Missed Opportunities to Prevent Workplace Injuries and Fatalities

Abstract

Prevention efforts, especially in high-income countries, have reduced work-related death and injury. Despite this, the global incidence of workplace fatalities remains unacceptably high with approximately 317 million incidents occurring on the job annually. Of particular concern is the occurrence and re-occurrence of incidents with a similar cause and circumstance, such as fatalities occurring in agriculture and transport industries. Efforts to reduce workplace fatalities include surveillance and reporting, investigation, and regulation. Challenges remain in all three domains, limiting the prevention of work-related injuries and deaths. In this commentary, the nature of these challenges and recommendations on how to overcome them are described. Examples of incidents of workplace injury and death, as well as injury prevention efforts are provided to ensure contextual understanding. Reflecting on the present enhances key stakeholders, policy and decision-makers' understanding of the opportunities to reducing harm and the associated human, and economic and legal costs.

Workers' Decompensation: Engaged Research with Injured Im/migrant Workers

“…The chronic overlooking of the environmental, social, and political contexts of workplaces and workers' lives constitutes a serious gap in the epidemiological literature and policies on occupational health (Woolford et al , 21). Legal, biomedical, and industrial approaches to occupational health rarely attend to the complex ways that structural vulnerabilities produce and exacerbate decompensation (Cartwright and Manderson ; Quesada et al ).…”

“…It will also require us to do more to change the sites of our interventions from the bodies and behaviors of workers to the structures and systems that chronically and perpetually injure and kill them. Anthropologists can find ways to include workers in policy and decision‐making initiatives and design creative strategies to instigate cultural and paradigm shifts that value workers' lives over corporate bottom lines (Woolford et al , 22). Our challenge as anthropologists, then, aside from documenting and analyzing these patterns, is to study up these systems and incorporate our models into everyday health care, policy, and occupational practice for the most structurally vulnerable and marginalized communities.…”

“…A 2015 OSHA report suggests that such high levels of subsidy of workers' compensation by other parts of America's social safety net may effectively reduce employers' financial incentives to prevent workplace accidents and illnesses in the first place (Michaels , 11) . Employers and labor contractors may not protect workers because current financial penalties and legal enforcements are weak (Woolford et al ).…”

“…There is already a severe undercounting of occupationally injured, ill, and dead workers, in part due to flawed, underfunded, and inconsistent surveillance and inaccessible reporting mechanisms (Grabell ; Grabell and Berkes ; Leigh et al ; Sered and Fernandopulle , 1; Spieler and Wagner ; Woolford et al ). The body counts are even less accurate for im/migrant workers because they often do not control the conditions of their work (Arcury et al ; Horton ; Rao et al ), and do not know their rights or do not have the same rights as other classes of workers (Woolford et al ). Injured im/migrants may also underreport or attempt to work through their injuries or illnesses due to the stigmas of being injured and unable to support their families (Horton ; Unterberger this issue).…”

“…Occupational health researchers, health‐care providers, and workers' compensation insurance companies may use reductionist biomedical metrics or ethnocentric ideas about im/migrant workers to determine what does and does not count as a work‐related illness, how much their injury or illness is worth monetarily, and whether or not the injury or illness is indeed work‐related or a preexisting condition (Holmes ; Horton ; Jain ; Saxton ; Woolford et al ). For example, Castillo (this issue) observes the mobilization of racist models amongst orthopedic surgeons and workers' compensation physicians attending to injured Latino day‐laborer patients in Rhode Island.…”