Institutional members access full text with Ovid®

Share this article on:

An Estimate of the U.S. Government’s Undercount of Nonfatal Occupational Injuries

Leigh, J. Paul PhD; Marcin, James P. MD, MPH; Miller, Ted R. PhD

Journal of Occupational and Environmental Medicine: January 2004 - Volume 46 - Issue 1 - p 10-18
doi: 10.1097/01.jom.0000105909.66435.53
CME ARTICLES: CME Article #2
Learning Objectives 
  • Estimate how many workers—and in which occupations—are presently excluded from the Bureau of Labor Statistics Annual Survey of Occupational Illnesses and Injuries.
  • Consider possible reasons for under-reporting of injuries by private firms and their employees.
  • Provide the best estimate of the degree of under-reporting, and note the possible consequences for workers’ health.

Estimate how many workers—and in which occupations—are presently excluded from the Bureau of Labor Statistics Annual Survey of Occupational Illnesses and Injuries.Consider possible reasons for under-reporting of injuries by private firms and their employees.Provide the best estimate of the degree of under-reporting, and note the possible consequences for workers’ health. Debate surrounds the size of the underestimate of nonfatal occupational injuries produced by the U.S. Bureau of Labor Statistics (BLS). We developed models that separated categories of injuries: BLS Annual Survey, federal government, agriculture, state and local government, self-employed outside agriculture, and all other. The models generated varying estimates depending on the assumptions for each category pertaining to job risks and amount of underreporting. We offered justification for the assumptions based on published studies as well as our own analyses of BLS data. The models suggested the Annual Survey missed from 0% to 70% of the number of injuries (from private firms, excluding the self-employed) it was designed to capture. However, when we included firms and governments the Annual Survey was not designed to capture, and considered reasonable assumptions regarding underreporting, we estimated the BLS missed between 33% and 69% of all injuries. We concluded that there was substantial undercapture in the BLS Annual Survey, some due to the excluded categories of government workers and the self-employed, as well as some due to underreporting.

From the Department of Epidemiology and Preventive Medicine, Medicine School, University of California at Davis, Davis, California (Dr. Leigh); the Center for Health Services Research in Primary Care, University of California at Davis Medical Center, Sacramento, California (Dr. Leigh); the Department of Pediatrics, University of California at Davis Medical Center, Sacramento, California (Dr. Marcin); and Pacific Institute, Calverton, Maryland (Dr. Miller).

Address correspondence to: J. Paul Leigh, PhD, Department of Epidemiology and Preventive Medicine, Medicine School, TB 168, University of California at Davis, Davis, CA 95616; E-mail address: jpleigh@epm.ucdavis.edu.

J.P. Leigh has no commercial interest related to this article.

©2004The American College of Occupational and Environmental Medicine