related illnesses remain undercounted, several ongoing occupational-injury surveillance efforts can be used to monitor injuries among young workers. These efforts are described in the rest of this section. Different systems monitor nonfatal and fatal work-related injuries.

Nonfatal Work-Related Injuries

Survey of Occupational Injuries and Illnesses

The official source of statistics on nonfatal work-related injuries and illnesses in the United States is the Annual Survey of Occupational Injuries and Illnesses (SOII) of the Bureau of Labor Statistics (BLS). Information is collected through an annual survey mailed to a stratified random sample of employers in private industry. Excluded from the sample are self-employed individuals; farmers and other employers with fewer than 11 employees; private households; and federal, state, and local government agencies. Employers who receive the survey are asked for information on all job-related injuries and illnesses for which they were required to maintain records by the Occupational Safety and Health Act. This requirement applies to any injury that results in death, loss of consciousness, restricted work activity, transfer to another job, or medical treatment beyond simple first aid (see 29 U.S.C. §657). There has long been a concern about the accuracy of the records kept by employers (for a full discussion of problems with the SOII, see National Research Council, 1987). The concern over the validity of the record-keeping, and thus the information submitted to BLS, increased in 1981, when the Occupational Safety and Health Administration exempted industries with below-average injury rates from its general-schedule inspections.

A redesigned survey was fully implemented in 1992. The SOII now includes the following information on nonfatal incidents involving days away from work: the occupations and demographics (including age and sex) of workers who sustain injuries and illnesses, the nature of the injuries or illnesses and how they occurred, and the amount of time workers were away from work (Bureau of Labor Statistics, 1997a). In 1993 the survey documented an estimated 21,620 injuries and illnesses involving days away from work among employees under the age of 18 (Centers for Disease Control and Prevention, 1996). Older adolescents accounted for almost all of the

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