At an ASSE session titled "Preventing Fatalities and Serious Injuries: What are We Missing?" Manuele, president of Hazards Ltd., showed data from the Bureau of Labor Statistics that the percentage of nonfatal injuries and illnesses involving 20 or less days away from work had fallen from 1995 to 2001. However, for incidents involving 21-30 days, there was a slight increase and for 31 or more days, the increase was nearly 23 percent.
The trend in workers' compensation claims and costs paralleled this trend, Manuele noted. Data from the National Council on Compensation Insurance showed that while the on-the-job claim frequency for workers' compensation injuries declined from January 1996 through December 2002, the average indemnity claim cost increased 66 percent and the average medical claim cost increased 83 percent. During the same period, the accumulated inflation in the U.S. economy was 17.2 percent, meaning workers' comp increases were 4.4 times higher than inflation.
Manuele's conclusion is that "the frequency of worker injuries is down; serious injuries are more prominent within the entirety of the lost-worktime cases reported; and average workers' compensation claims costs have risen at a remarkable rate."
In an analysis of more than 1,000 incident investigation reports, Manuele found that a large percentage of incidents resulting in severe injury occur: in unusual and non-routine work, in non-production activities, when sources of high energy are present and in at-plant construction operations.
He also noted that the causal factors for low probability/serious consequences incidents are different from less serious incidents. Many of the serious injury incidents are "unique and singular events, having multiple and complex causal factors that may have technical, operational or cultural origins."
Manuele cited two "age-old beliefs" that are barriers to the prevention of serious injuries. The first is that "Reducing incident frequency will equivalently reduce the occurrence of low probability/serious consequence events." He presented National Safety Council data that from 1973 to 2001, the occupational injury and illness rate for private industry dropped 50 percent, from 11.3 to 5.7, while the total lost workday case rate decreased 18 percent, from 3.4 to 2.8. "Obviously, the reduction in the lost workday incidence rate did not equal the reduction in incident frequency," he pointed out.
The second belief is that "Unsafe acts of workers are the principal causal factors for occupational incidents." Safety practitioners who believe this, Manuele said, "are doing a very shallow job of incident investigation and have little knowledge of the reality of incident causation." He said such a mindset "results in managements giving inadequate attention to systemic causal factors that reflect the organization's safety culture, design and engineering shortcomings, the hazards in the operational procedures in place and the system of expected behavior that has developed over time which may condone excessive risk taking."
Manuele recommended that safety managers study their incidents resulting in serious injury and suggested that the data may provide them "valuable leading indicators" for safety management system improvement. He said they should first select a definition of serious injury: lost work day cases involving either 21 or 31 days away from work; or cases valued at either $25,000 or more, or $50,000 or more. Then, they should gather incident data for a 3-year period. For each incident, they should record the nature of the work being done, note job titles of injured personnel, determine whether the injured persons were engaged in the organization's principle business or were ancillary personnel, and identify the "reality of the causal factors." He said they should then analyze and summarize the data "to determine what modifications in safety management systems should be proposed."
Manuele warned that safety managers may find the quality of the incident investigation reports they review "inadequate for in-depth causal factor determination." In assessing the more than 1,000 incident reports he reviewed from large companies, he rated some a 2 on a scale of 10, with 10 being the best. "Causal factor determination was dismal," he said. "Opportunities to re-adjust the focus of preventive efforts to the benefit of workers and employers were lost." Manuele added that after reviewing the incident investigation reports, he now believes the "quality of incident investigation is one of the primary markers in evaluation an organization's safety culture."