Asymmetric impact of the 2012 Occupational Health and Safety Law on occupational injury and disease reporting in Türkiye: An interrupted time series analysis with emphasis on emerging female occupational disease patterns.

Objectives

This study aimed to characterize 18-year trends in occupational injury (OI) and recognized occupational disease (OD) in Türkiye's compensation-based surveillance, with emphasis on emerging female disease patterns and on the impact of the 2012 Occupational Health and Safety (OHS) Law.

Methods

We extracted nationwide annual data (2007-2024) from Social Security Institution Statistical Yearbooks. We computed rates per 100 000 insured, the OI/OD ratio, and sex-stratified International Classification of Diseases, 10th Revision (ICD-10) sub-code distributions. Segmented regression with two intervention points used Newey-West heteroscedasticity- and autocorrelation-consistent (HAC) standard errors.

Results

The proportion of recognized OD among women rose from 0.9% (2007) to 25.5% (2024) but with marked asymmetry: respiratory OD remained 96% male while nervous-system OD shifted from 24% female (2018) to 75% female (2024), driven by ICD-10 G62.2 toxic polyneuropathy (26 of 40 female cases in 2024). Female musculoskeletal OD rose from 20% to 34% with dominant upper-extremity repetitive-motion sub-codes; no female silicosis was recorded 2018-2024. Annual OI rose 9.1-fold (80 602 to 733 646); recognized OD declined (1208 to 888). The 2012 OHS Law produced an OI level change of +584 per 100 000 (P<0.001) but no statistically significant OD level change (P=0.32); the OI/OD ratio rose from 67 to 826.

Conclusions

The convergence of women's share of OD toward 25% masks marked diagnostic asymmetries: women are visible primarily through feminized service-sector and chemical-exposure categories and scarcely in pneumoconioses. Reform priorities include diagnosis-stage notification, active screening of female workers in mixed-exposure environments, and gender-sensitive occupational history-taking.