Scope and Magnitude of Work Injuries

The only routinely published, national source of information about occupational injuries andillnesses in U.S. workers is the Annual Survey of Occupational Injuries and Illnesses (ASOII) conducted by the Bureau of Labor Statistics (BLS) of the U.S. Department of Labor. This survey is a random sample of about 250,000 private-sector establishments, but it excludes self-employedworkers, farms with fewer than 11 employees, private households, and all government agencies. The ASOII provides estimates of workplace injuries and illnesses from information that employers provide to BLS from their OSHA Form 200 log of recordable injuries and illnesses.

BLS has conducted this annual survey since 1972 and has thus provided basic information about cases of occupational injury or illness that required more than first-aid (including medical treatment, restricted work activity, or days away from work). This information includes the total number of cases categorized on the OSHA Form 200 log as either an injury or an illness. The illness data are separated into six subcategories; the category that contains most (but not all) musculoskeletal conditions is disorders associated with repeated trauma. This illness category also includes illnesses associated with noise-induced hearing loss, but MSDs account for the largest proportion of these cases, especially in recent years. All back disorders or injuries are placed in the single, broad injury category, which also includes all other types of injuries such as lacerations, fractures, and burns.

From this part of the ASOII, BLS reports that in 1995, 308,000 (or 62%) of all illness cases were due to disorders associated with repeated trauma (excluding low-back disorders, which are listed as injuries). The number of repeated trauma cases increased dramatically, rising steadily from 23,800 in 1972 to 332,000 in 1994—a 14-fold increase. In 1995, the number of cases decreased by 7% to 308,000 reported cases; but this number still exceeds the number of cases in any year before 1994.

Because these summary data did not adequately describe the nature of occupational injuries and illnesses and the related risk factors, the ASOII was redesigned in 1992 to capture more detailed information about injury and illness cases requiring days away from work. This redesigned survey captures demographic information about injured workers as well as the following characteristics of the injury or illness: (1) the employer’s description of the nature of the injury or illness, such as sprain or carpal tunnel syndrome; (2) the part of the body affected by the specified condition, such as back or wrist; (3) the source of the injury or illness that directly produced the disabling condition, such as a crate, heavy box, or a nursing home patient; and (4) the event or exposure that describes the manner in which the injury or illness was inflicted, such as overexertion during lifting or repetitive motion. The BLS data are based on information provided by employers from their records of work-related injuries and illnesses and then coded into these categories.

For injury and illness cases involving days away from work, BLS reports that in 1994 (the last year for which the detailed data were complete when this report was prepared), approximately 705,800 cases (32%) resulted from overexertion or repetitive motion. Specifically:

• 367,424 injuries were due to overexertion in lifting; 65% affected the back. Another 93,325 injuries were due to overexertion in pushing or pulling objects; 52% affected the back. In addition, 68,992 injuries were due to overexertion in holding, carrying, or turning objects; 58% affected the back. Totaled across these three categories, 47,861 disorders affected the shoulder. The median time away from work from overexertion injuries was 6 days for lifting, 7 days for pushing/pulling, and 6 days for holding/carrying/turning.

•83,483 injuries or illnesses occurred in other and unspecified overexertion events.

•92,576 injuries or illnesses occurred as a result of repetitive motion, including typing or key entry, repetitive use of tools, and repetitive placing, grasping, or moving of objects other than tools. Of these repetitive motion injuries, 55% affected the wrist, 7% affected the shoulder, and 6% affected the back. The median time away from work was 18 days as a result of injury or illness from repetitive motion.

The highest incidence rates (IRs) of work-related injuries and illnesses from over- exertion occur among workers in nursing and personal care facilities, scheduled air transportation, and manufacturing of travel trailers and campers. As Table 1–1 indicates, these industries have rates of overexertion disorders four times higher than the average rate for all private industry. More than 2 million workers are employed in the three highest-risk industries alone. However, rates are not available by occupation within these industries, and not all workers within a high-risk industry will be at equal risk of developing a work-related MSD.

Industries with the highest IRs of work-related injuries and illnesses from repetitive motion include a number of garment manufacturing sectors such as knit underwear mills, men’s and boy’s work clothes, and hats, caps, and millinery; these industries also include manufacturing sectors such as textile bags, potato chip and similar snacks, motor vehicles, and meat packing plants (Table 1–2). These industries have IRs that are more than eight times the rate for all private industry.

Not all workers in these high-risk industries are exposed to the working conditions associated with these clearly elevated rates of illnesses and injuries from overexertion and repetitive motion; however, smaller proportions of workers in other industries may be similarly exposed. For example, trucking and courier services, an industry employing over 1.6 million people, had IRs for overexertion disorders that were almost three times higher than the average rate for all private industries. Thus, these employment estimates provide a conservative approximation of the number of workers with heavy exposures to high-risk conditions.

The BLS data are surveillance information that might contain misclassifications of both exposure and health outcomes. However, some industries have notably and consistently elevated rates of musculoskeletal injuries and disorders that are not likely to be attributable to data collection or coding. Note that decisions about the event or exposure that resulted in an injury or illness are associations rather than causal inferences. Nevertheless, they provide some perspective on the magnitude of work-related MSDs.

Although workers often consider MSDs to be work-related, their reports of back pain do not appear to affect the reliability of their self reports about exposure to physical work. In the Ontario study [Liira et al. 1996], 24% of the long-term back disorders were related to bending and lifting, working with vibrating machines, and working in awkward postures. Interestingly, 8% of the population were exposed to at least two of these three factors, and an additional 3% were exposed to all three.

The impact of work-relatedness is demonstrated by the elevated MSD rates for certain industries in workers’ compensation data as well as the BLS data. For example, in the State of Washington workers’ compensation system, the overall IR of work-related MSDs was 3.87/100 workers in 1992, 3.72 in 1993, and 3.52 in 1994. Work-related MSDs in this study were defined as injuries and illnesses involving sprains/strains, joint inflammation, low-back pain, and nerve-compression syndromes. Four industries had rates at least four times the 1992–94 average rate: wallboard installation (23.6/100 workers per year), temporary help-assembly (23.6), roofing (19.9), and moving companies (18) [Washington State Department of Labor and Industries 1996].

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see also:

Table 1 Work Accidents - Injury and illness rates from overexertion causing missed work
Work Accidents - Private sector industries with the highest incidence rates of injuries

How Bad Is It? Scope and Magnitude of Work Injuries
national source of information about occupational injuries andillnesses in U.S. workers

Learn More Workplace Accident Lawyer
Learn more about workplace accidents and employer safety requirements.