Better Collection of Injury Data Can Protect Worker Health

A report released last month by the Government Accountability Office found that meatpacking and poultry workers face hazards that put them at risk of severe and lasting injury. Slippery floors, high-speed repetitive tasks, dangerous tools and equipment, chemical exposure, and other hazards present routine threats to employee safety.

In its report, GAO called on the Labor Department "to collect the data it needs to support worker protection and workplace safety." Unfortunately, some industry associations and members of Congress are criticizing the Occupational Safety and Health Administration for new rules designed to provide such data. We strongly agree with GAO's recommendation. Preventing work-related injuries requires good data — better than we have today.

Last year OSHA began requiring employers to report within 24 hours work-related incidents that result in an overnight hospitalization, amputation, or loss of an eye. This year, for the first time, OSHA is requiring large employers to upload the injury-incident information they are already collecting to a secure website. Both sets of data will help OSHA use its resources effectively. That's particularly relevant because OSHA only has enough personnel to inspect every work site just once every 145 years. OSHA will not be collecting personally identifiable information, but will be making the data publicly available to allow public health researchers and others access.

Finally, in order to address concerns about the systematic suppression of injury and illness reporting, OSHA now clarifies that programs designed to reduce reporting are not permitted.

Programs that use injury rates to determine bonuses or govern whether a company will win a contract create incentives to under-record work-related injuries. The accuracy of injury data can be compromised in other ways: Health care professionals report pressure from both employers and workers to minimize treatment to avoid recording an injury, supervisors fail to document work-related injuries, and workers fear punishment up to and including job loss if they report an injury. The practice of shaming or blaming employees who report injuries, such as giving demerits for suffering an injury, has a chilling effect on injury reporting. Suppressed reporting occurs through aggressive return-to-work policies. In order to reduce a lost-time injury rate, workers have been driven to work on the day of surgery or the day after, when still on narcotic medication for analgesia.

This new rule gives OSHA a much-needed enforcement tool to protect workers — especially low wage workers — from illegal discrimination and retaliation and to address systematic policies and practices that discourage reporting.

What we can't count remains invisible to us. Organizations that value safety encourage the reporting of near-miss events and reward workers for identifying hazards and solutions. These high-road employers demonstrate commitment to sustainability, transparency, and respect for frontline workers and their representatives.

The American Public Health Association supports these new rules. Transparency helps improve data accuracy, and accurate information will be invaluable for employers, workers, and public health researchers interested in identifying sources of injury and illness and evaluating the effectiveness of interventions. In just its first year, OSHA's new Severe Injury Reporting Program demonstrates the benefits of receiving prompt notifications of amputations. Grocery stores, which are only rarely inspected by OSHA, emerged unexpectedly as a leading industry for amputations. The newly available data helped pinpoint safety risks associated with food slicing and meat grinding and allowed OSHA to provide timely outreach and assistance to the grocery industry.

Public health professionals working at the state, county, and local levels rely on publicly available data for a variety of community health assessments; unfortunately, they have not had access to workplace illness and injury data, a problem this regulation addresses. State regulations addressing safe patient handling, for example, can be assessed by comparing baseline and follow-up data across the industry as well as by conducting comparisons with states that don't have the regulation. Similarly, the information will be valuable to municipalities that have adapted building codes designed to reduce safety hazards by allowing them to benchmark injury data.

Equally important, individual employers or their associations will have ready access to reports of injuries that are common within an entire industry but are not frequent enough to have alerted the individual employers in question. With easy access to these "sentinel case" data across an entire industry or community, employers will now be in a position to learn about these hazards and take action to prevent problems in their own establishments without having to wait for tragedy to strike.

Rosemary Sokas, M.D., MOH, MS, and Celeste Monforton, DrPH, MPH, are members of the American Public Health Association's Occupational Health and Safety Section and wrote this op-ed on behalf of the section. Sokas (sokas@georgetown.edu) is chair of the Georgetown University School of Nursing and Health Studies Department of Human Science. Monforton (cmonfort@gwu.edu) is a professional lecturer at the George Washington University Milken Institute School of Public Health.

Posted on Jun 23, 2016


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