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Upstate report says occupational disease in New York is an ‘epidemic in plain sight’

A new report from Upstate reveals an “epidemic hidden in plain sight” of death and injury in the workplace in New York State. 

According to the report, Occupational Disease in New York State: An Update, an estimated 7,016 deaths annually in New York are due to occupational disease. 

Additionally, 13 percent of diseases prevalent in the adult working population are attributable to occupational disease, with millions of workers in New York State exposed to hazardous conditions on the job.

All this at a cost to the state of $4 billion, most of which falls to the ill patient and taxpayers.  
Occupational disease is any condition or disorder that is caused by work. It includes things like exposure to chemicals, ergonomic hazards, stress, and Covid-19.

Michael Lax, MD, and Jeanette Zoeckler, PhD, who run Upstate’s Occupational Health Clinic Center and authored the study, call this an epidemic in plain sight, and even worse, one that is completely preventable. 

“Work is such an important part of our lives, yet surprisingly ignored with regard to how work may affect our health,” said Lax, a professor of family medicine, and public health and preventive medicine. “Our report sheds light on how prevalent hazardous working conditions are in New York State, resulting in large numbers of workers dying or becoming ill every year, and an enormous number of workers at risk of death or illness from an occupational disease. 

“The real tragedy is that all of these deaths and illnesses are unnecessary because they are preventable with improvements in working conditions. With this report we hope to start a conversation about how the toll of work-related disease can be more effectively addressed.” 

Lax and Zoeckler cite employer attitudes and practices, declining unionization, discrimination, and government policies, along with the changing nature of the workplace, as all contributing to the problem. The study also includes a category called emergent occupational hazards, which include psychological stressors, substance abuse, obesity and Covid -19. 

Despite the high numbers of injured and ill workers, funding and clinical resources to treat these patients remains scarce. There are only 30 board-certified occupational medicine specialists accepting patients with workers’ compensation insurance in the whole state. Based on current numbers, that means one specialist for every 66,666 patients. 

Upstate’s clinic is a part of the New York State Occupational Health Clinic Network, which is publicly funded and administered by the New York State Department of Health. Zoeckler said the network of clinics has not received an increase in funding in 12 years. 

Their study is the first statewide look at the issue in 30 years. The findings elucidate the problems of low-wage workers and how workplace illness and death disproportionally impacts minority and female workers. Since the recession of 2007, there has been a proliferation of low paying jobs and a decrease in well-paying ones. In New York, 40 percent of all jobs are low wage jobs. In Syracuse, 38 to 42 percent people are making what is considered low wages, wages impossible to live on. 

“It used to be that low-wage jobs were for those getting their first work experience,” Zoeckler said. “Now we are seeing folks expected to work those jobs long-term to support their families.” 

The Covid-19 pandemic brought the issues of vulnerable or essential workers to the forefront. Grocery store workers, sanitation and maintenance workers and bus drivers, for example, all had to report to work during lockdown. Since so many of these workers are Black, Latinx or women, death and illness from Covid impacted them disproportionately. 

Zoeckler said low-wage workers are more often immigrants or people who have had less opportunity to get an education. They may not be fully aware of their rights to a safer and healthier workplace.  
“There are a number of factors that stand in the way of workers getting what they need to stay safe healthy on the job,” Zoeckler said. “Training is often lacking. Also, there’s a lack of health and safety enforcement. Workers often just expect that work is dangerous and believe they must put up with difficult conditions. They end up being our patients here in the clinic when it’s too late, after they’ve been exposed to any number of hazardous conditions including poor ergonomics.” 

Zoeckler said two-thirds of the patients seen at the clinic present with musculoskeletal issues from unaddressed ergonomics. Examples might be diseases that result from the physical, repetitive work commonly found in food service, health care delivery or janitorial maintenance. Workplaces are frequently understaffed and pushing their workers to work faster.

At the other end of the spectrum, we see health problems result from sedentary office jobs.  
“Sitting is the new smoking,” she said. “Sitting, without getting up and moving around, is deleterious to long-term health.” 

The study also includes work-related stress, substance abuse, mental health issues and obesity, which aren’t normally thought of in terms of occupational hazards but the report’s authors assert that these need to be considered under the umbrella of work-related disease. Currently the Upstate clinic has been focusing on the mental health of teachers, health care workers and essential workers, who have had significant stressors placed on them throughout the pandemic. Zoeckler said mental health issues still carry a stigma in society but should be treated no differently than for example, an employee who needs time off for cancer treatments. 

“The pandemic has many working people strained and feeling like they are ‘at their wit’s end,’” Zoeckler said. “There is a connection between mental and physical health on the job. You might not get sick today from stress from your job, but down the line you may develop hypertension. Overly demanding work can have long-term health implications.” 

Even though the state legislature funded the Occupational Health Clinic Network in 1988, resources to treat occupational disease remain scarce. Zoeckler and Lax hope their report ignites conversation about what constitutes workplace illness, and spurs action to increase funding and strengthen the infrastructure around occupational health to increase prevention and treatment options.  


Report authors, from left, are Jeanette Zoeckler, PhD, MPH, and Michael Lax, MD, MPH.