Medical accessibility and underreporting of occupational diseases: effect of travel distance and travel time

ObjectivesUnderreporting of occupational diseases (ODs) could be attributed to poor medical accessibility, which is rarely discussed previously. Our cross-sectional study aims to evaluate how OD reporting is impeded by long travel distance/time (TD/TT) to the nearest major occupational medicine clin...

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Main Authors: Ping Hui Chen, Po-Ching Chu, Ching-Chun Huang, Chi-Hsien Chen, Yue Leon Guo, Ta-Chen Su, Pau-Chung Chen
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Rehabilitation Sciences
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Online Access:https://www.frontiersin.org/articles/10.3389/fresc.2025.1545460/full
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author Ping Hui Chen
Po-Ching Chu
Ching-Chun Huang
Chi-Hsien Chen
Yue Leon Guo
Ta-Chen Su
Pau-Chung Chen
Pau-Chung Chen
Pau-Chung Chen
Pau-Chung Chen
author_facet Ping Hui Chen
Po-Ching Chu
Ching-Chun Huang
Chi-Hsien Chen
Yue Leon Guo
Ta-Chen Su
Pau-Chung Chen
Pau-Chung Chen
Pau-Chung Chen
Pau-Chung Chen
author_sort Ping Hui Chen
collection DOAJ
description ObjectivesUnderreporting of occupational diseases (ODs) could be attributed to poor medical accessibility, which is rarely discussed previously. Our cross-sectional study aims to evaluate how OD reporting is impeded by long travel distance/time (TD/TT) to the nearest major occupational medicine clinics.MethodsUsing data from the Network of Occupational Diseases and Injuries Service (NODIS), Taiwan's OD surveillance system, and the annual Manpower Survey from 2008 to 2018, we calculate each district's incidence rate of ODs (IROD) and expected IROD based on industries and job titles. Each town's TD/TT to the nearest major occupational medicine clinics is estimated by Google Maps’ Distance Matrix API. The quasi-Poisson regression model is used to investigate the effect of TD and TT on IROD, while industries and job titles are adjusted by offsetting expected IROD. A subgroup analysis is then carried out to check the effect of employment status, sickness absence, and reporting years.ResultsA total of 3,420 cases of definite ODs are included in our study. Using the quasi-Poisson regression model, after adjusting industry types and job titles, TD and TT have a significant effect on IROD. As TD/TT increases by 10 km/10 min, IROD decreases by 10.90%/10.73%. It is estimated that ∼200 OD cases per year or 40% of ODs are therefore underreported. In the subgroup analysis, only mildly sick workers are still significantly affected by TD and TT.ConclusionsOur study shows how poor medical accessibility leads to underreporting, especially for mildly sick cases, and up to 40% of ODs could be underreported. Using this method, we can evaluate the cost-effectiveness of adding reporting hospitals in areas with poor medical accessibility.
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spelling doaj-art-4807fcd1be5b413b8d68cf9c0612095a2025-08-20T03:09:24ZengFrontiers Media S.A.Frontiers in Rehabilitation Sciences2673-68612025-04-01610.3389/fresc.2025.15454601545460Medical accessibility and underreporting of occupational diseases: effect of travel distance and travel timePing Hui Chen0Po-Ching Chu1Ching-Chun Huang2Chi-Hsien Chen3Yue Leon Guo4Ta-Chen Su5Pau-Chung Chen6Pau-Chung Chen7Pau-Chung Chen8Pau-Chung Chen9Department of Environmental and Occupational Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, TaiwanDepartment of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei, TaiwanDepartment of Environmental and Occupational Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, TaiwanDepartment of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei, TaiwanDepartment of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei, TaiwanDepartment of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei, TaiwanDepartment of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei, TaiwanDepartment of Public Health, College of Public Health, National Taiwan University, Taipei, TaiwanInstitute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, TaiwanNational Institute of Environmental Medicine, National Health Research Institutes, Zhunan, TaiwanObjectivesUnderreporting of occupational diseases (ODs) could be attributed to poor medical accessibility, which is rarely discussed previously. Our cross-sectional study aims to evaluate how OD reporting is impeded by long travel distance/time (TD/TT) to the nearest major occupational medicine clinics.MethodsUsing data from the Network of Occupational Diseases and Injuries Service (NODIS), Taiwan's OD surveillance system, and the annual Manpower Survey from 2008 to 2018, we calculate each district's incidence rate of ODs (IROD) and expected IROD based on industries and job titles. Each town's TD/TT to the nearest major occupational medicine clinics is estimated by Google Maps’ Distance Matrix API. The quasi-Poisson regression model is used to investigate the effect of TD and TT on IROD, while industries and job titles are adjusted by offsetting expected IROD. A subgroup analysis is then carried out to check the effect of employment status, sickness absence, and reporting years.ResultsA total of 3,420 cases of definite ODs are included in our study. Using the quasi-Poisson regression model, after adjusting industry types and job titles, TD and TT have a significant effect on IROD. As TD/TT increases by 10 km/10 min, IROD decreases by 10.90%/10.73%. It is estimated that ∼200 OD cases per year or 40% of ODs are therefore underreported. In the subgroup analysis, only mildly sick workers are still significantly affected by TD and TT.ConclusionsOur study shows how poor medical accessibility leads to underreporting, especially for mildly sick cases, and up to 40% of ODs could be underreported. Using this method, we can evaluate the cost-effectiveness of adding reporting hospitals in areas with poor medical accessibility.https://www.frontiersin.org/articles/10.3389/fresc.2025.1545460/fulloccupational diseaseGISgeographic information systemmedical accessibilityunderreportingIRR
spellingShingle Ping Hui Chen
Po-Ching Chu
Ching-Chun Huang
Chi-Hsien Chen
Yue Leon Guo
Ta-Chen Su
Pau-Chung Chen
Pau-Chung Chen
Pau-Chung Chen
Pau-Chung Chen
Medical accessibility and underreporting of occupational diseases: effect of travel distance and travel time
Frontiers in Rehabilitation Sciences
occupational disease
GIS
geographic information system
medical accessibility
underreporting
IRR
title Medical accessibility and underreporting of occupational diseases: effect of travel distance and travel time
title_full Medical accessibility and underreporting of occupational diseases: effect of travel distance and travel time
title_fullStr Medical accessibility and underreporting of occupational diseases: effect of travel distance and travel time
title_full_unstemmed Medical accessibility and underreporting of occupational diseases: effect of travel distance and travel time
title_short Medical accessibility and underreporting of occupational diseases: effect of travel distance and travel time
title_sort medical accessibility and underreporting of occupational diseases effect of travel distance and travel time
topic occupational disease
GIS
geographic information system
medical accessibility
underreporting
IRR
url https://www.frontiersin.org/articles/10.3389/fresc.2025.1545460/full
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