“Falls from height,” “struck by,” and “caught-in-between” are work injury terms so fierce that they grab attention and often dominate workplace safety training. For good reason, too — these injuries are severe and sometimes prevent employees from ever returning to their job.

“These injury types comprise nearly 64% of the total cost burden for U.S. business’ workers’ compensation costs,” explained Dr. Ronda McCarthy, national medical director of medical surveillance services at Concentra.

Due to the cost and severity of these catastrophic injuries, employers tend to concentrate their safety efforts on prevention. The Occupational Safety and Health Administration (OSHA) also mandates that programs be in place to train for such incidents.

But these attention-grabbing injuries are not the only injury types impacting workers’ compensation costs; overexertion, carpal tunnel syndrome and other seemingly minor injuries are taking a toll on health care costs and productivity.

“Recent research suggests that when a business includes loss of productivity in addition to direct medical and indemnity costs, low back pain is the costliest injury,” said Chris Studebaker, physical therapy director, Concentra.

“The impact of chronic overuse injuries is greater than many realize,” he said. “These injuries may come and go for the rest of an employee’s life, whether as a work-related injury or as a personal issue.”

Here are five serious injuries that are under-publicized in the workers’ compensation industry and how each is impacting costs and productivity.

1) Overexertion injuries, or musculoskeletal injuries, can cost up to $15 billion annually.

Overexertion injuries stem from an employee’s typical physical demands. This type of injury occurs when an employee is performing regular duties and develops a strain or sprain in places like a knee, a shoulder or the back. Tendon and muscle tears can also result from overexertion.

Dr. Ronda McCarthy, national medical director, medical surveillance services, Concentra

“In clinic, I see many overexertion injuries. Employees report working 12-hour shifts, 12 to 20 days in a row,” said McCarthy.

Overexertion injuries are common, she added. “The employer has production demands — and the employee needs to work. Unfortunately, these injuries accounted for approximately 30% of occupational injuries that resulted in time away from work, according to the Bureau of Labor Statistics.”

Employers are pressured to get the work done or get their product out. Employees may believe physical strains are just “part of the job,” and many enter these roles without first acclimating to the physical demands.

Newly hired employees with little to no training or conditioning for intense labor demands tend to suffer overexertion injuries the most.

“Risk factors associated with overexertion injuries are sustained awkward postures; rapid repeated motions; mismatch in size of the worker and the workplace equipment or tools; contact stress, vibration; cold environments; and sustained or high force demands,” said McCarthy.

“Employers can use administrative and engineering controls to reduce these risk factors. Post-offer, pre-placement exams and test may also be utilized to establish that employees are capable of performing the physical demands of an essential job task without injury to themselves or others.”

And the cost of overexertion injuries can add up. One report found that these injuries cost $15 billion annually and account for nearly 25% of the national injury burden.

2) Carpal tunnel syndrome only affects three to six percent of adults but can cost up to $2 billion annually.

Carpal tunnel syndrome, or CTS, is diagnosed by the pain, tingling, weakness or numbness it creates in the hand or wrist. It’s often associated with repetitive tasks and prolonged use of the wrist and hands.

According to Studebaker, CTS results in more lost work days than almost any other upper-musculoskeletal disorder. In direct costs alone, the industry is spending $2 billion annually.

“These chronic upper extremity injuries often take a long time to develop into debilitating injuries and subsequently take a long time to resolve,” said Studebaker.

“While injections, medication or surgery may at times be needed, upper extremity injuries such as tennis elbow, rotator cuff tendinopathy, and overuse injuries of the forearm and hand usually require slower forms of care such as tendon loading and postural re-education programs, manual therapy and, in some cases, dry needling from physical therapy as the optimal path to recovery,” he added.

The silver lining is that once CTS is discovered, it can be handled conservatively.

3) Despite regulations from OSHA, eye injuries are still prevalent in workers’ compensation.

Eye injuries can cost up to $300 million annually in lost productivity, medical treatment and workers’ compensation. But, said McCarthy, these injuries are largely preventable.

“OSHA has a regulation for eye and face protection,” she said. “The Personal Protection Equipment standard mandates the employer provide employees protective eyewear in specific conditions. And so, most eye injuries can be prevented if the employees are wearing their safety glasses.”

The problem comes in when an employee in a high-hazard position fails to wear safety gear.

“Many injuries would not have occurred if eye protection had been worn. That’s first and foremost,” she said. “Training and safety protocols need to emphasize the importance of eye protection.”

Secondly, employers can further prevent eye injuries by ensuring their employees have sufficient lighting in their work areas.

“You’re going to have fewer injuries and accidents if your employee is able to see accurately,” continued McCarthy.

Finally, McCarthy added that when eye injuries do occur, it is best to send an employee to a clinician sooner rather than later.

“A foreign body may be easy to remove if the affected employee comes to see a clinician right away. Waiting could mean referring the employee to an eye specialist, because more sophisticated equipment may be needed to remove the foreign body when a simple eye flush or swab may have removed the foreign body on the day of the injury. Any eye pain or decreased vision must be evaluated immediately to maximize the best possible outcome.”

4) Employees exposed to hazardous materials and other airborne pathogens are at an increased risk for lung disease.

Toxic and hazardous airborne exposures employees experience in the workplace can be at increased risk for lung disease. While employers are required to provide respiratory protection if the toxic or hazardous exposure is above certain levels as designated by OSHA standards, employees are still developing occupational respiratory illnesses.

“Currently, there’s an emphasis on respirable crystalline silica or silica dust,” said McCarthy. “Silica dust exposure affects about 2.3 million employees in construction and general industry. Many employees are exposed to respirable silica dust in very common, everyday work practices.”

Silicosis is a health effect from exposure to respirable silica dust. Silicosis is a preventable lung illness, but if contracted, it is incurable, progressive and can be fatal.

Chris Studebaker, physical therapy director, Concentra

Asbestos, coal dust and chemicals used in manufacturing are other common hazardous materials impacting employees’ respiratory system daily.

Occupational lung diseases develop over time and can be difficult to diagnose. For example, silica-related illnesses, said McCarthy, can take as few as several months to twenty years to develop depending on the exposure level. Asbestos-related lung disease, on the other hand, may take anywhere from 20 to 40 years to present itself.

“The employer at the time of the exposure is responsible for the illness,” said McCarthy, “even if the illness develops 30 years later. The employer can still be held responsible for the workers compensation costs associated with the evaluation and treatment of the illness.”

Employers should follow the pertinent OSHA regulations, which are minimum requirements, to prevent the health-related effects of occupational toxic and hazardous exposures in employees.

5) Heat-related illnesses are forecast to cost 1.8 billion in lost labor hours and $170 billion in lost wages.

Heat-related illnesses can be tricky. They can disguise themselves as a common viral syndrome — with symptoms of nausea and headaches, fatigue and muscle weakness.

Employees exhibiting such symptoms might be sent home early for rest and recuperation, but “sending a symptomatic employee home can actually be the worst thing a supervisor can do,” said McCarthy.

“Employees have died in their car on the way home. In other cases, employees have gone home feeling ill, then later sought medical attention to find out they have renal failure, because they’re actually suffering from a severe heat-related illness.”

Heat-related illnesses (HRI) are now being recognized in the occupational setting with the warming climate. Climate change is bringing excessive heat, with more days over 90 degrees Fahrenheit and more frequent heat waves globally. The National Oceanic and Atmospheric Administration reports in the last 20 years, 17 have been “the hottest on record.”

“Multiple national organizations are petitioning OSHA to pass a heat standard,” said McCarthy.

“Heat illnesses are 100% preventable. Too many employees are suffering from significant morbidity from heat related illnesses and some employees are dying.”

She added that, because this issue continues to be highlighted, more people are understanding it better.

“There are inexpensive measures that employers can implement at the worksite for employees exposed to hot environments,” she said. “Research has shown preventative measures when consistently applied can decrease heat-related illness rates and worker’s compensation costs.”  &