WHOLESALE AND RETAIL TRADE

Burden

Musculoskeletal disorders (MSDs) as of 2011 include cases where the nature of the injury or illness is sprains, strains, pinched nerve; herniated disc; meniscus tear; and various connective soft tissue injuries when the event or exposure leading to the injury or illness is overexertion and bodily reaction, which can be caused by repetitive motion (involving micro tasks), awkward postures, excessive force, and vibration. Prior to 2010, cases of Raynaud’s phenomenon, tarsal tunnel syndrome, and herniated spinal discs were not included.¹

According BLS, the average nonfatal injury rate for MSDs in both wholesale and retail have both declined over the past decade. The injury rate was 36.5 per 10,000 full-time workers in 2014 compared to 39.9 in 2004 in wholesale. For retail, the injury rate was 35.3 per 10,000 full-time workers in 2014, down from 43.9% in 2004. While the reductions are encouraging, there is still work to be done. The injury rates in WRT are still higher than the average for all industries (31.9 per 10,000 full-time workers in 2014). The retail sub-sectors with the highest rates of injury include building materials and gardening stores; general merchandise (department) stores; food and beverage stores; and furniture and home furnishing stores. In wholesale trade, merchants of nondurable goods have the highest MSD rates.²

MSD injuries are also costly. A recent study estimated the average cost of all MSD cases in all NORA sectors at $7,775 in 2004 dollars.³ After adjusting this cost to 2014 dollars, the average cost of MSDs in the WRT sector is estimated at approximately $9,743 per case. Using the BLS estimate of approximately 63,000 reported cases of MSDs in 2014, yields a total cost of $596 million in WRT. MSDs have a large economic impact on society that includes the cost of treatment and the related indirect costs of productivity losses. Workers, their families, employers, and tax payers share this burden.

Need

Until the NIOSH Wholesale and Retail Trade Program was created in 2006, there was little published information on the hazards, risks, and morbidity and mortality in the WRT sector. There still is a need for continuing assessment in these regards. There are few organized efforts to intervene in WRT to address the greatest hazards and risks. NIOSH is uniquely positioned to make a difference for the health and safety of workers in WRT due to the partnerships it has developed.

Impact

NIOSH is the leading U.S. federal entity investigating the causes of MSDs and back injury. NIOSH’s leading role in MSD research had its origins in in three international symposiums, held in 1972, 1974, and 1976 that served as the foundation for NIOSH’s subsequent 1981, Work Practice Guide to Manual Lifting, which was followed up in 1994 with the Revised NIOSH Lifting Equation . NIOSH staff have continued in this tradition of cutting edge MSD research and publications. NIOSH work in this area is valued by both the public and private professional organizations has offering an evidence approach to research and subsequent interventions designed to prevent MSDs. 

The WRT Program has worked extensively with the employers and trade associations to conduct research on manual material handling to prevent MSDs. Recently, NIOSH published Ergonomic Solutions for Retailers: Prevention of Material Handling Injuries in Grocery Stores eDoc, designed for employers to illustrate the use of mechanical assist devices for reducing injuries in retail grocery stores. It was identified by the Occupational Safety and Health Administration and seven safety publications as an important resource for preventing MSDs in high-risk food and beverage retail sectors.

Studies related to economic burden have been presented in several conferences and have been well acclaimed by the audience that involved other well-known economists. Successful completion of the ongoing studies related to economic burden will be the first attempt to evaluate costs of occupational injuries in WRT sectors and will shed some light on the true burden of occupational injuries in this sector.

Burden

Slips, trips and falls (STF) are the second most common cause of lost-workday injuries in general industry and can cause back injuries, sprains, strains, contusions, fractures, severe head injuries, paralysis, and even fatalities. STFs are the third most common cause of lost-workday injuries in WRT establishments. Seventy-five percent of the total STF injuries in WRT occur on the same level. STFs are responsible for 15% of all accidental deaths, the 2^nd leading cause behind motor vehicles and 25% of all reported injury claims.¹

Employees in retail operations have a higher incidence rate of STF injuries than private industry employees overall. While the rate in retail has dropped from 20.9 per 10,000 workers in 2004 to 17.3 per 10,000 in 2014, it is still very high. The average for all industries in 2014 was 16.6 per 10,000 full-time workers.³ Employees in grocery stores and establishments where meat is handled are at particular risk, with a 75% greater than average industry rate for all other private industries combined (28.3 vs. 16.1 per 10,000 full-time workers).^2,3

Need

Over the last 20 years or so, NIOSH safety researchers have examined the causes of falls and have compiled a list of hazards that are responsible for the majority of the falls in a range of industries that include construction, mining, manufacturing, and health services. The findings indicate that most STF incidents can be prevented with proper attention to the three categories of risk factors: workplace, work organization, and individual or personal factors.

However, there have been very few studies conducted in businesses in the WRT sectors that have dealt with the effectiveness of STF-related recommendations. The WRT sector is also unique because the workers are sharing their work space with the customers, which adds to the spills and clutter often found in food and beverage stores. NIOSH researchers are seeking to work with insurers, employers, and labor organizations to assess the effectiveness of the fall-related prevention strategies. Cost benefit studies are also needed to provide the economic incentive for adopting the various prevention strategies.

Impact

Peers and stakeholders used the WRT document on “ Preventing Slips, Trips and Falls in the Wholesale and Retail Trade Establishments ” in ongoing training courses that focused on preventing traumatic injuries in the workplace. The training courses conducted at both academic sites and by safety training experts ranged from 25 to 70 midlevel staff from mostly large retail companies. The document was also posted on the websites of the Loss Prevention Foundation and the Ergonomic Assist Systems & Equipment industry group websites. Liberty Mutual, a worker’s compensation underwriter that serves several large WRT companies, recognized and promoted it as an important document for their field investigative teams that followed up on fall-related injuries among retail establishments.

Many of the recommendations have been adopted by retail and wholesale companies that have had high rates of injuries from falls, according to reports by safety practitioners at ergonomic conferences. This document filled an important gap as it was focused on retail and wholesale establishments

Burden

Retail stores tend to have a greater exposure to the public than other industries. NIOSH research conducted by the Division of Safety Research (DSR) identified a number of risk factors for retail stores. They include some of the following risk factors. Money is frequently exchanged in plain view and kept in cash registers on-site. Also, retail employees often work alone or in small numbers, and their shifts can range from the early morning hours to late into the night when there are fewer people around.  Smaller retail business are frequently found in what law enforcement agencies identify as high crime areas, which increases the risk of fatal and nonfatal injuries. Additionally, retail stores may control alcohol, smoking materials, and pharmaceuticals that are often considered to be especially desirable and accessible.

Workplace violence is any act or threat of physical violence, harassment, intimidation, or other threatening disruptive behavior that occurs at the work site. It ranges from threats and verbal abuse to physical assaults and even homicide. It can affect and involve employees, clients, customers and visitors. Homicide is currently the fourth-leading cause of fatal occupational injuries in the United States.¹

Violence affects the workplace in a number of ways. Absenteeism, impaired job performance, and loss of experienced employees are only some of the costs that companies bear as a direct result of violence. According to OSHA, nearly 2 million American workers report having been victims of workplace violence each year. Unfortunately, many more cases go unreported.¹

Rates of nonfatal violence in the WRT sectors (0.6 in wholesale and 2.2 in retail trade out of 10,000 full time workers) are lower than that for all private industries (4 out of 10,000 full-time workers)² but the number of fatalities is quite high. The retail trade sector experienced 22% of all workplace violence (and other injuries by persons and animals) related fatalities in 2014 but only accounts for approximately 11% of the workforce.³ Put another way, out of 653 fatalities due to workplace violence, 146 cases of fatalities were in the retail trade sector.

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. The research conducted by the Division of Safety Research (DSR) has demonstrated the need for interventions that would be appropriate for the retail industry and sales related occupations. Products are needed for all workers that highlight common causes of workplace violence and effective intervention strategies, especially those in high-risk industries like retail convenience food and beverage stores as well as gasoline stations that are open 24 hours a day.. One of the highest priorities is to promote the adoption of known best practices to prevent workplace violence for sales-related occupations. Additionally, health economic research is needed by industry stakeholders to provide better justification for adopting interventions. We need additional information on the cost of controls and the return on investment of the strategies designed to prevent injuries.

Impact

More recently, NIOSH has focused on workplace violence prevention efforts aimed at convenience store workers. The implementation of evidence-based policies would help prevent work-related violence at retail establishments. They would also help to reduce employers’ costs associated with workplace disruptions caused and training new employees, reduce losses stemming extra home care provided by family members, and improve productivity. Additional impact would be realized by intervention research focused in the retail industry that would take into consideration the sociological and demographic studies characteristics of those communities that are at high risk for fatal and nonfatal injuries. To reduce on-the-job violence-related injuries and deaths, research is needed on the adoption of workplace violence prevention strategies and interventions that are targeted at those retail stores that have a history of workplace violence.

Burden

Risk of work-related transportation and motor vehicle crashes (MVCs) cuts across all industries, not just “professional drivers” (e.g. truck and bus drivers). Wholesale and retail trade employees frequently have to drive as part of their jobs. For example, retail workers use passenger vehicles for local deliveries and real estate agents drive clients to view homes for sale. Some key statistics:

• The incidence of motor vehicle-related injuries among wholesale workers was twice as high as the average for all industries in 2014 (20.1 per 10,000 workers compared to 10.0 per 10,000). The rate for retail was also slightly higher (10.8 per 10,000) than the average.¹
• Wholesale and Retail Trade had 10% deaths from all vehicle-related events in 2013. Only Transportation and Utilities, Agriculture, and Construction had higher rates.²
• Within Retail, transportation events are the cause approximately half of all fatalities (ranging from 42%-55% in 2010-2014). There were 77 fatalities in 2014.¹
• In the wholesale industry, vehicle-related events account for about a quarter of fatalities (ranging from 19%-26% in 2010-2014).¹

Need

WRT employers are interested in learning how to reduce or prevent motor vehicle-related events, both to improve safety and reduce costs. To keep making progress, it will important to develop partnerships with worker’s compensation insurance carriers to provide information, such as fact sheets, on the rates of MVCs. Insurance carriers are also interested in reducing the number and severity of motor vehicle-related events to reduce cost and “experience ratings” for each client. Research needed to reduce the burden of motor vehicle related injuries in WRT sector includes: obtaining more information on the number of fatal and non-fatal motor vehicle-related events; evaluating the economic costs and employers’ costs; and sharing the knowledge generated with employers through professional and work-related trade associations to grow employer awareness.

Impact

One of the important concerns is the economic impact of these fatal and nonfatal MVCs. Employers and safety experts need more information to ensure that both the human and business cost are fully recognized in order for changes and interventions to be implemented and sustained. Information generated from research focusing on the burden of motor vehicle-related events in wholesale and retail industries will help employers in the WRT sectors make informed decisions about developing or integrating interventions to protect workers. A reduction in MVCs or elimination of MVCs will benefit workers by providing a safe and secure workplace.