Keep the Top 10 Disabling Injuries at Bay

These 10 injury categories cost industry nearly $1 billion a week. They're expensive problems, but not inevitable, if you follow this preventive plan.

Serious injuries causing time off work fell 6 percent between 2000 and 2001, the largest decline since Liberty Mutual began compiling its Workplace Safety Index. The index ranks the leading causes of serious on-the-job injuries those resulting in an employee missing 6 or more days based on direct costs (payments to injured employees and their medical care providers). But for employers checking their bottom line, this downturn offered little relief, as the cost of these injuries continued its steady climb. In fact, with inflation accounted for, the cost of serious injuries and illnesses rose 4 percent, to $45.8 billion in 2001.

While preventive efforts are having a positive effect, noted Karl Jacobson, a senior vice president of Loss Prevention at Liberty Mutual, medical costs for occupational injuries continue to rise. Jacobson said the frequency of treatments is up per case; where one or two visits occurred in the past, workers now have three or four appointments. Medical technology and prescription drugs are increasingly sophisticated and more expensive. Liberty Mutual said another factor contributing to the cost increase is jurisdictions broadening their definition of work-related injuries.

This comes as employers contend with an expensive workers' compensation market. "Pricing is up drastically and the supply of insurance is down drastically," said Gary Glader, CSP, president of Network Safety Consultants, a Chicago-based safety consulting firm. High-hazard companies are finding it difficult to secure coverage, and may find themselves relegated to the assigned risk market. For them, said Glader, the result is the "highest dollar you can pay for coverage and the lowest possible service from the insurance company that writes it."

The Big Three

The three leading causes of workplace injuries overexertion, falls on the same level and bodily reaction pose a particularly thorny problem for employers. Between 1998 and 2001, the cost of overexertion cases grew 10.7 faster than inflation, while falls on the same level grew 17.2 percent and bodily reaction injuries increased 13.7 percent. Together, these three injury categories represent just over 50 percent of the total costs of serious workplace injuries.

Overexertion injuries are defined as being caused by "excessive lifting, pushing, pulling, holding, carrying or throwing of an object." Experts such as Glader say with baby boomers in the work force growing older, such injuries are going to be with us for some time .

Glader recommends that employers' preventive efforts begin with hiring. He said employers can have preplacement physical exams conducted to help ensure that workers will be physically capable of handling their assigned tasks. For example, he said, a job might require a worker to lift 30-40 pounds frequently. If an applicant comes in who has had several previous back surgeries, the employer can send him to have a functional capacity evaluation. "If he can't do it, the employer is under no obligation to hire him," said Glader.

Liberty Mutual's Jacobson said companies that have engaged the work force in preventing overexertion injuries have had good success. He said companies can train safety committees on ergonomic risks and designate master performers who understand how the work gets done. By combining ergonomic theory and a intimate understanding of the workplace, he said, employees can can provide "some very creative suggestions for control."

Jacobson acknowledged there is a high degree of variability in individuals, which can make it difficult to prevent overexertion injuries. "A person can lift great amounts of weight and then that same person can stoop over and pick up a pencil and hurt his back," he said. He recommended employers refer to guidelines such as NIOSH and Liberty Mutual have developed for safe lifting and manual material handling and also consider automation of particularly strenuous jobs.

In a recent publication, the Laborers Union noted that the various data indicate that "sprains and strains are the major cause of injury and illness incidents in construction." Said Scott Schneider, the union's occupational safety and health division director, "The concentration on sprains and strains in construction will produce the greatest improvement in quality of life for Laborers, not only in the short run but over the duration of their working careers and retirement."

Understanding the various factors that can lead to a fall is the first step in prevention, said Jacobson. Among the steps Liberty Mutual recommends for preventing these injuries:

  • Keep floors free of holes, water, grease and other potential fall hazards.
  • Provide footwear with the tread pattern and soling necessary to prevent slips.
  • Provide adequate lighting for all interior and exterior walking surfaces.
  • Highlight transitions in floor height.
  • Remove snow and ice in parking lots and on sidewalks.
  • Use appropriate non-slip floor surfaces, cleaners and waxes.

Compare and Act

Liberty Mutual's Jacobson said the company publishes its index, first, to get employers to understand that workers' compensation is a controllable cost and, second, to have them compare their costs to industry or national statistics and motivate them to take action. "Business leaders need to see this and start asking their own staffs, 'How are we doing?'" said Jacobson.

Hard Rock Caf did just that, developing a safety improvement program to address the leading causes of injuries, set measurable goals and track progress. Areas Hard Rock's management targeted included overexertion and falls on the same level. The company instituted a safety audit program and created lapel pins that managers could give employees to recognize their safe work. Hard Rock's operations in the United States saved $388,000 in 2001 and 2002 by reducing workplace injuries.

Sidebar: Preventing Highway Incidents

Highway incidents cost employers $2.3 billion in 2001, the seventh leading cause of work-related injuries according to the Liberty Mutual Workplace Safety Index. In an examination of highway fatalities, NIOSH recommended the following preventive measures.

Employers should:

  • Enforce mandatory on-the-job use of seat belts.
  • Ensure that employees who drive on the job have valid licenses.
  • Incorporate fatigue management into safety programs.
  • Provide fleet vehicles that offer the highest possible levels of occupant protection in the event of a crash.
  • Ensure that employees receive necessary training to operate specialized vehicles.
  • Offer periodic vision screening and general physicals for employees whose primary job duty is driving.
  • Avoid requiring workers to drive irregular hours or significantly extended hours.
  • Establish schedules that allow drivers to obey speed limits.
  • Set policies in accordance with states' graduated driver's licensing laws and child labor laws.
  • Assign driving-related tasks to younger employees incrementally.

Employees should:

  • Use safety belts.
  • Avoid using cell phones while driving.
  • Avoid other potentially distracting activities such as eating, drinking or adjusting non-critical vehicle controls while driving.
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