House Hearing Addresses Injury and Illness Underreporting

In a June 19 hearing, the House Committee on Education and Labor convened to consider potential underreporting of workplace injuries and illnesses, with several expert witnesses testifying that underreporting is a widespread problem that must be addressed.

“Underreporting on-the-job injuries and illnesses is not a new problem. Nor is it an isolated one: It happens in job sites across different industries and throughout the entire country,” said Committee Chairman George Miller, D-Calif., during his opening statement.

The hearing, “Hidden Tragedy: Underreporting of Workplace Injuries and Illnesses,” first called on A.C. Span Jr., a former employee of Bashas’ Distribution Center, an Arizona food distributor, to illustrate his experience with insufficient injury reporting and employer involvement. Span described a lack of training, an unsafe work environment and the employer’s unwillingness to address these issues.

Span said he received only 5 minutes of training for the heavy equipment he was expected to use 8 hours a day. He added that he witnessed unsafe working conditions and observed as coworkers incurred on-the-job injuries. According to Span, injured workers often were put on light duty, which resulted in a significant pay decrease. Employees, therefore, were reluctant to report injuries.

In light of these problems, Span said he and several other workers attempted to start a safety committee. When the company refused to hear their concerns. Span and his colleagues turned to OSHA, only to be disappointed once again with the results.

“In the end, while OSHA solved a few things, they did not fix everything and the company was never fined,” Span said. Two weeks later, the company announced plans to outsource jobs, and Span, along with 28 other balers, lost his job.

Research Points to Underreporting

Kenneth Rosenman, M.D., the professor of medicine chief for the division of occupational and environmental medicine at Michigan State University, stated during the hearing that research during the last two decades shows that the current reporting system provides an inaccurate injury count.

“There is no disagreement in the medical literature that an undercount exists and that this undercount is significant,” he said. He cited several studies that estimated between 33 and 69 percent of all nonfatal injuries go unreported.

Part of the problem, Rosenman said, is that the system ignores a large number of resources – such as hospital and emergency room databases, poison control center data, state laboratory reporting regulations, workers’ compensation and other sources of data – when compiling injury and illness information.

“What’s needed is a comprehensive system for work-related illnesses and non-fatal injuries that makes use of available, non-employer-based data systems analogous to what now exists for traumatic work-related fatalities,” he said.

The Statistics

John Ruser, the assistant commissioner of safety and health statistics at the Bureau of Labor Statistics (BLS), acknowledged that recent academic studies have accused BLS’s Survey of Occupational Injuries and Illnesses of underreporting.

The criticism in part stems from the fact that the survey does not count long-latent occupational illnesses like cancer or injury data for public sector employees, self-employed workers or workers in households or on small farms. Other allegations, however, assert that the BLS survey does not count some injuries and illnesses that are within the survey’s scope.

“BLS takes claims of potential underreporting seriously and has begun a number of activities to understand and, if necessary, address the issue,” Ruser said.

Ruser said that BLS has taken several steps to address these concerns. First, BLS conducted a quality assurance survey in 2007 and found that the survey of occupational injuries and illnesses accurately captured information on employer OSHA logs.

In addition, BLS instituted a program of research to examine and extend data matching, and also developed a pilot program of employer interviews to learn more about injury reporting on OSHA logs. Finally, Ruser said that BLS has discussed with NIOSH the possibility of conducting a research partnership.

OSHA Recordkeeping Expert Speaks Up

Bob Whitmore, who directed OSHA’s division of recordkeeping requirements since 1988 until he was placed on paid administrative leave in July 2007, emphasized he represented only himself, and not OSHA or the Department of Labor, at the hearing. He then stressed that OSHA’s recordkeeping system is not reliable.

“I contend that the current OSHA injury and illness information is inaccurate in part due to wide-scale underreporting by employers and OSHA’s willingness to accept these falsified numbers,” he said.

Decreasing injury and illness rates, therefore, do not necessarily indicate that workplaces are becoming safer, Whitmore explained. Instead, lack of enforcement allows employers to shirk their recordkeeping responsibilities.

“Not enforcing OSHA recordkeeping rules will mean many employers will not record injuries and illnesses affecting their workers,” he said.

Seeking Solutions

“At its best, this practice [maintaining OSHA logs] results in intensive efforts to improve safety,” said Robert McLellan, M.D., the immediate past president of the American College of Occupational and Environmental Medicine (ACOEM). “At worst, however, the spotlight on the log produces efforts to make the log look good rather than placing attention on reducing risks.”

To improve recordkeeping and protect employees from injury or illness, McLellan suggested updating the current OSHA standard and its enforcement to minimize underreporting. OSHA also should encourage a better understanding of the regulations and interpretation of the recordkeeping standard, he said.

Furthermore, the agency should consider implementing a Special Emphasis Program to increase the number of medical records reviewed as part of OSHA’s audit and verification program of occupational injury and illness records.

McLellan stressed that the goal is “not to point fingers, but to seek solutions.”

Fellner: Employers Maintain Accurate Records

Attorney Baruch Fellner, representing the U.S. Chamber of Commerce, was not convinced that injury and illness underreporting was as widespread or deliberate as other witnesses claimed.

“Based upon 40 years of experience, I believe that the steadily declining injury rates provided by OSHA and the Bureau of Labor Statistics are and must be substantially reliable,” he said.

Fellner pointed out that OSHA works to identify potential underreporting by inspecting not only employers with high injury rates, but also selects a statistical sample of employers with low rates to ensure those employers are not falsifying records. As a result of these inspections, Fellner said, OSHA has concluded “that the vast majority of establishments are in fact maintaining accurate records.”

“The title of this hearing declares in no uncertain terms that we are dealing with a tragedy of deliberately hidden injuries,” Fellner said. “Such a conclusion ignores the real efforts that employers are making to accurately identify all work-related injuries in a complex regulatory and medical environment.”

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