19 Compensation and Working Conditions Winter 1997

President Chester A. Arthur

signed the bill creating the

Bureau of Labor in the

Department of the Interior on June

27, 1884. His signature culminated

two decades of advocacy by labor

organizations seeking government

assistance in publicizing and

improving the status of the growing

industrial work force. Those two

decades following the War between

the States saw vast changes in the

American economy and society.

Those decades brought about a

national economy symbolized by the

transcontinental railroads. Rapidly

growing industries attracted unprecedented numbers of unskilled

workers recruited from among

BY DINO DRUDI

Dino Drudi is an economist in the Office of

Safety, Health and Working Conditions, Bureau

of Labor Statistics. Telephone (202) 606-6179.

A Century-Long

Quest for Meaningful

and Accurate

Occupational Injury

and Illness Statistics

For over a century, the Bureau has collected and disseminated

information on occupational injuries and illnesses. Data collection methods have evolved through trial-and-error. Recent program redesign takes ample consideration of past lessons and

holds great promise for success. Immediate challenges still confront the occupational safety and health program, however, as the

Bureau embarks on its second century of involvement with occupational injury and illness data.

immigrants, freed slaves, women,

and even children.1

Within a decade of the Bureau’s

establishment, from the mid-1890s

on, it published extensively on new

developments in State and foreign

social legislation and practices,

including accident prevention and

workers’ compensation.2

 This began

a long and continuing commitment

to the presentation of useful information on occupational safety and

health.

In 1914, Royal Meeker, the

Bureau’s third Commissioner,

asserted, “The Bureau should be in a

position to furnish at any time advice

as to the best methods of preventing

industrial accidents and occupational
 Compensation and Working Conditions Winter 1997 20

diseases.”3 By 1976, under Janet

Norwood, the Bureau’s tenth

Commissioner, the Survey of

Occupational Injuries and Illnesses

was the largest annual sample survey

conducted by the Bureau.4 Occupational injury and illness data have

long been considered a staple among

the Bureau’s traditional programs.

These programs collect, tabulate,

and publish data on employment,

wages, prices, and other economic

measures used in labor economics

and general commerce.5

The Bureau, through virtually all

its history, has relied on the cooperation of State agencies for occupational safety and health data collection. Carroll Wright, the Bureau’s

first Commissioner, envisioned a

network of collaborating State and

Federal agents collecting and

sharing data. He called this network

a “powerful chain of investigators.” 6

Starting with 3 States just before

World War I, 14 States were participating in the Bureau’s safety and

health statistics program by 1970,

when the Occupational Safety and

Health Act was passed. The Act

authorized BLS to make matching

grants to the States to cover part of

the cost of providing occupational

injury and illness data to BLS.7 BLS

also offered to provide technical

assistance and standardized data

formats allowing States to compare

their injury and illness experience

with other States. Consequently,

when the Census of Fatal Occupational Injuries program began in

1992, all 50 States and the District

of Columbia were participating. In

that same year, BLS introduced its

redesigned annual Survey of

Occupational Injuries and Illnesses.

This survey, which covers nonfatal

injuries and illness, had 42 States

and several territories participating

in the program.

Rudimentary beginnings

The primary problem with

counting occupational injuries and

illnesses was the difficulty associated

with identifying comprehensive,

uniform data sources.

Before the 1890s, the chief barrier

to occupational injury and illness

data was the lack of any statutory

obligation for employers to report

workplace injuries to a State

authority. Even thereafter, such

duties were limited and poorly

enforced. The subsequent introduction of State factory inspectors also

had little impact, due to incomplete

reports. Differences between

individual State reporting requirements further precluded meaningful

interstate comparisons.8 Even the

oldest and most complete industrial

injury data series – the statutory

requirement for railroads to report

injuries to the Interstate Commerce

Commission – was not entirely

trustworthy despite its enforceability

by monetary penalties.9 These

conditions in large part persisted

until the passage of the Occupational

Safety and Health Act in 1970.

In 1907, Arthur Reeves, a

commentator of the times, proposed,

to no avail, that States require all

incidents be reported to their labor

bureaus, and that BLS’s predecessor,

the Bureau of Labor, prepare

national tabulations.10 Ironically,

while the wave of enactments of

workers’ compensation laws in the

1910s provided a much broader and

more accurate source of work-related

fatality statistics, widely differing

State workers’ compensation statutes

proved an insurmountable obstacle

to a nationally uniform, comprehensive reporting system.11 The enactment of workers’ compensation

statutes may actually have hindered

development of national occupational injury and illness statistics

because many policy makers

believed that State workers’ compensation statutes had largely eliminated

the problem.12

In the years preceding World War

I, the Bureau began to give attention

to industrial incidents and occupational diseases. In 1909, BLS conducted a study of phosphorous

poisoning in the match-making industry.13 During this time, the Bureau

also reported on lead poisoning,

railway incidents, mining fatalities,

and other safety and health topics.14

In 1910, BLS began issuing an

annual report on injury rates in the

iron and steel industry. A few years

later, the Bureau established cooperative arrangements with three

important industrial States–

Massachusetts, New York, and Ohio

–for reporting industrial accidents.15

The Bureau, over the years, has also

continued to conduct various special

studies to supplement its regular

data series, and focus on areas of

particular interest.

Foundations of the present

system

In 1926, BLS began an annual

survey of the frequency and severity

of industrial injuries for several

manufacturing industries. The data

from this survey were based on State

records and reports from establishments in these industries.16

In the late 1920s, Ethelbert

Stewart, the Bureau’s fourth Commissioner, sought congressional

authorization for a safety division

within the Bureau. This division was

to act as a “clearing-house for the

information the States are gathering.” 17

While Stewart’s efforts ultimately

were unsuccessful, by 1930, data

covered a quarter of the workforce in

some 30 manufacturing industries.18

In 1939, BLS added survey-based

occupational fatality data, switching

from the previous method of

periodically aggregating State

workers’ compensation figures to

voluntary direct reporting by

employers.19 Unfortunately, this

kind of survey-based data collection

methodology raised a serious

potential for systematic bias in the

data. More specifically, cases of

underreporting by employers with

the worst safety records, and

consequent underestimation of the

total number of cases, began to

appear.20 For example, fewer than a

third of the construction firms

sampled in 1948-49 provided usable
21 Compensation and Working Conditions Winter 1997

fatality data to BLS.21

In 1937, the Bureau adopted an

injury classification system developed by the forerunners of the

American National Standards

Institute. At the request of Under

Secretary of Labor J. D. Hodgson,

the American National Standards

Institute formed a study group to

“review available reporting methods

and standards of reporting injuries

on a nationwide basis, and, if

necessary, develop a simple method

of reporting injuries.” 22

The study found the standard’s

detailed severity descriptions for

different kinds of injuries and special

exceptions were too complex. The

standard was also too insensitive to

measure trends in injury experience

and did not capture any occupational

illness data. Moreover, it allowed

employers to transfer injured

workers to another job. As long as

employees could carry out the duties

associated with the job to which they

were transferred, there was considered to be no time lost and, consequently, no recordable injury.23

During World War II, the Bureau

published monthly injury data for

industries of particular wartime

importance. Because industrial

incidents could adversely affect

wartime production, government

agencies used these data to identify

industries and establishments with

high injury rates. The Bureau also

undertook special studies to examine

the effects of long hours on industrial incidents. One study of

operations at the Frankford Arsenal

in Philadelphia showed that incidents happened more frequently

during the extended hours than

during the regular hours.24 The

Bureau also conducted detailed

studies of incidents in the foundry,

longshoring, and meatpacking

industries.25

After the war, BLS expanded its

survey of injury frequency and

severity to more manufacturing

industries and began surveying

nonmanufacturing industries as well.

By 1966, data were published for

over 650 industries.26

From the late 1930s to the mid1960s, BLS also collaborated with

the National Safety Council (NSC), a

congressionally-chartered private

sector organization with formal ties

to the American National Standards

Institute, in an effort to improve the

statistics. Together, NSC and BLS

would go over the latest information

from BLS surveys, Council estimates

and reports from Council members,

and special studies. They would also

agree on the occupational fatality

totals both agencies would publish

and on the distribution of those

fatalities among the major industry

groups. Consequently, during those

years BLS and NSC published

similar estimates.27

Starting with data for 1965, BLS

and NSC discontinued collaboration.

BLS relied upon its survey-based

occupational fatality data, while the

NSC built its estimates on data

gathered from a variety of sources.

These sources included the Federal

Government, private sector organizations, and its own members.28

After BLS initiated the Census of

Fatal Occupational Injuries (CFOI)

program, the National Safety

Council adopted the CFOI counts for

1992 and subsequent years. The

National Safety Council adjusts the

BLS counts to exclude fatal injuries

resulting from “intentional acts”

(homicides and suicides) included in

the BLS fatality census.

Aside from this relatively minor

methodological distinction, the

National Safety Council recognizes

that BLS’s new methodology

“employs the most satisfactory

approach to identification of and

collection of information about fatal

occupational injuries presently

available.”29 BLS occupational

fatality data are sufficiently detailed

to allow the National Safety Council

to identify the homicides and

suicides contained in the BLS data.

Table 1 presents data between

1992 and 1996 derived from the

BLS occupational fatality census.

Table 1. Work injury fatalities and fatality rates, 1992-96

1992 .................................................................... 6,217 119,168 5.2

1993 .................................................................... 6,331 120,778 5.2

1994 .................................................................... 6,632 124,470 5.3

1995 .................................................................... 6,275 126,248 4.9

1996 .................................................................... 6,112 127,997 4.8

Employment

(in thousands) Fatalities 2

1

Fatility rate3

Year

1

 The fatality figures are from the Census of Fatal Occupational Injuries program, 1992-96. These figures include work injury fatalities for all age groups. The 1996

figure is preliminary; figures for all other years are final. 2 The employment figures, except for military, are annual average estimates of employed civilians 16 years of

age and older, from the Current Population Survey (CPS)

1992-96. The resident military figures, derived from resident and civilian population data from the Bureau of the

Census, were added to the CPS employment totals. 3 The rate represents the number of fatal occupational

injuries per 100,000 employed workers and was calculated as: (N/W) x 100,000, where

N = the number of work injury fatalites to

 workers 16 years of age and older,

W = the number of employed workers,

 100,000 = per 100,000 workers.
 Compensation and Working Conditions Winter 1997 22

The table also contains Current

Population Survey employment data

and an overall fatality rate.30

The Occupational Safety and

Health Act of 1970 required the

Labor Department, in consultation

with the Department of Health,

Education, and Welfare (now the

Department of Health and Human

Services), to “develop and maintain

an effective program of collection,

compilation, and analysis of occupational safety and health statistics.”

The Act required the Department to

“compile accurate statistics on work

injuries and illnesses... [for] all

disabling, serious, or significant

injuries and illnesses, whether or not

involving loss of time from work,

other than minor injuries requiring

only first aid treatment and which do

not involve medical treatment, loss

of consciousness, restriction of work

or motion, or transfer to another

job.”31

Responsibility for implementing

this provision was given to BLS.

The Act required employers to

maintain accurate records of workrelated fatalities, and nonfatal

injuries and illnesses. Employers

had to report these incidents to BLS

if selected for inclusion in a particular year’s annual survey. Initially,

funding was provided as a passthrough from the Occupational

Safety and Health Administration.

However, in fiscal year 1992, the

Congress included funds for the

program as part of the Bureau’s

budget.

The Bureau’s voluntary survey

became mandatory, thereby solving

the problem of nonsampling bias

resulting from nonresponse, particularly from employers with the worst

safety records.32 Private establishments subject to the Act selected for

a given year’s survey were required

to report fatalities and nonfatal cases

involving lost workdays, transfer to

another job, termination of employment, loss of consciousness, or

restriction of work or motion.

Consequently, it would no longer be

possible to mask injuries by transferring injured workers to other jobs, or

retiring or dismissing them.33

Since 1973, occupational injury

and illness numbers and incidence

rates for the private sector collected

under the Act have been published.

They include data for both the

private sector overall and for specific

private sector industries. Table 2

presents overall private sector data

from 1973 through 1995.

The Bureau simultaneously

developed procedures to gather from

State workers’ compensation records

additional information on the worker

and case characteristics associated

with work-related injuries and

illnesses. Introduced in 1976, this

Supplementary Data System grew to

34 participating States by 1982. Data

from State workers’ compensation

systems met many data needs not

fulfilled by the annual survey.

However, state systems’ varying

definitions of industries, workers,

and cases covered made interstate

comparisons difficult and national

aggregation of State data even more

problematic. By 1992, BLS–in

response to a National Academy of

Sciences recommendation–phased

out the Supplementary Data System

and expanded the annual survey.

This expansion aimed to capture

worker and case characteristic data

for nonfatal cases.34

In 1977, the Bureau initiated a

series of direct studies of injured

workers called Work Injury Reports

(WIR).35 These reports provided

detailed information on the causes

and effects of selected workplace

injuries and illnesses. The reports

used questionnaires mailed to

injured or ill workers by States

participating in the Supplementary

Data System. From 1978 until

1990, the Bureau issued numerous

studies on varied topics such as back

injuries associated with lifting and

eye injuries. WIR surveys were

designed, often in cooperation with

the Occupational Safety and Health

Administration, to identify patterns

of incident causes, the activities in

which the worker was engaged at

the time of the incident, specifics

about the equipment used, the

personal protective equipment being

worn, any training the employee

received, etc. The BLS Handbook of

Methods for Surveys and Studies

explains the rationale behind Work

Injury Reports further:

Because it would be difficult,

if not impossible, for employers to provide some of the

needed information, [BLS

decided to] survey injured

workers directly. For example,

by surveying the worker

directly, it is possible to

expand the scope of questions

on work being done... to

include safety training, and

prior experience, if any,

provided by previous employers. Such information helps

safety and health experts...

zero in on... workers who

lacked any safety training on

the work activity they performed when injured.36

The modern era of safety and

health statistics

In 1984, the Congress appropriated funds to study BLS occupational

injury and illness statistics. BLS

turned to the National Academy of

Sciences to conduct the study. After

the study’s completion in October

1987, the Bureau totally redesigned

its occupational injury and illness

statistical program.37 A panel from

the Keystone Dialogue Group (a

nonprofit private sector organization

that facilitates consensus building

discussions among business, labor,

and government on public policy

issues) also contributed recommendations for redesigning the statistical

program.38 The chief criticisms of the

survey were that it shed little light

on the demographics of injured and

ill workers or the characteristics of

the incident, such as the kind of

injury or illness involved, how it

happened, and the specific kind of

job involved.

BLS redesigned the annual survey
23 Compensation and Working Conditions Winter 1997

1973 .................................. 11.0 3.4 - 7.5 6,078.7 1,908.0 - 4,165.0

1974 .................................. 10.4 3.5 - 6.9 5,915.8 2,001.8 - 3,908.1

1975 .................................. 9.1 3.3 3.2 5.8 4,983.1 1,825.2 1,730.5 3,152.6

1976 .................................. 9.2 3.5 3.3 5.7 5,163.7 1,978.8 1,875.4 3,180.4

1977 .................................. 9.3 3.8 3.6 5.5 5,460.3 2,203.6 2,092.1 3,250.6

1978 .................................. 9.4 4.1 3.8 5.3 5,799.4 2,492.0 2,327.5 3,302.0

1979 .................................. 9.5 4.3 4.0 5.2 6,105.7 2,757.7 2,553.5 3,342.3

1980 .................................. 8.7 4.0 3.7 4.7 5,605.8 2,539.9 2,353.8 3,060.4

1981 .................................. 8.3 3.8 3.5 4.5 5,404.4 2,457.5 2,269.2 2,941.8

1982 .................................. 7.7 3.5 3.2 4.2 4,856.4 2,182.4 2,016.2 2,668.6

1983 .................................. 7.6 3.4 3.2 4.2 4,854.1 2,182.7 2,014.2 2,667.6

1984 .................................. 8.0 3.7 3.4 4.3 5,419.7 2,501.5 2,303.7 2,913.4

1985 .................................. 7.9 3.6 3.3 4.3 5,507.2 2,537.0 2,319.2 2,965.9

1986 .................................. 7.9 3.6 3.3 4.3 5,629.0 2,590.3 2,356.9 3,034.6

1987 .................................. 8.3 3.8 3.4 4.4 6,035.9 2,801.6 2,483.9 3,230.6

1988 .................................. 8.6 4.0 3.5 4.6 6,440.4 2,977.8 2,585.8 3,458.7

1989 .................................. 8.6 4.0 3.4 4.6 6,576.3 3,073.9 2,624.2 3,497.9

1990 .................................. 8.8 4.1 3.4 4.7 6,753.0 3,123.8 2,613.5 3,625.6

1991 .................................. 8.4 3.9 3.2 4.5 6,345.7 2,944.2 2,398.4 3,398.3

1992 .................................. 8.9 3.9 3.0 5.0 6,799.4 2,953.4 2,331.1 3,846.0

1993 .................................. 8.5 3.8 2.9 4.8 6,737.4 2,967.4 2,252.5 3,770.0

1994 .................................. 8.4 3.8 2.8 4.6 6,766.9 3,061.0 2,236.6 3,705.9

1995 .................................. 8.1 3.6 2.5 4.4 6,575.4 2,972.1 2,040.9 3,603.2

Cases

without lost

workdays

With

days away

from work4

Total

cases Total3

Cases

without lost

workdays

With

days away

from work4

Lost workday cases

Total3

Total

cases

Year1

5

5

5

5

6

6

6

6

1

 Data for 1973-1975 are based on the Standard Industrial Classification Manual, 1967 Edition; data for 1976-1987 are based on the

Standard Industrial Classification Manual, 1972 Edition; and data for

1988-1995 are based on the Standard Industrial Classification Manual,

1987 Edition. 2

 The incidence rates represent the number of injuries and illnesses

per 100 full-time workers and were calculated as: (N/EH) X 200,000,

where:

N = number of injuries and illnesses,

EH = total hours worked by all employees

during the calendar year,

200,000 = base for 100 full-time equivalent

workers (working 40 hours per week,

50 weeks per year).

3 Total includes cases involving restricted work activity only, in

addition to days-away-from-work cases with or without restricted work

activity. 4

 Days-away-from-work cases include those which result in days

away from work with or without restricted work activity. 5

 To maintain historical comparability with the rest of the series,

data for small nonfarm employers in low-risk industries who were not

surveyed were imputed and included in the survey estimates.

 6 Data for 1992-1995 exclude fatal work-related injuries and illnesses.

NOTE: Because of rounding, components may not add to totals.

Data for 1976-1995 exclude farms with fewer than 11 employees.

Dashes denote data not available.

Injury and illness incidence rates Number of injuries and illnesses (000's) 2

Table 2. Nonfatal occupational injury and illness incidence rates and numbers for private sector industries, 1973-95

Lost workday cases

to add the collection of demographic

data on workers whose injuries and

illnesses required recuperation away

from work. The new survey also

collected detailed information about

the circumstances of workers’

injuries and illnesses. The demographic and economic information

includes industry, occupation, age,

gender, race or ethnic origin, and

length of service with the employer.

The case circumstance data include

the physical characteristics of the

injury or illness, what happened,

how it happened, and what equipment, materials, tools, or substances

directly inflicted the injury or led to

the exposure.

BLS scrapped the old American

National Standards Institute (ANSI)

Z16.2 rules of selection and codes,

and devised an entirely new classification structure containing considerably more guidance and detail. In

September 1995, ANSI adopted the

Bureau’s new coding structure as a

national standard.39

While BLS retained from the old

ANSI Z16.2 rules the Nature of

Injury or Illness, Part of Body

Affected, and Source of Injury or

Illness concepts, it retitled “Type of

Accident or Exposure” as ”Event or

Exposure” to emphasize that some

events, such as assaults, are not

“accidental.” They also replaced the

Supplementary Data System’s

Associated Object or Substance

classification with an entirely new

classification titled “Secondary

Source.” New definitions, rules of

selection, and detailed codes were

implemented for all five classifications. In the new scheme, source and

secondary source use identical

codes.40 Associated object or

substance, designed to identify the

object, substance, or person with
 Compensation and Working Conditions Winter 1997 24

respect to which measures could

have been introduced to prevent the

incident or mitigate the injury or

illness, had proven unusable because

it was too vague and subjective. By

contrast, secondary source is

designed to identify objects, substances, or persons generating the

source of injury or illness or contributing to the event or exposure. It

recognizes that many cases have no

secondary source associated with

them.

The new survey design balanced

safety and health professionals’

desire for expanded data with

employer burden and survey expense

considerations. For example, cases

resulting in only restricted work or

motion or medical treatment

continued to be summarized, rather

than studied in detail. Employers

were permitted to submit supplementary forms containing the requisite

information, such as workers’

compensation reports, instead of

completing corresponding parts of

the questionnaire. Employers with

relatively large numbers of days

away from work cases were allowed

to provide a randomly selected

subset of their cases for the year.

The National Academy of

Sciences also expressed concern with

the high rate of sampling error for

the survey estimates of work-related

fatalities. Although there are a

significant number of job-related

fatalities each year, they are a very

small proportion of all workplace

injuries and illnesses. Thus, workrelated fatalities are statistically

“rare events,” which cannot be

measured with high accuracy by a

sample survey.

The National Academy of

Sciences recommended that BLS

compile a universe of fatalities,

which only a census could provide.

Consequently, BLS eschewed the

notion of gathering fatality data

through the annual survey. Simultaneous with expansion of the annual

survey in 1992, BLS launched the

Census of Fatal Occupational

Injuries (CFOI) which assembles

data on all work-related fatal injuries

from a diverse array of sources.

CFOI, which expanded the scope of

data beyond those used by Federal

and State agencies administering

specific laws and regulations to

include all industries and occupations, aims to include all workers

who had died on the job and who

had worked for pay, compensation,

or profit at the time of the fatal

event. They are included in the

census only if, at the time of the

fatality, they were engaged in a legal

activity and were present at the site

of the incident as a job requirement.

CFOI also captures worker and case

characteristics.41

CFOI is able to accomplish this

by drawing information on fatal

work injuries from as many as 25

different source documents –

including death certificates, State

workers’ compensation reports, news

media accounts, and State motor

vehicle incident reports. Information is also provided from such

diverse sources as State farm

bureaus, local police departments,

emergency medical services, and the

National Association of Chiefs of

Police. In addition, other Federal

agencies having jurisdiction over or

compiling data about fatalities

affecting specific groups of workers

provide data to BLS. These agencies

include the Occupational Safety and

Health Administration, the Employment Standards Administration, the

Mine Safety and Health Administration, the Department of Defense, the

U.S. Coast Guard, the Department of

Justice, and the National Transportation Safety Board.

As table 3 shows, no single

source is completely adequate for

identifying all occupational fatalities. However, when several sources

are used, a fatality missed by one

may be captured by another and will

ultimately be included in the data.

For 1995, over 18,000 source

documents were used to identify and

verify information on over 6,000 jobrelated fatal injuries. Using multiple

sources also provides more detailed

information about the circumstances

surrounding fatal occupational

injuries. Information collected from

various source documents is used to

code up to 30 data elements for each

job-related fatality.

Data needs in the near future

The introduction of the CFOI

program, and the redesign of the

annual Survey of Occupational

Table 3. Source documents used to compile information on fatal work injuries,

Census of Fatal Occupational Injuries, 1995

Death certificates ................................................ 2,114 4,894

News media reports ............................................ 1,699 2,616

State workers' compensation .............................. 945 2,304

State coroner/medical reports ............................. 125 2,070

OSHA reports ...................................................... 669 2,041

State-initiated follow-ups ...................................... - 1,555

State motor vehicle reports ................................. 93 598

Other Federal reports .......................................... 60 238

Other ................................................................... 500 2,111

1 Death certificates marked “at work.”

Initiating

source

document

Total

1
25 Compensation and Working Conditions Winter 1997

Injuries and Illnesses, which

occurred near the century mark of

BLS’s involvement in occupational

safety and health research, raise

occupational safety and health

statistics to a new level of sophistication. These two statistical series

open up new opportunities for

understanding, and devising

strategies to address, job-related

hazards. But will they define the

status quo for the foreseeable future,

or will the state of the art further

advance?

Summary statistics often point at

areas where further detailed studies

could focus. For example, the

incidence of disorders associated

with repeated trauma increased

elevenfold between 1982 and 1994.

Summary data provide a wealth of

useful information about these

conditions, such as: there were

332,100 repeated trauma cases in

1994, accounting for 41.1 cases per

10,000 full-time workers, and they

tend to concentrate in industries

such as meat packing and motor

vehicle and car body manufacturing.42

But, further research by safety

and health professionals might show

the extent to which carpal tunnel

syndrome and other repetitive

motion disorders underlie this 12-

year change; the tools, machinery, or

equipment involved; etc. Gaining

further insight into how disorders

associated with repeated trauma

occur may lead to measures that

could be taken to prevent them.

Bureau data highlight diverse

areas needing such special attention,

and point in directions further

research might explore. For example, safety and health professionals could conduct studies to gain

insights into the causes of serious

injuries and illnesses. Studies of this

kind would investigate such issues as

how well equipment is designed,

whether training on the use of tools

or equipment sufficiently addresses

safety and health considerations, or

whether some hazards are inherent in

the nature of certain kinds of work.

There is also a growing need for

more detailed information on the

costs associated with fatal and

nonfatal injuries and illnesses, and

the cost savings that would accrue

from particular injury and illness

reduction strategies. Both the costs

incurred consequent to injuries and

illnesses, and the benefits that would

accrue from their prevention and

mitigation, are of two kinds:

• Internalized costs borne

directly by employers, injured

employees, and insurers such

as workers’ compensation

premiums and payouts, lost

employee income if the injury

or illness does not exceed the

workers’ compensation

waiting period, and lost

productivity; and

• Externalized social costs

borne by society at large, such

as increased welfare payments

for disabled workers not

covered by workers’ compensation and their families.

Because employers keep records of

their costs, it is generally easier to

quantify costs borne directly by

employers (internalized costs), than

those borne by society at large

(externalized costs).

A sentinel event is an incident

whose occurrence is a warning

signal that the quality of occupational injury and/or illness prevention efforts may need to be improved.43

An example might be a hammer

falling off a high girder on a

construction site. The hammer could

fall harmlessly to the ground; could

fall on an expensive piece of

equipment; could just barely miss a

worker on the ground; could hit the

worker in the shoulder, putting him

out for a few days to recuperate;

could glance harmlessly off the hard

hat on his head; or could inflict a

fatal skull fracture if he is not

wearing his hard hat. If careless

practices develop, such as leaving

tools unsecured high up in the

structural steel frame of the building,

the hammer that falls harmlessly to

the ground today could fall fatally on

a worker’s head tomorrow. The

hammer falling harmlessly to the

ground is the sentinel event pointing

to a hazardous condition that should

be addressed to prevent a more

serious injury.

One school of thought holds that

only events that result in injury or

illness should be measured and fall

within the scope of desired prevention efforts. This school of thought

also believes that the best hazardindicators are incidents that actually

produce work-related injuries or

illnesses. This belief is increasingly

predominant as agencies move to cut

costs and employer recordkeeping

burden. BLS currently collects

occupational injury and illness data

only for cases that result in actual

injuries or illnesses.

However, another school of

thought believes statistical systems

should be designed to identify a

broader range of sentinel events, so

safety and health professionals will

be aware of hazards before an injury

or illness-producing event or

exposure occurs, rather than after it

has already occurred, where data

about it can serve only to prevent

some future event or exposure. An

example of including such sentinel

events in a safety program is the

Federal Aviation Administration’s

tracking aircraft “near misses.”

The efficacy of capturing data on

sentinel events rests on an assumption that the fundamental characteristics of actual injuries and illnesses

are similar to those of sentinel events

resulting in no injury or illness. For

example, the falling hammer might

not have struck anyone because the

worker who inadvertently dropped it

may have looked over and shouted a

warning to those on the ground,

alerting them to the hazard in time for

them to move safely out of the way.

Conclusion

Patricia C. Cohen observes that
 Compensation and Working Conditions Winter 1997 26

“in the nineteenth century, what was

counted was what counted”,44 which

labor economist Marc Linder

suggests is every bit as true in the

twentieth century as well.45 And it

may well be a universal truth.46

Cohen notes that the political

origins, design, collection, and uses

of economic data are in part based

on the insight that counting methods

embody assumptions about the

objects of enumeration.47 And

Linder, citing Arthur Reeves,

reminds us that for a long time in

American history such objects of

enumeration as fatal and nonfatal

occupational injuries and illnesses

were not considered important

enough to count.48 Indeed, J.M.

Clerc went so far as to state that, at

certain junctures in American

history, occupational injuries and

diseases were considered the

inevitable tribute to the progress of

the American economy.49

It remains ironic that both those

like Linder, who decry on-the-job

“casualties,” and those whom Clerc

describes as considering these

“casualties” to be a measure of

economic progress, have a common

interest in meaningful and accurate

occupational injury and illness

statistics. Moderates such as Carroll

Wright, the Bureau’s first Commissioner, were called upon to keep

track of what one of his contemporaries, C.H. Mark, characterized as

the “stupendous loss” of life and

injury experience consequent to

industrialization.50

Despite the progress BLS has

made over the past century, the

Bureau, like other sources of

occupational injury and illness data,

found itself confined by legal

strictures and lack of appropriate

data sources. Until the advent of the

BLS Census of Fatal Occupational

Injuries program, for example,

consensus on a fatal work injury

count eluded BLS and other organizations attempting to quantify this

phenomenon.51

Early attempts to develop accurate fatality data saw fruition only by

1992. It was then that BLS recognized that a diversity of data sources

would be necessary to secure good

data on fatal work-related injuries.

Similarly, BLS vacillated between

collecting occupational injury and

illness data by means of direct

survey versus piggybacking on State

workers’ compensation records.

Neither method worked particularly

well, due, respectively, to survey

underreporting by the firms with the

worst injury and illness records in

the years preceding the Occupational

Safety and Health Act,52 and

interstate variations in waiting

periods and other workers’ compensation requirements. But, by

allowing employers to use workers’

compensation forms to the extent

they provide information sufficient

to fulfill the Occupational Safety and

Health Act’s requirements,53 the Act

created the practical framework to

enable BLS to reconcile these two

methods of data collection and take

advantage of the best aspects of each.

Consequently, in the 1992 redesign,

BLS began accepting workers’

compensation forms as input to the

survey of nonfatal occupational

injuries and illnesses, to the extent

workers’ compensation forms

contain the requisite information.

Just as the present system of

occupational safety and health

statistics might not have been

imaginable a century ago when the

Bureau began publishing information on this topic, it is not clear

whether budgetary conditions,

public demand, or available information resources will enable

organizations producing safety and

health statistics to improve upon the

usefulness of their data. Will there

be sufficient resources to undertake

special follow-up studies, improve

cost data, or develop information on

sentinel events in the proximate

future?

What does the century-long effort

to produce meaningful and accurate

statistics tell us about occupational

injury and illness statistics today,

and the statistics needed for

tomorrow’s demands? Will other

issues suddenly appear that become

more pressing? The future can be

filled with surprises that mock

today's expectations.

—ENDNOTES—

1

 Joseph P. Goldberg and William T. Moye,

The First Hundred Years of the Bureau of Labor

Statistics, Bureau of Labor Statistics, Bulletin

2235, September 1995, p. 1. 2 Ibid., p. 26. 3 Ibid., p. 100; Presidential Papers, Wilson Administration, Letter from Meeker to Presidential

Secretary Joseph Tumulty, February 6, 1914. 4 Goldberg and Moye, The First Hundred

Years, p. 252.

5 Ibid., pp. 115, 259. 6 Ibid., p. 14. 7 Joseph W. Hines and Gunnar Engen, “BLS

Regional Offices: 50 Years of Federal-State Cooperation,” Monthly Labor Review, December

1992, p. 40. 8 Marc Linder, “Fatal Subtraction: Statistical

MIAs on the Industrial Battlefield,” Journal of

Legislation, Notre Dame Law School, Vol. 20,

No. 2, 1994, pp. 106-107. 9 Industrial Accident Statistics, Bureau of

Labor Statistics, Bulletin 157, March 1915, p. 7. 10 Authur Reeves, “Our Industrial Juggernaut,” Everybody’s Magazine, 1907, p. 156. 11 Linder, “Fatal Subtraction,” pp. 106-107.

12 In the hearings on S. 3983, a bill to create a

Division of Safety in the Department of Labor,

before the Senate Committee on Education and

Labor, 69th Congress, 1926, Connecticut Senator

Hiram Bingham said:

[In] Connecticut... [w]e passed an

employer’s liability compensation act,

which requires all employers... to see to

it that their employees should be protected at work. Now, this had the very

natural effect of making the manufacturers do what they should have done before, look into the causes of their own

accidents and guard against them.

[T]his is the proper theory of government, put on the individual the initiative of seeing to it that he corrects his

own errors, rather than to have the Government to tell him what he must do in

order to correct them, and that is the

reason, I take it, why we do not find it

necessary to collect accident statistics

any more; it is because the workmen are

protected, and the manufacturers themselves are seeing to it that they can and

do establish the very latest form of safety

devices, for their own protection, and

for the saving in insurance, and for the

safety of their workers.
27 Compensation and Working Conditions Winter 1997

13 John B. Andrews (Secretary, American Association for Labor Legislation), “Phosphorous

Poisoning in the Match Industry in the United

States,” Bulletin 86, January 1910, pp. 31, 145-

146; Hearings on Health Activities of the General

Government before the House Committee on Interstate and Foreign Commerce, 61st Congress,

1910, pt. VI, p. 408. 14 Goldberg and Moye, The First Hundred

Years , pp. 58, 60. 15 Hines and Engen, “BLS Regional Offices,”

p. 40. 16 Goldbert and Moye, The First Hundred

Years, p. 133; Lyle R. Schauer and Thomas S.

Ryder, “New Approaches to Occupational Safety

and Health Statistics,” Monthly Labor Review,

April 1972, p. 14. 17 Hearings on Establishing a Division of

Safety before the House Committee on Labor, 69th

Congress, 1926, p. 16. 18 Goldberg and Moye, The First Hundred

Years, p. 133.

19 Max Kossoris and Swen Kjaer, “Industrial

Accidents in the United States During 1939,”

Monthly Labor Review, October 1940, pp. 86, 89. 20 Linder, “Fatal Subtraction,” p. 115;

Schauer and Ryder, “New Approaches to Occupational Safety,” pp. 14-19; Dino Drudi, “The

Evolution of Occupational Fatality Statistics in

the United States,” Compensation and Working

Conditions, Bureau of Labor Statistics, June

1995, p. 2. 21 Work Injuries in Construction, 1948-49,

Bureau of Labor Statistics, Bulletin 1004, 1950,

pp. 2-3. 22 Proposed National System for Uniform

Recording and Reporting of Occupational Injuries and Illnesses, American National Standards

Institute, 1970, p. 10. 23 Schauer and Ryder, “New Approaches to

Occupational Safety,” pp. 14-19. 24 Goldberg and Moye, The First Hundred

Years, pp. 169-170.

25 Ibid., p. 170. 26 Ibid., p. 205. 27 Documentation of National Safety Council Statistics Department Estimating Procedures

for Motor Vehicle, Work, Home, and Public

Deaths and Death Rates, National Safety Council, February 1982, pp. 7-8; BLS Handbook of

Methods for Surveys and Studies, Bureau of Labor Statistics, Bulletin 1458, 1966, p. 205. In

1954, Commissioner of Labor Statistics Ewan

Clague explained to the President’s Conference on

Occupational Safety that, because BLS cannot

obtain a complete count of fatal work injuries, the

BLS and National Safety Council technical staffs

“assemble all these bits and pieces of work-injury

data, fit them together like pieces in a jigsaw

puzzle... match them up... and make adjustments

so the figures will be comparable.” (See The

President’s Conference on Occupational Safety:

Proceeding, May 4-6, Bureau of Labor Statistics,

Bulletin 175, 1954, pp. 7-8.) 28 Hearings on the Occupational Safety and

Health Act Review before the Subcommittee on

Labor of the Senate Committee on Labor and Public Welfare, 93rd Congress, 1974, pp. 92-93.

29 Correspondence from Alan F. Hoskin, Statistics Department Manager, National Safety

Council, to Karin G. Kurz, BLS Clearance Officer, November 29, 1995. 30 For further discussion of BLS’s experimental fatality rate data, see Fatal Workplace Injuries in 1992: A Collection of Data and Analysis,

Bureau of Labor Statistics, Report 870, April

1994, pp. 4-5. 31 Occupational Safety and Health Act, Public Law 91-596, 84 Stat. 1590, §24, 1970. 32 For further explanation, see Linder, “Fatal

Subtraction,” p. 115; Schauer and Ryder, “New

Approaches to Occupational Safety,” pp. 14-19;

and Drudi, “The Evolution of Occupational Fatality Statistics,” p. 2. 33 Schauer and Ryder, “New Approaches to

Occupational Safety,” p. 14. 34 Although the Supplementary Data System

proved ill-suited to providing national statistics and

was discontinued, BLS provided interested States

with formats to enable them to continue using it

for State-level administrative statistics. As recently

as 1995, data similar to those provided to BLS

under the Supplementary Data System were being actively used on the State level. OSHA, in

cooperation with one such State, undertook a special project using workers’ compensation claims

to identify the 200 companies with the worst health

and safety records. While these companies represented only 1 percent of the State’s employers, they

accounted for almost a third of the State’s workers and almost half its compensable injuries and

illnesses. OSHA later expanded the program to

other States. See Frank Swoboda and Stephen

Barr, “Guardian of Employee Safety Is About to

Get a Work-Over: White House Promises New

OSHA Mind-Set to Rely on Cooperation,” The

Washington Post, May 16, 1995, p. A15. 35 Goldberg and Moye, The First Hundred

Years, p. 252.

36 BLS Handbook of Methods for Surveys and

Studies, Bureau of Labor Statistics, Bulletin 2414,

1992, p. 117. 37 Counting Injuries and Illnesses in the

Workplace: Proposals for a Better System, National Academy of Sciences, National Research

Council, Washington, DC, 1987. 38 Keystone National Policy Dialogue, on

Work-Related Illness and Injury Recordkeeping,

The Keystone Dialogue Group, Keystone, Colorado, January 1989. 39 Guy Toscano, Janice Windau, and Dino

Drudi, “Using the BLS Occupational Injury and

Illness Classification System as a Safety and

Health Management Tool,” Compensation and

Working Conditions, Bureau of Labor Statistics,

June 1996, pp. 19-23. 40 Occupational Injury and Illness Classification Manual, Bureau of Labor Statistics, December 1992. 41 Guy Toscano and Janice Windau, “The

Changing Character of Fatal Work Injuries,”

Monthly Labor Review, October 1994, p. 17. 42 Occupational Injuries and Illnesses:

Counts, Rates, and Characteristics, 1994, Bureau of Labor Statistics, Bulletin 2485, April

1997, p. 7.

43 Paul J. Seligman and Todd M. Frazier, “Surveillance: The Sentinel Health Event Approach,”

Public Health Surveillance, ed., by William

Halperin and Edward L. Barker, Jr., Van Norstrand

Reinhold, 1992, p. 16, derived from A.D.

Langmuir, “William Farr, Founder of Modern

Concepts of Surveillance,” International Journal

of Epidemiology, Vol. 5, No. 1, 1976. 44 Patricia Cohen, A Calculating People: The

Spread of Numeracy in Early America, 1982,

p. 207. 45 Linder, “Fatal Subtraction,” p. 106.

46 Drudi, “The Evolution of Occupational Fatality Statistics,” p. 1. 47 Cohen, A Calculating People, p. 211. 48 Linder, “Fatal Subtraction,” p. 106, Reeves,

“Our Industrial Juggernaut,” 1907, p. 147. 49 J.M. Clerc, Introduction to Working Conditions and Environment, Vol. 29, 1985. 50 C.H. Mark, “Our Murderous Industrialism,”

World Today, Vol. 12, 1907, p. 97. 51 The BLS survey of occupational injuries

and illnesses estimated that there were 2,900

work-related fatalities during 1990. For the same

year, the National Safety Council estimated

10,500 work-related fatalities. The National

Institute for Occupational Safety and Health’s

National Traumatic Occupational Fatality program estimated 5,500 work-related fatalities in

1990 for the United States, except Connecticut

and New York City.

National Safety Council estimates cover unintentional injury-related deaths involving persons

in the civilian labor force, 14 years and older, except for private household workers. Homicides and

suicides are excluded. See Accident Facts: 1994

Edition, National Safety Council, Itasca, Illinois,

1994, p. 39.

National Institute for Occupational Safety and

Health estimates cover traumatic injuries (intentional and unintentional) of persons 16 years and

older identified on the death certificate as occurring “at work.” While death certificates cover all

deaths occurring in a State, only those death certificates identifying a fatal injury as one that occurred “at work” (i.e., the “at work” box on the

death certificate is checked-off) are used to compile the number of fatal occupational injuries. Persons completing the death certificate might not

recognize the work relationship of some injuries,

such as automobile crashes. For further discussion of methodology, see National Traumatic Occupational Fatalities: 1980-1985, National Institute for Occupational Safety and Health, March

1989.

State and Federal workers’ compensation reports also fail to capture a census of fatal occupational injuries. The self-employed; employees of

small farms, private households, and railroads; and

seasonal employees are generally excluded from

workers’ compensation coverage. 52 For further explanation, see Linder, “Fatal

Subtraction,” p. 115; Schauer and Ryder, “New

Approaches to Occupational Safety,” pp. 14-19;

and Drudi, “The Evolution of Occupational Fatality Statistics,” p. 2. 53 Schauer and Ryder, “New Approaches to

Occupational Safety,” p. 15.