0 

HIDDEN TRAGEDY: 

Underreporting of Workplace Injuries and 

Illnesses 

A MAJORITY STAFF REPORT BY 

THE COMMITTEE ON EDUCATION AND LABOR 

U.S. HOUSE OF REPRESENTATIVES 

THE HONORABLE GEORGE MILLER 

CHAIRMAN

June 2008 
1 

TABLE OF CONTENTS 

Executive Summary........................................................................................................................ 2 

Introduction..................................................................................................................................... 4 

Why is Accurate Recordkeeping Important?.................................................................................. 4 

Background: The Recordkeeping System....................................................................................... 5 

The Status of Recordkeeping: An Academic Research Review..................................................... 7 

Estimates of the BLS undercount vary, but it is clear that the SOII misses a significant 

number of workplace injuries and illnesses................................................................................ 8 

The annual downward trend reported in the SOII is also questionable..................................... 9 

Ergonomic injuries are significantly underreported. ................................................................. 9 

Why Are Injuries And Illnesses Underreported?.......................................................................... 11 

Certain categories of workers, accounting for a significant portion of the workforce, 

are excluded from the survey. ................................................................................................... 11 

Occupational illnesses are particularly difficult to identify as work-related........................... 11 

Immigrants are less likely to report workplace injuries and illnesses...................................... 12 

Workers are often reluctant to apply for workers’ compensation. ........................................... 12 

The musculoskeletal disorder column has been taken off of the OSHA 300 Log. .................... 13 

Some workers and employers do not understand the reporting system.................................... 13 

Employers have an incentive to underreport............................................................................ 14 

Methods used by employers to discourage accurate reporting. ............................................... 15 

Direct intimidation of workers.............................................................................................. 15 

Bringing seriously injured workers right back to work ........................................................ 17 

Discouraging appropriate medical attention ......................................................................... 17 

Discouraging physicians from reporting injuries or diagnosing illnesses ............................ 19 

“No fault” absentee policies.................................................................................................. 19 

Safety incentive programs and games................................................................................... 19 

Manager incentives and bonuses: ......................................................................................... 21 

Drug testing after every accident or injury ........................................................................... 21 

Contractors and contracting out dangerous work ................................................................. 22 

Misclassification of workers:................................................................................................ 23 

Underreporting Problems in the Railroad Industry....................................................................... 24 

Behavioral Safety: Bad for Safety, Bad for Recordkeeping Accuracy......................................... 25 

OSHA’s Role in Ensuring Accurate Reporting ............................................................................ 29 

Other Measures Can Be Used To Target Unsafe Workplaces...................................................... 31

Appendix 1: House Hearings on Education and Labor, 110th Congress ...................................... 33 

Appendix 2: Glossary ................................................................................................................... 34 

Appendix 3: Academic Study Table............................................................................................. 35
2 

Executive Summary 

The Occupational Safety and Health Act of 1970 requires the Department of Labor to 

collect and compile accurate statistics on the extent of occupational injuries, illnesses and 

fatalities in the United States. Employers are also required to keep accurate records of 

workplace injuries, illnesses and deaths. Top officials at the Department of Labor (DOL) 

and Occupational Safety and Health Administration (OSHA) often cite declining injury, 

illness and fatality numbers to demonstrate the effectiveness of their programs and to 

fight off criticism that OSHA has abandoned its original mission of setting and enforcing 

workplace safety and health standards. 

But extensive evidence from academic studies, media reports and worker testimony 

shows that work-related injuries and illnesses in the United States are chronically and 

even grossly underreported. As much as 69 percent of injuries and illnesses may never 

make it into the Survey of Occupational Injuries and Illnesses (SOII), the nation’s annual 

workplace safety and health “report card” generated by the Bureau of Labor Statistics 

(BLS). If these estimates are accurate, the nation’s workers may be suffering three times 

as many injuries and illnesses as official reports indicate. Despite these reports, OSHA 

has failed to address the problem, relying on ineffective audits to argue that the numbers 

are accurate. 

Experts have identified many reasons for underreporting. Twenty percent of workers—

including public employees and those who are self-employed—are not even counted by 

BLS. Work-related illnesses are difficult to identify, especially when there are long 

periods between exposure and illness, or when work-related illnesses are similar to other 

non-work-related illnesses. In addition, recent changes in OSHA’s recordkeeping 

procedures have affected the accuracy of the count of musculoskeletal disorders (MSDs). 

Finally, some employers are confused about reporting criteria and OSHA staff is often 

not well-trained to provide accurate advice. 

But a major cause of underreporting, according to experts, is OSHA’s reliance on selfreporting by employers. Employers have strong incentives to underreport injuries and 

illnesses that occur on the job. Businesses with fewer injuries and illnesses are less likely 

to be inspected by OSHA; they have lower workers’ compensation insurance premiums; 

and they have a better chance of winning government contracts and bonuses. Selfreporting allows employers to use a variety of strategies that result in underreporting of 

injuries and illnesses: 

• Workers report widespread intimidation and harassment when reporting injuries 

and illnesses. Reports, testimony and news accounts show that many employers 

have fired or disciplined workers who report injuries and illnesses or complain 
3 

about safety hazards. Others have added “demerits” to an employee’s record for 

reportable injuries or illnesses or for absenteeism that allegedly result from 

“safety violations.” 

A recent Charlotte Observer series, “The Cruelest Cuts,” details the experiences 

of poultry workers who were disciplined, harassed and fired for reporting injuries, 

like shattered ankles, numb hands from tens of thousands of repetitive motions 

every day, and serious knife cuts. Many of their injuries often never appeared in 

the plant’s OSHA injury and illness logs. Steelworkers have described a problem 

called “bloody pocket syndrome,” where workers hide their injuries until after 

their shift to avoid being disciplined. 

• Employers have been reported to provide inadequate medical treatment and force 

workers back to work too soon after serious injuries – sometimes right after 

surgery – so that their injuries will not be properly recorded. 

• While they may be well-intentioned, widespread and popular safety incentive 

programs which provide awards for a period of time without a recordable injury, 

can have the effect of putting pressure on workers not to report their injuries. 

Keeping track of the number of workplace injuries and illnesses that occur every year in 

the United States is not just an exercise in paperwork. For individual employers and 

workers, accurate counting of workplace injuries and illnesses is essential to identify and 

address safety and health hazards and to ensure that workers receive appropriate medical 

treatment. On a national level, accurate records are important to evaluate the state of 

worker health and safety in the country so that OSHA can effectively allocate its scarce 

resources, accurately target its inspections and evaluate the effectiveness of its efforts. 

Several studies in the 1980s identified serious problems in the system of recordkeeping 

for injuries, illnesses and fatalities. As a result of those studies, significant changes were 

made in the way that fatality data were collected, and other changes were made in 

employers’ reporting requirements. Twenty years later, as more evidence of 

underreporting is generated, it is time to take another serious look at the recordkeeping 

system. 

This report reviews the importance of accurate recordkeeping, evidence that injuries and 

illnesses are significantly underreported, the reasons why injury and illness statistics are 

underreported, methods that some employers use to discourage reporting, other measures 

that may be more helpful for OSHA and employers to identify workplace safety 

problems, and OSHA’s failure to address these problems adequately. 

In compiling this report, majority staff has conducted interviews with a large number of 

employers, employees and labor representatives and has reviewed numerous academic 

studies, news articles and investigations, employer safety programs, and federal and state 

reports and investigations. 
4 

Introduction 

The Occupational Safety and Health Act of 1970 requires the Department of Labor to 

collect and compile statistics on the extent of occupational injuries, illnesses and fatalities 

in the United States. Employers are also required to keep accurate records of workplace 

injuries, illnesses and deaths. But extensive evidence from academic studies, media 

reports and worker testimony show that work-related injuries and illnesses in the United 

States are chronically underreported. A number of reports blame much of this 

phenomenon on intimidation and harassment of workers in retaliation for reporting 

injuries. 

This report reviews the importance of accurate recordkeeping, evidence that injuries and 

illnesses are significantly underreported, the reasons why injury and illness statistics are 

underreported, methods that some employers use to discourage reporting and OSHA’s 

failure to address these problems. 

Why is Accurate Recordkeeping Important? 

For individual employers and workers, accurate counting of injuries, illnesses and other 

safety and health indicators is essential to identify the root causes of workplace incidents 

and illnesses, to address unsafe workplace conditions, to ensure that workers get 

appropriate medical treatment and to establish an effective management safety system. 

In addition, accurate recordkeeping is essential on the national policy level to ensure that 

the goals of the Occupational Safety and Health Act, to ensure safe workplaces, are 

fulfilled: 

• Targeting of OSHA Inspections: OSHA relies on accurate injury and illness 

data to target its inspections at the most dangerous worksites. Inaccurate data 

mean that OSHA may not be inspecting high hazard facilities. 

• Setting OSHA’s priorities: OSHA needs information on where workers are 

getting injured, sick and killed, in order to identify high-hazard industries where 

aggressive enforcement programs may be required, and to determine what new 

standards are needed and how to target its compliance assistance efforts. 

The lack of accurate surveillance information leads to the inability to 

allocate appropriate resources, the inability to initiate and prioritize 

targeted interventions, and the inability to evaluate the effectiveness 

of those interventions. 

-- Professor K D Rosenman, Department of Medicine, Michigan State University 
5 

• Judging the effectiveness of OSHA programs: An accurate and reliable 

assessment of the extent of occupational injuries, illnesses and fatalities is 

essential to enable policy makers to determine whether OSHA’s programs are 

succeeding or failing and where improvements can be made. 

Under the Bush Administration, OSHA has been criticized by Congress, the 

media, labor unions and citizens for failing to fulfill the original mandate of the 

Occupational Safety and Health Act. Numerous Congressional hearings have 

been held over the past year to oversee the performance of OSHA and the DOL. 

At almost every hearing where top OSHA or DOL officials have appeared, their 

main and often only defense against every issue raised – failure to issue standards, 

failure to issue promised guidelines, favoring voluntary programs over mandatory 

standards and enforcement, or failure to enforce ergonomic violations – has been 

that injuries, illnesses and fatalities have been going down, so the agencies must 

be doing something right. 

• Determining the state of workplace safety and health in this country: There is 

no doubt that the state of health and safety in this country has improved since 

OSHA was created. But far too many workers are still killed and injured on the 

job. According to government statistics, 16 workers are killed in this country 

every day of the year from falls, trench collapses, getting caught in machinery, 

electrocutions, explosions, violence, and vehicle crashes.1

 NIOSH estimates that 

ten times that number die from occupational diseases such as cancer or respiratory 

diseases2

. In addition, over 11,000 workers are injured every day – one every 

seven seconds.3 Are workplace safety trends still improving? Could we be doing 

better? What are the research needs? Accurate statistics are necessary to make 

these determinations. 

Background: The Recordkeeping System 

 

1

 Bureau of Labor Statistics, Census of Fatal Occupational Injuries, (2006), at 

https://www.bls.gov/iif/oshwc/cfoi/cfoi_revised06.pdf 2

 Kyle Steenland, Carol Burnett, Nina Lalich, et al., Dying for Work: The Magnitude of US Mortality From Selected 

Causes of Death Associated With Occupation, 43 AM. J. OF INDUSTRIAL MED. 461, (2003). 3

 Bureau of Labor Statistics, Survey of Occupational Injuries and Illnesses, at 

https://www.bls.gov/iif/oshwc/osh/os/osnr0028.pdf. 

Congresswoman McCarthy. I am asking, do you feel that you have enough 

inspectors to do the work that needs to be done around the country? 

Assistant Secretary Foulke. I would say that we are obviously doing the job 

we need to be doing, because if you look today, the most recent data that we 

have, we had the lowest injury, illness and fatality rates ever. 

-- Hearing on the Combustible Dust Explosion and Fire Prevention Act of 2008, March 12, 2008 
6 

The Occupational Safety and Health (OSH) Act requires employers to keep accurate 

records of workers’ injuries and illnesses, and mandates OSHA to develop regulations 

“requiring employers to maintain accurate records of...work-related deaths, injuries and 

illnesses.”4 OSHA establishes definitions and recordkeeping guidelines for employer 

reporting of injuries, illnesses and fatalities. Employers must only record 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. Employers are 

responsible for keeping a log of injuries and illnesses (OSHA 300 Log). The log must be 

available to employees and their representatives, and the Annual Summary of the log 

must be posted in the workplace each year from February 1 to April 30. In addition, the 

employer must investigate the circumstances of all cases recorded in the log and prepare 

an incident report outlining the factors that led to the incident.5

 

Under the OSH Act, the Secretary of Labor is charged with the responsibility to “develop 

and maintain an effective program of collection, compilation an analysis of occupational 

safety and health statistics,” and to compile accurate statistics on work-related injuries 

and illnesses. 6 This charge has been delegated to BLS. 7

The BLS selects a representative number of employers to report injury and illness data 

for use in creating the annual Survey of Occupational Injuries and Illnesses (SOII). The 

SOII constitutes the nation’s official annual workplace injury and illness “report card.” 

But the SOII excludes millions of workers, including self-employed individuals, farms 

with fewer than 11 employees, employees of federal, state and local government 

agencies, and private household workers. 8

After a number of Congressional hearings on underreporting in the 1980s and 1990s, the 

National Academy of Sciences9 and the Keystone Institute10 conducted studies on the 

effectiveness and accuracy of OSHA recordkeeping. The NAS study found serious and 

willful underreporting among major corporations and looked at remedies to the problem. 

As a result of this work, the method of collecting workplace fatality statistics was 

changed. Since 1992, workplace fatality statistics have been collected in a different 

manner than injuries and illnesses. Although employers are required to report all fatalities 

to OSHA, the BLS also makes independent efforts to establish the number of workers 

killed on the job each year. This program, called the Census of Fatal Occupational 

Injuries (CFOI), also uses such sources as death certificates, workers’ compensation 

 

4

 Occupational Safety and Health Act of 1970, 29 U.S.C. § 657. 

5

 Occupational Safety and Health Administration, Recording and Reporting Occupational Injuries and Illnesses, 29 

C.F.R. § 1904 (1994). 

6

 Occupational Safety and Health Act of 1970, 29 U.S.C. § 673. 

7

 Occupational Safety and Health Administration, Recording and Reporting Occupational Injuries and Illnesses, 29 

C.F.R. § 1904 (2003). 

8

 Bureau of Labor Statistics, Occupational Safety and Health Summary Data (February 05, 2002), at

https://www.bls.gov/iif/oshsum1.htm. 9

 NATIONAL ACADEMY OF SCIENCES, COUNTING INJURIES AND ILLNESSES IN THE WORKPLACE: PROPOSAL FOR A BETTER 

SYSTEM, (Earl S. Pollack & Deborah Gellerman Keimig, eds. 1987). 10 The Keystone Center, The Keystone National Policy Dialogue on Work-Related Illness and Injury Recordkeeping, 

Final Report, (1989). 
7 

records, news accounts, and employer and police reports to Federal and State agencies to 

verify the accuracy of workplace fatality statistics. Consequently, CFOI is considered to 

be more accurate and reliable than SOII. Prior to the launch of CFOI in 1992, workplace 

fatality estimates made by various organizations varied greatly from 3,000 to 11,000 

deaths nationally per year. 11

Also as a result of these studies, OSHA developed the Site Specific Targeting program 

(SST) in the mid 1990s, designed to target inspections at the most dangerous workplaces. 

In order to do this, OSHA developed the OSHA Data Initiative (ODI), which enables the 

agency to annually collect injury and illness information directly from employers in 

80,000 larger establishments in high hazard industries, excluding the construction and 

maritime industries (determined by previous reported injury and illness rates.) The 

companies with the highest rates within those industries are among those selected for 

targeted inspections.12 

The Status of Recordkeeping: An Academic Research 

Review 

Numerous studies have found that the Bureau of Labor Statistics Survey of Occupational 

Illnesses and Injuries (SOII) drastically underestimates the number of workplace injuries 

and illnesses suffered by American workers each year. Studies also question the extent of 

the downward trend reported by the SOII. 

According to the studies cited below, the BLS annual survey may fail to report nearly 70 

percent of lost-work time injuries and illnesses. Although the SOII portrays dramatic 

decreases in the rate of worker injury and illness throughout the last decade, independent 

analyses suggest that actual occupational injury and illness rates have remained constant 

or declined only modestly in recent years.13-14 In fact, one study demonstrates that 

changes in OSHA’s recordkeeping requirements—rather than a real reduction in 

workplace injuries and illnesses—have contributed significantly to the decline in injuries 

and illnesses reported in the SOII.15 

Simply put, the SOII cannot be trusted as a gauge of the safety of American workplaces. 

As a result of its reliance on the flawed employer-based system underlying the SOII, 

OSHA may be failing to inspect dangerous workplaces, leaving many American workers 

at risk of injury, illness and exploitation. 

 

11 Guy Toscano & Janice Windau, The Changing Character of Fatal Work Injuries, MONTHLY LABOR REV., October 1, 

1994, 17, at https://www.bls.gov/opub/mlr/1994/10/art2full.pdf 12 Occupational Safety and Health Administration, Site-Specific Targeting 2008 (SST-08), CPL-08-03 (CPL 02) (May 

19, 2008), at http://www.osha.gov/OshDoc/Directive_pdf/CPL_02_08-03.pdf. 13 Lee S. Friedman & Linda Forst, Occupational Injury Surveillance of Traumatic Injuries in Illinois, Using the Illinois 

Trauma Registry: 1995-2003, 49 J. OCCUPATIONAL & ENVTL. MED. 401, (2007). 14Lee S. Friedman & Linda Forst, The Impact of OSHA Recordkeeping Regulation Changes on Occupational Injury 

and Illness Trends in the US: a Time-series Analysis, 64 OCCUPATIONAL ENVTL. MED. 454, (2007). 15 Id. 
8 

Estimates of the BLS undercount vary, but it is clear that the SOII misses 

a significant number of workplace injuries and illnesses. 

• Researchers at Michigan State University found that the SOII missed up to 68 

percent of work-related injuries and illnesses occurring annually in Michigan 

from 1999 to 2001. After comparing BLS statistics to a number of other 

databases, the researchers found that the OSHA logs captured only around 31 

percent of illnesses and 33 percent of injuries reported in other databases. 16

• Another study that compared the SOII with worker’s compensation records in six 

states estimates that the SOII missed almost 340,000 lost-time injuries in the 

sampled industries from 1998 to 2002. At most, the BLS survey reported 76 

percent of all injuries in the six states in the sampled industries. Many more 

injuries and illnesses were reported to the state workers’ compensation system 

than to the BLS.17 

• A study of the Denver International Airport (DIA) construction project provides 

evidence that the SOII may underestimate injury and illness rates in the 

construction industry by over 50 percent. The researchers used workers’ 

compensation and payroll data to estimate the total number of lost-work-time 

injuries during the project. It found that the overall injury rate for the DIA project 

was more than twice the rate reported by BLS for the construction industry during 

the project years.18 

• One study estimates that the SOII misses between 33 and 69 percent of all workrelated injuries and illnesses when the excluded categories of workers (e.g. 

government employees and the self-employed) are included in the count. In 

developing their estimate, the researchers took into account relative job risks and 

previous studies’ findings regarding injury and illness underreporting in specific 

job categories.19 

• Another analysis finds that for 1998, the actual number of workplace injuries and 

illnesses for private industries currently included in the BLS survey was 40 

percent higher than the SOII estimate. If government employees and the selfemployed are included, then the occupational injury and illness estimate for 1998 

rises to 80 percent higher than the BLS estimate. The researchers used the 

National Health Interview Survey, conducted by the National Center of Health 

 

16 Kenneth D. Rosenman, Alice Kalush, Mary Jo Reilly, et al., How Much Work-Related Injury and Illness is Missed by 

the Current System?, 48 J. OCCUPATIONAL & ENVTL. MED. 357, (2006). 17 Leslie I. Boden & Al Ozonoff, Capture-recapture Estimates of Nonfatal Workplace Injuries and Illnesses, 18 

ANNALS OF EPIDEMIOLOGY 261, (2008). 18 Judith E. Glazner, Joleen Borgerding, Jan. T. Lowery et al., Construction IndustryRates May Exceed National 

Estimates: Evidence from the Construction of the Denver International Airport, 34 AM. J. INDUSTRIAL MED. 105, 

(1998). 19 J. Paul Leigh, James P. Marcin, & Ted R. Miller, An Estimate of the U.S. Government’s Undercount of Nonfatal 

Occupational Injuries, 46 J. OCCUPATIONAL & ENVTL. MED. 10, (2004). 
9 

Statistics, to estimate injury rates and then compared their findings to the BLS 

estimates.20 

The annual downward trend reported in the SOII is also questionable. 

• While BLS figures show a consistent 37.4 percent decline in workplace injuries in 

Illinois between 1998 and 2003, an analysis employing Illinois Trauma Registry 

(ITR) data demonstrates a fairly level rate of traumatic workplace injuries in the 

state over the same period. The researchers argue that since the ITR is based on 

trauma center records from across the state and does not depend on employer selfreporting, it likely reflects a more accurate picture of the trends in occupational 

injuries than the SOII.21 

• A study by NIOSH researchers using data from non-fatal hospital emergency 

department (ED) admissions finds that “no substantial reduction was observed in 

the overall number and rate of ED-treated occupational injuries/illnesses during 

1996-2004.” This finding stands in contrast to the SOII, which documented a 

decline in injuries and illnesses for those years.22 

Not only do the findings of this study bring into question the BLS’s reported 

decline in injuries and illnesses, but it also brings into question the total number 

of injuries and illnesses reported by the BLS. First, the authors point out that 

workers suffering from chronic occupational illnesses rarely go to emergency 

rooms for treatment (and that these illnesses are difficult to ascribe to previous 

workplace exposures). Second, previous studies show that emergency room 

admissions account for only around one-third of all occupational injuries and 

illnesses23 implying that the real rate may be closer to 7.5 per 100 workers, rather 

than the 5.0 reported by BLS. 

• According to researchers at University of Illinois at Chicago, 83 percent of the 

reported decrease in occupational injuries and illnesses in the US from 1992 to 

2003 was caused by changes in recordkeeping rules in the 1990’s and early 

2000’s, and only 17 percent of the decrease over that time were actually due to a 

true decrease in injuries and illnesses.24 

Ergonomic injuries are significantly underreported. 

 

20 Gordon Smith, Helen Wellman, Gary Sorock, et al., Injuries at Work in the US Adult Population: Contributions to 

the Total Injury Burden, 95 AM.J. PUB. HEALTH 1213, (2005). 21 Friedman & Forst, supra note 13. 22 S.J. Derk, S.M. Marsh & L.L. Jackson, Nonfatal Occupational Injuries and Illnesses—United States, 2004,

MORBIDITY & MORTALITY WEEKLY REPORT (April 27, 2007), at 

http://www.cdc.gov/MMWR/preview/mmwrhtml/mm5616a3.htm. 23 S.J. Derk, S.M. Marsh & L.L. Jackson. Nonfatal OccupationalInjuries and Illnesses Among Workers Treated in 

Hospital Emergency Departments—United States, 2003, MORBIDITY & MORTALITY WEEKLY REPORT (April 28, 2006), 

at http://www.cdc.gov/MMWR/preview/mmwrhtml/mm5516a2.htm. 24 Friedman & Forst, supra note 14. 
10 

In February 2008, the Charlotte Observer published a six-part series called “The Cruelest 

Cuts: The Human Cost of Bringing Poultry to Your Table.” The Observer reported on the 

unsafe conditions in poultry plants in North and South Carolina, focusing on pressures on 

workers not to report injuries. According to the report, House of Raeford's 800-worker 

poultry processing plant in West Columbia, S.C., reported no musculoskeletal disorders 

over four years, although twelve employees who worked at the plant during that time said 

they suffered pain brought on brought on by MSDs and two said they had surgery for 

carpal tunnel at company expense.

Similarly, House of Raeford’s Greenville, S.C., plant has boasted of a five-year safety 

streak with no lost-time accidents. But the Observer reported that the plant kept that 

streak alive by bringing injured employees back to the factory hours after surgery. 25

According to Tom Armstrong, a University of Michigan professor who has studied the 

prevalence of MSDs in poultry processing, “it’s highly unlikely a large poultry plant 

could go consecutive years without a case of carpal tunnel or tendonitis. ‘I’d be skeptical 

of the record-keeping in a situation like that.”26

Other studies have confirmed the Observer’s conclusions that MSDs are underreported. 

• In developing OSHA’s ergonomics standard in 2000, OSHA cited extensive peerreviewed studies that documented extensive and widespread underreporting on 

the OSHA Log of occupational injuries and illnesses in general. Based on this 

evidence as well as evidence and testimony submitted during the hearing and 

public comment process, OSHA concluded that work-related MSDs such as back 

injuries, carpal tunnel syndrome, and tendonitis were being substantially 

underreported on OSHA Logs and that the number of lost-time, work-related 

MSDs quantified in the Agency’s risk assessment on the basis of the BLS data 

was understated by at least a factor of two.

27

• A recent American Journal of Industrial Medicine study has confirmed OSHA’s 

findings that ergonomic injuries are underreported. Using worker’s compensation 

and physician reporting data from Connecticut, researchers estimate that from 

1995 to 2001, the actual number of work-related upper-extremity MSDs in 

Connecticut was as much as six times higher than reported in the SOII. The 

researchers also conclude that there is no evidence to support the overall declines 

in MSDs indicated by the BLS survey.28 

• A study of hotel workers in Las Vegas showed that more than three-quarters 

suffered work-related pain which was severe enough for over 80 percent to take 

 

25 Kerry Hall, Ames Alexander & Franco Ordonez, The Cruelest Cuts: The Human Cost of Bringing Poultry to Your 

Table, , CHARLOTTE OBSERVER, Feb. 10, 2008, at 1A. 26 Id. 27 OSHA Ergonomics Program; Final Rule, 29 C.F.R. § 1910 (2000, amended June 30, 2003). 28 Tim Morse, C. Dillon, E. Kenta-Bibi et al., Trends in Work-related Musculoskeletal Disorder Reports by Year, Type, 

and Industrial Sector: A Capture-Recapture Analysis, 48 AM. J. INDUS. MED. 40, (2005). 
11 

pain medication and over 60 percent to see a doctor. Yet two thirds of those 

workers did not report their injuries to their supervisors. 29

Why Are Injuries And Illnesses Underreported? 

There are a number of reasons that injuries and illnesses are underreported to OSHA and 

the BLS. Many categories of workers are not counted by the BLS. Some workers do not 

want to get caught up in the slow difficult workers’ compensation process. Others are not 

aware that their injury or illness is work-related or reportable, or do not report because 

they are afraid of being stigmatized. Some employers find OSHA’s recordkeeping criteria 

confusing. But of far more concern are the incentives that employers have to underreport, 

and actions that some employers take to intimidate and harass workers who report 

injuries and illnesses. 

Certain categories of workers, accounting for a significant portion of the 

workforce, are excluded from the survey. 

Government workers, the self-employed, and farms with fewer than 11 employees are 

excluded from the SOII, further exacerbating the survey’s undercount of occupational 

injuries and illnesses. These uncounted workers, over whom OSHA has limited 

jurisdiction, amount to over 20 percent of the total workforce. Government workers 

alone—including police officers, firefighters and public works employees who often 

work in high-risk conditions—accounted for over 14 percent of the labor force in 2007.

30 

Occupational illnesses are particularly difficult to identify as work-related. 

Workers, employers and medical professionals often fail to detect the work-relatedness of 

occupational diseases such as asthma, heart disease, liver and kidney disorders and 

MSDs. This problem is particularly difficult with diseases that have long latency periods 

(the time between exposure and disease). For certain cancers, for example, twenty to 

thirty years may pass from the time of workplace exposure to the time of diagnosis. In 

addition, diseases such as asthma that are similar to non-occupational diseases are 

difficult to connect to workplace exposures.31 Most physicians receive little training in 

occupational disease recognition and often fail to connect disease with work.32-33 

The United States has no comprehensive occupational health data collection system, 

making it particularly difficult to collect occupational illness statistics. Many states have 

no mandates requiring health care professionals to report cases of occupational injury or 

 

29 Theresa Scherzer, Reiner Rugulies, & Niklas Krause, Work-related Pain and Injury and Barriers to Workers’ 

Compensation Among Las Vegas Hotel Room Cleaners, 95 AM. J. PUB. HEALTH 483, (2005). 30 Bureau of Labor Statistics, Current Population Survey (2007), at ftp://ftp.bls.gov/pub/special.requests/lf/aat12.txt. 31 Ruth Ann Romero Jajosky et al., Surveillance of Work-Related Asthma in Selected U.S. States Using Surveillance 

Guidelines for State Health Departments— California, Massachusetts, Michigan, and New Jersey, 1993–1995, 

MORBIDITY & MORTALITY WEEKLY REP. (June 25, 1999), at 

http://www.cdc.gov/MMWR/preview/mmwrhtml/ss4803a1.htm. 32 P.J. Landrigan & D.B. Baker, The Recognition and Control of Occupational Disease, 266 JAMA 676, (1991). 33 M.B. Lax, Occupational disease: Addressing the Problem of Under-Diagnosis, 6 NEW SOLUTIONS 81, (1996).
12 

illness, and numerous studies have noted inadequate reporting even in those states that 

have a mandate.34

Immigrants are less likely to report workplace injuries and illnesses. 

• Immigrant workers, among the most vulnerable to employer exploitation, face 

many barriers in reporting workplace injuries and illnesses and in obtaining 

appropriate medical care. They often confront language problems and are more 

likely to work in jobs that do not provide health insurance or paid sick leave. If 

they are undocumented, they may fear employer retaliation that could result in the 

loss of their jobs or even deportation.35-36 

• A study by researchers at the Wake Forest University School of Medicine found 

that injury and illness rates for Latino poultry workers in six counties in western 

North Carolina exceeded rates reported by plants to OSHA. The researchers 

suggested that many factors could contribute to the lack of injury and illness 

reporting by immigrants, including language barriers, fear of losing a job, 

incentive programs that reward low rates of absenteeism, and lack of access to 

health care.37 

• Researchers at the UCLA Labor Occupational Safety and Health Program 

surveyed a group of 75 immigrants in the Los Angeles area who worked in lowwage, low skill jobs. They found that only 63 percent of the workers who 

experienced an injury reported it, and many of the workers knew others who did 

not report injuries that they suffered. 38 

• Even with unionization, immigrant workers may hesitate to report injuries and 

illnesses. Seventy-five percent of unionized hotel workers in a 2005 study 

reported work-related pain, but only 20 percent filed workers’ compensation 

claims. The fear of getting “in trouble” or being fired was among the primary 

concerns for workers who did not report their injuries.39 

Workers are often reluctant to apply for workers’ compensation. 

Workers are often discouraged from filing workers’ compensation complaints because of 

the difficulty of the system and because employers sometimes discourage workers from 

applying for workers’ compensation.40

 

34 Lenore S. Azaroff, Charles Levenstein & David Wegman, Occupational Injury and Illness Surveillance: Conceptual 

Filters Explain Underreporting, 92 AM. J. PUB. HEALTH 1421, (2002). 35 Jajosky, supra note 31. 36 Marianne P. Brown, Alejandra Domenzain, & Nelliana Villoria-Siegert, Voices from the Margins: Immigrant 

Workers’ Perceptions of Health and Safety in the Workplace (December 2002), at 

http://www.losh.ucla.edu/publications/voicesreport.pdf. 37 Sara A. Quandt, Joseph G. Grzywacz, Antonio Marin et al., Occupational Illnesses and Injuries Among Latino 

Poultry Workers in Western North Carolina, 49 AM. J. INDUS. MED. 343, (2006). 38 Brown, Domenzain, & Villoria-Siegert, supra note 36. 39 Scherzer, Rugulies & Krause, supra note 29. 40 Azaroff, Levenstein, & Wegman, supra note 34. 
13 

Long waiting periods, insufficient wage replacement and fights over the work-relatedness 

of occupational illnesses can discourage workers from utilizing the workers’ 

compensation system, particularly if they are covered by health insurance.41 

The system is particularly difficult for immigrant workers who may not be aware that 

they are covered by the workers’ compensation system. For low income workers, the 

waiting periods, disputes and low wage replacement can mean unemployment and 

financial disaster. 

The musculoskeletal disorder column has been taken off of the OSHA 300 

Log. 

In 2001, OSHA published a change in recordkeeping requirements that would have 

required employers to check a special box on their injury/illness logs if an injury was an 

MSD.42 This information would enable OSHA to better understand the magnitude and 

distribution of work-related MSDs, and would also provide a useful analytical tool at the 

establishment level. The Bush administration then delayed the effective date, and 

eventually repealed the provision altogether.

Although employers are still required to record on the log MSDs that are work-related 

and result in lost work time, some fear that the elimination of the specific reporting 

requirement has led to even more severe underreporting of MSDs.43 This problem is 

compounded by the fact that employers and physicians may fail to diagnose an MSD as 

work-related because many work-related musculoskeletal disorders mimic nonoccupational disorders. 

Some workers and employers do not understand the reporting system. 

Some experts who advise corporations on injury and illness reporting rules note that 

many employers are confused about reporting criteria and OSHA staff is often not welltrained to provide accurate advice.44

In addition, some mental health care workers who are assaulted by patients may not 

report their injury to workers’ compensation or their employer, believing that such 

 

41 Id. 42 The former Log (200 Log) included a column devoted to “repeated trauma” cases, which were defined as including 

noise-induced hearing loss cases as well as cases involving a variety of other conditions, including certain 

musculoskeletal disorders. Hearing Loss and MSD’s were separated into two columns in the original 300 Log. 43 AFL-CIO, Comments of the American Federation of Labor and Congress of Industrial Organizations on OSHA’S 

Proposed Delay of the Effective Date of Employer Injury and Illness Recordkeeping Requirements for Musculoskeletal 

Disorders and Hearing Loss (March 20, 2002) (on file with Committee staff); AFSCME, Comments of the American 

Federation of State County and Municipal Employees on OSHA’s Proposed Delay of the Effective Dates for Employer 

Injury and Illness Recordkeeping Requirements Related to Musculoskeletal Disorders and Hearing Loss (August 30, 

2002) (on file with Committee Staff). 

44 Interview by Committee staff with Steve Newell, Senior Consultant, ORC Worldwide (June 13, 2008). 
14 

assaults are “part of the job.”45 According to interviews with committee staff, health care 

workers in understaffed institutions feel that if they take time off for injuries, their 

patients will be left without care.46

Employers have an incentive to underreport. 

There are many incentives built into the injury and illness reporting system for some 

employers to underreport injuries and illnesses. 

1. Low injury and illness rates decrease the chance of being inspected by OSHA. 

As described above, OSHA’s Site Specific Targeting Program (SST) targets 

employers with high injury and illness rates for inspection. The system is based on 

employer self-reporting of injuries and illnesses. The higher an employer’s rate, the 

more likely the employer is to receive an OSHA inspection. The program therefore 

provides incentives for some employers to cheat.

In addition, OSHA’s Ergonomic Enforcement Plan, which relies on the lost workday 

rate reported by employers, also provides employers with an incentive to underreport. 

If an employer reports a low rate of ergonomic injuries and has an ergonomic 

program on the books, “OSHA will determine whether to conclude the ergonomics 

portion of the inspection.”47

Duke University researcher Hester Lipscomb, however, points out in a study of 

African-American women poultry workers, that 

Unfortunately, this approach fails workers such as the women in our study who 

were in industries where under-reporting of injuries has been suggested. Not only 

was the validity of the data on which injury rates were based questioned; the 

establishments have an economic incentive to under-report in order to avoid 

evaluations.48

2. Low numbers of injuries and illnesses decrease workers’ compensation expenses. 

Under workers’ compensation programs, employers must often pay the entire cost of 

treatment, unlike regular health insurance which involves co-pays. In addition, workrelated injuries and illnesses can raise employers’ workers’ compensation premiums. 

3. Low injury and illness rates can earn businesses bonuses and incentives. 

 

45 L. Erickson & S.A. Williams-Evans, Attitudes of Emergency Nurses Regarding Patient Assaults, 26 J. EMERGENCY 

NURSING 210, (2000). 46 Phone Interviews by Committee Staff with Worker Representatives, Washington, D.C. (May 2008). 47 Occupational Safety and Health Administration, OSHA’s Ergonomic Enforcement Plan, at

http://www.osha.gov/SLTC/ergonomics/enforcement_plan.html. 48 H.J. Lipscomb, J..M. Dement, C.A. Epling, M.A. McDonald, and A.L. Schoenfisch, Are We Failing Vulnerable 

Workers? The Case of Black Women in Poultry Processing In Rural North Carolina, 17 NEW SOLUTIONS 1-2 (2007). 
15 

States and other public entities sometimes offer bonuses to contractors who can show 

exemplary safety records upon completion of projects. Contractors with better safety 

records also have a better chance of winning government contracts.49 

4. Low injury and illness numbers look good to the public and to customers. 

Companies may boast to their customers, stockholders and the surrounding 

community about the number of days they have gone without a recordable injury.50 In 

addition, high injury and illness numbers make employers ineligible for certain 

OSHA award programs such as the Voluntary Protection Program.51

Methods used by employers to discourage accurate reporting. 

Evidence compiled from worker interviews, labor union reports, academic studies and 

media investigations show that employer actions – some intentional and some 

unintentional – can discourage workers from reporting injuries and illnesses. As 

described below, these actions include directly intimidating and harassing workers, 

discouraging workers from receiving appropriate medical attention that might trigger the 

recording of an injury on the OSHA log and bringing seriously injured workers back to 

work immediately after surgery to ensure that no lost work-time is recorded that may 

raise workers compensation rates. 

Direct intimidation of workers: The direct intimidation of workers to discourage 

reporting of injuries and illnesses takes many forms, both subtle and overt. Reports, 

testimony and news accounts show that many employers discourage reporting and 

retaliate against workers who report injuries and illnesses or complain about safety 

hazards. Disciplinary actions and intimidation may include job loss, pay cuts, denial of 

overtime or promotion opportunities, and/or harassment. 

Workers in many industries have expressed their fear that reporting an injury or illness 

could cause them to lose their job. This fear is particularly acute in industries like poultry 

and meatpacking that rely heavily on immigrant workers, a population particularly 

vulnerable to employer exploitation. 

 

49 Elizabeth Douglass, Edison Says Safety Data Were Rigged, L.A. TIMES, October 22, 2004, at A1; Occupational 

Safety and Health Administration, State Incentives Promoting Voluntary Compliance (Aug. 2, 2007), at 

http://www.osha.gov/dcsp/osp/oshspa/2002_report/state_incentives.html. 50 Los Angeles County Metropolitan Transportation Authority, Metro Gold Line Eastside Extension is More Than 80 

Percent Complete (May 23, 2008), at http://www.metro.net/news_info/press/Metro_087.htm.; North Poll Workshop, 

North Pole Workshop Boasts Stellar Safety Record; Rest of Area Logs Injuries (Dec. 25 2007), at 

http://www.ohsonline.com/articles/56997; National Semiconductor Corporation, National Semiconductor Achieves One 

Million Hours of Manufacturing with No Lost Time Injuries (Apr. 29, 2002), at 

http://www.national.com/news/item/0,1735,758,00.html; GlaxoSmithKline, Corporate Responsibility Report 2005

(Mar. 24, 2006), at http://www.gsk.com/responsibility/cr_report_2005/employees/hs-injury-illness-rate.htm; Holz 

Rubber Co., Holz Rubber Company Achieves No Lost-Time Injuries for One Year (Nov. 1 2005), at 

http://news.thomasnet.com/companystory/474094. 51 Occupational Safety and Health Administration, Recognizing Excellence in Safety and Health Voluntary Protection 

Programs (March 15, 2007), at http://www.osha.gov/dcsp/vpp/vpp_kit.html. 
16 

• California state auditors and OSHA investigators identified repeated instances of 

worker intimidation and harassment intended to discourage occupational injury 

and illness reporting during the Kiewit-Pacific/FCI Constructors/Manson 

Construction—A Joint Venture (KFM) San Francisco Bay Bridge reconstruction 

project. 52 

• In 2008, the Charlotte Observer’s “The Cruelest Cuts” report documented how 

the North Carolina poultry industry exploits immigrant workers’ fears of 

deportation to suppress reporting of painful and debilitating injuries. The 

newspaper interviewed more than 50 workers no longer employed at the poultry 

processing firm House of Raeford and ten of those reported that they were fired 

after reporting injuries.53 

• At the Smithfield Packing Co. pork slaughterhouse in Tar Heel, North Carolina, 

workers reported being harassed and even terminated after reporting injuries and 

describe managers denying that injuries happened at work. In 2002, Melvin 

Grady tore his Achilles tendon when he slipped on a stairway at the Smithfield 

plant. According to Grady, Smithfield denied that the claim was work-related and 

informed Grady that he could not receive workers’ compensation benefits. The 

company sent him “short-term disability” payments for several weeks after he had 

surgery on his leg. In December 2002, Smithfield demanded that Grady provide a 

doctors’ note giving him permission to work without restrictions. When Grady, 

still recovering from his surgery, could not get the note from his doctor, 

Smithfield terminated him.54 

Teresa Nieto stated that after a frozen hog carcass fell onto her back, she received 

only cursory care from the plant clinic. According to Nieto, upon returning to 

work, her supervisor and a member of the plant’s security team confronted her, 

threatening that they would send her to court for “acting up” and that no hog had 

fallen on her.55

• Workers in the steel industry report that they risk their jobs when they report 

safety hazards or even minor injuries. Steelworkers describe “bloody pocket 

syndrome” where workers who may have as little as a cut on their hand will hide 

it, fearing retaliation, and wait until after their shift to go to the hospital.56 

 

52 California State Auditor, San Francisco-Oakland Bay Bridge Worker Safety: Better State Oversight Is Needed to 

Ensure That Injuries Are Reported Properly and That Safety Issues Are Addressed, Report 2005-119 (February 9, 

2006), at www.bsa.ca.gov. 53 Hall, Alexander & Ordonez, supra note 25. 54 Human Rights Watch, Blood, Sweat, and Fear: Workers’ Rights in U.S. Meat and Poultry Plants (January 2005), at 

http://www.hrw.org/reports/2005/usa0105/usa0105.pdf 55 Research Associates of America, Packaged with Abuse: Safety and Health Conditions at Smithfield Packing’s Tar 

Heel Plant 9 (January 2007), at 

http://www.smithfieldjustice.com/Documentos/Annual_Report/Static%20copy%20of%20Safety%20and%20Health%2

0Report.pdf

56 Will Buss, Steelworkers Perform Myriad of Tasks Consolidation Forces, Workers To Learn Different Tasks, 

Belleville News-Democrat, April 4, 2005, at 1B. 
17 

 

• A contractor on the Colorado-to-Ohio Rockies Express natural gas pipeline is 

facing allegations from former safety inspectors that the company used threats, 

intimidation and attempted bribery to skirt safety requirements. The inspectors 

have stated that the company hid worker injuries and, in order to meet ambitious 

project deadlines, cut corners that endangered worker safety. 57 

• Rose Roddy was told by the Vice President of Human Resources at PeerlessPremier Appliance Co. that she would be deemed “industrially unemployable” by 

the company if she continued to suffer injuries on the job because she had 

suffered 14 “injuries” over her 24-year employment with the company – including 

“exposure to gas fumes” and “carbon monoxide exposure.” 58

• Buzzi Unicem USA has a policy that describes measures that may be taken 

against an employee for a “safety rule” violation that results in “‘medical 

treatment’ for injuries or illnesses by a licensed physician or other health care 

giver.”59 The “program,” involving three steps, places responsibility for accidents 

or illnesses squarely on the worker’s shoulders. Step three results in the 

employee’s termination. 

Bringing seriously injured workers right back to work: To avoid lost work-time 

which will raise workers’ compensation rates, employers may bring employees who have 

suffered injuries back to work immediately for “light duty” work – even after major 

surgery. 

• The KFM San Francisco Bay Bridge Project investigation provides an example of 

this employer tactic. After suffering a major knee injury, Arne Paulson was 

carried onto tugboats for months by co-workers so that no “lost time” or 

“restricted work” was recorded.

60 

• During his testimony before the Committee in 2007, Keith Ludlum, an employee 

at Smithfield Packing’s Tar Heel plant, told the story of a worker who broke his 

leg on the job. The worker, who required a full leg cast, was informed that he had 

to return to work the day after the accident or he would lose his job. Since he 

reported to work the next day, Smithfield avoided reporting a lost work day due to 

injury on its OSHA log.61 

Discouraging appropriate medical attention: Employers may discourage workers 

 

57 Tom Beyerlein, Concerns About Pipeline Were Ignored, Inspectors Say, Dayton Daily News (May 18, 2008), at 

http://www.daytondailynews.com/search/content/oh/story/news/local/2008/05/18/ddn051808pipelineinside.html. 58 Letter to Rose Roddy from Phyllis K. Schleicher, Vice President of Human Resources, Peerless-Premier Appliance 

Co. (January 10, 2003) (on file with committee staff). 

59 Memorandum on Buzzi Unicem USA, Safety and Health Rule Infraction Guidelines (March 31, 2006) (on file with 

committee staff).

60 Erik N. Nelson, Bay Bridge Worker Lost Job Due to Knee Injury, INSIDE BAY AREA, August 24, 2006. 61 Strengthening America’s Middle Class Through the Employee Free Choice Act Hearing Before the House Comm. on 

Education and Labor, Subcomm. on Health, Employment, Labor, and Pensions, 110th Cong. (2007) (written testimony 

of Keith Ludlum, employee of Smithfield Packing Co.). 
18 

from receiving appropriate medical attention in order to avoid triggering an injury or 

illness report. Employers often have their own on-site health care staff that is trained in 

which treatments do and do not constitute first aid because injuries requiring treatment 

beyond first aid are recordable.62 Injuries requiring only first aid are not recordable. 

Some workers have turned to a company health clinic only to be sent back to the 

production line with minimal treatment. Others have been discouraged from receiving 

treatment from anyone but the company doctor. Several case studies provide the stories 

of workers who were discouraged from receiving appropriate medical attention. 

• House of Raeford poultry worker Celia Lopez’s hands began to hurt so badly that 

she could barely keep working after lifting and weighing thousands of turkey 

breasts each day. The first aid attendant and physician’s assistant at the plant kept 

giving her pain relievers but refused to send her to a doctor. Finally, months later 

she went to a doctor and was diagnosed with carpal tunnel syndrome. The doctor 

who performed the surgery said that had she come in earlier, before the damage 

was so severe, she might have avoided surgery.

63

• After Smurfit-Stone employee Francisco Pulido severed his left pinkie to the first 

knuckle, he was taken to Pinnacle Urgent Care, where he had to wait for the clinic 

to open because it was after hours. Pulido was finally treated, but not until he 

began to go into shock from “extreme pain.” Smurfit-Stone then suspended Pulido 

for 3 days. 

CalOSHA later fined the company $3,700 for failing to properly train its 

employees. Smurfit Stone and Pinnacle managers are being prosecuted because 

they “allegedly discouraged employees from reporting on-the-job injuries and 

filing workers’ compensation claims, threatened them with suspensions and 

terminations for trying to file claims, and engaged in other improper practices in 

an apparent attempt to reduce the packing company's insurance costs.” 64

Meanwhile, as a current and former manager faced insurance fraud charges, 

Smurfit-Stone trumpeted its “incredible record of safety achievement” and 

celebrated its “safest year in company history in 2007.”

65 

 

62 Azaroff, Levenstein, & Wegman, supra note 34. 63 Ames Alexander, Franco Ordonez & Kerry Hall, Workers Say They’re Denied Proper Medical Care, CHARLOTTE 

OBSERVER, Feb. 12, 2008. 64 Jim Johnson, New Charges in Salinas Workers’ Comp Case, THE MONTEREY COUNTY HERALD, January 3, 2008. 65 Smurfit-Stone Completes Safest Year in Company History, PRNEWSWIRE, February 5, 2008. 

They'd say, “Oh, you're not hurting.” They made me feel that I was 

bothering them to go to the nurse, that I was supposed to take the 

pain. 

— Charlotte Outerbridge, The Cruelest Cuts: The Human Cost of Bringing Poultry To Your 
19 

Discouraging physicians from reporting injuries or diagnosing illnesses: When 

workers must receive treatment, employers may “bargain” with or even threaten doctors 

to prevent the diagnosis of a recordable injury or illness. 

• On the KFM San Francisco Bay Bridge project, welder Chris Hallstrom told 

Cal/OSHA that one of KFM’s safety managers would always accompany him into 

the exam room when being seen by a doctor for a work-related injury. The safety 

managers would attempt to “bargain over the wording of the work status report 

and the job restrictions” to try to avoid the triggering of a report.

66 

• The American College of Occupational and Environmental Medicine, 

representing 5,000 doctors, recently sent a letter to OSHA stating that doctors are 

routinely pressured to under-treat and mistreat workplace injuries and illnesses. 

For example, an employer may pressure doctors to treat a cut with bandages 

instead of stitches to avoid a triggering a report of an injury. Treatment with 

stitches is considered “medical attention beyond first aid” and renders the injury 

reportable, while treatment with bandages is considered “first aid” and not 

reportable.67

“No fault” absentee policies: Some companies give employees a fixed number of 

days off for all purposes, including sick and vacation leave and recuperation from a 

workplace injury or illness. If workers use up all permissible days, they may be 

terminated, even if they miss days due to work-related injuries. 

Bashas’, which operates a food distribution warehouse that distributes food and 

merchandise to more than 166 grocery stores throughout Arizona, uses a point system for 

absences and tardiness. Although time lost due to industrial injury is supposed to be 

excluded from this point system, injured workers report that they have been assessed 

points and had their pay cut for going to the doctor or missing time due to work-related 

injuries.68 

Safety incentive programs and games: Safety incentive programs and games that 

provide monetary prizes or days off when a work crew succeeds in going “accident free” 

for a certain time period are marketed as a way to improve worker safety and health by 

giving workers an incentive to work safely. As described below, however, depending on 

how an incentive program is structured, reluctance to lose the bonus or peer pressure 

from other crew members whose prizes are also threatened reduces the reporting of 

injuries and illnesses on the job, rather than reducing the actual number of workplace 

injuries and illnesses. 

 

66 Garrett D. Brown & Jordan Barab,“Cooking the Books”—Behavior-Based Safety at the San Francisco Bay Bridge, 

17 NEW SOLUTIONS 4 (2007). 67 Alexander Ames, Doctors Feel Push to Downplay Injuries, CHARLOTTE OBSERVER (April 9, 2008), at 

http://www.charlotte.com/217/story/587539.html. 68 Staff Interviews with former Bashas’ Supermarkets Workers, Washington, D.C. (June 10, 2008). 
20 

“Traditional” incentive programs – those that offer prizes if no injuries are reported – 

have also been criticized by OSHA and other accident analysis experts. A 1998 OSHA 

study concluded that these programs may have a “chilling effect”69 on the workplace – 

creating a hostile working environment. According to Richard Fairfax, director of 

compliance programs for OSHA, "the fact that some employers use these programs in 

lieu of formal safety and health programs is of very real concern to us.... There have 

been cases where injured employees were pressured not only by fellow employees, but by 

their supervisors, to not report injuries in order to maintain eligibility for safety 

incentives." 70

• Throughout the reconstruction of the eastern span of the San Francisco Bay 

Bridge in California, Kiewit-Pacific/FCI Constructors/Manson Construction – A 

Joint Venture (KFM) reported an injury rate 55 to 72 percent below the rates 

experienced by other major bridge construction projects in the bay. But KFM’s 

record turned out to be too good to be true. In June 2006, Cal/OSHA issued 

“Willful” citations against KFM for failing to record at least 13 worker injuries at 

the bridge, to investigate reported accidents, and to record injuries within the time 

period required by law.71

KFM offered monetary incentives to all employees for meeting quality and 

completion goals, but only if no Log 300 recordable injuries were reported. The 

program allowed employees to receive substantial bonuses—upwards of $1,500 in 

some cases. The career advancement of managers, foreman, and supervisors was 

also dependent on achieving a clean safety record. If a single worker reported an 

injury, the entire crew would lose its bonus. 72

 

Pile excavation crew foreman Arne Paulson stated: “It was known by everyone 

not to report any injuries because that would mean no BBQ, no tool prizes, no 

tool box prizes. Everyone would want to know who ‘lost’ the prizes for the crew, 

so everyone was terrified to report anything.”73 Welder Mario Armani said the 

cash “bonus program keeps guys away from reporting accidents, many injuries 

 

69 Dennison Associates, An Analysis of Safety Incentive Programs (June 1998), (report for the Occupational and Health 

Administration). 

70 William Atkinson, Good Safety Incentives Gone Bad, MC MAGAZINE (Spring 2002), 

http://www.precast.org/publications/mc/SafetyArticles/02_Spring_IncentivesGoneBad.htm. 71 Brown & Barab, supra note 66, at 312. 72 Id, at 314. 73 Id, at 315. 

“The incentive plan works against reporting injuries. Everybody 

trying to keep their jobs—don’t make waves. When you reported 

injuries, they treated you as a criminal... KFM created an 

atmosphere where you didn’t want to report.” 

— David Roundtree, a welder on the KFM San Francisco Bay Bridge Project 
21 

are not reported, many employees would clean out their own eyes [metal shivers 

from grinding] or have their co-workers do it.” 74

• In 2004, the discovery of unreported injuries and illnesses at Southern California 

Edison caused the company to give back $35 million in taxpayer funded safety 

incentive funds received from the state of California over the course of 7 years. 

The company’s own investigation found that their safety incentive program “may 

have discouraged the reporting of some incidents” and created pressure not to 

report injuries.75

• A 1998 report by Denison Associates, commissioned by OSHA, found that “there 

is no evidence that safety incentive programs, standing alone, improve safety. To 

the contrary, some safety incentive programs adversely affect safety.” The study 

noted that reports of the success of these programs are based on anecdotes and do 

not distinguish between reported injury reductions that are due to safer working 

conditions and those attributable to reporting practices.76

Not all safety incentive programs are bad. For example, “non-traditional” programs that 

provide rewards to workers for attending training classes and safety meetings and 

identifying and reporting unsafe conditions, close calls and minor injuries can promote 

safety without discouraging reporting of injuries or unsafe conditions. These programs 

also require trust between managers and workers so that workers do not fear discipline or 

accusations that they have hurt productivity when problems are reported.77 

Manager incentives and bonuses: General foreman, superintendents, craft 

superintendents, job superintendents and project managers on the California Bay Bridge 

project received significant monetary awards and “merit cards” essential for salary 

increases and individual career advancement. But the awards were dependent on no 

injuries or illnesses being reported. Foremen, fearful of losing their bonuses, would 

pressure workers not to report, and workers, afraid of angering their foremen, would 

comply. 78

Drug testing after every accident or injury: To intimidate workers, employers may 

require that workers are tested for drugs or alcohol before receiving treatment, 

irrespective of any potential role of drug intoxication in the incident. 

 

• Smurfit-Stone employee Jesse Vasquez alleges that he was subjected to a drug 

test at the request of his manager before he could receive treatment for a back 

injury. His manager is currently facing allegations of workers’ compensation 

fraud.79 

 

74 Id, at 315. 75 Elizabeth Douglass, Edison Says Safety Data Were Rigged, L.A. TIMES, October 22, 2004, at A1. 76 Dennison Associates, supra note 69. 77 James L. Nash, Rewarding the Safety Process: “Nontraditional” Incentive Programs Can Improve Safety – Without 

Making OSHA Nervous, OCCUPATIONAL HAZARDS, Mar. 1, 2000. 78 Brown & Barab, supra note 66, 314. 79 Johnson, supra note 64. 
22 

• A study of Las Vegas hotel workers found that 32 percent of workers who 

reported musculoskeletal injuries said they were forced to take a drug test after 

reporting their injury to workers’ compensation, 80 even though studies show that 

these injuries are caused by physical workload, the increase in the workload and 

ergonomic problems – not drugs.81

Contractors and contracting out dangerous work: When outside contractors 

injured or killed, their injuries or deaths are not listed on the main employer’s OSHA log, 

nor do they register in the primary employer’s industrial classification. 

Almost half of the workers on the BP Texas City refinery site were contractors on the day 

in 2005 when a massive explosion killed 15 workers. All of the workers killed that day 

were contractors. None of the fatalities or the injured contractors was listed on BP’s 

OSHA 300 Log, nor did they register in the industrial classification for refineries. 82 

The lack of site logs is a major problem impacting the effectiveness of OSHA’s SST 

program in petrochemical, chemical and other industries. The SST targets companies in 

industry classifications that show high injury and illness numbers for priority inspections. 

But contractor injuries, illnesses and deaths will show in the industry classification of the 

contractor, not in the industry classification of the site owner, meaning that where 

contractors suffer a large number of injuries or fatalities, the industry may seem much 

safer than it actually is.83

The use of outside contractors is growing throughout American industry and has major 

implications on workplace safety, especially in large complex operations such as the 

petrochemical and chemical industries. This problem was first noted in the 1991 John 

Gray Institute report following the catastrophic 1989 explosion at Philips 66 in Pasadena, 

Texas that killed 23 workers and injured 232 others.84

According to the John Gray report, because most facilities did not keep track of the injury 

and illness records of their contractors, valuable information was unavailable to plant 

managers “for the purpose of selecting, monitoring and controlling safety outcomes for 

contact labor.” The report noted that the current system does “not provide an accurate 

reflection of the composition of the experiences of workers in the petrochemical 

industry.” In addition, OSHA did not require the primary employer to keep a site log (an 

injury and illness log that includes all workers on a site, regardless of employer), making 

 

80 Scherzer, Rugulies, & Krause, supra note 29. 81 Niklas Krause, Theresa Scherzer & Reiner Rugulies, Physical Workload, Work Intensification, and Prevalence of 

Pain in Low Wage Workers: Results From a Participatory Research Project With Hotel Room Cleaners in Las Vegas, 

48 AM. J. INDUS. MED. 326, (2005). 82 U.S. Chemical Safety and Hazard Investigation Board, Investigation Report: Refinery Explosion and Fire, Report 

No. 2005-04-I-Tx (March 2007), at http://www.csb.gov/completed_investigations/docs/CSBFinalReportBP.pdf. 83 Lise Olsen, Murky Stats Mask Plant Deaths, HOUSTON CHRONICLE (May 16, 2005), 

http://www.chron.com/disp/story.mpl/business/3183356.html 84 John Calhoun Wells, Thomas A. Kochan & Michal Smith, Managing Workplace Safety and Health: The Case of 

Contract Labor in the U.S. Petrochemical Industry (July 1991) (report for the Occupational Safety and Health 

Administration). 
23 

this information unavailable to OSHA. 

Similarly, construction projects also employ a large number of sub-contractors who keep 

their own separate injury and illness logs, making it difficult for OSHA to determine the 

safety performance of large sites or of general contractors. Again, no site log is required 

by OSHA. 85

In order to address this problem, the 1989 Keystone Report recommended that “a 

‘contractor site log’ (i.e., copies of the subcontractor logs) be maintained for major 

construction sites and major construction rehabilitation activities.” 86 Similarly for the 

petrochemical industry, the John Gray report recommended that “OSHA require plants to 

collect and record site specific injuries and illness data for all workers on site.” 87

OSHA does not require construction contractors to maintain a site log, although OSHA’s 

Process Safety Management Standard does require employers covered by standard to 

maintain an internal site log, although these are not collected by OSHA as part of its 

Specific Targeting program (SST), nor by BLS in compiling the SOII or it census of 

occupational fatalities.88 

The problem does not only exist in the petrochemical industry. A 2003 Omaha WorldHerald report portrays the health and safety risks faced by the workers who perform the 

highly hazardous job of cleaning meatpacking plants each night. Their injuries escaped 

the notice of the OSHA targeting program because they worked for a cleaning company 

contracted by the plant owners. Any recordable injury that they suffered was classified 

not with meatpacking industry statistics, but rather in an industry category that included 

the professions of housekeepers and office cleaners – a lower-risk category that was not 

included in OSHA’s inspection targeting list. 89 

Misclassification of workers: When workers are misclassified as “independent 

contractors” instead of regular employees, the employer can avoid workers’ 

compensation payments and recording injuries on the OSHA 300 log since self-employed 

individuals are not covered by these systems. As mentioned above, when employers 

contract jobs to outside contract employers, injuries among the contract workers do not 

have to be recorded on the contracting employer’s OSHA log even if they occur at the 

employer’s site. 90

According to a 2000 U.S. Department of Labor study, audits of employers in nine states 

found that between 10 and 30 percent of firms misclassify their employees as 

 

85 The Keystone Center, supra note 10. 86 The Keystone Center, supra note 10. 87 John Calhoun Wells, Thomas A. Kochan & Michal Smith, Managing Workplace Safety and Health: The Case of 

Contract Labor in the U.S. Petrochemical Industry (July 1991) (report for the Occupational Safety and Health 

Administration). 

88 Occupational Safety and Health Administration Process Safety Management Standard, 29 CFR § 1910.119 (1992). 89 Jeremy Olson, and Steve Jordan, On the Job of Last Resort: Meat Plant Risks Extend to Nightly Clean-up Work, The 

Omaha World-Herald, October 12, 2003, at 1A. 

90 Lise Olsen, supra note 83 
24 

independent contractors.91 Employers have a strong economic incentive to misclassify 

employees as independent contractors. In addition to not paying the employer share of 

Social Security, Medicare, or unemployment taxes, employers also do not have to 

provide contractors with workers’ compensation insurance.92 As a result, injuries 

suffered by independent contractors – including those who are misclassified – do not go 

on the employers’ logs and do not increase the workers’ compensation premiums or the 

likelihood that they will be inspected by OSHA. 

At a March 2007 hearing before the U.S. House of Representatives Committee on 

Education and Labor, Subcommittee on Workforce Protections, Cliff A. Horn of the 

Mason Contractors Association of America and John J. Flynn of the International Union 

of Bricklayers and Allied Craftworkers testified that employee misclassification is 

widespread in their industries. Flynn pointed out that when employers neglect their 

responsibility to pay workers’ compensation, then the U.S. health care system often 

absorbs the cost of their care.93 

Underreporting Problems in the Railroad Industry 

In 2007, the U.S. House of Representatives Committee on Transportation and 

Infrastructure conducted an in-depth review of railroad employee injury reporting 

practices in response to evidence of a long history of underreporting and complaints of 

harassment of employees who report injuries. Committee staff compiled more than 200 

individual cases of alleged management harassment following injury reports.

 94

Some of the techniques used by railroad management include: 

• "Risky" employee assessments: Employees are placed in disciplinary jeopardy 

by being assigned points for safety incidents, rule infractions, and injuries 

regardless of the cause, often before an investigation is done. 

. 

• Targeting employees for increased monitoring and testing: Injured employees 

are "targeted" for close supervisor scrutiny, where minor rule infractions result in 

employee termination following injuries. 

• Supervisors discouraging employees from filing accident reports: Front-line 

supervisors often try to subtly prevent employees from filing injury reports and/or 

lost workday reports in an attempt to understate or minimize on-the-job injury 

statistics 

 

91 Planmatics, Inc., Independent Contractors: Prevalence and Implications for Unemployment Insurance Programs

(prepared for U.S. Dep’t of Labor) (2000), at http://wdr.doleta.gov/owsdrr/00-5/00-5.pdf 92 Government Accountability Office, Employer Arrangements: Improved Outreach Could Help Ensure Proper Worker 

Classification, GAO-06-656 (July 2006). 93 Providing Fairness to Workers Who Have Been Misclassified as Independent Contractors Hearing Before the House 

Comm. on Education and Labor, Subcomm. on Workforce Protections, 110th Cong. (2007) (written testimony of Cliff 

A. Horn of the Mason Contractors Association of America). 

94 The Impact of Railroad Injury, Accident, and Discipline Policies on the Safety of America's Railroads Hearing 

Before the House Comm. on Transportation and Infrastructure, 110th Cong., (2007).
25 

• Supervisors attempting to influence employee medical care: Railroad 

supervisors are often accused of trying to accompany injured employees to their 

medical appointments to try to influence the type of treatment they receive. In 

addition, they try to send employees to company physicians instead of allowing 

them to choose their own treatment providers. 

• Light duty work programs v. injury leave: Injured employees are required to 

come to work, often doing nothing but sitting in an empty room and allowing 

carriers to minimize the required reporting of lost work days. 

• Availability policies: These policies require employees to work a certain number 

of days per year. If the employee cannot work the required number of days, he or 

she is no longer a full-time employee. 

• Supervisor compensation: Some companies base management compensation 

upon performance bonuses, which can be based in part upon recordable injury 

statistics within their supervisory area. 

The report concluded: 

Today's railroad regulatory environment is more oriented toward assigning blame 

to a single individual, without a thorough examination of the underlying causes 

that led that single individual to commit an error. This approach is apparent in 

both railroad internal investigations of injury accidents, as well as FRA regulatory 

reports. 95

Behavioral Safety: Bad for Safety, Bad for 

Recordkeeping Accuracy 

The theoretical underpinning of many safety programs that rely on discipline or rewards 

is the belief that most workplace accidents are caused by the unsafe behavior of workers. 

Rewarding good behavior or punishing bad behavior, according to this philosophy, can 

prevent accidents. 

But experts in analyzing accident causation note that, since workers are human and 

inevitably make errors, the consequence of rewards or punishment is often a failure to 

report incidents, rather than a reduction of injuries and illnesses. Most have rejected the 

theory of the “careless worker” and the behavioralist theory for the following reasons: 

• In order for an accident to happen, an unsafe condition must be present. These 

may range from conditions like slippery floors or objects that are too heavy for 

workers to lift safely, to management system errors such as allowing or 

encouraging frequent deviation from safe procedures, not providing training to 

 

95 Id. 
26 

workers, ignoring past warnings and close calls and lack of oversight by 

supervisors or enforcement agencies.

One of those conditions is pressure for more production. Andrew Hopkins, a 

sociologist and safety analyst, explains: 

Production pressures routinely lie behind unsafe actions by workers in this 

way. Despite all the company rhetoric about putting safety first, the 

experience of many workers, not all, is that production takes precedence 

over safety....Such pressures are particularly intense when pay systems 

are tied to production, so that lost time is lost pay, or where there are 

quotas, with penalties for not achieving the quota.96

Where such conditions exist, punishing the worker will not prevent future 

accidents. The most effective solution is to identify and address the root cause of 

the problem, which in this case is too much emphasis on increased production at 

the expense of safety. 

• While there is almost always a human element involved in accidents, most 

incidents (major and minor) have many complex causes and human error is 

almost never one of the root causes. Worker errors are generally the consequences

– or last link in a causal chain, not the causes themselves. 97-98

Following the catastrophic 2005 explosion at BP’s Texas City refinery that killed 

15 workers, BP immediately fired several workers and managers. The initial 

results of the BP’s internal investigation blamed the accident on the “surprising 

and deeply disturbing” actions of these employees.99 The 2007 Chemical Safety 

Board investigation report, however, found a multiplicity of causes for the 

explosion, including cost-cutting at the top of the corporation that affected safety 

conditions, outdated equipment, malfunctioning valves and indicators, worker 

fatigue, poor training, locating trailers too close to hazardous areas and ignoring 

numerous warnings and “near misses.” 100

Similarly, the commission that was assembled to investigate the 2003 Columbia 

space shuttle disaster criticized managers’ tendency to blame the actions of 

individual workers (or even single causes) when investigating accidents: 

Many accident investigations do not go far enough. They identify the 

technical cause of the accident, and then connect it to a variant of 

“operator error” – the line worker who forgot to insert the bolt, the 

 

96 Andrew Hopkins, What Are We To Make Of Safe Behaviour Programs?, 44 SAFETY SCIENCE 583, (2006). 97 Id. 98 Improving Workplace Safety: Strengthening OSHA Enforcement of Multi-Site Employers Hearing Before the House 

Comm. On Education and Labor, Subcomm. on Workforce Protections, 110th Cong. (2007) (written testimony of Frank 

A. White, Senior Vice President, ORC Worldwide). 

99 T.J. Aulds, BP Blames Employees for Fatal Blasts, THE GALVESTON COUNTY DAILY NEWS, May 18, 2005. 100 U.S. Chemical Safety and Hazard Investigation Board, supra note 88. 
27 

engineer who miscalculated the stress, or the manager who made the 

wrong decision. But this is seldom the entire issue. When the 

determinations of the causal chain are limited to the technical flaw and 

individual failure, typically the actions taken to prevent a similar event in 

the future are also limited: fix the technical problem and replace or retrain 

the individual responsible. Putting these corrections in place leads to 

another mistake – the belief that the problem is solved.101

• Blaming workers for accidents can make safety problems worse. 

Programs that have the result of discouraging workers from reporting incidents 

that may be predictive of future or more serious accidents can have a detrimental 

effect on worker safety. The Chemical Safety Board, in its report on the 2005 BP 

Texas City explosion that killed 15 workers, noted that one thing missing at BP 

was a “reporting culture where personnel are willing to inform managers about 

errors, incidents, near-misses, and other safety concerns.” When workers were not 

encouraged to report, managers did not investigate incidents or take appropriate 

corrective action. 102

Instead of punishing pilots or other workers for the “errors” that they make, the 

Federal Aviation Authority has taken a completely different approach to 

addressing the problem of preventing accidents, according to a recent report by 

the U.S. House Transportation Committee: 

Recognizing these human factors and complex accident causation 

principles, the FAA began to promote and establish voluntary reporting 

programs such as NASA's Aviation Safety Reporting System ("ASRS"), 

where anyone in the aviation system could report a mistake or a violation 

and receive immunity from the finding of a civil penalty violation. In 

addition, the FAA has established a ‘Voluntary Self Disclosure’ program 

where both organizations and individuals can disclose a violation, cease 

and desist from the unsafe practice, develop a corrective action plan, and 

be immune from civil penalty action. The dramatic improvement in U.S. 

air safety over the last two or more decades has been directly linked to the 

implementation of these "non-punitive" principles in the regulatory 

environment.103

Not all incentive programs are detrimental, as mentioned above, nor is all safety-related 

discipline a problem if it is actually justified. There are situations where despite repeated 

training, frequent warnings and consistent enforcement of safety policies, there is clear, 

willful disregard of an established rule by workers or managers and some disciplinary 

action from the employer may be necessary. In rare cases OSHA has chosen not to cite an 

 

101 Columbia Accident Investigation Board, Columbia Accident Investigation Board Report Volume I, 97, (2003), at 

http://caib.nasa.gov/news/report/pdf/vol1/full/caib_report_volume1.pdf 102 U.S. Chemical Safety And Hazard Investigation Board Investigation Report, supra note 88. 103 The Impact of Railroad Injury, Accident, and Discipline Policies on the Safety of America's Railroads Hearing 

Before the House Comm. on Transportation and Infrastructure, 110th Cong., (2007). 
28 

employer, based on “unavoidable employee misconduct,” recognizing that the employer 

had no control over an employee’s actions and had done everything in its power to ensure 

safe working conditions. 

Some employers, however, try to blame workers for the incident, even though the 

employer has legal responsibility for safety in the workplace and other factors are almost 

always to blame. For example, according to a former supervisor, Cintas, a large industrial 

laundry company, has a company policy to write up a disciplinary action immediately 

after every accident – before any investigation is done. 104

After an employee is hurt or killed, the employer often blames the worker for not 

following proper procedures, although further investigation generally finds that 

procedures are rarely followed (with full knowledge of supervisors), or workers have not 

been trained in the procedures, or the procedures are so old that they do not match the 

actual working conditions. 105

Other organizational factors such as fatigue or work overload can also explain a worker’s 

failure to follow proper procedures. Many workers report, for example, that while the 

written procedures may say to shut off a machine and wait for maintenance to come and 

repair it, the unwritten rule is to do anything necessary to make the production quota by 

the end of the day or face disciplinary action. 

• After Eleazar Torres Gomez was pulled into a 300 degree oven and killed while 

attempting to unjam an industrial laundry conveyor at a Cintas industrial laundry 

in Tulsa Oklahoma in 2007, the company immediately blamed him for his own 

death. According to a Cintas press release, 

Although the investigation is still ongoing, it is clear that our partner did 

not follow established safety rules which would have prevented this tragic 

accident. Unfortunately, the partner climbed on top of a moving conveyor 

to dislodge a jam, contrary to all safety training and procedures, and fell 

into a dryer. 106

OSHA later issued a $2.8 million citation against Cintas, finding that 

“management at the Cintas Tulsa laundry facility ignored safety rules that could 

have prevented the death of this employee.” 107 According to press reports, the 

OSHA investigation found that because workers were under a lot of pressure to 

keep the lines moving, they routinely tried to unjam the machines while they were 

still running, with management’s full knowledge.108 

 

104 Phone Interview by Committee staff with former Cintas Supervisor, Washington, D.C. (May 17, 2008). 105 Hopkins, supra note 96. 106 Cintas, Media Statement Regarding: March 6 Incident in Tulsa, OK (March 22, 2007), at 

http://www.cintas.com/Company/News_Media/press_releases/Tulsa_OK.aspx 107 Occupational Safety and Health Administration, U.S. Department of Labor's OSHA Proposes $2.78 Million Fine 

Against Cintas Corp. Following Tulsa, Okla., Employee Death in Industrial Dryer (August 16, 2007), at 

http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=NEWS_RELEASES&p_id=14397. 108 James Bandler and Kris Maher, House Panel to Examine Cintas Plants’ Safety Record, WALL ST. J., Apr. 23, 2008, 

at B1. 
29 

• When a Caterpillar worker at the company’s Peoria plant was injured after being 

shocked while repairing a machine, he and his co-workers were disciplined for 

not following proper “lockout-tagout” procedures, even though the machine had 

been miswired during a previous modification and there was no written procedure 

that applied.109 

• Brent Churchill, a lineman for Central Maine Power, was electrocuted in 2000 

after failing to put his insulating gloves on before reaching for a 7,200 volt cable. 

Because of mandatory overtime, Churchill had slept a total of five hours over the 

previous two and a half days. His death lent momentum to the passage of the 

passage in Maine of the country’s first law limiting the number of hours an 

employee can be required to work.110

OSHA’s Role in Ensuring Accurate Reporting 

OSHA audits. OSHA conducts recordkeeping audits which, according to the agency, 

indicate that injury and illness logs are a reasonably accurate reflection of those injuries 

and illnesses actually reported by employees at work. Under the program, OSHA 

inspectors interview a “sample of employees” about reporting procedures and look for 

mistakes and inconsistencies by reviewing medical records, workers’ compensation 

records, insurance records and, “if available,” payroll absentee records, company safety 

incident reports and company first aid logs.111

But OSHA’s auditing method may miss those workers who are afraid to report or choose 

not to report an injury or illnesses to the employer, to workers’ compensation or to 

insurance. Unless OSHA’s “sample of employees” identifies workers who have suffered 

unreported injuries or illnesses and who are not afraid to talk to the OSHA compliance 

officer, OSHA audits will not identify those missing injuries or illnesses, nor the reasons 

that they have not been reported. 

The California Bay Bridge Auditors’ Report identified the same problem when it 

questioned whether employer injury reports are accurate, noting that CalOSHA “does not 

have a process to verify the reasonable accuracy of the annual injury reports employers 

are required to maintain”, that CalOSHA “has no legal requirement to collect these 

reports” nor a “systematic process to detect injuries that go unrecorded.” 112

Finally, as noted above, by making ergonomic inspections dependent on recorded MSDs, 

OSHA’s Ergonomics Enforcement Program actually rewards employers for 

underreporting their ergonomic injuries. 

 

109 Interview by Committee Staff with Caterpillar Employee, Washington, D.C. (June 3, 2008). 110 Mary Williams Walsh, As Hot Economy Pushes Up Overtime, Fatigue Becomes a Labor Issue, N.Y.TIMES, Sept. 17, 

2000, at 32. 

111 Occupational Safety and Health Administration, Audit and Verification Program of Occupational Injury and Illness 

Records, CPL-02-00-138 (January 12, 2006), at 

http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=DIRECTIVES&p_id=3329. 112 California State Auditor, supra note 52. 
30 

Other OSHA procedures. Paragraph 11(c) of the Occupational Safety and Health Act 

makes it a violation of the Act to “discharge or in any manner discriminate against any 

employee because such employee has filed any complaint or instituted or caused to be 

instituted any proceeding under or related to” the Act.113 

There is, however, no specific mention of employer actions that would discourage 

reporting. This section of the OSH Act is rarely used against such actions, although 

Paragraph 1904.36 of OSHA’s recordkeeping regulation notes that Paragraph 11(c) also 

applies to discrimination against an employee for reporting a work-related fatality, injury 

or illness. The recordkeeping regulation itself, however, does not explicitly prohibit 

discouragement of reporting, forcing workers to go through the ineffective and time 

consuming 11(c) process.114

 

113 Occupational Safety and Health Act, 29 U.S.C. § 660. 114 Occupational Safety and Health Administration, Recording and Reporting Occupational Injuries and Illnesses, 29 

C.F.R. § 1904 (Jan. 19, 2001). 
31 

Other Measures Can Be Used To Target Unsafe 

Workplaces

Injury, illness, and fatality rates are not the only way – or even the best way in many 

cases – to assess and ensure workplace safety. 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 are much better indicators of potential hazards than counts of slips, trips and falls 

that comprise most injury reporting. 115

These “leading indicators” – observations that can help predict safety problems – can be 

just as important and more useful than “lagging indicators” – looking at the injuries that 

have already occurred in preventing future incidents. But these leading indicator 

measures are not usually recorded by employers and if recorded, are not monitored by 

OSHA or BLS. 116-117 

At a U.S. House of Representatives Committee on Education and Labor hearing last year 

on the catastrophic explosion at BP’s Texas City refinery, it was revealed that both the 

company and OSHA were using only injury statistics to assess the safety of refineries. 

Yet many experts agree that these statistics are meaningless when attempting to 

determine how likely it is that a refinery may experience a catastrophic explosion. Much 

better are “process safety” indicators: how well the company follows up on near misses; 

how well the company maintains its equipment and how willing the company is to shut 

down a process when there are problems.118

In addition, workplace illnesses are especially difficult to count. Many work-related 

illnesses mimic the flu or other common household maladies. Others may cause serious 

disease like cancer or heart disease many years or decades after workers were exposed. 

The injury and illness statistics that OSHA currently collects are therefore almost useless 

in targeting inspections at workplaces were employers are exposed to workplace health 

hazards. 119 

Conclusion 

 

115 John Calhoun Wells, Thomas A. Kochan & Michal Smith, Managing Workplace Safety and Health: The Case of 

Contract Labor in the U.S. Petrochemical Industry (July 1991) (report for the Occupational Safety and Health 

Administration). 

116 Improving Workplace Safety: Strengthening OSHA Enforcement of Multi-Site Employers Hearing Before the House 

Comm. On Education and Labor, Subcomm. on Workforce Protections, 110th Cong. (2007) (written testimony of Frank 

A. White, Senior Vice President, ORC Worldwide). 

117 U.S. Chemical Safety and Hazard Investigation Board Investigation Report, supra note 88. 118 The BP-Texas City Disaster and Worker Safety Hearing Before the House Comm. on Education And Labor, 110th

Cong. (2007). 

119 NATIONAL ACADEMY OF SCIENCES, supra note 9.
32 

Although the Occupational Safety and Health Act of 1970 requires the Department of 

Labor to collect and compile statistics on the extent of occupational injuries, illnesses and 

fatalities in the United States, and requires employers to keep accurate records of 

workplace injuries, illnesses and deaths, strong evidence from academic studies, media 

reports and worker testimony cast serious doubt on the accuracy of these numbers. 

This report has reviewed the importance of accurate recordkeeping, evidence that injuries 

and illnesses are significantly underreported, the reasons why injury and illness statistics 

are underreported, methods that some employers use to discourage reporting, and 

OSHA’s failure to address these problems. 

If policy makers are going to be able to assess the success or failure of this country’s 

efforts to address the problem of workplace death and injury, accurate statistics are 

essential. And if workers are to have faith in the system, they must also have faith that 

OSHA and policy makers are aware of the hazards that workers face and the injuries and 

illnesses they suffer. 

It is incumbent on the Occupational Safety and Health Administration and Bureau of 

Labor Statistics, working with other agencies and experts, to assess the full extent of this 

problem and develop solutions. 
33 

Appendix 1: House Hearings on Worker Health and 

Safety, 110th Congress 

"The BP-Texas City Disaster and Worker Safety" 

Full Committee 

Thursday, March 22, 2007 

"Protecting the Health and Safety of America's Mine Workers" 

Full Committee 

Wednesday, March 28, 2007 

Have OSHA Standards Kept up with Workplace Hazards?" 

Subcommittee on Workforce Protections 

Tuesday, April 24, 2007 

"Evaluating the Effectiveness of MSHA's Mine Safety and Health Programs" 

Full Committee 

Wednesday, May 16, 2007 

"Workplace Safety: Why do Millions of Workers Remain without OSHA Coverage?" 

Subcommittee on Workforce Protections 

Tuesday, May 24, 2007 

"The S-MINER Act (H.R. 2768) and the Miner Health Enhancement Act of 2007 (H.R. 

2769)" 

Subcommittee on Workforce Protections 

Thursday, July 26, 2007 

"Why Weren't 9/11 Recovery Workers Protected at the World Trade Center?" 

Full Committee 

Wednesday, September 12, 2007 

"Workplace Tragedies: Examining Problems and Solutions" 

Subcommittee on Workforce Protections 

Monday, January 14, 2008 

"H.R. 5522, The Combustible Dust Explosion and Fire Prevention Act of 2008" 

Full Committee 

Wednesday, March 12, 2008 

"Improving Workplace Safety: Strengthening OSHA Enforcement of Multi-Site 

Employers" 

Subcommittee on Workforce Protections 

Wednesday, April 23, 2008 
34 

Appendix 2: Glossary 

ACOEM – American College of Occupational and Environmental Medicine 

ASRS – Aviation Safety Reporting System 

BLS – Bureau of Labor Statistics 

CalOSHA – California OSHA 

CFOI – Census of Fatal Occupational Injuries 

CPS – Current Population Survey 

DOL – Department of Labor 

ED – Emergency Department 

FAA – Federal Aviation Administration 

FRA – Federal Railroad Administration 

GAO – Government Accountability Office 

IRS – Internal Revenue Service 

ITR – Illinois Trauma Registry 

MSDs – musculoskeletal disorders 

NEISS – National Electronic Injury Surveillance System 

NHIS – National Health Interview Survey 

NIOSH – National Institute for Safety and Health 

ODI – OSHA Data Initiative 

OSHA – Occupational Safety and Health Administration 

SOII – Survey of Occupation Injuries and Illnesses 

SST – OSHA’s Site-Specific Targeting program 
35 

Appendix 3: Academic Study Tables 
Author(s) Title/Journal Data Used Methods 

Leslie I. Boden and Al Ozonoff 

2008 Capture-recapture Estimates of Nonfatal 

Workplace Injuries and Illnesses, Annals of 

Epidemiology (Vol. 18, pg. 500) 

Bureau of Labor Statistics Survey of Occupational Injuries and Illnesses (SOII) and workers’ compensation records, 1998- 2002 

The researchers linked individual case records for establishments reporting to tBLS and individual case records from workers’ compensation data for 1998 2002 from six states: Minnesota, Wisconsin, New Mexico, Oregon, Washingtoand West Virginia. They employed capture-recapture analysis, a statistical techniqoften used in epidemiologicstudies involving several overlapping, but incomplete data sources, to estimate the proportion of injuries report

Lee S. Friedman and Linda Forst 

2007 Occupational Injury Surveillance of Traumatic 

Injuries in Illinois, Using the Illinois Trauma Registry: 1995-2003, Journal of Occupational and 

Environmental Medicine (Vol. 49, pg. 401) 

Illinois Trauma Registry (ITR) 

The researchers used the ITRwhich provides detailed, complete data on severe occupational injuries, to estimate the number of Illinoworkers who suffered workrelated nonfatal traumatic injuries from 1995 to 2003. Since the ITR is a populatiobased registry and does not depend on employer reportinit likely reflects a more accurate picture of the trendoccupational injuries than thSOII. 

Appendix 3: Academic Study Table 
Lee S. Friedman and Linda Forst 

2007 The Impact of OSHA Recordkeeping Regulation 

Changes on Occupational Injury and Illness Trends in the US: a Time-series Analysis, Occupational Environmental Medicine (Vol. 64, pg. 454) 

BLS Survey of Occupational Injuries and Illnesses, 1992-2003 

Two changes in OSHA recordkeeping have impactethe agency‘s data collectionAn OSHA recordkeeping rufirst applied in 1995, limited OSHA’s access to employer documentation by requiring that all injury and illness datcollection occur through maor electronic transmissions. 2002, OSHA introduced a ninjury and illness reporting form that eliminated the specific category on the reporting form for musculoskeletal disorders. Tresearchers employed a joinpoint regression analysis usiSOII time series data to estimate the impact of these recordkeeping changes on thtrends in injury and illnesses

Kenneth D. Rosenman, Alice Kalush, Mary Jo Reilly et al. 

2006 How Much Work-Related Injury and Illness is 

Missed by the Current System?, Journal of Occupational and Environmental Medicine (Vol. 48, pg. 357) 

Bureau of Labor Statistics Survey of Occupational Injuries and Illnesses (SOII), workers’ compensation records, OSHA Annual Survey, OSHA Integrated Management Information System, Occupational Disease Report for Michigan, 1999-2001 

The researchers matched company and individual records from the SOII to company and individual records in four other Michigdatabases: worker’s compensation, OSHA AnnuSurvey, OSHA Integrated Management Information System, and the OccupationDisease Report. They used capture-recapture analysis, a statistical technique often usin epidemiological studies involving several overlappinbut incomplete data sourcesestimate the proportion of injuries and illnesses reporte
Tim Morse, C. Dillon, E. KentaBibi et al.

2005 Trends in Work-related Musculoskeletal Disorder 

Reports by Year, Type, and Industrial Sector: A Capture-recapture Analysis, American Journal of Industrial Medicine (Vol. 48, pg. 40) 

Workers’ compensation and physician reporting data for Connecticut, 1995-2001 

Using worker’s compensatioand physician reporting data from Connecticut, the researchers estimated the number of work-related uppextremity musculoskeletal disorders (MSDs) in Connecticut from 1995 to 2001. 

Sara A. Quandt, Joseph G. Grzywacz, Bless Burke et al. 

2006 Occupational Illnesses and Injuries among Latino 

Poultry Workers in Western North Carolina, American Journal of Industrial Medicine (Vol. 49, pg. 343) 

Survey data on 200 Latino poultry workers in six counties in western North Carolina 

The researchers conducted face-to-face interviews with representative sample of Latpoultry workers in six westeNorth Carolina counties, collecting data on occupatioand psychological health, safety training, and the safetclimate inside the processing plant. 
Theresa Scherzer, Reiner Rugulies, and Niklas Krause 

2005 Work-related Pain and Injury and Barriers to 

Workers’ Compensation Among Las Vegas Hotel Room Cleaners, American Journal of Public Health (Vol. 95, pg. 483) 

Researcher –collected survey data on unionized hotel room cleaners 

The researchers surveyed 94unionized hotel room cleanein Las Vegas, NV about worrelated pain, injury, disabilitand reporting. 

Gordon Smith, Helen Wellman, Gary Sorock et al. 

2005 Injuries at Work in the US Adult Population: 

Contributions to the Total Injury Burden, American Journal of Public Health (Vol. 95, pg. 1213) 

National Health Interview Survey (NHIS), 1997-1999 

Used the NHIS, which incluinformation on the workrelatedness of injuries, to develop an estimate of the annual at-work injury rate in the U.S. The researchers compared their results to the BLS statistics. 
S.M. Marsh, S.J. Derk, and L.L. Jackson 

2004 Nonfatal Occupational Injuries and Illnesses 

Among Workers Treated in Hospital Emergency Departments—United States, Morbidity and 

Mortality Weekly Report (Vol. 55, pg. 449) 

National Electronic Injury Surveillance System (NEISS), Bureau of Labor Statistics Survey of Occupational Injuries and Illnesses (SOII) and Current Population Survey 

The researchers employed NEISS and CPS to estimate rate of emergency departme(ED)-treated workplace injufrom 1996 to 2004. They compared their findings to thSOII numbers. 
J. Paul Leigh, James P. Marcin, and Ted R. Miller 

2004 An Estimate of the U.S. Government’s Undercount 

of Nonfatal Occupational Injuries, Journal of 

Occupational and Environmental Medicine (Vol. 

46, pg. 10) 

Bureau of Labor Statistics Survey of Occupational Injuries and Illnesses (SOII) 

To estimate underreporting, researchers employed separamodels for six broad categorof workers: workers includein the SOII, federal government employees, agricultural workers, state anlocal government employeenon-agricultural self-employworkers, and “other” individuals not covered by tSOII. In developing the models, the researchers madassumptions about the risk oinjury in each job category athe likely degree of underreporting given previostudies’ findings. This produced varying estimates each of the six models. 
Lenore Azaroff, Charles Levenstein, and David H. Wegman 

2002 Occupational Injury and Illness Surveillance: 

Conceptual Filters Explain Underreporting, American Journal of Public Health (Vol. 92, pg. 1421) 

Previous research and reporting on workplace injuries and illnesses 

The researchers modify a “filter model” developed for Australia to explain the documentation of work-relainjuries and illnesses in the United States. 

Marianne P. Brown, Alejandra Domenzain, and Nelliana VilloriaSiegert 

2002 Voices From the Margins: Immigrant Worker’s 

Perceptions of Health and Safety in the Workplace, UCLA Labor Occupational Safety and Health Program, at http://www.losh.ucla.edu/publications/voicesreport.pdf 

Researcher-collected survey data on immigrant workers 

The researchers surveyed 75 immigrants in the Los Angearea working in low-wage, lskill jobs in several industrieincluding the hotel, restauraand garment industries. Theasked the workers about theopinions, perceptions, and experiences around workplahealth and safety. 

Judith E. Glazner, Joleen Borgerding, Jan T. Lowery et al. 

1998 Construction Industry Rates May Exceed National 

Estimates: Evidence from the Construction of the Denver International Airport, American Journal of Industrial Medicine (Vol. 34, pg. 105) 

Bureau of Labor Statistics Survey of Occupational Injuries and Illnesses (SOII), payroll records, workers’ compensation 

Used workers’ compensatioand payroll data to estimate total number of lost work-timinjuries during the Denver International Airport (DIA) construction project.