US workplace injuries underreported, study shows

By Tom Eley

18 November 2009

A new Government Accountability Office (GAO) survey reveals that the number of workplace accidents and illnesses in the US is underreported, the result of pressure on company doctors and nurses to conceal or minimize injuries, workers fearful of reporting them, and ineffective government workplace safety enforcement.

Among 1,187 company doctors, nurses, and health care professionals surveyed by the GAO, more than one half said that company officials have pressured them to minimize workplace injuries and sicknesses. Over one third reported that they have been told to curtail medical treatment so that workplace injuries would not have to be reported.

More than two thirds of surveyed medical personnel said they know of employees who feared being fired or otherwise disciplined if they reported their injuries. ”Workers may not report a work-related injury or illness because they fear job loss or other disciplinary action, or fear jeopardizing rewards based on having low injury and illness rates,” the GAO says.

Also contributing to the underreporting of injuries are company incentive programs that award prizes and bonuses to workers and plants that report few injuries, the GAO points out.

The Occupational Safety and Health Administration (OSHA), the federal agency tasked with monitoring workplace safety in about half of US states, routinely fails to interview workers to verify employer claims about their injuries, according to the report.

OSHA seldom audits workplaces, conducting only about 250 inspections of the roughly 130,000 work sites for which it has responsibility. These audits typically come about two years after accidents have occurred—by which time many of the injured workers have switched jobs—and rely heavily on company log books.

“OSHA does not always require inspectors to interview workers about injuries and illnesses—the only source of data not provided by employers—which could assist them in evaluating the accuracy of the records,” the report notes.

Law requires companies record in log books any accident that leads to time missed at work or any injury that goes beyond routine first aid. But the system is based on self-compliance, and employers have an obvious interest in minimizing workplace injuries. Reporting low injury rates avoids regulatory scrutiny and lessens the costs associated with insurance and workers’ compensation, while increasing the likelihood of winning production contracts.

Among other methods of limiting their reported injury levels, company health practitioners report responding to serious injuries with first aid—for example, treating cuts that require stitches with only bandages.

In other cases, employers seek additional medical opinions on injuries until they arrive at a non-serious diagnosis. “One practitioner said that an injured worker’s manager took the worker to multiple providers until the manager found one who would certify that treatment of the injury required only first aid, which is not a recordable injury,” the GAO reported.

The GAO also reports that OSHA does not examine injuries in all industries, among them eight “high hazard” injuries, including ski and amusement parks, Great Lakes transportation, and industrial laundries.

Democrats in the US Congress requested the GAO study in response to widespread skepticism over official workplace injury and sickness statistics, which claim a steady decline took place from 1992 to 2007. Academic studies have suggested that official federal statistics may overlook as many as 69 percent of all work site injuries and sicknesses.

Officially there were 4 million reported cases in which workers were injured or became sick and 5,600 died as a result of workplace conditions in 2007, the last year for which statistics are available.

The GAO report makes clear what workers already know well: owners and management are able to trample over safety and environmental regulations with impunity, and employees have little recourse to defend themselves. Created in 1970, OSHA’s regulatory authority has been gutted by successive Republican and Democratic administrations. Since its creation, it has realized only a handful of convictions in workplace accident and death cases.