As a corollary to the value proposition of the Institute it was necessary to identify business relevance, in contrast to customer demands, of the various risks. The LMWSI was the approach we developed – an approach which was widely accepted in industries by risk managers and internationally used in identifying and validating research agendas and intervention strategies.
Copies of the actual indices are here, while the the results and comparison of 13years indices was published in the Journal of Safety Research: The direct cost burden of 13 years of disabling workplace injuries in the U.S. (1998–2010): Findings from the Liberty Mutual Workplace Safety Index
A conversational piece, aimed at explaining to customers and the lay reader, was published in the in-house newsletter:
Workplace Safety Index
Looking back: Origins of a National Metric
In July of 2000, the Liberty Mutual Research Institute for Safety began an initiative to develop a reliable, annual ranking of the 10 leading causes of disabling workplace injuries and their direct costs to industry. Under the leadership of Director Tom B. Leamon, Ph.D., a core group of four scientists was assigned to the project.
A concept emerges
According to Director of Research Operations Theodore Courtney, M.S., C.S.P., the Workplace Safety Index concept emerged from the Institute’s early work on injury costs, specifically, low back pain and upper extremity musculoskeletal injuries. “We saw a huge demand from the scientific and business communities for these earlier cost papers and recognized a gap in the information available to researchers and practitioners. There was no summary-level statistic to illustrate the cost burden of U.S. occupational injuries,” says Courtney, who was the program manager for the inaugural Workplace Safety Index.
“While the challenges in front of us were considerable, we were confident that we could develop an estimate of the overall workplace injury cost burden,” he explains. At the time, the team noted that most occupational injury reports focused on either the nature of injury or body parts injured. While very informative, these reports dealt with injury characteristics after the fact – the what of the injury. To better address prevention, the team determined that the Index should focus on the how of the injury (the event that caused it) and the associated costs.
The Evolution of the Index
The goal was to combine cost data from Liberty Mutual’s workers compensation claims with frequency data from the U.S. Department of Labor’s Bureau of Labor Statistics (BLS) annual survey of U.S. occupational injuries.
“The problem,” explains Helen Marucci-Wellman, M.S., research scientist and principal investigator of the Workplace Safety Index team, “was that the two sets of injury narratives did not necessarily use the same terminology to describe the same events. We needed to develop common definitions and a common language.” For example, the term “overexertion” had to reflect the experiences of people whose injuries occurred as a result of lifting, pushing, pulling, or carrying an object. “This type of consistency had to be present for all of the causes studied,” explains MarucciWellman. “Only by comparing apples to apples could we ensure sound data linkage and the most accurate rankings possible.”
The research team also made a key methodological decision to focus the Index on the most disabling injuries, defined as those resulting in six or more days away from work. “To maintain the strength of the data, it made sense to align our cost data with BLS frequency data for injuries involving six or more days away from work. This methodology allowed us to provide a solid estimate of actual workers compensation dollars paid out,” explains Marucci-Wellman.
Finally, to broaden the study’s findings, the team compared the relative proportions of each injury cause to national estimates of the cost of workers compensation benefi ts from the National Academy of Social Insurance (NASI), which includes cost data from a broad range of insurers. By including NASI data, the Workplace Safety Index could cover groups missed by the BLS survey and be more representative of the national experience of disabling occupational injuries.
“We faced many other obstacles and challenges in developing the inaugural Workplace Safety Index. But, our primary goal was to work with the strengths of the various data sources to produce the best achievable estimates,” notes Marucci-Wellman.
The Workplace Safety Index is Unveiled
The first Workplace Safety Index, released at the end of 2000, garnered a positive response in both the occupational safety community as a whole and within Liberty Mutual. Industry executives began to take notice of the national cost burden of injuries and gained a better understanding of what drives the costs. In the scientific community, the Index began to play a role in helping researchers better focus their resources and efforts. In addition, Liberty Mutual’s Loss Prevention field organization immediately began using the Index with corporate safety professionals to help reduce workplace injuries.
Over the years, mainstream and business media, such as USA Today, US News and World Report, the Wall Street Journal, and the Boston Herald, have published the Index findings, as have business and safety oriented publications, such as Chief Financial Officer, Risk and Insurance, and Occupational Hazards. “This level of visibility has helped the Workplace Safety Index work its way into the fabric of the health and safety discussion in the U.S.,” says Institute Director Y. Ian Noy, Ph.D. “The annual findings have become a valuable tool for the business and research communities, helping them focus their efforts and allocate their resources toward the areas of greatest need.”
The Most Disabling Workplace Injuries Cost Industry an Estimated $48.3 Billion
Between 1998 and 2005, the real (inflation-adjusted) cost of the most disabling workplace injuries increased nearly four percent, despite a concurrent 21 percent decrease in the frequency of occupational injuries.* These findings, and many others, are presented in the 2007 Liberty Mutual Workplace Safety Index.
Produced annually, the Workplace Safety Index identifies the leading causes of the most disabling U.S. workplace injuries based on data reported from 1998 (the baseline year for Workplace Safety Index data) through the most recent year for which data are available – in this case 2005. The 2007 Index also captures cost trends for the overall and leading causes of the most disabling injuries from 1998 through 2005, with “most disabling” defined as those injuries that cause an employee to miss six or more days from work.
According to the 2007 Index, the estimated direct U.S. workers compensation costs for the most disabling workplace injuries and illnesses in 2005 were $48.3 billion. After adjusting for inflation, the overall cost figures represent a 3.9 percent increase compared to the baseline year (1998).
To develop the 2007 Workplace Safety Index, researchers applied Liberty Mutual 2005 workers compensation claims costs to the workplace injury frequencies reported by the U.S. Department of Labor’s Bureau of Labor Statistics that year. The relative proportions of each injury type were then applied to the national estimates of the cost of workers compensation benefi ts from the National Academy of Social Insurance, which includes information from a broad range of insurance providers.
2005 Top Ten Injury Causes
The top 10 causes of the most disabling work-related injuries remained essentially the same as in prior years. Overexertion maintained its first place ranking. This event category, which includes injuries related to lifting, pushing, pulling, holding, carrying, or throwing, has historically accounted for more than one-quarter of the overall national burden each year. In 2005, these injuries cost businesses $12.7 billion in direct costs.
Also consistent with past years, fall on same level ranked second as a leading cause of disabling injury. In 2005, this category claimed direct costs of $6.6 billion and accounted for 13.6 percent of the total burden of injury. However, for the first time in the history of the Workplace Safety Index, fall to lower level moved ahead of bodily reaction into the third-place ranking. With $5 billion in direct costs, this category accounted for 10.4 percent of total costs, slightly higher than its next-place contender. Notably, fall on same level and fall to lower level combined, accounted for nearly a quarter of the total cost of all disabling injuries in 2005. This demonstrates that falls, as a single event category, are comparable to overexertion in terms of the impact on the overall cost burden.
Bodily reaction, which includes injuries resulting from an incident of free bodily motion (such as bending, climbing, reaching, standing, sitting, or slipping or tripping without falling), ranked fourth in 2005 with $4.8 billion in costs and 10 percent of the total injury burden. Struck by object took the fifth place ranking, accounting for 9 percent of the total injury cost burden at $4.4 billion.
The remaining five injury events each accounted for less than 5 percent of the direct cost of disabling injuries in 2005. These included highway incidents, representing 4.8 percent of the total injury burden at $2.3 billion; repetitive motion, with related injuries accounting for 4.4 percent of the burden at $2.1 billion; struck against object, which accounted for 4.3 percent at $2 billion; caught in/compressed by (injuries resulting from workers being caught in or compressed by equipment or objects), which accounted for 3.9 percent of the total
* Frequency as reported by the U.S. Department of Labor, Bureau of Labor Statistics.
Widely published in the trade and business press, the Workplace Safety Index has reached the eyes of thousands of business readers over the years. This widespread dissemination of the Index findings has drawn the attention of the business community to the national burden of the most disabling work-related injuries. “When senior management decision-makers learn that disabling work-related injuries cost this country nearly $50 billion in direct costs – or about a $1 billion a week – it gets their attention,” states Karl Jacobson, Senior Vice President of Liberty Mutual Group.
Unlike other occupational injury reports, which focus on frequency or loss rates, the Workplace Safety Index identifies the top 10 causes of disabling injuries and their associated direct costs to industry. According to Jacobson, this cause/cost approach allows safety professionals to make a case for prevention in a way that resonates with senior business management.
“Any business that’s trying to improve a process must first make a business case for the process changes. Safety is no exception,” explains Jacobson. “The Workplace Safety Index helps safety managers initiate the necessary dialogue with senior executives,” he adds. Armed with the Index and their company’s worker injury data, corporate safety managers are better positioned to define, prioritize, and address safety concerns from a prevention angle. The Index provides Knowledge is power. Whether confronting an adversary, refi ning a strategy, or reaching a destination, the better informed you are, the greater your chance for success. This fact is especially true for occupational safety researchers and safety professionals, whose success at reducing the burden of workplace injuries is highly dependent on the quality of the information they possess. To support their efforts, the Liberty Mutual Research Institute compiles the annual Workplace Safety Index. With vital information on the leading causes and costs of serious occupational injuries, the Index provides an informational tool to increase awareness and to help safety researchers and professionals prioritize their workplace safety initiatives and resources.
the backdrop for safety managers to benchmark the nation’s top injury causes and costs, and compare them to their own company’s loss performance. “Most business executives are driven by data,” continues Jacobson, “so when they see that overexertion comprises a quarter of the nation’s disabling injury burden, and they realize it’s a major loss source for their company, they may be more inclined to take appropriate preventive action.”
Charting Research Directions
The Research Institute has traditionally based its research programs on the major causes of disabling occupational injuries. These causes include overexertion, slips, trips, and falls, highway incidents, and repetitive motion. “We have long known that these areas pose a significant burden on industry,” explains Institute Director Y. Ian Noy. “However, the Workplace Safety Index has allowed us to sharpen our research focus by identifying the loss areas where we can have the most impact with the resources we have.”
Together, injuries caused by overexertion and slips and falls comprise more than half of the U.S. disabling occupational injury burden. Accordingly, these areas remain a high research priority at the Institute, with ongoing projects ranging from laboratory investigations of manual materials handling exposures, to behavioral studies of the impact of individual perceptions on same-level slips and falls (see From Research to Reality, Vol. 10, Issues 2 and 3), to fi eld studies of factors contributing to ladder falls. “By studying the underlying mechanisms, conditions, and circumstances that contribute to these leading injury causes, we provide the scientific basis for real-world safety solutions,” explains Noy.
“…the trends suggest that safety research is having an impact, and together, with our business partners, the entire safety community continues to make progress.”
The Institute also conducts research related to other significant occupational injury causes, including highway incidents, struck by/against, repetitive motion, and bodily reaction. “Though less frequent, these injuries nonetheless contribute to about 50 percent of the total burden and represent a significant source of disability and considerable individual suffering,” notes Noy.
Current injury data reflected in the Index show a downward trend, and Noy is cautiously optimistic that this is a sign of progress. “It is heartening that injury frequencies are going down. That is good news for safety researchers and professionals. We can’t claim credit for the decrease in injury frequency, but the trends suggest that safety research is having an impact, and together, with our business partners, the entire safety community continues to make progress.”
Beyond the Institute
Barry Bloom, Ph.D., Dean of the Harvard School of Public Health, Boston, MA, puts it simply: “The Index reminds the public health community of the challenges workers and employers face every day in the prevention of occupational injuries.” According to Bloom, one of the Index’s most important contributions is that it has added the “cost dimension” to quantifying the public health burden of work-related injuries in the U.S. “By incorporating costs, the Index integrates measures of injuries beyond simple surveillance statistics – it includes society’s financial burden of workplace injuries.”
The Index has helped shape the recently formed Occupational Injury Prevention Research Training Program at the Harvard School of Public Health (HSPH). The Training Program is the newest component of the National Institute for Occupational Safety and Health-funded Education and Research Center at the HSPH. “This program has succeeded in attracting a number of students and funded research projects. It is becoming one of our leading programs in occupational safety and health,” notes Bloom.
While important in its own right, the burden described by the Index is “only the tip of the iceberg,” cautions Bloom. The Index does not capture the costs associated with injuries resulting in five or fewer lost workdays, non-recordable injuries and illnesses, lost productivity, or training replacement workers. “These other factors add substantially to the burden; however, measuring them is very difficult,” explains Bloom. “Such challenges are representative of the hard work yet to be done in research and education for the prevention of work-related injuries.”
“The Index reminds the public health community of the challenges workers and employers face every day in the prevention of occupational injuries.”