— A Proverb
By Karen O’Hara
Sometimes a tragic loss results in a calling. When Shawn Boone, 33, died in 2003 of burns suffered in an aluminum dust explosion at his workplace in Indiana, his sister, Tammy Miser, took a crash course in work-related fatality investigations. “In my struggle to obtain information, it became clear to me there was a need for a centralized resource for families experiencing a workplace death,” she said. “You assume there is a process, but you don’t know what it is or what the regulations are, because you never expect something like this to happen.”
Ms. Miser made it her mission to establish the United Support Memorial for Workplace Fatalities (USMWF), a non-profit organization that assists families and others affected by workplace deaths. USMWF advocates on behalf of victims’ rights, lobbies for occupational health and safety protections, and provides a broad range of resources to survivors, including an online memorial page with photos and tributes.
“Part of my motivation was that I wanted to understand our family’s legal rights and what we were entitled to know,” she explained. “There are some people with whom you are so close – like my brother was to me – and when you suddenly lose them, you need to know exactly what happened.”
Ms. Miser estimates about one-third of reported work-related fatalities in the U.S. find their way onto the USMWF website (www.usmwf.org) from a variety of sources. Regardless of the cause of death, if it happens at work, USMWF will post it. The organization’s motto is: “…Because going to work shouldn’t be a grave mistake!”
Fatalities Mount
Despite efforts to protect them, people die on the job, and each work-related death represents an incalculable loss in terms of human suffering. In 2008, the most recent year from which comprehensive data are available, 5,214 workers were killed on the job – an average of 14 a day – and an estimated 50,000 more died from occupational diseases, according to U.S. government statistics. In April of this year, 29 men died in a blast at Massey Energy Co.’s mine in West Virginia. The BP oil rig explosion in the Gulf of Mexico killed 11 men, and seven more workers suffered fatal injuries in a fire at the Tesoro refinery in Anacortes, Wash.
These types of disasters garner national media attention and serve as a wake-up call. Singular fatalities get far less publicity, but they have a profound cumulative effect. In the last eight days of April alone, nine other fatalities and one incident involving multiple hospitalizations were reported to the federal Occupational Safety and Health Administration (OSHA). (1) Several of the fatalities that occurred between April 23-30 involved pressurized equipment failures. A deputy was shot; a plumber slipped while loading a truck; a man working in a corn storage bin suffocated when he was engulfed by grain; a track maintenance supervisor was electrocuted by a high-voltage rail; a slate roofer fell 18 feet onto a porch; and a man was crushed while cutting a bundle of pipe.
Weekly Toll: Death in the Workplace, a blog to which Ms. Miser and other USMWF volunteers contribute, suggests additional fatalities occurred during the last week of April that were not reported to OSHA. For example, USMWF bloggers posted the following: two police officers killed in separate vehicle-related incidents; two miners who died when a roof fell; a construction worker killed when a trench collapsed; a train conductor who fell and was struck by a locomotive; and a sewage treatment facility explosion that killed one worker. The discrepancy between OSHA statistics and blog entries may be attributed, in part, to ongoing investigations about work-relatedness, timing lapses and varying information sources, Ms. Miser said.
Injury Rates
In addition to fatalities, approximately 4.6 million occupational injuries were reported in 2008.
On a positive note, non-fatal workplace injuries and illnesses among private industry employers in 2008 occurred at a rate of 3.9 cases per 100 equivalent full-time workers, a decline from 4.2 cases in 2007, the Bureau of Labor Statistics reports. The total recordable injury and illness incidence rate among private industry employers has declined significantly each year since 2003, when estimates from the National Survey of Occupational Injuries and Illnesses were first published using the 2002 North American Industry Classification System.
However, government officials and labor leaders believe the actual number of injuries that occur annually is considerably higher than what is reported. In the 2010 edition of Death on the Job: The Toll of Neglect, the AFL-CIO cites estimates ranging from 9 to 14 million work-related injuries a year, with associated direct and indirect costs of $156-$312 billion. According to OSHA, more than half of reported cases require a job transfer, work restrictions or time off. Meanwhile, approximately 9,000 workers are treated daily in hospital emergency departments; about 200 of them are hospitalized.
Loss is Costly
To quantify the monetary cost of accidents, injuries and fatalities, the National Safety Council (NSC), a non-profit organization focused on injury and fatality prevention, estimates both dollars spent and income lost.(3) Estimates are approximate because so many factors can come into play. For example, calculable costs of work-related motor-vehicle crashes include wage and productivity losses, medical and administrative expenses, vehicle and property damage, and employers’ uninsured costs. In Table 1, total per-death costs are estimated using averages based on respective injury/death ratios. Multiplying the number of deaths by these average costs provides an estimate of the economic loss associated with both deaths and injuries in these categories.
In terms of death rates by industry, the agriculture, forestry, fishing and hunting industries topped the list in 2008, with 29 fatalities per 100,000 workers, surpassing mining with 21, transportation and warehousing with 13, and construction with nine per 100,000 workers.
While statistics show that some occupations are inherently dangerous, others involve risks that are not as readily apparent. For instance, scientists at the National Institute for Occupational Safety and Health (NIOSH) recently reported that the wholesale and retail trades sector accounts for a disproportionately high percentage of work-related injuries and illnesses in private industry. In a study, they found that overexertion and contact with objects/equipment are the leading causes of injury or illness in that sector, accounting for 57 percent of incidents.(4)
Disabling Injuries
Even though a community generally will not be able to estimate the number of disabling injuries that occur in work, home and public non-motor vehicle situations in any given year, it is useful to understand the approximate economic loss per death and per disabling injury in these three classes of accidents, NSC officials say. Table 2 from the NSC shows the per-case average cost of wage and productivity losses and medical and administrative expenses. The figures do not include any estimate of property damage or non-disabling injury costs and is not intended to be used to estimate total economic loss to a community from these kinds of injuries.
According to the Liberty Mutual Safety Index, 2009, which is based on 2007 data compiled by Liberty Mutual, a leading workers’ compensation insurer, the U.S. Bureau of Labor Statistics and the National Academy of Social Insurance (NASI), a non-profit organization, more than $52 billion in direct U.S. workers’ compensation costs are attributed annually to disabling work-related injuries and illnesses. (5) Overexertion is the leading cause of these injuries, followed by falls.
In August 2009, the NASI released a study on U.S. workers’ compensation payments for medical care and cash benefits for workers injured on the job: Payments increased 2 percent to $55.4 billion in 2007, the most recent year with complete data. The grand total includes $27.2 billion for medical care (an increase of 3 percent compared to the prior year) and $28.3 billion in wage replacement benefits for injured workers (an increase of 0.8 percent).
“The costs to employers for workers’ compensation are what they pay each year. For employers who buy insurance, costs are premiums they pay to insurance companies plus benefits they pay under deductible arrangements in their insurance policies,” the NASI reports. “For employers who insure their own workers, costs are the benefits they pay plus administrative costs. In 2007, employers paid a total of $85 billion nationwide for workers’ compensation.”
Federal Response
Workers Memorial Day, marked annually on April 28, honors men and women who have suffered job-related injuries, illnesses, and death. Acknowledging the day, John Howard, M.D., NIOSH director, said:
“The challenges and opportunities that we face as occupational health and safety professionals are clear:
1. We must work to eliminate, once and for all, the hazards that still persist in the industries on which our economy is built. No one should suffer a job-related injury or illness.
2. We must anticipate and engage the health and safety needs of the changing workplace. A rising generation of strong, capable workers is vital for America’s economic recovery and prosperity.
3. We must develop and use new technologies and methodologies that will shape more rapid, more effective workplace interventions.
“Scientific research is a fundamental driver of progress. NIOSH is honored to lead the strategic efforts that contribute to better recognition and understanding of occupational hazards, development and application of new preventive measures, and evaluation of those measures. We are committed to working with our diverse partners in those endeavors as wisely and as diligently as we can. In memory of the men and women who are honored on Workers Memorial Day 2010, we can do no less.” (Editor’s Note: Dr. Howard will be the keynote speaker at RYAN Associates’ National Conference, Oct. 11-13 in Boston. Watch for details in the next edition of VISIONS.) On the same occasion, Labor Secretary Hilda Solis noted: “In April, our nation’s consciousness was jarred by the loss of workers in the Upper Big Branch Mine disaster in West Virginia, an oil rig explosion south of Louisiana and a refinery fire in Washington state.
“The pain brought on by each of these tragedies is beyond comparison, and we should not think of the incidents as isolated. The fact is they all involve worker safety issues, which merit national attention and point to a disturbing pattern of deadly neglect that our country can no longer tolerate. “…The mission of the Department of Labor’s worker safety and health protection agencies is clearer than ever. And, our effort to save lives through enhanced enforcement, a forward-looking and progressive regulatory agenda, expanded outreach and a relentless commitment to enforcing the law has never been more necessary.”
OSHA Activity
OSHA is among federal agencies placing a renewed emphasis on workplace safety. For example, the agency plans to use a fiscal 2011 budget boost to significantly increase its regulatory enforcement efforts, which diminished when the Bush administration emphasized voluntary compliance and protection programs. In recent testimony before the Senate Health, Education, Labor and Pensions Committee, Dr. David Michaels, an occupational and environmental health professor who recently took over the helm at OSHA, made several suggestions:
- Make violations of the Occupational Safety and Health (OSH) Act that result in a death or serious bodily injury felony offenses.
- Require employers to abate serious, willful, and repeat hazards after a citation is issued, regardless of whether the case is contested. Currently, abatement is not required during the contest period, which can extend for years. Dr. Michaels said OSHA has identified at least 30 workers who died on the job between 1999 and 2009 during the contest period triggered by a citation. “The only situation worse than a worker being injured or killed on the job by a senseless and preventable hazard is having a second worker needlessly felled by the same hazard,” he said in prepared remarks.
- Trenching fatalities and serious injuries should result in presumptive willful citations because hazards associated with unprotected trench work are widely recognized.
- Give OSHA inspectors authority to “tag” a hazardous condition that poses an immediate danger of death or serious injury, which would require the employer to take immediate corrective action or shut down the operation. The Mine Safety and Health Administration (MSHA) already has this authority.
- Allow repeat citations for similar violations at workplaces in states with their own OSH enforcement agencies.
- Provide OSHA protections to public employees, unless the state where they work does.
- Give the agency greater latitude to protect contract workers by amending the OSH Act’s general duty clause.
Efforts are already underway to revise outdated regulations. In addition, OSHA scheduled a series of daylong meetings in June to collect public comments on proposed rules for Injury and Illness Prevention Programs, known as I2P2. As proposed, rather than wait for an inspection or a workplace incident to trigger correction, employers would be required to implement a plan to proactively identify and eliminate hazards.
Meanwhile, OSHA released 15 years of data on worker exposure to toxic chemicals. These data provide insights into the levels of toxic chemicals commonly found in workplaces, and how exposures to specific chemicals are distributed across industries, geographical areas and time.
“We believe this information, in the hands of informed, key stakeholders, will ultimately lead to a more robust and focused debate on what still needs to be done to protect workers in all sectors, especially in the chemical industry,” Dr. Michaels said.
Other Agencies on Board
Mining: Following the Big Branch mine disaster, the MSHA launched a coal mine inspection blitz in an effort to uncover workplace health and safety violations. At a May 20 hearing, Joe Main, MSHA director, told a U.S. Senate subcommittee the Justice Department is conducting a “serious criminal investigation” into what led to the explosion at the mine. Mr. Main said MSHA is evaluating organizational changes to better cover the high concentration of coal mines in West Virginia.
Transportation: In the Department of Transportation, Secretary Ray LaHood formed a safety council to tackle critical issues facing the department’s 10 operating divisions, including the Federal Motor Carrier Safety Administration (FMCSA), which oversees the trucking industry. “Now is the time to identify and address the top safety issues that cut across our agencies,” Mr. LaHood said. “The council will take our commitment to safety, which is our highest priority, to the next level.”
Minerals Management: Secretary of the Interior Ken Salazar has ordered a restructuring of the Minerals Management Service to ensure the independence of its inspection and enforcement duties. Mr. Salazar also sent a letter to Congressional leaders asking for their input on agency reforms. “We have a responsibility to ensure that the operation and oversight of offshore operations are following the law, protecting the workers, and guarding against future incidents and spills,” he said in a letter to Congressional leaders. “The reforms will change the way the Department of the Interior does business in the offshore program to ensure that we fully attain these goals.”
Emergency Management: Federal Emergency Management Agency (FEMA) Administrator Craig Fugate announced the launch of a new mobile web site, m.fema.gov, to make it easy for disaster victims to access emergency preparedness and disaster assistance using a smartphone. A companion site, www.disasterassistance.gov/disasterinformation/deepwater.html – is designed to help Gulf residents and businesses affected by the oil spill file claims against BP.
Grassroots Interventions
While change at the federal level is percolating, there remains an ongoing need at the grassroots level to address risk factors that contribute to work-related injuries, illnesses, and fatalities. Risk factors to which employees are subject are numerous. Besides inherently dangerous conditions in some industries, they include stress, depression, and fatigue. Studies show employees who feel unappreciated at work, have personal problems or are involved in conflicts with supervisors or co-workers are more likely to be inattentive or careless. Other risk factors include production quotas; inadequate training; ineffective use of personal protective equipment, lax rule enforcement; and failure to identify and eliminate hazardous conditions. Some employees with chronic medical conditions have repeated absences. Others show up for work but are not fully productive because they are in pain, are taking medications that affect function or simply lack energy.
It is widely acknowledged that many of these factors can be addressed by occupational health and safety professionals with preventive solutions such as:
- onsite education and safety training;
- behavioral health evaluations and interventions, including medication, bio-feedback and/or counseling;
- ergonomic assessments and workstation/tool adjustments;
- medical surveillance;
- pre-placement and fitness-for-duty physical screening; and
- exercise, weight loss and smoking cessation programs.
In addition, occupational health professionals can help employers create a foundation for workplace safety year-round by emphasizing what may seem on the surface to be relatively benign risks, according to Job Genius, a publication of Express Services, Inc. Oklahoma City.(6) For example:
Sleep: For every 90 minutes of sleep lost per night, daytime alertness is reduced by 32 percent, studies show. In a National Sleep Foundation survey, about one-third of respondents said lack of sleep affects their quality of life. Not getting enough sleep is associated with diabetes, heart disease, obesity, and depression. The Centers for Disease Control and Prevention recommends adults get seven to nine hours of sleep a day.
Stress: Stress is linked to health issues such as high blood pressure, headaches and stomach ailments, anxiety, and depression, and it can lead to job dissatisfaction, poor performance, absenteeism, and turnover. Employers and employees should be encouraged to focus on task management (priority-setting) and sustaining a healthy work-life balance.
Overexertion: Strains and sprains resulting from overexertion on the job can largely be avoided with ergonomic interventions, training on proper lifting and work posture, job rotation, frequently scheduled stretch breaks and other mechanisms.
Overtime: Employers and workers should be aware of the dangers of working harder, not smarter. Studies suggest that working excessive overtime affects one’s attitude as well as one’s cardiovascular fitness. Finally, employers and employees are strongly encouraged to prohibit the use of cells phones and other electronic devices while driving. According to the National Safety Council, motor vehicle accidents are the leading cause of work-related fatalities, and it is estimated at least 25 percent of all crashes involve talking on a cell phone. Last year, more than 200 state bills were introduced to ban cell phone use while driving.
References
1. Weekly fatality/catastrophe report; www.osha.gov/dep/fatcat.
2. Death on the Job: The Toll of Neglect, 2010; AFL-CIO; www.aflcio.org.
3. Injury Facts,® available in booklet form or on CD-ROM under a multi-use license; www.nsc.org.
4. Occupational Fatalities, Injuries, Illnesses, and Related Economic Loss in the Wholesale and Retail Trade Sector; V Anderson, et al., NIOSH; Am J Ind Med, ©2010 Wiley-Liss, Inc.; available ahead of print: www3.interscience.wiley.com.
5. Workplace Safety Index, 2009; Liberty Mutual Research Institute for Safety; www.libertymutual/researchinstitute.
6. Five Risky Things You Do at Work – Break These Habits to Stay Safe: www.expresspros.com/us/jobgenius/2010/06.
