patient labor will will come to order for the purposes of conducting a hearing on the issue of under reporting of workplace injuries and illnesses  the occupation and i recognize myself for the purposes of an opening statement the occupational safety safety and health act of one nine hundred seventy requires a day u s department of labor to collect and compile accurate statistics on occupational injuries illness state ality in the united states accurate injury and illness records help the occupational safety and health administration better allocated resources accurately target targets inspections and evaluate the success of its efforts to improve the health and safety of american workers secretary folk sites are grossly inaccurate today we will hear about the growing numbers of of academic study to conclude the department of labor is actually counting the reporting as few as one third of all workplace illnesses injuries and deaths some of the an accounting can be blamed on the fact that millions of public employees and self employed workers are not required to report injuries and illnesses to their parmalee were some of it is a result of the difficulty in counting arche patient illnesses like cancer asthma that may appear years after workers an issue a workplace exposure however critics also correctly point to a more significant reason why the difficult to get accurate injury and illness data the nation's workplace injury and illness report card is based upon a system of self reporting by employers  system gives employers an incentive to under report injuries the fewer injuries and illnesses an employer reports the less likely it will be inspected by ocean the more likely it will pay a lower premiums for workers compensation there is also mounting evidence that a number of employers are engaging in intimidation in order to keep workers from reporting their own injuries and illnesses their recent charlotte observer investigation on the hazardous working conditions in north carolina's poultry industry revealed a shocking record of work abuse and exploitation often leading to crippling injuries and illnesses the observer also uncovered concerted efforts by discipline in and intimidate and fire workers in retaliation for reporting serious on the job injuries  observer found that workers were forced to return to work immediately after having surgery so the company would have would not have to file for workers compensation i want to commend the charlotte observer for their amazing work on this important story on revealing work and working conditions that remain hidden to most americans we learned about workers with shattered ankles and workers with hands went numb after thousands of repetitive motion workers who suffered serious knife cuts while on the job but none of these injuries appeared on the poultry company's accidents or injury logs as required by law we also read about the very same poultry processing plant probably claiming a perfect safety records records that were hard to believe if you know anything about the hazards working conditions under reporting of on the job engine injuries and illnesses is not a new problem nor is it an isolated one it happens in job sites across different industries and throughout the entire country as demonstrated by the extensive report released in this committee today it is it is a regular some practice for the steelworkers to avoid detection and therefore retaliation by management by keeping their injured hands in their pockets this is known as a buddy pocket syndrome it's a recent transportation committee hearing also revealed some are patterns in the rail industry and that the threats are not just limited to workers we will hear testimony today that occupational physicians are often pressured improperly report to to improperly report them provide an inappropriate treatment to injured workers in order to keep the incidents off of the osha log although there is widespread agreement that workplace injuries and illnesses are woefully unreported osha refuses to recognize that the problem exists the agency stubborn stubbornly refuses to perform thorough audits which further calls into question the accuracy of the statistics it relies on today we will hear testimony from a long time osha official about the agency's failure to seriously address this problem some will dismiss record keeping promises instead if it can paperwork violations but these infractions are anything but in significant without accurate injuries and illness statistics employers and workers are unable to identify and address safety and health hazards that ensure that the workers get appropriate medical treatment we cannot properly evaluate the status of our nation's workplace safety and health laws in this country if we do not start with accurate information we simply must not allow the lack of information to permit hazardous working conditions to go unaddressed putting workers limbs and lives at risk the purpose of today's hearing is to evaluate the extent and the cause of this problem and to learn what we can do to improve reporting in order to protect workers health and safety and i'm grateful to all of our witnesses for taking the time to join us today and i look forward to your testimony at this point i would like to recognize congress and mccain who is the senior republican committee for his opening statement thank you charlie miller and good morning we're here today to examine how the department of labor collect statistics on workplace injuries illnesses and fatalities and roche's record keeping system standard employer's record and report work related injuries illnesses and fatalities this data is then used to evaluate the effectiveness of the agency's practice and target industries and companies with high evidence rates for future inspection i understand that today's hearing was triggered in large part by a series of newspaper articles were published earlier this year in which it was alleged that a certain business has not been properly or accurately reporting its employees i njuries and illnesses to osha such an allegation is troubling and certainly warrants further investigation but mr chairman you know as well as anyone that i hesitate and i think we all has a tape to draw broad base conclusions from the examples that have not been fully investigated for that reason i hope today's hearing is approached as an opportunity to listen and learn rather than to seek evidence that supports existing conclusions osha's recordkeeping standard is an important tool that allows us to monitor workplace safety and target initiatives that can reduce injury and illness because of its importance i appreciate the opportunity to look more closely at the data collection methods used for the record keeping standard the information gathered through this standard helps ensure affective enforcement of workplace safety standards i also think we need to look more closely at the guidance offered to employers about what to record what to report and when to do so employers are held responsible for compliance with this standard which is why it's important that they be given clear guidance about their responsibilities i that the discussion today may turn to questions about the accuracy of the data associated with the record keeping standard it's a ballad concern and that's why i look forward to hearing from our witnesses with the bureau of labor statistics about the  process in place to ensure the integrity of the data reported and collected under this standard ultimately i think the greatest value we can draw from today's hearing is a greater understanding of the mechanisms in place to ensure the this distribution center a food warehouse and distribution center located in chandler arizona originally from chicago a c worked at home construction before moving to air arizona has the father of an eighteen year old and he worked as a baylor college of occupational environmental medicine he is a board certified occupational medicine physician additional certification in family medicine dr mcclellan has an extensive experience in occupational medical consultant to business in a wide range of economic sectors including health care manufacturing nuclear energy and public safety baru fellner is representing the u s chamber of commerce he is a partner and gibson dunn and crutcher in washington d c practice in the area of labor relations he's also worked in the office at the department of labor and the appellate court branch of the national labor relations board mr filner receives the a from george washington university a law degree from harvard law john w worser is served as assistant commissioner of safety health and working conditions  at the u s bureau of labor statistics since november two thousand and six dr richard responsible for the census of fatal occupational injuries the survey of occupational injuries and illnesses and special surveys mysteries are hoes and the doctor was or holds a witnesses because of the importance of getting complete full and truthful testimony the witnesses in an investigative hearing before the committee in congress are sworn in and our witnesses will will will be sworn today so before we move to your testimony if i could ask you to please stand and raise your right hand and i will ask of you do you swear that the testimony that you're about to give that you will tell the truth the whole truth and nothing but the truth that the record that the a witness is answered in the affirmative and thank you very much for that and now mr mr spann will hear from you under our system a green light will go on when you begin to testify which gives you five minutes and then  four minutes and your testimony in orange light will go on and give you an idea to start to wrap up but we want you to complete your thoughts and then a red light will go on when your five minutes is up again feel free to complete your sentences or your or your thoughts at that point nineteen to twenty dollars an hour your pay is drop you know a lot of people that work there for years they can't afford from their pay to drop the minimum wage is considered the price of gas and everything else there in arizona  started working witness a lot of things that need to be changed and so i mean more people that work with me decided to get a safety committee going we tried to approach the best of the you have to get the job done at the bash is a corporation or the selectors they pick the orders for one hundred sixty six stores you are put on a time limit to have pieces and have them ready within a certain jack and drive with no training you know it's very scary sight even to imagine that this is happening you know i never experienced anything like this before what i've seen and i hope that you know we can make a difference a big change thank you good morning and thank you for this opportunity i am robert mcclelland an occupational medicine physician and the immediate past president of the american college of occupational and environmental medicine known as a calm i served as the chief of the section of occupational and environmental medicine at dartmouth hitchcock medical center and is associate professor of medicine and community in family medicine at dartmouth medical school founded in one thousand nine hundred sixteen a com represents more than five thousand positions and other health care professionals and is largest medical society dedicated to protecting and promoting the health workers a cons interesting notion recordkeeping stems from our role as physicians with a dual mission we provide direct care to workers in the clinic and we serve as public health officers of the employed population over the last year i had the opportunity to tour the country to meet with occupational physician ems working in a variety of settings during these visits physicians reported that some employers exerted pressure on them to alter treatment and or return to work statement in ways likely to minimize osha record ability based on the frequency of this report i suggested that a calm convene a special session on osha recordkeeping at a comms recent annual scientific meeting my testimony today represents the results of preliminary exploration of this issue by our college social lot has grown to serve many purposes beyond that for which it was originally designed for example today many owners select contractors on the basis of the contractor's rates for lost work days and total recordable at its best this practice results in intensive efforts to improve safety as worst however the spotlight on the log produces efforts to make the log look good rather than placing attention on reducing risks a con members reported various incentive programs to produce to produce a good osha log have distracted safety programs from the primary goal of prevention when workers and managers are promise valuable prizes to avoid recordable injuries our members have observed pressures to under report in brief when a single metric becomes a focus of safety efforts it can become distorted by a variety of forces a cam a com has not conducted its own a systematic research on this issue but we find anecdotes of distorted reporting troubling indicating a process and a system in need of review because of the potential for causing both medical harm and flaws to to cicle results let me give just a few examples we observe first that there is a wide variability in employers understanding and application of the record keeping standard many employers make every effort to comply assiduously to the letter of the standard others particularly smaller employers find the rule inordinately complex and confusing and complete the log in correctly through ignorance of the rules a number of our members complain that the stink sins in the standard between first aid and medical treatment are nonsensical and dr bad medical practice several members indicate that selected workers employers and insurance companies have tried to influence medical treatment in ways that may result in harm to a worker or in some cases excessive costs for example certain employers have asked clinicians to write work is tolerated on the return to work form to avoid recording lost work days a member reported that the employer then expected the worker with a fractured leg to sit in a wheelchair at a construction site one member relayed an instance where a safety team it at a site without an on site medical office in appropriately controlled access to health care providers in the context of plant incentive programs that rewarded the absence of recordable injuries she intervened when she learned after worker was exposed to vinyl chloride safety personnel had applied a hazardous chemical potash to the workers skin since they had read that potash could be used to neutralize environmental spills in few of these examples and many others detailed in our written testimony it comes advocacy on osha record keeping is quite straightforward number one physicians must always do the right thing for the patients although health care providers do not have a regulatory obligation under the standard they do have an ethical obligation to correctly diagnose report and treat injuries number two we believe that osha must encourage a better understanding of the requirements interpretations of the record keeping standards number three it's time to consider updating the current osha record keeping standard and it's in force meant to minimize under reporting number four it is time for osha to consider undertaking a special emphasis program to increase the number of medical records reviewed as part of osha's audit and verification program of occupational injuries and illness records and number five  calm supports efforts to broaden the suite of occupational health indicators used at a national state and facility level in order to improve the quality of the data necessary to prevent work related injuries and illnesses our intention today is not to point fingers rather to seek solutions that are based on doing what's right for the patient and that are grounded in good science and best occupational medicine practices thank you thank you very much i'm sorry thank you chairman miller congressman mckeon and members of the committee for inviting me to talk about the workplace injury and illness statistics produced by the u s bureau of labor statistics the b l s provides annual estimates of workplace injuries illnesses and fatalities from two separate programs these are the census of fatal occupational injuries and the survey of occupational injuries and illnesses often called soy it is the survey that has come to be the focus of much of the underco allegations so it will be the focus of my remarks today the survey is a federal state cooperative program that estimates the number and rate of new non fatal workplace injuries and illnesses the data are obtained from a sample of employers who gather their information from osha logs and supplementary materials they keep throughout the year because the data come from osha logs the injuries and illnesses counted by our survey or osha recordable cases only these cases may differ from those counted and other data systems such as workers compensation and important advantage of the survey is that it provides the most complete occupational injury and illness counts available for the nation and consistently across states this includes estimates by state and industry that state policymakers use to track their own injury and illness experience compared to similar states other surveillance systems do provide some estimates of workplace injuries and illnesses however these other systems tend to collect only a small amount of data where they are not consistent across states recently some academic studies have asserted that our survey undercounts the total number of workplace injuries and illnesses a review of this literature suggests that three different types of under count are asserted first it is pointed out that the survey does not count most long latent occupational illnesses such as cancer the b l s has long acknowledged this point many work related illnesses take years to develop and may be difficult to attribute to a specific workplace a system based on employer records like our survey does not capture most of these illnesses instead the overwhelming majority of new reported illnesses in our survey are those that relate more directly to the workplace the undercount literature also mentions that we do not count occupational injuries and illnesses incurred by workers outside of the survey scope that is the survey does not include all public sector workers the self employed workers and households and on small farms to partially address this issue we are expanding our survey to include government workers starting with the two thousand and eight survey b l s will collect state and local government data for all states this will allow us to estimate provide estimates for some high hazard public sector occupations such as police and firefighters in addition b l s is exploring with osha ways to collect data for federal government agencies it is more difficult today to collect data for other groups of workers these workers principally the self employed are not covered by the occupational safety and health act and are not required to record injuries and illnesses in addition b l s samples establishment from a list of those on the state unemployment insurance roles the self employed are rarely on this list b l s has held discussions with the national institute for occupational safety and health or niosh and with some other groups on ways to utilize other data to estimate workplace injuries and illnesses for these not uncovered groups of workers the last undercount allegation is that our survey does not count some worker injuries and illnesses that are within the scope of the survey these allegations come from academic studies that match individual case data in the survey to data and other surveillance systems such as workers compensation studies typically find that the survey and the other data systems each miss a substantial number of cases the b l s takes claims of potential under reporting seriously and  number of activities to understand and if necessary address the issue first in two thousand and seven b l s conducted a quality assurance survey that indicated that the survey accurately captured the data entered on employers osha logs second instituted a program of research to examine and extend the previous data matching where the goal is to learn of certain types of cases and respondents show greater apparent under report counting and to determine what factors might explain these findings t s is also undertaking a pilot program of employer interviews to learn about injury and reporting and illness on osha logs and other data systems this is not in an audit of employer's osha logs which is an activity outside of gun research with matched workers compensation and survey data for a single state some preliminary findings suggest that a variety of factors may explain apparent undercount results one explanation is that there are legitimate differences between the types of cases that are included in different systems that academic undercount research previously mentioned tries to account for these differences another explanation is that some workers compensation cases for a particular year are entered into the worker's comp databases long after the end of that year in order to be timely our survey collects data soon after the end of the calendar year perhaps before some of these cases have been recognized finally there are some methodological issues that might magnify research estimates of the survey undercount for example our survey collects data for establishment while workers compensation data are reported by company when a company has multiple establishments it is difficult to determine in the workers compensation data for with a particular case comes from this makes matching individual cases difficult and when you fail to match cases in these systems it appears there is an undercount in summary the b l s provide believes that a variety of factors may account for the research showing differences between the cases captured in the survey of occupational injuries and illnesses and another data systems the b l s is issue instituted a program of research to understand and explain these differences within the constraints of its mission as a statistical agency b l s will continue to work to ensure that the survey accurately measures within scope workplace injuries and illnesses thank you thank you  good morning chairman miller members of the committee my name is bill ricks on there i am an attorney with a law firm of gibson dunn and crutcher here in washington and i very much appreciate your invitation to participate in this important hearing dealing with the extent of under reporting under osha is complex record keeping requirements i am appearing this morning on behalf of the united states chamber of commerce the world's largest business federation i'm also here in my personal capacity is that attorney was found himself on both sides having been a participant in the development of the law and policy of osha during his first decade and then a frequent critic of osha thereafter i hope to draw on this balanced experience in attempting to answer the critical question that underlies this hearing and that is does the current record keeping sister accurately reflect employers understanding of their osha record keeping requirements before turning to my prepared remarks i think it would be important to be directly responsive to the chairman's opening statement and specifically to one of the  underpinnings of the concerns that are expressed by this committee namely that there is an incentive on the part of employers to under record because the fewer injuries if i heard correctly this morning the fewer injuries that are recorded the less likely employers are to be inspected in response to the point made by the chairman this morning let me rely on the report of the a annual report on fatalities in the workplace of the a f l cio points out that as a result of the number of inspectors both state and federal the likelihood of employers to be inspected the seven million workplaces in the united states to be inspected is one so in a hundred years or so it seems to me that the incentive of underreporting in order to make the likelihood to be somewhat longer than once in a hundred years is a small incentive and i would think that this committee should look carefully before it jumps to the conclusion that that incentive in any practical or real aspect exists for underreporting based upon forty years of experience i believe that the steadily declining injury rates provided by osha and the bureau of labor statistics are and must be substantially reliable these statistics are the linchpin of oceans and forstmann and compliance policies and priorities and let me rely on the words of richard fairfax osha as director of enforcement under both democrat and republican administrations one of the most respected osha personnel and he said that inspectors search for underreporting in the charlotte observer said quote but when we try to track it down it goes nowhere period close quote osha uses at least two methods to try to track down under reporting first that compares information supplied by employers in high hazard industries with what is on their osha three hundred logs and then further compares those logs with medical records and second under its site specific targeting program it not only inspects employers with high injury incidence rates but also selects a statistical sample of employers with lower rates in order to find out whether or not they are cooking the books and they have concluded that the vast majority of establishment are in fact maintaining accurate records let me suggest now that those who disagree with that statement ignore the complex legal factual and regulatory framework that human resources personnel on a daily basis are asked to implement first human resource personnel are supposed to decide whether an injury has occurred secondly they are supposed to decide whether or not the workplace is the discernible cause of that injury those determinations are clear when an employee god forbid has an amputated finger as a result of an unguarded machine or falls off an unguarded platform and breaks his heart those decisions are far from clear and the dispute erupts when the focus shifts to working with pain and let there be no mistake we do not trivialize pe pain is real but the subjectivity of its symptoms and whether those symptoms constitute paso anatomic injury as well as the difficulty of ascertaining discernible causes raise a number of distinct challenges for any record keeper who aspires to perfect accuracy and let me further suggest to the committee that the issues are not only in the subjective area of pain but they also involve the more routine injury record asian questions any recording scheme that has forty six sections and two hundred pages of frequently asked questions has got to be a regulation which is difficult to implement and just to give you one example how much moe trin over the counter mo oring is prisk rip ssion oriented and requires record keeping as opposed to non prescription oriented motoring and doesn't require recordkeeping when is a soft splint you use versus a hard split a soft splint is not recordable when is oxygen used for purposes of treatment which is recordable for prophylactic glee when it is not record yourselves in the shoes of the staff that is trying to make these decisions on a day to day basis innocent error is unfortunate but in evitable let me conclude with a modest with a modest observation employers are doing a good and conscientious job we can all agree that there is clearly some underreporting and osha must remain vigilant to minimize it in order to maintain the integrity of its enforcement and regulation programs but the committee should focus on the scope of the problem the title of this hearing declares in the uncertain terms that we are dealing with a tragedy of deliberately hidden injuries such a conclusion ignores the real efforts that employers are making to accurately identify all work related injuries in a complex regulatory and medical environment this concludes my remarks i would like my more extended testimony to be submitted for the record i look forward to your questions thank you thank you dr rosen thank you for the opportunity to talk about the system to keep track of occupational injuries and illnesses in the united states a name is kenneth roseman i'm a physician an epidemiologist who has studied studied and written about surveillance systems for the last twenty five years recent newspaper articles have once again and i really want to emphasize once again highlighted shortcomings in the nation's efforts to track work related conditions a basic tenet for preventing and minimizing any diseases to have a system that provides accurate information on both the frequency and circumstances associated with those conditions such a system is essential in order to determine how much resources how to target interventions to evaluate those interventions and if necessary to redirect the interventions the current us system to count injuries occupational injuries and illnesses in the united states does not provide this necessary information in one thousand nine hundred eighty seven the national academy of sciences issue report counting injuries and illnesses in the workplace proposals for a better system as a consequence of that report and the deficiencies noted in the system some changes were made the most pronounced change was how acute work traumatic we're counted somebody dying because of a trench collapse being electrocuted falling off or scaffold as a consequence of these changes made in the tracking system the number of work related deaths doubled in the first year of the new system so they doubled this hundred percent increase in the number of deaths was not due to a sudden increase in the hazard to work but rather to the implementation of a new and system to  these death no such changes were made how work related diseases such as lead poisoning silicosis work related asthma were counted or how non fatal injuries such as amputations  in the last twenty years others have researched and published multiple studies that the current system provides an inaccurate count of work related illnesses and non fatal injuries there is no disagreement in the medical literature that an undercount exists and that this undercount is significant attached to my statement or fifteen references from the medical literature i want to quickly summarize the work for investigators first dr levy from the university of california davis whose work shows that the current system thirty three to sixty nine percent of all non fatal work related injuries he calculated using the current system that work related injuries and university who have shown interest in the six states of minnesota new mexico oregon washington west virginia and wisconsin that the current system misses up to fifty percent of non fatal work related injuries and  illnesses doctors friedman and frost from the university of illinois in chicago will shown that reductions in the non fatal work related injuries reported over the last decade are not due to improvements in the workplace conditions but rather reductions in osha's and force of record record keeping rules and changes by ocean the definition of work related injuries actually show that eighty three percent of the decrease in the last decade were due to these record changes by osha and not to any reduction in actual injuries and illnesses so that even one would hope if the underreporting was consistent that one could at least look at trends but their data says  my work with colleagues from michigan state university that show the current system is sixty six percent of work related injuries and illnesses in michigan we found that this undercount occurred across all different types of industries and for both injuries and illnesses in a separate study we showed that the current system missed one third of amputations and a similar study in minnesota also showed those results so  summary the current system to count work related injuries and illnesses has been repeatedly studied and shown by research is to have a large undercount expert panels that have reviewed the current system have reached a similar conclusion the current system for non fatal injuries and occupational injury illnesses relies solely on employer reporting and the previous speaker spoke to some of the problems with employer reporting and  current system ignores the large number of databases that are not dependent on coverage or compliance with osha recordkeeping these include hospital emergency room databases poison control cent state lab tory reporting regulations disease reporting laws and workers compensation what is needed is a comprehensive system for work related illnesses non fatal injuries that makes use of available on employer based data systems analogous to what now exists for dramatic work related fatalities currently the annual number of work related illnesses and injuries reported is based on a statistical extrapolat from a relatively small sample of employers about a hundred fifty to two hundred thousand out of our seven million employers statistical extrapolation from a wider range of medical data systems is essential if we are to have an accurate tracking system that will provide the basic numbers needed for targeting the effort to reduce these injuries thank you thank you very much mr whitmore yes before i get going i would just like to say how proud i am to see so many members here today and i want to say how much i appreciate your attendance and chairman miller ranking member mccann and other dedicated committee members my name is bob whitmore i'm a vietnam veteran within the additional thirty six years of government service at the u s department of labor i have directed the national osha engine on this record keeping system since one thousand nine hundred eighty and then the dems department of labor's expert leave in a non beauty status eleven months ago therefore at the outset i want to make it very clear that i am here today representing myself as a concerned citizen one with over twenty years of experience directly related to the subject of today's hearing i'm not here representing oh sure the department of labor contend that the current issue in june on this information is inaccurate due in part to wide scale under reporting by employers and which is willingness to accept these falsified numbers there are many reasons why osha would accept these numbers when one but one important institutional factor has dramatically affected the agency since one thousand nine hundred two regardless of the political party steady annual declines in the number of workplace injuries and illnesses make it appear that osha's fulfilling its mission in one thousand nine hundred two congress passed that holds osha accountable and we're going to be we're going to be judged by where these numbers go thanks to get all of us want to see ever duction in the number of workplace injuries and illnesses however this reduction must be the result of fewer injuries and illnesses actually occurring and not the result of falsified reporting is impossible to evaluate the effectiveness of any osha program if the data aren't accurate inaccurate data also make it harder to know how to protect america workers from real hazards to understand how we got to this point is a critically important to look at the history of the ocean recordkeeping system that history can be broken into three segments whatever referred to as the taxi fare era began with the start of the record keeping system in one thousand nine hundred eighty two and continue hundred eighty six while citations for record keeping topped the list of the most cited osha standard of regulation during this period the fines in these cases were usually one hundred dollars dollar fine to union carbide in west virginia for inaccurate record keeping during this period i've reviewed over forty cases in which we applied the newly developed instance by instance penalty policy allowing us to cite and find a company for each through ninety two i believe dr rooster wrote an article in eighty eight and ninety one with the robert smith that addressed that very fact employers ok why employers may have many incentives not to record injuries and illnesses accurately for example many plant corporate managers physicians and supervisors receive bonuses based on their osha recordable rates so when you enforce the recordkeeping rules cumulative trauma disorders does this mean workplaces are becoming more unsafe no it just means that we have had an act we had a more accurate picture of what was going on because employers were actually reporting injuries  go up when you enforce recordkeeping rules if you don't know force or rules will report a rates will go down will they go down the answer is yes and this is the most important point of my oral testimony not enforcing osha recordkeeping rules main many employers will not record injuries and illnesses affecting their workers to falling reported rates mean more places are actually safer and healthier no estimates about how many injuries and illnesses gone reported range from thirty to sixty percent i believe the in an attempt to make agencies quantify their performance with objective finding for the first time directly accountable for the rise and fall of the industry we're going to ask you if you can if you can wrap it up please thank you yes  information it doesn't take an expert to question these data when one looks at just a few examples he is still playing kentucky reported no cases on their federal local workers is that correct yes sir that's correct we have it already expanded the survey to include state and local government workers and any discussion of expanding that to part time employees which are rapidly growing sector of the economy and all in all employment areas not just you know to retail now it's a it's a it's all across the economy any worker who has an employment relationship with an employer is covered by our survey so we already capture many part time workers or i think maybe you're referring to the self employed and at this point in time we have on our back i marries in the question of whether or not in fact part time employees are accurately counted within ye captured the data for those injuries and illnesses to those workers will be captured you also into getting a statement toward the end the b l s is undertaking a pilot program of employer interviews and the reason why you're not him interviewing employees our focus is on employers because those are the entities that provide us with our data and it's that we have a list of employers to which we can go to the bureau of labor statistics uses a sample frame which is which consists of establishment let me go back to the testimony this morning and in the number of studies referred to here there's this suggestion that there's a niche mismatch between the interest of the employee and the employer why would you not conduct discussions with the employees about the reporting system i think that would have to be done by another agency that has access to a role of employees as opposed to employers we perhaps another agency such as the national institute for occupational safety and health good lord as are you are going you know if you don't have authority to talk to them we have a list of establishment so we go to sir and so we are in a lot of those establishment the two employees in that same establishment at this time sir we are focusing on talking with employers about the chosen not to talk to employees for this study we have chosen not to talk with so the study will only be about employers it will  will have half the picture when the study is all done we are hoping to understand the decisions that employers make about what they require and osha logs and how they file workers compensation claims and this impacts of course the kind of information that we receive dr mcclung can we get there without talking to employees on the on an official capacity as to what's taking place in the workplace i can't speak to the regulatory authority of mismatch of data we've got people looking at different databases and i think even dr risser suggested that we have different databases here is that accurate so i think the bottom line is we want to know how many occupational injuries and illnesses occur and so you know do you dismiss work or com dater because he has different definitions to me those are injuries and illnesses and they need to be considered and clearly all the medical databases the hospital discharge the emergency room data is being ignored and so i would say no it's not a mismatch it's just there's a lot more out there direction of discarding the record keeping regulation that is promulgated so and disregarding was aware of what does the what does the additional evidence outside of that system suggest to you to digital evidence suggests beyond the employer based survey doubled the number of workplace vitality and that's what i'm suggesting we need a system that needs counsel all the other injuries non fatal and illnesses that were missing and what was the third of amputation and there's a study from the university of minnesota that has similar day to day in minnesota third of a amputations were being missed by the current system what you're telling us that that's just not plausible that's just couldn't happen in that kind of a facility a steel steel mill could have to say i was highly skeptical would be an understatement and you have to understand  chairman miller that when they're talking about workers comp and it's your record keeping most compensable cases are osha recordable the reverse is not true many of the osha recordable so not fellner your testimony suggests that comparing workers compensation claims to osha recordable trees is an inappropriate comp peris i think we were discussing that talk a little bit about that and i think you didn't get a chance to fully explain that can you elaborate on that thank you congressman good i'd be delighted to do so the the cliche i used before was it's like counting apples and oranges and let me be a little bit more specific in that regard workers any attempt to compare a single osha record keeping regulation no matter how complex with worker compensation regimes begins with the following problem there is no single worker's compensation regime there are fifty of them and each one is distinct unto itself in so far as to how it categorizes and compensates for various injuries and illnesses to them with respect to the universe of employees that are subject to osha jurisdiction and recordkeeping once again it's apples and oranges workers compensation by and large includes self employed individuals it includes federal state and local individuals it includes a variety of other individuals that are not subject to osha jurisdiction the ten employees or less exception to osha jurisdiction immediately comes to mind so the universe that is looked at when you look at workers compensation injuries and illnesses is a much broader a much more expanded universe than is  involved in osha recordkeeping number three the definition of what constitutes an injury on the one hand and number two whether it is workplace related on the hand could not be more different in the workers compensation in the fifty workers compensation context then exists in ocean osha has its own definitional framework the fifty regimes have their definitional frameworks so to suggest that one can simply look at a worker's compensation list of injuries and illnesses and transpose them to osha record keeping and say direction very sincerely but it looked to me like the story again of the elephant with the three blind men trying to describe it one person touches the side of the elephant and says an elephant's a wall somebody your testimony says this happened under democrat and republican regimes the problems you have with this it's not a partisan thing although you know probably the the fact that we're doing it now with a democratic congress a republican administration kind of you know tends to think well it's it's all a republican problem that we're going to expose i think i'm glad we're having the hearing because i as i i come from a small business background and i'm i'm starting to think you know did we report all of our injuries do we know of all of our injuries we didn't have some of ours was retail business so we didn't have some of the problems that mr spann talked about you know where you have warehousing we didn't we didn't have that kind of a situation with big equipment that kind of stuff but  i can see problems i don't know exactly answers and i think we're going come up with a lot more questions today than than answers but i again appreciate you all being here  and and and i know if we get all of your full testimonies on the record and go through the questions we have or they probably would lead to we should have more hearings to find out more of what's what's going on and my time's  back i think the gentleman cerna recognized the gentleman from maryland mr sarbanes for five minutes thank you mr chairman i'm glad we're having this hearing today about fifteen years ago i worked on a report with the organization called the public justice center in maryland and we entitled it was it was a look at the poultry industry in particular and we called it the name of the report was the disposable workforce because what we found w a lot of evidence of some of the issues that have been described in the charlotte observer series but in protected to kill was happening is if you got hurt you were gone and that's why the workforce was disposable they didn't have access to care if they got hurt and the employers in those instances were taking advantage of the demand for the work to basically sideline people if they if they suffered an injury so i'm very very keen on the discussion that we're having today  i'm very focused as well on what we can do about it in terms of raising the vigilance within osha and one of the questions i had is a few of you have alluded to the fact  that they're sort of bonuses in incentives out there that reward i mean you know in addition to sort of the general reputation of a company for having a low a low injury report that inside the company there are incentives and bonuses for rimadyl people and others human resources whatever it is if the if that can is low and i wondered if anyone would speak to me we can talk start with dr rosemond speak to the question of whether that's just a practice that ought to be banned or prohibited or curbed in some way and what the potential to do that is i think  there certainly are practices out there as you describe that discourage workers from coming forward and some are incentives and some you know or sort of almost punishment if they  do the point i was trying to make is we need to go beyond an employer based system which when some way minimize whatever incentives or disincentives and we we have all these additional databases out there and i think it's very important as a point i try to make in terms of acute dramatic work related fatalities where the system has gone beyond employer base and i think it's very important i mean one could  law not allow maybe some of these incentives but i don't think that's really the total answer i think it's going beyond employer based system do you think there's enough do you think there's enough information out there in data that we could eliminate the undercount problem is that possible to do well we have to remember that the whole system for non fatal injuries is based on a statistical sampling and an extra and i think yes we're smart enough to use other data systems to do the extrapolation do a better extrapolation do a better statistical sampling so the answer is yes i response just like to point out that c s t e which stands for the council for state territorial epidemiologists have actually been looking at this issue for some period of time and have been a number of states now an ongoing project which uses a suite of nineteen different occupational health indicators i really for the purpose of trying to take a better look at the whole elephant recognizing that each one of these databases looks at only the arm or the the t whatever to use your analogy sir and so i think that there are certainly are a number of databases that could be linked that could improve the situation however i will also say that there are no databases yet that really help us very much thank you for your testimony today it's not easy to do what you've done i want to acknowledge that you're new to reside in my district and i'm very proud of that you had mentioned it in your testimony  is well statistics on you know steel plant that has zero reported injuries and so forth what is the system and i guess we heard a little bit about it but what's the system inside osha that would that would where that would pop up on a radar screen and trigger an investigation or somebody to go out and check the situation in other words how do we allocate the resources of osha across the different workplaces that we look at thank you mr sarbanes appreciate your comments bottom line is this ok osha inspect when there's a fatality when there's a complaint or if there's a planned inspection a targeted inspection i think the run recently announced for this coming year has like around four thousand the stablished months with high last time right no one's looking below five no one's looking at that i looked at it and said you know guys we can't go on like this there aren't mine pa steel mills out there some point today to talk a little bit about his numbers because in one instance he said in two thousand and five i believe it was there was one hundred audit stock one hundred we had put in for four hundred in the primary list ok they only did one hundred is that going to tell you everything you know they need to know about low employer reporting i don't think so i'm not the ph d statistician never wanted to be never will be i know that these low rates are bogus i have looked at him over my head over my career and they basically shut me down in one thousand nine hundred two thank you you seem to feel otherwise would you tell us why those are the odds in your estimate are not adequate well we have to be a little careful here because the word audit is thrown around a lot and i know it's hard for you guys it's hard for me and i have to deal with this stuff on a fairly regular basis there's a separate program that does records audit checks ok just to give you an idea in two thousand and six the last one i believe that was done there were twenty four employers in that sample that had more than two hundred fifty employees i don't think we can say a whole heck of a lot for all them lawyers above two hundred fifty employees based on a sample of twenty four ok and the audit sir done the critical thing you have to understand that when our auditors in this audit program go in they say i want to see certain folders on certain people like representative here i want to see your medical records who do you think get some form the employer who do you think can sim the folder the employer you're totally dependent because they don't follow up with a medical access order to go to the hospitals the clinics are used to check that's where we get our big cases not every employer is you know is dumb enough to have the goods right there and hand him over to you but there are cases where that happens and don't get me wrong there are a lot of really good big employers around ok you know everybody says i think ninety percent are doing the right thing and my response has been throughout my career give me the ten you take care of the ninety they're doing a great job give me the ten that don't care about their employees and don't care about what osha does or stands for  the gentleman from michigan mr gilding apologize i had another hearing this morning on resources committee but i i read your testimony appreciate the testimony i can just recall things years ago i'm seventy eight years old i can recall my dad who worked in the plant and how things were then may come a long way since then but there's there's human nature it's a good side to give the nature nurture the bad side human nature and at times we have to make sure the law protects people from the bad side human nature and i can recall my dad almost being killed in the plant by being pulled into his machine couldn't had an open capacity to turn his own machine off that was a long time ago that was in the thirty's but human nature remains the same and  law protects people against the shortcomings of employers and and that is a ten percent that's a ten percent we want to make sure that our watches and protects their employees from the night very much appreciate the testimony this morning and thank you mr chairman thank you very much mr spann i apologize i came in late this morning when your went and i missed your testimony i wonder if you could talk a little bit about your injury and the effects you know and any repercussions you had from reporting the injury and you know the effect of these incentive games that they playing in terms of being able to thank you and i like to say that i was hurt doing my job at the bass's warehouse my supervisor standing next to me we were alone tractor trailer and i got some debris in my eyes which they did not have any safety glasses anything like that was given to me and i went home and the next day i had an affection so i went to the emergency room after calling my doctor about me being a diabetic i have to be real careful and contact my supervisor at the warehouse and explain to him what happened the plant matters explained to him what happened and what situation i was in and the doctor gave me some days off work because of infection i had in mind and he did i mean he told me to bring in the documentation who take care after returning back to work with the doctor my doctor documentation stating that he kept me off of work for few days and the reason why he did take the papers and he also punish me by giving the point that and he tried to deny that it ever happened but my supervisor explained that he was standing there when she did did take a carrier and from that point i don't know what happened but i checked the osha to have the log and it's not even mentioned in that but on the osha law but i was just listening to this guy here to my love state and the facts and figures for the osha papers are right and i'm just you know i'm a worker i know from experience not from what i'm told and wh your testimony which i miss you said that you know make sure i heard you right that you you received ten minutes of training to drive a forklift yes what would you say is the average time for a person to become reasonably proficient minutes to drive a pallet jack not need to remind you that these the equipment that i had to use to perform my job i would have to be able heavy equipment all through the eight hour shift as well as the people who've been hired who united states and these are the ones that's been recorded pick about the ones that's not being recorded well let me ask you if i could mr filner something that troubling to me dr rosen as i understand it rosen did a study argue that the ergonomic issues are hard for employees to diagnose and and that their record keeping regulations are complicated but it would seem to me that amputations aren't too hard for employers to be able to diagnose and yet with the b l s only estimated study but to the extent that that study relies in whole or in part on workers compensation data to the extent that it does then my prior response to congressman mckeon would apply and that is the extent to which that six hundred eighty includes individuals not subject to osha has jurisdiction then we are indeed talking about apples and oranges appropriate numbers of amputations were recorded under o and appropriate worker's compensation amputations occurred pursuant to his examination just one final comment we may be talking about apples and oranges but we're talking about people who've lost limbs too and i think that when we have an under reporting sixty percent you know whoever is responsible for not getting the numbers correctly can be apples and oranges it can be apples and anything but the fact of the matter remains these are these are people these are workers who've been armed severely harmed and i do not mean to denigrate any amputation god forbid for one second the question is whether those workers were subject osha's jurisdiction and i would have to look much more closely at his study in order to make that determination and respond to your question ok the my time's up i'll come back to you dr oz because i know you wanted to come in the chair would no recognize gentle lady from california as well as the for five minutes thank you mr chairman and i am so sorry that i've missed most of the questions so i'm going to ask a question that i think you all can answer for me but i have two points the first point is the answer to your question probably has to do with who you who's hired you to work for them on this which i find quite disturbing  but when we're doing such a poor job i believe in collecting the real data on workforce injuries and when we have a hard time reporting  severed limbs amputations how in the world do we report help which isn't obvious and near misses i mean because it's where i was a human resources professional for twenty years and that was back at the beginning we had cal osha and actually near misses made the difference quite often mcclellan that question and then any of the rest of you know thank you for the question because it's a question of significant concern to our members and most of our members who when asked by an employer employer to advise them as to how to take good measure of how the employer is doing with respect to health and safety would advise them to look beyond simply the osha log and very much to include first aid reports as well as as you point out near misses the difference between a few millimeters scratch on the skin which requires a bandaid it might be considered a first aider or a near miss and a significant la perhaps a deer enough to cause an amputation is luck not safety and so the point here is that the osha log itself will not give a true look for the purpose for really which we have it in which is to  the bottom of the iceberg in order to prevent anyone from getting on the ocean log for the real reason because it's safe well mr span if an employer had an appropriate  committee safety committee wouldn't would near misses a report on with internally of near misses a good indicator to the committee of what needed to be  determine what needs to be change and what steps they may take to make the place even safe to work with a bit to go to work you know said you have to go to work and look around you scared on what's going to happen or what limb is going to be called of today a work injured worker is ready to go back to work or a worker in poor health is ready to come back to work if they were put back on light duty with full pay would there be any objection to that question a lot of people would go back to work of the like get their forte yeah and the be able to support their family and pursue the american dream like we all that we have just support our families and you know the price of gas today who could afford to take off work business will say thank you very much real quickly near misses the really good companies out there they're collecting information on near misses already ok because they understand what you're saying i think you're right about safety and health program a good one should have that this right here is a picture from the charley observer of a gentleman's ankle with one two three four five screws in it this was a near miss there's a real hit and didn't get recorded it was an oversight company raffles or other incentive programs in your workplace today in courage workers to be more safe or do they encourage workers to do perhaps hide their injuries do not have any engines in your department so most of the people will love to take their wife on a cruise to california is a great american whatever the case may be so i believe it's using to keep people quiet from report fresh laceration obviously had just occurred requiring sutures and he asked the he asked the physician to consider this has not work related that to pretend that it had occurred the night before because to consider it work related would mean that his entire team would miss out on an opportunity for steak dinner we reviewed emergency department data and so was there was work or conference station data but we also looked at emergency i think it's important this issue whether it's within the scope or o a i mean as a health care provider i'm interested in amputations and i'm interested in preventing imputations and i think it's too narrow to say well osha may not cover this i think we need to think about work related injuries and illnesses and how are we going to prevent them in the united states and one other point i'd like to make is you know there's been it's true this issue that mr filner has raised about worker comp well maybe that's a different fruit but you know in seven states this is now been looked at and there in seven states are not being counted in the current annual survey oil and in these studies these people all had at least three last work days so these were people in the worker's comp system in michigan it was seven days away from work in some of the states because each state does vary but in all seven states people with at least three days away from work were not being counted in our current statistics and to me that's not apples and oranges those people who are off work because of a work related injury and illness and they were the department of labor take care of american workers the mission of take care of american workers i'm very appreciative of his work i want to do it's job  honestly and openly i want to show you this from the charlotte observer series this is their safety program it's a t shirt and it  thank all the town for coming i just wanted to enclose the just say something here it seems mr moore brought up a great point we have you know it's ninety percent of the employers are doing the right thing and reporting this our job is to to make sure that those to those people who work and with the temper sent who aren't i'm thoroughly convinced is under reporting going on to the t shirt you know maybe it's just pan i was just thinking as a teacher you wear that adventure land or something you know it's just incredible this is a great hearing and i have the honor of being able to talk to chair the last part of it it's been my first chance to sit in this chair but he thank you but he did bring up a good thing i think to one last thing i think it's important that we just don't talk to the employers when we going to find out what's going on in that factory or that that plant we've got to talk to the workers they do the work every single day because using it they're the ones getting hurt they're the ones that have seen their coworkers getting hurt if we just really only talk to the employer we will never really is as the chairman said ever get a real picture of what is actually going on there and i hope and someday we will get to where workers actually had the very same rights and the opportunity to to to be able to stay safe let me just remind the members of the fourteen day summit additional materials for the record i think all of you for taking time out of i know busy schedules to