The current national surveillance system for work-related injuries and illnesses may miss two-thirds of the total number of occupational injuries and illnesses, according to a study led by Michigan State University, East Lansing Professor Kenneth D.Rosenman and team in an article in the April Journal of Occupational and Environmental Medicine.

"Based on the results of our analysis we estimate that the number of work-related injuries and illnesses in Michigan is three times greater than the official estimate derived from the BLS annual survey," Dr. Rosenman and colleagues report. Whereas BLS statistics suggest that work-related injuries affect 1 in 15 Michigan workers per year, the new results suggest that the true rate is closer to 1 in 5.

These are fairly shocking numbers. It is well known that workplace injuries, and especially illnesses are underreported. OSHA's ergonomics rulemaking revealed, for example, that musculoskeletal injuries were underreported by half. But this is the most significant estimate of under-reporting that I have seen.

Rosenman blamed the problem on several factors. First, the BLS system excludes government workers in the 26 states where public employees don't have OSHA coverage. In addition, BLS excludes the self employed and farms with fewer than 11 employees. With occupationally related diseases, employers may not know that employees have contracted occupational diseases years after they had left their employment.

In my view, one of the most significant reasons may be "the perception by employers of financial and regulatory disincentives for complete reporting." Herein may lie not only the main problem with reporting, but also the most dangerous effect of underreporting.

OSHA currently bases its inspection targetting on employer self-reporting. In other words, low number of injuries and illnesses mean a smaller chance of being inspected. The study's "perception" of regulatory disincentives for complete reporting is, therefore, more of a reality. While it is illegal for an employer to refuse to list a reported injury or illness, we have seen employers use a variety of means to discourage workers from reporting injuries and illnesses.

Behavioral and safety incentive programs that reward workers or groups of workers who don't report injuries is one way to use peer pressure to keep reporting down (if not actual injuries.) Disciplining "unsafe workers" who report injuries is another method used by employers to discourage workers from reporting injuries.

We saw both of these methods used most recently when the The Oakland Tribune reported last year of the amazingly low injuries and illnesses record of KFM Joint Venture and their lead firm Kiewit Pacific Co in the repair of the Oakland Bay bridge. The company had a "Foreman Safety incentive Program" in which they doled out $100 to $2,500 bonuses, depending on the number of worker hours logged without a recordable injury. Crews were given cash bonuses for not having any so-called "recordable" injuries for a month's worth of work. On the other hand, KFM also suspended workers who reported injuries.

It doesn't have to be this way. Rosenman's study reports that the BLS, responding to 1987 report by the National Academy of Sciences which showed that the BLS national estimates missed 50% work-related deaths (from accidents), launched the Census of Fatal Occupational Injuries (CFOI). CFOI data is is derived from a variety of sources (such as state vital statistics registrars, coroners, and medical examiners; state departments of health, labor and industries, and workers' compensation agencies; state and local police departments; and state farm bureaus) and doesn't depend on employer self-reporting. However, no such system has ever been implemented to improve national injury and illness reporting.

Not only are the methods of collection different between CFOI and the BLS injury and illness reporting system, but so are the results. Using CFOI, BLS reports that workplace fatalities have gone up two years in a row. But using the traditional injury and illnesses employer self-reporting method, injuries and illnesses continue to go down year after year.

Kind of makes you wonder....

Labels: Behavioral Safety, Ergonomics, Recordkeeping