In a previous blog, Robin Kobayashi discussed how the Charlotte Observer uncovered the underreporting of injuries at poultry plants. Click here.  The newspaper's investigation led to a House committee hearing on June 19, 2008 regarding the underreporting of workplace injuries and illnesses.

The following is a quick guide of the key points in the House Report. If you want to read the full House Report, click here.

Summary of Conclusions. Based on collections of data by the Department of Labor (DOL) made pursuant to the Occupational Safety and Health Act of 1970, officials at the DOL and the Occupational Safety and Health Administration (OSHA) often cite declining numbers of work-related injuries, illnesses, and deaths to demonstrate the effectiveness of their programs. However, in a staff report released in June 2008, the Committee of Education and Labor of the United States House of Representatives has concluded that work-related injuries and illnesses in the United States are chronically and even grossly underreported, rendering meaningless the numbers upon which DOL and OSHA base their claims. Basing their conclusions on academic studies, federal and state reports, media reports, and worker testimony, the Committee concludes that as many as 69 percent of work-related injuries and illnesses are not included in the Survey of Occupational Injuries and Illnesses (SOII), the nation's annual workplace safety and health report generated by the Bureau of Labor Statistics (BLS).

Need for Accurate Recordkeeping. The report notes the importance of accurate recordkeeping, recognizing that for employers and employees, obtaining an accurate count of injuries, illnesses, and other indicators of workplace health and safety is essential in order to:

• Identify the root causes of workplace accidents and illnesses;
• Address unsafe conditions at work;
• Ensure that workers get appropriate medical treatment; and
• Establish an effective management safety system. 

OSHA's Operational Goals. The report also recognizes the importance of accurate recordkeeping for fulfilling the operational goals of OSHA, as accurate injury and illness data is essential in order to:

• Target OSHA inspections at the most dangerous worksites;
• Set OSHA priorities and identify high-hazard industries where aggressive enforcement programs may be required;
• Judge the effectiveness of OSHA programs already in place; and
• Determine the state and trends of workplace health and safety in the U.S.

Recordkeeping Requirements. The report notes that OSHA establishes recordkeeping guidelines for employers to follow, although employers are only required to log injuries and illnesses if they involve lost work time, medical treatment other than first aid, restriction of work or motion, loss of consciousness, or transfer to another job. The BLS then selects a representative number of employers to report injury and illness data for use in creating the annual SOII. The BLS also makes independent efforts to determine work-related fatalities, using sources such as death certificates, workers' compensation records, news accounts, and employer and police reports to verify the accuracy of workplace fatality statistics. OSHA also collects annual injury and illness information directly from employers in 80,000 larger establishments in high hazard industries, excluding construction and maritime industries, targeting those companies with the highest injury rates.

Review of Academic Research.  Citing numerous academic studies from the past decade, the report concludes that the SOII drastically underestimates the number of workplace injuries and illnesses suffered each year in the , perhaps failing to report almost 70 percent of lost-time injuries and illnesses in the last decade. In addition, although the SOII suggests dramatic decreases in the rate of worker injuries and illnesses in the last decade, these independent academic analyses suggest that the rates have actually remained relatively constant or declined only modestly. The report also notes one study that concludes that changes in OSHA recordkeeping requirements had contributed significantly to the decline in injuries and illnesses reported in the SOII, contrary to the conclusion that any real reduction in workplace injuries and illnesses has occurred. The report also notes media and academic studies that provide evidence that musculoskeletal disorders (MSDs) are significantly underreported. For example, one newspaper reported that while one South Carolina poultry processing plant reported no MSDs over a four-year period, 12 employees who worked at the plant during that period said they suffered pain brought on by MSDs and two had surgery for carpal tunnel syndrome at company expense. Other studies confirm the underreporting of MSDs, concluding that actual rates of MSDs in the workplace may have been two to six times higher than those reported in OSHA logs or in the SOII.

Reasons for Underreporting. The report suggests many reasons why workplace injuries and illnesses are being underreported in the SOII:

• Because of limited OSHA jurisdiction, the SOII automatically excludes self-employed workers, farms with fewer than 11 employees, employees of federal, state, and local government agencies, and private household workers. These uncounted workers constitute over 20 percent of the total workforce. Government workers alone, including high-risk occupations such as police officers and firefighters, account for over 14 percent of the workforce.
• Illnesses suffered by workers are particularly difficult to identify as work-related, especially when the illness has a long latency period between exposure to some toxin or pathogen and diagnosis of a resulting disease.
• Immigrants are less likely to report workplace injuries and illnesses. They often confront language problems, are more likely to work in jobs that provide no health care or paid sick leave, and may fear employer retaliation that could result in loss of employment or even deportation, if they are undocumented.
• Workers often will not file workers' compensation claims because of the difficulty of the workers' compensation system and because employers sometimes discourage the filing of such claims.
• OSHA has removed a specific reporting box for MSDs from employer record logs, and while employers are still required to report MSDs, elimination of this specific MSD reporting box may result in severe underreporting of MSDs. This underreporting is compounded by the fact that MSDs caused by work often mimic non-occupational disorders.
• Many employers may be confused about reporting criteria and OSHA staff is often not sufficiently trained to provide accurate advice.
• Many employers have strong incentives to underreport workplace injuries and illnesses. In addition to looking good to the public and to customers, low injury and illness rates decrease the chance of being inspected by OSHA, decrease workers' compensation expenses and keep premiums down, and can earn bonuses and incentives for businesses and contractors working on public contracts.

Employer Tactics to Discourage Accurate Reporting. Citing evidence from worker interviews, labor union reports, academic studies, and media investigations, the committee report also discusses employer actions that can discourage workers from reporting injuries and illnesses or otherwise result in inaccurate reporting. Among these actions are:

• Direct intimidation of workers, through use of both subtle and overt means, including threats of pay cuts, denial of overtime or promotion, harassment, and even termination from employment.
• Bringing injured workers, even seriously injured workers, back to ``light-duty'' work immediately after injuries, even after major surgery.
• Discouraging employees from receiving appropriate medical attention in order to avoid an obligation to file an injury or illness report, which can include providing minimal treatment to workers at company health clinics.
• Discouraging physicians from reporting injuries or diagnosing illnesses, for example, by ``bargaining'' over the wording of a work status report or otherwise exerting pressure on doctors to treat injuries with minor, and often inadequate, treatment that does not trigger an obligation to file an injury report.
• Giving employees a fixed number of days off for all purposes, including sick leave or recuperation from an injury, with termination from employment the penalty for exceeding the allotment.
• Establishing safety programs and games with prizes or bonuses that provide work crews with incentives for going ``accident free'' for a certain period of time, thereby creating an atmosphere of peer pressure and reluctance to report injuries.
• Providing manager incentives and bonuses when crews under manager control report no injuries and illnesses.
• Requiring employees to undergo drug and alcohol testing before receiving treatment after an accident or injury in order to intimidate employees.
• Utilizing contractors or otherwise contracting out the most dangerous work, as injuries or deaths to contractors are not required to be listed on an employer's OSHA log, nor do they register as injuries or deaths in the primary employer's industrial classification, even if the injury or death occurs at the employer's work site.
• Misclassifying workers as independent contractors instead of regular employees, thereby avoiding both workers' compensation obligations and OSHA recording requirements when these workers are injured.

Underreporting in the Railroad Industry. The report reviewed a 2007 U.S. House of Representatives Committee on Transportation and Infrastructure review of railroad employee injury reporting practices, which noted some of the same techniques used by railroad management to harass employees into not reporting injuries:

• Placing employees in jeopardy of being disciplined by assigning points for safety incidents, rule infractions, and injuries.
• Targeting injured employees for increased monitoring and testing.
• Having front-line supervisors discourage employees from filing injury reports.
• Having supervisors accompany injured employees to medical appointments in order to attempt to influence treatment decisions.
• Requiring injured workers to come to work, even if they are provided nothing to do at work but sit.
• Requiring employees to work a certain number of days per year in order to maintain status as a full-time employee.
• Basing management compensation on performance bonuses that include a component for recordable injury statistics.

The Role of Behavioral Safety in Theories of Accident Causation. The report criticizes the theoretical basis for many safety programs that rely on discipline or reward to reduce industrial injuries--the notion that most workplace accidents are caused by the unsafe behavior of workers--noting that the consequences of a system of rewards and punishment is often a failure to report injuries, rather than an actual reduction in injuries. Relying on expert accident causation analysis, the report notes problems with this simple incentive-based approach to reducing workplace accidents:

• Accidents first require the presence of unsafe conditions, such as slippery floors, objects too heavy for safe lifting, management ratification of frequent deviations from the use of safe procedures, inadequate training, ignoring past warnings and close calls, lack of supervisor oversight, and pressure for increased production.
• Most accidents have many complex causes, and human error is almost always a consequence, or last link in the causal chain, rather than a root cause. Root causes might include outdated or malfunctioning equipment, budget cuts that adversely affect safety conditions, worker fatigue, poor training, and ignoring numerous warnings or ``near misses.''
• Blaming workers for accidents can make safety problems worse, as the lack of a culture that encourages workers to report injuries may result in failure of management to investigate incidents or take appropriate steps to correct safety problems. In addition, employers often blame employees for not following proper procedures even when management knows that procedures are rarely followed, or workers have not been properly trained, or procedures are outdated, or fatigued workers are under pressure to meet production goals.

OSHA's Role in Ensuring Accurate Reporting. Although OSHA conducts recordkeeping audits which it states indicate that employer injury and illness logs are a reasonably accurate reflection of those injuries and accidents actually reported by employees, the committee report notes that these audits, which include interviews with sample employees, may miss those workers who are afraid to report or choose not to report an injury or illness to the employer, to workers' compensation, or to other insurance providers. The report also notes that while the Occupational Safety and Health Act makes it a violation to discharge or otherwise discriminate against an employee who files a complaint or institutes a proceeding under OSHA, there is no direct mention in OSHA rules of employer actions that discourage reporting.

Measures of Safety Problems Other Than Injury Rates. Despite the tendency to utilize employee injury, illness, and fatality rates as indicators of workplace safety, the report notes that other measures may provide more accurate indications of workplace safety. For example, in petroleum refineries, chemical plants, and other complex operations dependent on process safety, records of process upsets, ``near miss'' reports, audit results, equipment inspections and reports of small chemical releases can be much better indicators of potential hazards than the slips, trips, and falls that make up most injury reporting. However, these leading indicator measures are not usually recorded by employers or monitored by OSHA or BLS.