Traumatic Injury Prevention Program

Burden: Falls in the workplace can occur during the simple act of tripping over a cord or from a complex series of events such as a construction worker using equipment to perform a job 50 feet above the ground. Regardless of how falls occur, they remain a common cause of injury and death for workers in the United States, as reflected by the most recent data below.

• In 2015, 26% of the 902,160 nonfatal work injuries resulting in one or more days away from work were related to slips, trips, and falls¹
• In 2015, 17% of the 4,836 deaths were related to slips, trips, and falls²
• In 2013, $18 billion in direct costs to businesses was linked to slips, trips, and falls³

Need: NIOSH is the only U.S. federal entity responsible for conducting research and making recommendations for the prevention of work-related injuries and deaths from falls. Falls remain a persistent and costly problem, which warrants the need for additional fall prevention research efforts. Such efforts should focus on common precursors to fall events as well as the evaluation and implementation of engineering and administrative solutions in high risk industries, including construction, food services, and public safety.

Impact: Our research collaborations with partners have contributed to innovations like the NIOSH Ladder Safety App, guidance for Slip, Trip, and Fall Prevention for Healthcare Workers, and the National Stand Down To Falls in Construction campaign. We continue our efforts in this area by leveraging Institute strengths in partnership to: develop effective and practical strategies to design out fall risk, craft engineering solutions, and implement organizational interventions to reduce fall incidents and prevent fall injuries.

¹ Bureau of Labor Statistics (2017). Resource Table R4 (p. 1). Number of nonfatal occupational injuries and illnesses involving days away from work by industry and selected events or exposures leading to injury or illness, private industry, 2015. http://www.bls.gov/iif/oshwc/osh/case/ostb4756.pdf

² Bureau of Labor Statistics (2017). All charts, Census of Fatal Occupational Injuries. Fatal occupational injuries by major event, 2015 (p. 3). http://www.bls.gov/iif/oshwc/cfoi/cfch0014.pdf

³ Liberty Mutual Research Institute for Safety (2016). 2016 Liberty Mutual Workplace Safety Index (based on 2013 injury data). https://www.libertymutualgroup.com/about-liberty-mutual-site/research-institute-site/Documents/2016%20WSI.pdf

Burden: Millions of workers drive or ride in a motor vehicle as part of their jobs. The risk of a motor vehicle crash affects workers in all industries and occupations, whether they drive heavy or light vehicles on the job, and whether driving is a main or incidental job duty. As recent data show, on-the-job crashes take a heavy toll on workers and their families, communities, and employers:

• In 2015, vehicle crashes made up 37% of all work-related injury deaths in the United States, and were the first or second leading cause of death in every major industry group¹
• In 2013 alone, motor vehicle crashes at work cost U.S. employers $25 billion – $65,000 per nonfatal injury and $671,000 per death²
• In 2010, based on the results of a NIOSH survey, more than one in three long-haul truck drivers have experienced a serious truck crash during their career³

Need: NIOSH is the only U.S. federal entity responsible for conducting research and making recommendations for the prevention of work-related motor vehicle crashes and resulting injuries for all worker populations. Guided by data that shows the injury and cost burden, our research and outreach focuses on truck drivers and other high-risk workers such as emergency responders, oil and gas workers, and taxi drivers. We also consider the general population of workers who drive, including those who drive light vehicles and for whom driving may not be the primary job duty. Our research program emphasizes development and evaluation of safety interventions that are both effective and practical in preventing work-related motor vehicle crashes.

Impact: Through partnerships with industry, labor, professional and trade associations, government agencies, and academia, NIOSH has developed a strong understanding of the safety risks, work settings, and barriers to progress associated with on-the-job driving. To move our research results into the workplace, we contribute to safety rulemaking by other federal agencies and to consensus standards that are widely used by employers and industry to guide vehicle design and testing and motor vehicle safety management. We also communicate crash-prevention information directly to workers and employers through user-friendly fact sheets, webpages, social media (e.g., @NIOSH_MVSafety), and the e-newsletter Behind the Wheel at Work. While we have made significant progress to keep those who drive for work safe, the opportunity still exists to build our evidence base for solutions to prevent on-the-job crashes.

¹Bureau of Labor Statistics (2017). Table A-2. Fatal occupational injuries resulting from transportation incidents and homicides, all United States, 2015. https://stats.bls.gov/iif/oshwc/cfoi/cftb0296.xlsx

² Network of Employers for Traffic Safety (2016). Cost of motor vehicle crashes to employers – 2015. http://trafficsafety.org/wp-content/uploads/2016/03/NETS-CostOfCrashes-Report-2015.pdf

³Chen GX, Sieber WK, Lincoln JE, Birdsey J, Hitchcock EM, Nakata A, Robinson CF, Collins JW, Sweeney MH [2015]. NIOSH national survey of long-haul truck drivers: Injury and safety. Accid Anal Prev 85:66-72. http://dx.doi.org/10.1016/j.aap.2015.09.001

Burden: Workplace violence is the act or threat of violence, ranging from verbal abuse to physical assaults, and the impact can range from psychological issues to physical injury, or even death. Violence can occur in any workplace. The 2014 statistics provided below for the United States describe part of the problem, but it is important to note that many cases of violence go unreported.

• In 2015, 16,160 intentional injuries by other persons resulted in one or more days away from work¹
• In 2015, about 9% of reported fatal workplace injuries were the result of workplace violence²
• Recent publications in 2013 and 2014 highlighted differences in work-related homicides by age, sex, race, ethnicity, region and whether or not you were born in the United States^3,4

Need: NIOSH is the only U.S. federal entity responsible for conducting research and making recommendations for the prevention of workplace violence. Rates of workplace violence vary dramatically by industry and occupation. Our research demonstrates the need for industry and occupation-specific interventions. Products that highlight common causes of workplace violence and effective intervention strategies are needed for all workers, especially those in high-risk industries like public and social services. Adoption of known best practices to prevent workplace violence for occupations at increased risk remains a high priority need. Additionally, health economic research demonstrating the costs of controls and other strategies to prevent injuries and the return on investment is crucial for their adoption by industry stakeholders.

Impact: To date, NIOSH and stakeholder’s workplace violence prevention efforts have focused on healthcare workers, taxi drivers, convenience store workers, education staff, and law enforcement personnel. Examples of impact include thousands of healthcare workers taking NIOSH’s free online violence prevention course, and cities and taxi companies requiring the use of security cameras that NIOSH research demonstrated are associated with reduced homicides. Additional intervention research in these and other high risk industries and focused research on sociological and demographic characteristics remains a major opportunity for impact. Wide-spread adoption of targeted workplace violence prevention strategies and interventions will help to reduce on-the-job violence-related injuries and deaths.

¹Bureau of Labor Statistics (2017). Resource Table R4 (p. 2). Number of nonfatal occupational injuries and illnesses involving days away from work by industry and selected events or exposures leading to injury or illness, private industry, 2015. http://www.bls.gov/iif/oshwc/osh/case/ostb4756.pdf

²Bureau of Labor Statistics (2017). All charts, Census of Fatal Occupational Injuries. Fatal occupational injuries by major event, 2015 (p. 3) http://www.bls.gov/iif/oshwc/cfoi/cfch0014.pdf

³Steege, AL et al (2014). Examining occupational health and safety disparities using national data: A cause for continuing concern. American Journal of Industrial Medicine; 57:527-538. http://onlinelibrary.wiley.com/doi/10.1002/ajim.22297/full

⁴Chaumont Menendez, et al (2013). Disparities in work-related homicide rates in selected retail industries in the United States, 2003-2008. Journal of Safety Research; 44:25-29. http://dx.doi.org/10.1016/j.jsr.2012.12.002

Burden: From augers that drill holes in the ground to forklifts used for moving materials around a worksite, machinery and industrial vehicles are vital in performing a variety of work tasks in agriculture, construction, and manufacturing industries. However, machinery and industrial vehicles are involved in many work-related injuries and deaths, which are reflected in the most recent data below.

• In 2015, 232,120 injuries due to contact with objects and equipment were so severe they resulted in one or more days away from work¹
• In 2015, about 15% of deaths were due to contact with objects and equipment²
• In 2013, $9.2 billion in direct costs to businesses were due to deaths and injuries from contact with objects and equipment³

Need: NIOSH is the only U.S. federal entity responsible for conducting research and making recommendations for the prevention of work-related injury and death from machinery and industrial vehicles. Prevention through Design (PtD) research efforts are ideally suited for designing out safety hazards from machinery and industrial vehicles. There is a need for outreach to equipment manufacturers with important safety information that supports design improvements and cost-effective controls. Additionally, strengthening partnerships with industry is needed to disseminate injury prevention information and strategies.

Impact: In support of PtD, NIOSH and partners developed cost-effective roll over protective structures for tractors and aerial lift safety education tools. Additional PtD efforts as well as outreach to manufacturers and employers may help to influence national standards as well as the machinery and industrial vehicles purchased for workplace use.

¹Bureau of Labor Statistics (2017). Resource Table R4 (p. 1). Number of nonfatal occupational injuries and illnesses involving days away from work by industry and selected events or exposures leading to injury or illness, private industry, 2015. http://www.bls.gov/iif/oshwc/osh/case/ostb4756.pdf

²Bureau of Labor Statistics (2017). All charts, Census of Fatal Occupational Injuries. Fatal occupational injuries by major event, 2015 (p. 3). http://www.bls.gov/iif/oshwc/cfoi/cfch0014.pdf

³ Liberty Mutual Research Institute for Safety (2016). 2016 Liberty Mutual Workplace Safety Index (based on 2013 injury data). https://www.libertymutualgroup.com/about-liberty-mutual-site/research-institute-site/Documents/2016%20WSI.pdf

Burden: High-risk jobs, such as those in transportation, construction, and agriculture, have substantially higher levels of workers dying from injuries as a result of the type of work they perform, while vulnerable workers are part of a group susceptible to injury risks in different ways. Vulnerable workers can include young workers, older workers, immigrant or migrant workers, temporary or seasonal workers, and workers holding multiple part-time or low-paying jobs. While we recognize many health risks are associated with specific jobs or industries, one group should not bear the brunt of injuries over another or accept that injuries are ‘just part of the job,’ yet that is not the case based on recent data.

• Using surveillance data spanning 1998 through 2007, workers less than 25 years of age have higher rates of occupational injuries treated in emergency departments than other age groups¹
• Workers 65 years and older have the highest rate of death compared to other age groups²
• Between 2003 and 2015, most work-related deaths to Hispanic workers were to those born outside of the U.S.³
• In 2015, homicides were the second leading cause of work-related death for women, behind roadway vehicle incidents.⁴

Need: NIOSH is the only U.S. federal entity whose mission encompasses prevention of work-related injury and death for all workers. Vulnerable workers span all industries and occupations. Focused dissemination efforts are needed to reach the breadth of these workers who may not have labor agreements or membership in business associations that provide access to safety efforts. Engineering research that fits the work to the worker and makes equipment easier to use safely is crucial, especially among high-risk jobs.

Impact: Our efforts have reached a variety of high risk jobs and vulnerable worker groups. For example a recent CDC Vital Signs report, Trucker Safety: Using a Seat Belt Matters, reached a large audience to raise awareness that not all truck drivers routinely use their seat belts. NIOSH and partners developed Youth@Work: Talking Safety, a curriculum to teach high school students how to stay safe at work. Further, the NIOSH-supported National Children’s Center for Rural and Agricultural Health and Safety developed guidance documents for children in agricultural work environments. In addition to these products, our surveillance work was integral in identifying hazards and tailoring prevention efforts, which contributed to a decline in the number of deaths among the highest risk industries in Alaska. Specifically, there was a 75% decline in the number of commercial fishing deaths and 88% decrease in the number of pilot deaths. All types of workers, and their employers, benefit from injury prevention guidance and safer equipment and workspaces. For this reason, additional surveillance, research, and materials focused on high risk jobs and vulnerable workers are valuable in reducing injuries and disparities.

¹CDC [2010]. Occupational injuries and deaths among younger workers — United States, 1998-2007. MMWR 59(15):449-455. https://www.cdc.gov/mmwr/pdf/wk/mm5915.pdf

²Bureau of Labor Statistics (2017). All charts, Census of Fatal Occupational Injuries. Fatal work injury rates by age group, 2015 (p. 13). http://www.bls.gov/iif/oshwc/cfoi/cfch0014.pdf

³Bureau of Labor Statistics (2017). All charts, Census of Fatal Occupational Injuries. Number of fatal work injuries involving Hispanic or Latino workers, 2003-2015 (p. 11). http://www.bls.gov/iif/oshwc/cfoi/cfch0014.pdf

⁴Bureau of Labor Statistics (2017). All charts, Census of Fatal Occupational Injuries. Distribution of fatal injury events by gender of worker, 2015 (p. 9). http://www.bls.gov/iif/oshwc/cfoi/cfch0014.pdf