Trends in occupational fall incidence in Japan, 2014-2021: A nationwide study.

BACKGROUND: The incidence of occupational falls in Japan increased 9% over the past decade from 2014 to 2021. Occupational falls are increasing in aging workforces; however, surveillance systems rely largely on crude incidence rates that do not account for demographic changes over time. We estimated age standardized and age-sex standardized incidence rates of occupational falls in Japan, and examined temporal trends across industries from 2014 to 2021. METHODS: We conducted a population-based study using nationwide administrative data. Incident cases of occupational falls were obtained from the Reports of Occupational Accidents and Diseases. Annual workforce populations were estimated from the Labour Force Survey using survey weights. Age standardized and age-sex standardized incidence rates per 100,000 employees were calculated using the 2015 workforce population as the standard. RESULTS: A total of 234,711 incident cases of occupational falls were documented between 2014 and 2021. Crude incidence rates increased over time. From 2016 onwards, age standardized rates were lower than crude rates across all industries, reflecting changes in workforce age structure. Additional sex standardization further attenuated temporal patterns, highlighting the influence of workforce sex composition on observed trends. The attenuation after age-sex standardization was most pronounced in the medical, health care, and welfare industry. CONCLUSIONS: Changes in workforce age and sex structure substantially influenced temporal patterns of occupational falls. Age-sex standardized incidence rates provide a more appropriate indicator for monitoring occupational fall risk in aging and increasingly gender-diverse labor forces.