Although processing seafood is a critical step in the supply chain for one of Alaska’s most valuable natural resources, few studies have addressed workers’ safety and health. This industry comprises both offshore (in large vessels) and onshore factories that engage in production and packaging activities, including: eviscerating fish; shucking shellfish; processing oils; and canning or freezing seafood.¹ During 2014–2015, Alaskan fishermen harvested the majority of the United States’ seafood, with an annual average of 5.8 billion pounds, and generated the largest portion of national revenue, at $1.7 billion, with subsequent processing adding value.² During 2015, there were 24,863 workers in Alaska’s seafood processing industry, both onshore and offshore, 22% of whom worked in the industry year-round, and 30% of whom were Alaskan residents.³ Demographic data are only available on these 30% of all workers who were Alaskan residents, with an average age of 41 years and 68% male.³ The majority of positions are seasonal and many out-of-state and foreign workers are recruited to meet labor demands.^4–6 While wages vary by occupation and experience, many new workers make minimum wage. Jobs are physically and mentally demanding, frequently requiring repetitive tasks in cold and wet environments, oftentimes 12 to 18 hours per day for weeks.^4–6

The Alaska Occupational Safety and Health Section [AKOSH] regulates onshore factories and has categorized seafood processing as a high-hazard industry.⁷ During 2014–2015, the Census of Fatal Occupational Injuries did not report any fatalities in this industry.⁸ Although the fatality risk is low, there is evidence that the risk of nonfatal injuries and illnesses is elevated. The Survey of Occupational Injuries and Illnesses (SOII) reported that in 2015, Alaska’s broad “food manufacturing” industry experienced a rate of 8.3 injuries/illness per 100 full-time workers, which was twice the all-industry rate of 4 per 100 full-time workers.⁹ Within that broad category, SOII data on seafood processing, specifically, are unavailable. However, seafood processing industry workers constitute over 95% of all food manufacturers in Alaska.¹⁰

Limited research has investigated hazards and risk factors in the seafood processing industry. Globally, seafood processors are at high risk for developing dermatologic and respiratory allergic reactions.^11–14 Risk factors for musculoskeletal disorders include: highly repetitive and forceful upper extremity movements; localized mechanical stress; awkward and/or static postures at workstations; prolonged standing; temperature extremes; and poor workplace organization.^15–18 Two recent studies have investigated acute traumatic injuries among offshore seafood processors working in Alaskan waters. The first study analyzed injuries among all crewmembers (deckhands, processors, engineers, etc.) during 2001–2012 working onboard two fleets with the capability to harvest and process seafood, freezer-longliners and freezer-trawlers (also known as amendment 80 or non-Pollock catcher-processor vessels). This study found that processing tasks were responsible for most of the lacerations, punctures, avulsions, amputations, and poisonings among all crewmembers, with the most frequent causes including being caught in running processing equipment and slipping knives.¹⁹ The second study focused solely on injuries among offshore processors during 2010–2015, across the multiple catcher-processor and mothership fleets operating in Alaska. This study identified one fatal and 304 nonfatal injuries among processors that were reported to the US Coast Guard. No injuries were attributed to vessel disasters or falls overboard. The single fatal injury involved the worker becoming caught between a conveyor belt and a wall in the vessel’s freezer hold. The most frequently occurring nonfatal injuries were sprains/strains/tears, contusions, and fractures. The work activities most frequently associated with injuries were processing seafood on the production line, stacking blocks/bags of frozen product, and repairing/maintaining/cleaning factory equipment.²⁰ Neither study was able to calculate injury rates among seafood processors, specifically, due to a lack of workforce denominator data by occupation. To date, there have been no epidemiologic studies on Alaska’s onshore seafood processing industry. Recent studies on Washington State’s and Oregon’s seafood processing industries have shown high rates of accepted workers’ compensation (WC) claims.^21–22 Limitations of the Oregon study were that (a) it analyzed workers’ compensation disabling claims, which represented only the most severe incidents, and (b) the dataset did not provide a narrative description of the injury/illness characteristics and circumstances, and therefore it was not possible to identify the work activity associated with the injury/illness.²²

WC claim reports provide a rich source of information for safety and health research and surveillance.²³ In Alaska, the Division of Workers’ Compensation is charged with administering the Alaska Workers’ Compensation Act, which requires employers or their insurance carriers to pay for injured or ill employees’ work-related medical, disability, and reemployment benefits.²⁴ Employers must report to the Division an employee’s death, injury, disease, or infection that arises out of and in the course of employment.²⁵ For a variety of coverage-related legal reasons, WC claims are an inadequate data source for injuries/illness among offshore workers.^26–27 For onshore workers – who are more uniformly covered by the Alaska Workers’ Compensation Act – the “remote site doctrine” can apply in certain geographic locations. The principle behind this doctrine is that workers at remote sites are required to eat, sleep, and socialize on employers’ premises. Therefore, injury and illness caused by personal activities on employers’ premises must be compensated.²⁸ For onshore workers, this study aimed to (a) estimate the risk of injuries and illnesses, (b) determine injury and illness patterns, and (c) identify modifiable workplace hazards.

For all industries in Alaska during 2014–2015, there were 37,240 claims for nonfatal injuries/illnesses that were approved for compensation. Of the 40 fatalities excluded from this analysis, none occurred in the seafood processing industry. There were 3,161 claims in the entire seafood processing industry, both onshore and offshore. Claims for offshore incidents (128) and those in unknown locations (52) were excluded from the analysis. Claims for medical testing (92), which involved a few instances in which one worker with tuberculosis potentially could have exposed many others, were also excluded, because they did not represent injury/illness. Therefore, 2,889 claims among onshore workers in the seafood processing industry were included in this analysis. Workers’ ages ranged from 16–79 years, with a median of 37 years. Most claims (82%) were among men. Information on workers’ date of hire was missing for 75% of claims.

This is the first epidemiologic study to estimate risk, characterize injury and illness patterns, and identify modifiable hazards in Alaska’s onshore seafood processing industry. The majority of WC claim report narratives were sufficiently detailed to allow for OIICS and work activity coding. This study provides detailed information on injury/illness characteristics and circumstances, which can inform targeted prevention strategies and future research.

No fatalities among workers were reported during 2014–2015. This finding is consistent with CFOI data demonstrating that workers in this industry are at low-risk for fatalities.⁸ However, consistent with SOII data,⁹ the frequency and rate of claims for nonfatal injuries/illnesses are concerning. Each year, workers experienced over 1,300 injuries/illnesses for which they received compensation for medical treatment and/or lost work time. Compared to the all-industry average annual rate of 44 claims per 1,000 workers, the rate in the onshore seafood processing industry was significantly higher, at 63 claims per 1,000 workers. Furthermore, this claim rate likely underestimates the true risk of nonfatal injuries/illnesses. For example, in the limitations section below we discuss issues related to (a) utilizing WC claims as a data source, and (b) using worker counts as the exposure measure for calculating rates for a highly-seasonal industry. Studies in the Pacific Northwest seafood processing industry have also identified elevated rates of accepted WC claims. Research examining which industries in Washington State were high-risk for common, high-cost injuries found that the seafood processing industry experienced a rate of 31.1 claims per 1,000 FTEs during 2002–2010.²⁰ In Oregon during 2007–2013, there was an average annual rate of 24 disabling claims per 1,000 workers in the seafood processing industry, which was over twice the all-industry disabling claim rate. Disabling claims were a subset of all claims, representing the most severe incidents.²¹ More broadly, workers in food system industries across the United States (including food creation, processing, distribution and storage, retail, and preparation) are at high risk for fatalities, injuries, and illnesses. Prior research utilizing a farm-to-table analysis found that, compared to workers in nonfood system industries, workers in food system industries had a significantly higher morbidity rate (RR=1.62; 95% CI 1.3 to 2.01) and occupational mortality rate (RR=9.51; 95% CI = 2.47 to 36.58).³²

In the Alaskan onshore seafood processing industry, sprains, strains, and tears constituted one-third of all claims and most frequently affected workers’ trunk and upper limbs. Additionally, workers’ upper limbs frequently experienced musculoskeletal injury/illness due to cumulative trauma, as well as reported pain and inflammation, which could have been symptoms of musculoskeletal injury/illness. These results, which demonstrate the importance of preventing musculoskeletal injury/illness to workers’ upper limbs and trunk, are consistent with prior research.^{15–20, 22} Similar to seafood processors, poultry processors are at high-risk for musculoskeletal injuries/illnesses, particularly in their upper limbs.^33–34 In both animal processing industries, facilities are designed for rapid line production and then movement of the packaged product for storage and transport, requiring strenuous, repetitive manual labor and awkward postures. Given these similarities, interventions in the poultry processing industry might be translatable to seafood processing.³⁴ Following musculoskeletal injuries/illnesses among onshore seafood processors in Alaska, the next most common types of injuries were bruises, lacerations/punctures/amputations, and fractures – the majority to workers’ upper limbs. Exposure to seafood substances resulted in infections, dermatitis, and allergic reactions – including respiratory symptoms, which was consistent with prior research.^11–14 Crushing injuries, hearing loss, and concussions were also concerning because of their potential for causing long-term impairment.

Workers in the onshore seafood processing industry faced ergonomic-related, physical, biological, chemical, and psychosocial hazards. The most frequently occurring events were “contact with objects and equipment” (1,020) and “overexertion/bodily reaction” (993). As expected, processing/canning/freezing activities on the production line (818) and transporting/packaging/handling activities away from the line (495) were associated with the most injuries/illnesses. Common sources of injuries/illnesses included: repetitive motion and bodily position; floors/stairs/ground; fresh and frozen seafood; trays; boxes/cartons/bags; and processing machinery.

When deciding upon hazard controls, elimination and engineering controls should be favored over administrative controls and personal protective equipment (PPE), in order to provide the most effective protection.³⁵ Implementing ergonomic interventions is vital for improving safety and health in this industry. To develop interventions using a participatory approach, companies should implement ergonomic programs that include worker participation.³⁶ To prevent slips, trips, and falls, passageways should be kept clear of obstructions, with substances/seafood frequently removed. These factories are wet work environments, and proper drainage should be maintained, with appropriate gratings, mats, raised platforms, and surface design. Worksite assessments could include slip resistance testing.³⁷ Performing regularly-scheduled preventive maintenance, following appropriate lockout procedures, and properly guarding machinery and equipment could prevent injuries.^38–39 Less-hazardous cleaning product formulations should be utilized when possible. Potential strategies for controlling workers’ dermal and respiratory exposure to seafood substances, which resulted in infections, dermatitis, and allergic reactions, include wearing proper PPE on the processing line and while cleaning, as well as improving ventilation systems.¹³ Among all accepted claims, fewer than 10% fell under the remote site doctrine. Nevertheless, employers who operate remote worksites need to ensure the safety of dormitories, cafeterias, recreational areas, and surrounding grounds.

While not accounted for in this study using WC data, work organization factors potentially could have contributed to injuries/illnesses. In mass production manufacturing environments, physical and psychosocial stressors often include repetitive and monotonous tasks, rigid work pace with physically intensive work cycles, highly-regulated break patterns, and low decision-authority and skill discretion.⁴⁰ Workers in Alaska’s seafood processing industry are often on-duty for long hours every day (e.g., 12–18 hours per day) for weeks at a time.^4–6 With very long shifts, and when 12-hour shifts combine with more than 40 hours of work a week, workers’ physiological performance deteriorates and they experience increased injury rates and more illness.⁴¹

This analysis has several limitations. First, WC claims data likely underrepresent the true burden of nonfatal conditions, and are more representative of risk for acute injuries than illnesses and cumulative injuries, due to a wide variety of factors involving reporting and compensability, especially among vulnerable workers.^{23, 42} Second, using worker counts as the exposure estimate to calculate rates and make risk comparisons is not ideal, because this exposure estimate does not take into account the varying lengths of time that workers spend on the job throughout the year. In this highly-seasonal Alaskan industry, the workforce can fluctuate from a high of 20,500 in July to a low of 3,900 in December.¹⁰ Likewise, the regional claim rates do not account for potential operational differences, such as one region having more factories with year-round operations than other regions with mainly seasonal operations. Using full-time equivalent (FTE) worker estimates, which accounts for hours worked, would have provided better risk measures, but these data currently do not exist. Third, comprehensive workforce demographic data do not exist to calculate rates by age and sex. Fourth, the dataset did not provide information on long-term disability, and injury severity was not coded. Finally, the work activity coding for cumulative trauma was based on the narratives, which might not have accounted for the possibility that multiple types of activities could have contributed to conditions.

Future research is needed to estimate (a) comprehensive demographic data, and (b) FTE denominator data for all industries in Alaska, in order to calculate injury/illness rates that allow for more accurate risk comparisons. To develop a detailed work activity classification system, researchers could collaborate with companies to visit factories and document all stages of the process – from offloading the seafood from vessels to shipping out the packaged product. To better identify high-risk activities and the specific mechanisms of injury, researchers or practitioners could also perform ergonomic and safety assessments. Researchers or employers could investigate if injuries/illnesses are associated with certain times of season, shifts, or worker fatigue. The remote location of many worksites, away from advanced medical care, might influence treatment (including if they file for workers’ compensation) and outcomes, including severity and disability.

This study found that workers in Alaska’s onshore seafood processing industry were at elevated risk for injuries and illnesses and it identified modifiable workplace hazards. Our findings highlight the need for ergonomic and safety solutions to prevent musculoskeletal injuries/illnesses in this worker population. Across the United States, workers in food system industries are at high risk for fatalities, injuries, and illnesses.³² In contrast to the seafood processing industry, occupational safety and health in poultry and meat processing have received widespread attention. Recently, the United States Government Accountability Office made recommendations to increase efforts to study injuries, illnesses, and incident reporting among poultry and meat processing workers.⁴³ The seafood processing industry faces similar hazards, and likewise merits research, support, and resource investments. There is evidence that seafood processing companies that invest in safety and health can create an environment that protects their most valuable asset, the workers. For example, AKOSH’s Voluntary Protection Program (VPP) and Safety and Health Achievement Recognition Program (SHARP) acknowledge employers and employees who have made outstanding efforts to achieve exemplary safety and health at their worksites.^44–45 Currently and in the past, Alaskan seafood processing worksites have earned VPP and SHARP status.^46–47 Collaborations between industry, safety and health practitioners, and researchers could effectively identify, develop, and evaluate tailored interventions to improve the health and safety of seafood processing workers.