rates of both fatal and nonfatal occupational injuries have declined since the passage of the OSH (Occupational Safety and Health) Act in 1970, much remains to be done. In 2006, 5,840 workers—more than 110 workers each week—died as a result of injuries sustained on the job. These deaths occurred across all industry sectors (BLS, 2007a). Nonfatal work-related injuries far outnumber fatalities and are much more difficult to count. According to the Bureau of Labor Statistics (BLS), in 2006, 3.9 million nonfatal injuries were sustained by U.S. workers in private-sector employment (BLS, 2007b). The injury rate based on this number was 4.2 per 100 full-time workers. More than half of these injuries required workers to transfer to another job, restrict their duties at work, or take time off from work to recuperate. These BLS estimates are widely recognized to underestimate the full extent of the problem. They exclude nonfatal injuries among the 22 percent of the workforce that are not in private-sector employment, and there is also evidence that private-sector injuries are undercounted. One population-based study of work injuries (Smith et al., 2005) estimated that counts of injuries resulting in days away from work were 1.4 times higher than BLS workplace-based estimates for the private sector.

Direct workers’ compensation costs for occupational injuries and illnesses that occurred in the United States in 2005 were estimated to be $88.4 billion, a 2.3 percent increase over the estimate for 2004 (Sengupta et al., 2007). This number reflects only a portion of the economic costs of workplace injuries and illnesses. Researchers have found that many injuries never enter the workers’ compensation system and that workers’ compensation benefits cover only a fraction of lost earnings (Boden and Ozonoff, 2008; Rosenman et al., 2006; Silverstein et al., 1997). A recent study shows that in five states studied, only between 29 and 46 percent of lost earnings were replaced (Reville et al., 2001). Finally there may be substantial additional costs related to the disruption of work and the hiring and training of new workers (Leigh et al., 2000).

In recent years, researchers have also begun to conceptualize and demonstrate empirically the social and economic consequences of occupational injuries for the lives of individual workers and their families. Long-term financial hardship, changes in injured worker domestic function as well as ability to perform activities of daily living, and shifts in family dynamics associated with loss of income and disability are among the outcomes that have been noted (Dembe, 2001; Hensler et al., 1991; Morse et al., 1998; Pransky et al., 2000; Strunin and Boden, 2004).


NIOSH is a component of the Centers for Disease Control and Prevention (CDC), an agency of the Department of Health and Human Services (HHS). Cre-

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