Photo by Earl Dotter.

Workplace safety and health surveillance and recordkeeping sound boring, but good data about who’s getting hurt, sick or killed — how and why– are vital to determining the need for safety and health protections, funding and where to put resources for inspections, standards and other strategies to keep workers from getting sick, injured and killed at work.

We currently have an aging, uncoordinated and unwieldy surveillance and recordkeeping system. In an effort to improve workplace injury and illness surveillance and reporting in this country, the National Academies of Sciences has issued a report, commissioned by OSHA, NIOSH and the Bureau of Labor Statistics (BLS), that made a number of recommendations, including that the agencies account for a shift in the traditional workforce toward a “gig economy” and that agencies focus on vulnerable worker populations by collecting information on race and ethnicity. (Full report here. Report-In-Brief here.)

Of particular interest is the report’s recommendation that OSHA “develop plans to maximize the effectiveness and utility of OSHA’s new electronic reporting initiative for surveillance,” considering that OSHA’s last Regulatory Agenda indicated that the agency may be planning to roll back several major features of the new recordkeeping regulation and OSHA Assistant Secretary Nominee Scott Mugno is on the committee that produced this report and the recommendations.

What’s the Problem?

What is occupational safety and health surveillance and why do we need to improve it? Surveillance is defined as “ongoing, systematic collection, analysis, and interpretation of health data.” What’s it for? “OSH surveillance provides the data and analyses needed to understand the relationships between work and injuries and illnesses in order to improve worker safety and health and prevent work-related injuries and illnesses.”

OSHA Assistant Secretary Nominee Scott Mugno is on the committee that produced this report and the recommendations

The BLS currently collects data from a representative sample of employers in order to develop an annual national count of workplace injuries and illnesses (although no one really believes that illnesses are well counted.)  OSHA requires most employers to keep their own injury and illness records which OSHA only checks when inspectors are at the workplace for an inspection. It wasn’t until last month, , however, those employers who keep records are required to send a summary of that information to OSHA. OSHA will use that data to target inspections at the most dangerous workplaces and NIOSH analyzes the information to characterize workplace safety an health conditions among different industries and occupations. OSHA had originally planned to post the data although it is unclear whether the Trump administration will follow through.

The NAS report calls for changes in the way that BLS and OSHA collect data, noting that since current injury and illness surveillance programs were established, there have been huge changes in the employment landscape, including the growth in “nonstandard work arrangements”:

Employment in manufacturing has declined, while there has been significant growth in employment in the service sector, including health care. Individuals are likely to be working more than one job over their working life, and may hold multiple jobs at the same time. The workforce is much more diverse, with many more women, racial and ethnic minorities, and immigrants employed. Growth has occurred in nonstandard work arrangements, such the use of independent contractors and “gig economy” workers (on-demand contractors and freelance workers).

What Is To Be done?

The report contains 17 separate recommendations, including a “meta-recommendation” that NIOSH “form and lead a coordinating entity in partnership with OSHA, BLS, and other relevant agencies” and include an OSHA surveillance strategic plan.

  • The problem of undercounting injuries and illnesses needs to be addressed. Currently, 9% of the current working population is not even counted using current techniques: the self-employed, household workers, federal workers, U.S. Postal Service workers, and workers on farms with fewer than 11 employees. In addition, work-related diseases are rarely counted.
  • Prevention and counting of occupational disease need to be emphasized. The report notes that current recordkeeping systems focus on collecting data about injuries and illnesses that have already happened, but do not put enough emphasis on collecting data on hazards and exposures in order to focus on prevention, especially for long-latency occupational diseases that may only be visible years after exposure to the hazard. In addition, all federal health surveys should include information on industry and occupation.

The problem of undercounting injuries and illnesses needs to be addressed.

  • In order to better identify vulnerable worker populations and risks that may be associated with different types of employment arrangements (such as the use of independent contractors, the outsourcing of functions to other entities,”on-demand” or “gig” work where employment is characterized by short-term contracts or freelance work), information on race, ethnicity, and employment arrangements need to be incorporated into OSHA and BLS recordkeeping systems.
  • In addition to systems for better reporting and collecting injury and illness information, such as the OSHA electronic reporting initiative,  there also needs to be a plan for “thoughtful analysis, careful interpretation, and dissemination of results to engage in policy development or public health action for prevention.”
  • Efforts should also be made to gain additional information from workers compensation systems and BLS should develop a “Household Survey of Occupational Injuries and Illnesses” (HSOII) to fill data gaps for populations of workers who are missing from current employer-based injury reporting.
  • NIOSH, OSHA and BLS should set up an alert system to publicize emerging OSH problems either as new illness or injury or of old associations found in new settings that create injury or disease.
  • NIOSH should work with state surveillance systems to develop a methodology to improve collection of information on occupational disease.
  • OSHA and BLS should integrate their data collection efforts. Currently, employers selected in the annual BLS survey also have to make a separate report to OSHA.
  • There should be regular reports to the nation that publicize the overall burden of occupational injury and disease on health, the economy, and society.

Rolling Back OSHA’s Electronic Recordkeeping Regulation?

Scott Mugno
Scott Mugno will have decisions to make

Employers are currently sending OSHA their summary injury and illness information (Form 300A), but starting next year, employers with 250 or more workers will be required to electronically send more detailed injury and illness records to OSHA — the information found on OSHA Forms 300 and 301.

The NAS report says that the new OSHA rule “will provide an extensive new data source regarding injury and illness that can be used by OSHA, NIOSH, state agencies, employers, workers, and researchers for a range of surveillance and prevention purposes.”  The agencies also need to develop ways to to conduct improved analysis of the data and a way to report findings in a way that will assist employers to make their workplaces safer.

During a January 9 press conference following release of the report, AFL-CIO health and safety director Peg Seminario, who was on the panel that created the report,  said that without individual case information, the data wouldn’t be detailed enough for analysts to adequately characterize the information in a way that regulatory OSHA and NIOSH would find most useful, according to Business Insurance.

“If they reexamine and do not get that information, you wouldn’t capture any specific case information about the kinds of injuries that are occurring,” Ms. Seminario said. “You wouldn’t capture any of the information about who these injuries are occurring to. Any of the detailed case information would not be available to the agencies to essentially fill in and have a picture as opposed to an outline of what is happening. And it wouldn’t be available to others to use as well for surveillance purposes.”

Seminario is the only member who was also on a previous 1987 report on improving recordkeeping systems.

Mugno, who should soon be arriving to take the reins at OSHA (Congress willing and the creek don’t rise,) will have to decide whether or how much to modify the electronic recordkeeping regulation in light of the strong recommendations in a report that he had a role in creating.   The most recent regulatory agenda stated that “OSHA has now determined that it cannot guarantee the non-release of personally identifiable information” (such as employee names), although prior to issuance of the standard, OSHA and OMB’s Office of Information Regulatory Affairs set up systems to ensure that confidential, personally identifiable information could not be released. In fact, most of that information would never even be submitted to OSHA by the employer, and for other information (e.g. birthdates or dates of hire) there were ways to ensure its confidentiality.

When the regulation was issued, OSHA included a question about confidentiality of personally identifiable information in the Frequently Asked Questions. OSHA’s response was:

OSHA has effective safeguards in place to prevent the disclosure of personal or confidential information contained in the recordkeeping forms and submitted to OSHA. OSHA will not collect employee name, employee address, name of physician or other health care professional, or healthcare facility name and address if treatment was given away from the worksite. All of the case specific narrative information in employer reports will be scrubbed for PII using software that will search for, and de-identify, personally identifiable information before the data are posted.

What has changed since then? Not clear.

And it’s unclear whether that FAQ information is still on OSHA’s website as the FAQ page is “temporarily unavailable” due to “technical difficulties.”

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