Workers Health & Safety Centre

Work-related injuries, illnesses and death are alarmingly underreported

A supervisor looks at a worker's injured arm

To make the case for prevention many will cite compensation statistics as they observe the Day of Mourning on April 28. However, it is important to remember these statistics represent only a fraction of the actual number of workers hurt on the job in any given year. Thousands of injuries, illnesses and deaths go unreported by employers, supervisors or workers even though reporting is mandated by law.

According to a U.S. government report entitled Hidden Tragedy: Underreporting of Workplace Injuries and Illnesses, as much as 69 per cent of occupational injuries and illnesses are not reported or recorded.

Here in Canada, a survey of union members by University of Windsor labour studies director, Alan Hall, found 34 per cent of injuries alone went unreported. Looking specifically on the type of injuries that weren’t reported the survey showed 27 per cent of all workers surveyed suffered a “major back injury”—with almost one-third of these not reported. Other Canadian researchers have observed upwards of 50 per cent of workplace injuries unaccounted for.

Work-related illnesses and occupational disease are underreported to an even greater extent. For instance, a study linking WSIB data with the Ontario Cancer Registry determined 65 per cent of all mesothelioma cases diagnosed between 1980 and 2002 had not filed for compensation by June 2004 (Mesothelioma is considered a ‘sentinel’ occupational cancer associated with asbestos exposure.)

Attempts to measure underreporting of occupational disease in Ontario was perhaps first undertaken in the mid-1980s in a report prepared for Paul Weiler’s study of the Ontario compensation system. This report conducted by researcher Annalee Yassi, then estimated a total of 6,000 worker deaths annually from occupationally-related cardiovascular disease, occupational cancer and work-related lung disease alone.

Current cancer statistics further highlight underreporting. Many researchers believe between eight and 16 per cent of all cancer deaths are work-related. Based on these percentages and estimates provided by the Canadian Cancer Society, between 2,232 and 4,464 Ontarians were killed in 2012 from work-related cancer. With less than 300 occupational disease fatality claims registered with Ontario’s WSIB in 2012, the level of underreporting is significant.

Why is there underreporting?
There are many reasons why injuries, illnesses and deaths are underreported. In the case of occupational disease, an overall “lack of awareness” is often cited.

According to the U.S. report Hidden Tragedy mentioned above: “workers, employers and medical professionals often fail to detect the work-relatedness of occupational diseases such as asthma, heart disease, liver and kidney disorders, and musculoskeletal disorders.” 

With respect to reporting of occupational injuries Hall maintains that a lack of awareness is less often the case. “Managers play a critical and ongoing role shaping and policing the boundaries of acceptable and unacceptable reporting,” says Hall.

In a recent study of 1,020 carpenter apprentices in Chicago and St. Louis, some 58 per cent reported a safety incentive or negative consequence of reporting work-related injuries on their current jobsite. On work sites where they were disciplined (for experiencing injuries) workers were 50 per cent less likely to report their work-related injuries.

Though many, including Hall, feel the problem goes beyond just management pressure. “Underreporting is not a simple function of employer power or management manipulation and intimidation, there are also cultural processes and factors operating and developing within specific workplaces and occupations, and more broadly within society as a whole, that are extremely influential.”

Hidden Tragedy highlights the significance of financial incentives for employers and the fact underreporting would make it less likely for them to receive a visit from government inspectors. The latter is certainly the case in Ontario where enforcement strategies continue to depend in large measure upon lost-time injury rates.

Leading indicators
With hundreds of underreported worker deaths each year in Ontario and thousands more suffering injuries and illnesses, much work remains to prevent these workplace casualties from occurring in the first place.

An effective way to determine what needs to be done to reduce or better yet eliminate workplace injuries and illnesses is to examine the “leading indicators.” A leading indicator is a measure of an organization’s ongoing health and safety program and initiatives, or of the workplace conditions leading to illness and injuries. By analyzing the leading indicators and developing and implementing appropriate interventions workplace parties can work together to successfully protect workers from injuries, illness and death.

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