this
population and therefore, were not seen as part of the Clinic Network.
Figure 3.15. Number of Respiratory System Disease
Diagnoses in NYS OHCN Patients, by Year and World
Trade Center (WTC) Status, 2004-2012
Maybe Work-related (not WTC)
Not Work-related (not WTC)
Work-related (not WTC)
Maybe Work-related (WTC)
Not Work-related (WTC)
Work-related (WTC)
700
Number of Diagnoses
600
500
400
300
200
100
0
2004
2005
2006
2007
2008
Year
2009
2010
2011
2012
Figure 3.18. Percentage of work-related asthma diagnoses in NYS OHCN patients, by industry of
employment and World Trade Center (WTC) status. The majority of non-WTC work-related
asthma diagnoses occurred among those employed in the services industry (46%), followed by the
manufacturing industry (31%). The principle occupations at risk for work-related asthma, excluding the
WTC disaster, included machine operators (7%), administrative support (7%), and service occupations
(5%) (data not shown). Work-related asthma diagnoses among those with WTC-related exposures
occurred among those employed in public administration (51%), services (30%), and construction
(25%) industries. The principle occupations at risk for work-related asthma among the WTC exposed
population included protective services (25%), construction trades (14%) and professional specialties
(12%) (data not shown).
Figure 3.18. Percentage of Work-related Asthma
Diagnoses in NYS OHCN Patients, by Industry of
Employment and World Trade Center (WTC) status,
2004-2010
WTC
Not WTC
0.2
Agriculture
8.8
0.7
2.2
Mining
25.0
Construction
13.8
8.3
Manufacturing
30.3
12.3
10.1
Transportation
2.2
2.6
Wholesale
1.3
Retail
4.2
1.8
3.5
Finance, Insurance, Real Estate
30.1
Services
46.1
50.7
Public Administration
15.4
0.9
0.2
Other
0
10
20
30
Percentage
40
50
60
Figure 3.18a. Percentage of work-related chronic obstructive pulmonary disease (COPD) and
allied conditions diagnoses, in NYS OHCN patients, by industry of employment and World Trade
Center (WTC) status. The majority of non-WTC work-related COPD diagnoses occurred among
those employed in the services industry (33%) followed by those in the manufacturing industry (23%).
Work-related COPD diagnoses among those with WTC-related exposures occurred among those
employed in public administration (38%), services (22%), and construction (21%) industries. The
principle occupations at risk for work-related COPD among the WTC exposed population included
protective services (22%), construction trades (19%) and professional specialties (11%) (data not
shown).
Figure 3.18a. Percent of Work-related Chronic
Obstructive Pulmonary Disease and Allied Conditions
Diagnoses, by Industry of Employment and World
Trade Center (WTC) Status, 2004-2010
WTC
0.0
Agriculture
Not WTC
5.5
0.6
1.9
Mining
Construction
20.9
9.7
4.9
Manufacturing
22.9
8.8
7.3
Transportation
1.8
1.8
Wholesale
1.0
Retail
3.3
1.0
2.6
Finance, Insurance, Real Estate
21.9
Services
Public Administration
33.2
38.2
11.6
0.8
0.2
Other
0
10
20
30
Percent of Patients
40
50
Diseases of the Skin and Subcutaneous Tissue
(ICD-9-CM Codes 680-709)
Figure 3.21. Number of skin and subcutaneous tissue disease diagnoses in NYS OHCN patients,
by year and work-relatedness. There were 491 diagnoses of a disease of the skin and subcutaneous
tissues, of which 60% were work-related and 14% were possibly work-related. There were 228
diagnoses of contact dermatitis (ICD-9-CM Code 692) of which 64% were work-related (data not
shown). Another 14 were of dermatoses including actinic keratosis and seborrheic keratosis (ICD-9CM Codes 702.0 and 702.1). These were often identified in skin cancer screenings conducted by the
Clinics. Overall, there were 491 patient visits where diseases in this category were diagnosed (data not
shown).
Figure 3.21. Number of Skin and Subcutaneous Tissue
Disease Diagnoses in NYS OHCN Patients, by Year
and Work-relatedness, 2004-2012
Maybe Work-related
Not Work-related
Work-related
Number of Diagnoses
60
50
40
30
20
10
0
2004
2005
2006
2007
2008
Year
2009
2010
2011
2012
Contact Dermatitis
Figure 3.22. Number of contact dermatitis diagnoses in NYS OHCN patients, by source of
exposure. There were 226 diagnoses of contact dermatitis. Exposures among these patients included 42
hydrocarbon exposures, including 10 exposures to cutting oils and 21 exposures to non-specified
solvents. Another 57 exposures were to miscellaneous chemicals and materials including 15 exposures
to non-specified chemicals such as chemical dust, 9 exposures to cleaning materials, and 6 to indoor air
pollutants. Patients could be exposed to more than one agent.
Figure 3.22. Number of Contact Dermatitis Diagnoses
in NYS OHCN Patients, by Source of Exposure,
2004-2012
Mineral and Inorganic Dusts
24
Metals and Metalloids
10
Acids, Bases, Oxidizers
1
Aldehydes and Acetals
5
Hydrocarbons
42
Polymers
14
Misc. Chemicals & Materials
57
Physical Factors
9
Microorganisms
11
Other
53
0
10
20
30
40
Number of Contact Dermatitis Diagnoses
50
60
Diseases of the Musculoskeletal System and Connective Tissue
(ICD-9-CM Codes 710-739)
Figure 3.23. Number of musculoskeletal system and connective tissue disease diagnoses in NYS
OHCN patients, by year and work-relatedness. There were 11,741 diagnoses of a disease of the
musculoskeletal system of which 87% were work-related and another 8% were possibly work-related.
In general, there was a steady increase in diagnoses of these conditions from 2004 through 2007, and
then a decrease in the number of diagnoses after 2007. Among the diagnoses of work-related
musculoskeletal conditions, 6,278 (61%) were among females; 4,264 (42%) were among NYC
residents; and 5,674 (55%) were among Whites, 2,048 (20%) among African-Americans, and 1,961
(19%) among Hispanics (data not shown). Overall there were 10,231 patient visits where diseases in
this category were diagnosed.
Figure 3.23. Number of Skin Musculoskeletal System
and Connective Tissue Disease Diagnoses in NYS
OHCN Patients, by Year and Work-relatedness,
2004-2012
Maybe Work-related
Not Work-related
Work-related
1600
Number of Diagnoses
1400
1200
1000
800
600
400
200
0
2004
2005
2006
2007
2008
Year
2009
2010
2011
2012
Figure 3.24. Percentage of work-related musculoskeletal system and connective tissue disease
diagnoses in NYS OHCN patients, by occupation and ethnicity. Approximately one-fourth (24%) of
those with diagnoses of musculoskeletal diseases worked in services occupations, including 776
nursing aides and 282 janitors and cleaners. There were 832 diagnoses among African-Americans.
Forty-two percent of all musculoskeletal disease diagnoses among African Americans occurred to
workers in service occupations. There were 1,763 diagnoses (17%) among those who worked in
executive and professional specialty occupations with 110 diagnoses among editors and reporters.
Twenty-four percent of the diagnoses of musculoskeletal diseases among Asians and Whites worked in
executive and professional specialty occupations. There were 1,261 musculoskeletal disease diagnoses
among those who worked in administrative support occupations, of which 674 (53%) were White and
351 (28%) were African-American; 1,035 were diagnosed among machine operators with 459 (44%)
among Hispanic workers and 407 (39%) among White workers. Among the machine operators
diagnosed with musculoskeletal diseases, 140 worked with textile sewing machines.
Figure 3.24. Percentage of Work-related
Musculoskeletal System and Connective Tissue
Disease Diagnoses in NYS OHCN Patients, by
Occupation and Ethnicity, 2004-2010
White
Hispanic
African American
Asian
Professional Specialty
Technicians
Sales
Administrative Support
Services
Farming
Mechanics
Construction Trades
Percision Production
Machine Operators
Transportation
Laborers
0
5
10
15
20
25
30
35
Percentage of Work-related Diagnoses
40
45
Figure 3.25. Percentage of musculoskeletal system and connective tissue disease diagnoses in NYS
OHCN patients, by type of disease. There were 1,285 diagnoses of disorders of the cervical region
(ICD-9-CM Code 723) of which 755 were cervicalgia and 363 were cervical radiculitis. There were
2,467 diagnoses of other disorders of the back (ICD-9-CM Code 724) of which 1,351 were lumbago
and 393 were radicular syndrome of lower limbs. Twenty-one percent (n=2,411) of the diagnoses were
peripheral enthesopathies (ICD-9-CM Code 726), including 839 with rotator cuff syndrome, 719 with
enthesopathy of the elbow (267 with medial epicondylitis and 436 with lateral epicondylitis), 385
diagnoses of enthesopathy of the wrist, and 65 with unspecified enthesopathy. An additional 1,333
diagnoses were made for other disorders of the synovium (ICD-9-CM Code 727), of which 354 were
de Quervain's disease and 382 were other tenosynovitis of the hand and wrist. Other disorders of the
soft tissue (ICD-9-CM Code 729) accounted for 882 diagnoses including 563 for myalgia and myositis.
Figure 3.25. Percentage of Musculoskeletal System and
Connective Tissue Disease Diagnoses in NYS OHCN
Patients, by Type of Disease, 2004-2012
1% 3%
10%
21%
21%
11%
7%
8%
18%
Osteoarthrosis
Invertebral Disc Disorders
Other Disorders of the Back
Other Disorders of Soft Tissue
Other Musculoskeletal Disorders
Other Disorders of the Joints
Other Disorders of Cervical Region
Peripheral Enthesopathy
Other Disorders of Synovium
Injuries and Poisonings
(ICD-9-CM Codes 800-999)
Figure 3.27. Number of injury and poisoning diagnoses in NYS OHCN patients, by year and
work-relatedness. There were 6,793 diagnoses of injuries or poisonings, of which 93% were workrelated and another 3% were possibly work-related. There were 6,793 patient visits where patients were
diagnosed with injuries and poisonings (data not shown).
Figure 3.27. Number of Injury and Poisoning
Diagnoses in NYS OHCN Patients, by Year and Workrelatedness, 2004-2012
Maybe Work-related
Not Work-related
Work-related
1200
Number of Diagnoses
1000
800
600
400
200
0
2004
2005
2006
2007
2008
Year
2009
2010
2011
2012
V-Codes
(ICD-9-CM Codes V01-V84)
Figure 3.30. Number of diagnoses for patients not currently sick, seen for a specific purpose in
NYS OHCN patients, by year and work-relatedness. Patients recorded with V-codes in their medical
records by the NYS OHCN were patients who were not sick and encountered the NYS OHCN for some
specific purpose. This included prophylactic vaccinations or screening for conditions for which the
patients were at high risk (such as Lyme Disease, asbestos screenings, and lead screenings). There were
27,009 diagnoses classified with V-codes; 22,171 (82%) were seen as part of group screenings.
Figure 3.30. Number of Diagnoses for Patients Not
Currently Sick, Seen for a Specific Purpose in NYS
OHCN Patients, by Year and Work-relatedness,
2004-2012
Maybe Work-related
Not Work-related
Work-related
4500
4000
Number of Diagnoses
3500
3000
2500
2000
1500
1000
500
0
2004
2005
2006
2007
2008
Year
2009
2010
2011
2012
Patient Exposures
Figure 4.1. Percentage of NYS OHCN exposures, by exposure category and sex. Overall there were
60,809 different exposures identified in the NYS OHCN database. Approximately one-third of these
(n=18,706) were ergonomic factors, including keyboard use and repetitive motion. Another quarter of
these (n=13,503) were mineral and inorganic dusts, including asbestos, silica and non-specified dusts.
The next largest groups of exposures included physical factors such as heat, cold, and radiation
(n=10,700), pyrolysis products (n=4,597), and microorganisms including molds and yeast (n=3,036).
Miscellaneous chemicals and materials accounted for 4,122 exposures and included indoor and outdoor
pollutants and pesticides. Metals accounted for 2,169 exposures and included lead. Non-specified
hydrocarbons accounted for 1,091 exposures. Females were more likely to have reported exposures to
ergonomic factors, and males were more likely to have reported exposures to mineral and inorganic
dusts.
Figure 4.1. Percent of NYS OHCN Exposures, by
Exposure Category and Sex, 2004-2012
Male
Mineral and Inorganic Dusts
Female
28.4
12.5
Metals and Metalloids
0.9
Misc. Inorganic Cmpds
1.0
0.7
5.3
2.2
2.2
Hydrocarbons
6.1
Misc. Chemicals & Materials
Pyrolysis Products
7.8
10.0
3.6
18.0
16.9
Physical Factors
21.0
Ergonomic Factors
4.3
Microorganisms
45.9
6.1
0.6
0.6
Other
0
5
10
15
20
25
30
Percent of Exposures
35
40
45
50
Exposures to Mineral and Inorganic Dusts
Figure 4.2. Number of NYS OHCN exposures to mineral and inorganic dust, by year, World
Trade Center (WTC) status and patient type. There were 13,503 reported exposures to mineral and
inorganic dusts, of which 3,149 (23%) were among group screening patients and 6,616 (49%) were
related to the World Trade Center (WTC) disaster. Among the dust exposures, 2,915 were asbestos and
8,969 were non-specified dusts (data not shown).
The majority of exposures to mineral and inorganic dusts were associated with V-codes recorded in the
medical records (n=5,317). Patients recorded with V-codes in their medical records by the NYS OHCN
were patients who were not currently experiencing symptoms. They encountered the NYS OHCN for
some specific purpose such as to receive prophylactic vaccinations or to be screened for conditions for
which they were at high risk (such as Lyme disease, asbestos screenings, and lead screenings). Of
these, 2,027 (38%) were related to the WTC disaster. Among the non-WTC-related dust exposures
associated with V-codes (n=3,290), 62% were among group screening patients. Another 4,631 dust
exposures were associated with diagnoses of diseases of the respiratory system, and 1,900 were
associated with diagnoses of symptoms, signs and ill defined conditions (data not shown).
Figure 4.2. Number of NYS OHCN Exposures to
Mineral and Inorganic Dust, by Year, World Trade
Center (WTC) Status and Patient Type, 2004-2012
Symptomatic Patients (not WTC)
Group Screening Patients (not WTC)
Symptomatic Patients (WTC)
Group Screening Patients (WTC)
3500
Number of Exposures
3000
2500
2000
1500
1000
500
0
2004
2005
2006
2007
2008
Year
2009
2010
2011
2012
Figure 4.3. Percentage of NYS OHCN exposures to mineral and inorganic dusts, by type of
respiratory disease diagnosis and World Trade Center (WTC) status. Among reported exposures to
mineral and inorganic dusts not related to the WTC disaster, there were 2,332 diagnoses of respiratory
diseases, of which 237 (10%) were pleural thickening due to asbestos (ICD-9-CM Code 511). Among
the 294 diagnoses of pneumoconioses among dust exposures not related to the WTC disaster, 164 were
asbestosis (ICD-9-CM Code 501) and 153 diagnoses were respiratory conditions due to chemical
fumes and vapors (ICD-9-CM Code 506). There were an additional 752 (37%) diagnoses of “chronic
obstructive pulmonary disease and other conditions” among dust exposures not related to WTC, of
which 495 were asthma (ICD-9-CM Code 493), 120 were chronic airway obstructions (ICD-9-CM
Code 496) and 95 were chronic bronchitis (ICD-9-CM Code 491).
Among the reported mineral and inorganic dust exposures related to the WTC disaster, there were
2,010 diagnoses of respiratory diseases. Among those, 1,183 (57%) were diagnosed with “other
diseases of the upper respiratory tract”, including 495 patients with chronic pharyngitis and 307 with
chronic sinusitis (ICD-9-CM Codes 472 and 473, respectively). There were another 738 diagnoses
(35%) of “chronic obstructive pulmonary disease and other conditions” of which 490 were asthma.
Figure 4.3. Percentage of NYS OHCN Exposures to
Mineral and Inorganic Dusts, by Type of Respiratory
Disease Diagnosis and World Trade Center (WTC)
Status, 2004-2012
WTC
Not WTC
3.4
2.8
Acute Respiratory Infections
56.5
Other Diseases of the Upper Respiratory Tract
32.0
5.2
5.6
COPD and Other Allied Conditions
Pneumoconioses and Other Lung Diseases Due to
External Agents
4.0
15.2
0.7
Other Diseases of the Respiratory System
12.8
0
10
20
30
40
Percentage of Exposures
50
60
Non-specified Dusts or Asbestos
Figure 4.4. Percentage of NYS OHCN exposures to non-specified dusts or asbestos, not World
Trade Center (WTC) related, by industry. Exposures to asbestos, not related to the WTC disaster,
were reported primarily among those in construction industries (38%) followed closely by the services
industries (33%). The latter group was from exposures in elementary and secondary schools and
colleges. Exposures to non-specified dust not related to the WTC disaster were reported primarily in
public administration (36%), construction (22%), and services (21%) industries.
Figure 4.4. Percentage of NYS OHCN Exposures to
Non-Specified Dusts or Asbestos, Not World Trade
Center (WTC) Related, by Industry, 2004-2010
Asbestos
Agriculture
0.0
0.8
Mining
0.9
0.7
Construction
Dust, NOS
38.0
22.2
Manufacturing
6.6
Transportation
6.4
7.1
Wholesale
2.0
1.6
Retail
1.9
1.6
0.4
Finance, Insurance, Real Estate
9.2
1.8
Services
33.4
21.4
7.7
Public Administration
35.8
0.2
0.3
Other
0
5
10
15
20
25
Percentage of Exposures
30
35
40
Exposures to Metals and Metalloids
Figure 4.5. Number of NYS OHCN exposures to metals and metalloids, by year. There were 2,169
reported exposures to metals and metalloids, of which 1,358 (63%) were among group screening
patients. Included among these exposures were 1,569 exposures to lead, 46 to inorganic mercury, and
59 to non-specified welding (data not shown). Among those with reported exposures to lead, 768 (58%)
were from the construction industry.
Nearly half of reported exposures were associated with V-codes recorded in the medical records
(n=893). Among these, 699 (78%) were group screening patients. Another 834 exposures were
associated with diagnoses of injuries and poisonings of which 265 (40%) were toxic effects of lead and
its compounds (ICD-9-CM Code 984). Twenty percent (n=109) of exposures associated with this
diagnosis were not part of group screenings. Another 106 metals exposures were associated with
diseases of the respiratory system (data not shown).
Figure 4.5. Number of NYS OHCN Exposures to
Metals and Metalloids, by Year, 2004-2012
Number of Exposures
350
Symptomatic Patients
Group Screening Patients
300
250
200
150
100
50
0
2004
2005
2006
2007
2008
Year
2009
2010
2011
2012
Exposures to Non-specified Hydrocarbons
Figure 4.7. Number of NYS OHCN exposures to non-specified hydrocarbons, by year. There were
1,334 reported exposures to non-specified hydrocarbons, of which 189 (14%) were among group
screening patients. The reported exposures were primarily solvents (n=890) and paint (n=236) (data not
shown). The diagnoses associated with these exposures were varied, with 494 (37%) diseases of the
respiratory system, 212 (16%) signs and symptoms, and 157 (12%) injuries and poisonings (data not
shown).
Number of Exposures
Figure 4.7. Number of NYS OHCN Exposures to NonSpecified Hydrocarbons, by Year, 2004-2012
200
180
160
140
120
100
80
60
40
20
0
Symptomatic Patients
2004
2005
2006
2007
Group Screening Patients
2008
Year
2009
2010
2011
2012
Exposures to Ergonomic Factors
Figure 4.13. Number of NYS OHCN exposures to ergonomic factors, by year. There were 18,706
reported exposures to ergonomic factors, of which 673 (4%) were among group screening patients.
Figure 4.13. Number of NYS OHCN Exposures to
Ergonomic Factors, by Year, 2004-2012
Number of Exposures
3500
Symptomatic Patients
Group Screening Patients
3000
2500
2000
1500
1000
500
0
2004
2005
2006
2007
2008
Year
2009
2010
2011
2012
Figure 4.14. Percentage of NYS OHCN exposures to ergonomic factors, by type of factor. Of these
reported exposures, 10,597 (57%) were repetitive motion including keyboard use, 3,014 (16%) were
stress, and 2,816 (15%) were lifting. Another 1,030 (6%) were to non-specified ergonomic factors.
Of those reported exposures to factors associated with stress, 84% were diagnosed with mental
disorders. Exposures to repetitive motion were primarily associated with diagnoses of carpal tunnel
syndrome (n=1,093) (ICD-9-CM Code= 354.0), tenosynovitis of the hand or wrist including de
Quervain's disease (n=781) (ICD-9-CM Codes 727.04 and 727.05), lateral or medial epicondylitis
(n=756) (ICD-9-CM Codes 726.31 and 726.32), and cubital tunnel syndrome (n=585) (ICD-9-CM
Code 354.2) (data not shown).
Figure 4.14. Percentage of NYS OHCN Exposures to
Ergonomic Factors, by Type of Factor, 2004-2012
3.7
5.5
15.1
2.8
16.1
56.7
Ergonomic Factors, NOS
Repetitive Motion/Keyboard Use
Stress
Forceful Movements, NOS
Lifting
Other
Exposures to Microorganisms
Figure 4.15. Number of NYS OHCN exposures to microorganisms, by year. There were 3,036
reported exposures to microorganisms, of which 2,440 (80%) were among group screening patients.
The majority of these patients (n=1,607) were exposed to non-specified infectious agents, and 589
(24%) were exposed to molds (data not shown). Most of these patients were seen for prophylactic
vaccinations against diseases including arthropod-borne viral diseases (n=286) (ICD-9-CM Code V05)
or for other routine specified and unspecified examinations (n=1,081) (ICD-9-CM Codes V72.85 and
V72.90) (data not shown).
Figure 4.15. Number of NYS OHCN Exposures to
Microorganisms, by Year, 2004-2012
450
Symptomatic Patients
Group Screening Patients
Number of Exposures
400
350
300
250
200
150
100
50
0
2004
2005
2006
2007
2008
Year
2009
2010
2011
2012
Industries and Occupations of Patients
Services
(SIC Codes 70-89)
Figure 5.24. Occupations of NYS OHCN patients working in the services industry, by patient
type. Patients working in the services industry were primarily employed in service occupations. Within
the services occupations, 41% were seen as part of group screenings. The principle services
occupations included 976 working in cleaning and building services occupations, excluding
households; 228 in protective services, including 140 working in firefighting and fire prevention
occupations; 151 in personal service occupations, including 69 in childcare; 103 in private households;
and 154 in food preparation and service occupations. There were 1,951 service industry patients
working in managerial and professional specialty occupations, of which 37% were group screenings.
These included 369 teachers, 446 in professional specialties, and 742 in health treating occupations.
Another 1,567 patients were employed in technical, sales and administrative support occupations, of
which 37% were group screenings. These patients were primarily in administrative support
occupations, including secretaries, stenographers and typists (n=152) and general office clerks (n=36).
Figure 5.24. Occupations of NYS OHCN Patients,
Working in the Services Industry, by Patient Type,
2004-2012
Group Screening
Symptomatic
861
Managerial & Professional Specialty
1434
647
Technical, Sales & Administrative Support
1175
1356
Service
1823
41
40
Farming, Forestry & Fishing
462
Precision Production, Craft & Repair
332
285
360
Operators, Fabricators & Laborers
0
200
400
600
800 1000 1200 1400 1600 1800 2000
Number of Patients
Figure 5.25. Diagnoses among NYS OHCN patients working in the services industry, by patient
type. Among the patients employed in the services industry, there were 8,793 diagnoses of which 41%
were group screenings (n=3,624) and 39% were V-codes (n=3,991). Excluding V-codes, patients
working in the services industry were diagnosed primarily with diseases of the musculoskeletal system
(n=1,460) including 41 diagnoses of enthesopathy of the elbow region and 84 diagnoses of myalgia
(ICD-9-CM Codes 726.3 and 729.1, respectively). There were 1,015 diagnoses of injuries and
poisonings, of which 720 were sprains or strains (ICD-9-CM Codes 840-848), and 84 were contusions
on upper and lower limbs and 39 open wounds on fingers (ICD-9-CM Codes 923-924, and 883,
respectively). There were 783 diagnoses of diseases of the respiratory system, including 239 diagnoses
of asthma, 245 diagnoses of chronic pharyngitis and sinusitis, and 23 diagnoses of asbestosis (ICD-9CM Codes 493, 472-473, 501, respectively).
Figure 5.25. Diagnoses Among NYS OHCN Patients
Working in the Services Industry, by Patient Type,
2004-2012
Group Screening
Infectious Diseases
7
31
Neoplasms
4
14
Symptomatic
21
28
Endocrine Diseases
9
Mental Disorders
202
28
Nervous System
521
38
40
Circulatory System
52
Respiratory System
731
Digestive System
11
41
Skin Diseases
11
65
25
Musculoskeletal System
1,435
29
Symptoms & Signs
230
81
Injury & Poisonings
1,131
3,305
V codes
686
-
500
1,000
1,500
2,000
Number of Patients
2,500
3,000
3,500
Figure 5.26. Exposures among NYS OHCN patients working in the services industry, by patient
type. Among patients working in the services industry, there were 10,720 exposures identified. Of
these, 3,166 were to ergonomic factors, of which 96% were symptomatic patients. These exposures
were primarily repetitive motion (n=1,322) and stress (n=739). There were 2,245 exposures to mineral
and inorganic dusts, of which 57% were group screenings.
Figure 5.26. Exposures among NYS OHCN Patients Working in the
Services Industry, by Patient Type, 2004-2012
Group Screening
Symptomatic
Microorganisms
7%
Mineral and
Inorganic Dusts
34%
Microorganisms
28%
Mineral and
Inorganic Dusts
14%
Metals and
Metalloids
1%
Misc. Inorganic
Cmpds
1%
Hydrocarbons
2%
Misc. Chemicals
& Materials
8%
Ergonomic
Factors
3%
Metals and
Metalloids
2%
Misc. Inorganic
Cmpds
2%
Physical
Factors
17%
Misc.
Pyrolysis Chemicals &
Materials
Products
8%
3%
Hydrocarbons
0.5%
Pyrolysis
Products
1%
Ergonomic
Factors
44%
Physical Factors
17%