Top 10 Causes of Disabling Workplace Injuries — and What They Cost

Overexertion and falls on the same level are two of the top causes of disabling workplace injuries, according to Liberty Mutual's 2019 report.
By: | April 23, 2019

Perhaps no other single issue stands out in a business owner’s mind more than the safety and security of employees. Every workplace has its hazards, but no one ever expects accidents to happen at work. So what are the biggest causes of disabling workplace injuries and what safety measures can companies take to protect their most valuable assets?

The annual Liberty Mutual Workplace Safety Index documents the top ten causes of the most serious workplace injuries—those causing an employee to miss five or more days from work — and ranks them by their direct cost to employers.

The findings of the Index should be a tool for employers — working with their insurers and brokers—to better protect employees and control their total risk costs.

According to James Merendino, vice president and general manager of GRS Risk Control at Liberty Mutual, the top causes of the most serious workplace injuries and illnesses have been largely stable over the past several years, according to the Liberty Mutual Workplace Safety Index.

However, changes in the study’s methodology make it difficult to compare performance over time in detail.

James Merendino, vice president and general manager of GRS Risk Control, Liberty Mutual

“The stability of the top causes means that risk managers and brokers can use the data in their efforts to improve safety to better protect employees and the total cost of risk,” Merendino said. “This year’s study is the first to also report findings for specific industries, helping employers and brokers benchmark safety performance and focus their safety resources.”

On average, U.S. companies lose more than $1 billion per week due to disabling workplace injuries. And while the frequency of workplace accidents is down, the cost of these accidents — from medical payments to jury verdicts—is up, continuing to make safety a top priority for employers.

According to the study, the top 10 causes of workplace injuries and their subsequent cost to U.S. companies include:

1. Overexertion involving outside sources. This includes injuries related to lifting, pushing, pulling, holding or carrying. Cost: $13.1 billion

2. Falls on the same floor level. This may include slipping on a wet floor. Cost: $10.4 billion

3. Struck by object or equipment including falling objects from above. Cost: $5.2 billion

4. Falls to lower level from a ladder or platform. Cost: $4.9 billion

5. Other exertions or bodily reactions from activities. These may include crawling, reaching, bending, twisting, climbing, kneeling, or walking. Cost: $3.7 billion

6. Roadway incidents involving motorized land vehicle. Cost: $2.7 billion

7. Slip or trip without fall. This may include tripping over an object but not falling to the ground. Cost: $2.2 billion

8. Caught in or compressed by equipment or object. This may include becoming caught in rollers or gears. Cost: $1.9 billion

9. Repetitive motions involving microtasks. Working on an assembly line is often a cause of this injury. Cost: $1.63 billion

10. Struck against object or equipment. This may include walking into a door or drawer. Cost: $1.2 billion

Of the eight industries highlighted in the index, the industries that are the most costly in terms of workplace injuries can be seen in the table below. Because this year’s Index is the first to also report results by eight select industries, it is not possible to discuss cost trends by industry.


Industry Sector Cost (Billions) Percent of All Industries Top 5 Causes as a Percent of Sector
Construction $     9.87 17.8% 78%
Professional and Business Services $     7.86 14.2% 70%
Manufacturing $     7.62 13.7% 67%
Health care and social assistance $     5.17 9.3% 79%
Retail Trade $     5.09 9.2% 79%
Transportation and warehousing $     4.37 7.9% 67%
Wholesale trade $     4.04 7.3% 71%
Leisure and Hospitality $     3.46 6.2% 71%
Total: $    47.48 85.7%

So what were the biggest surprises from the 2019 Liberty Mutual Workplace Safety Index? Quite simply, most of the surprises involve the first-ever reporting of the leading causes of workplace accidents by select industries.

Specifically, the Liberty Mutual team was surprised by the consistency of the top causes across the eight industries for which sufficient data were available. As Merendino explained, all eight industries had “Overexertion and Falls on Same Level” within the top five causes, and these were the top two causes in six of those industries.

“The construction industry had “Falls to Lower Level” as their top cause,” Merendino said. “The only other industries where Overexertion was not the top cause was Professional & Business Services and Leisure & Hospitality industries, where “Falls on Same Level” was the top cause.”

Steps to Take

To better protect employees and the bottom line, each employer needs to understand the root causes of the most serious workplace injuries they face. As Merendino explained, a clear understanding of the risk from organizational, social, physical, process, and equipment systems is essential.

“Only then can they effectively mitigate and manage risk through work design, system controls, technology, training, and strategic risk management,” Merendino said.

And while all efforts to improve safety need to be based on a specific employer’s operations and employees, there are three techniques that Merendino said are often key to driving safety improvements. These tools have proven effective in a variety of industries.

  1. Establish a strategic safety plan. This document identifies the top safety challenges facing the company and the ways these will be mitigated and managed. The plan should focus on reducing existing risk, as well as those from any new operations or technologies.
  2. Set expectations. Senior management must take every opportunity to underscore and reinforce their total commitment to a safe working environment. Safety must be seen as a strategic priority and an enabler of company success.
  3. Directly involve front line employees in the strategic safety program.  These are the people who do the work, and who understand how it can be done safely, and why shortcuts are sometimes taken.

“Companies should have strategic safety programs that outline the top challenges they face and how these will be managed and mitigated,” Merendino said. “Making continued improvements in workplace safety requires companies develop strategic safety programs—which include the thoughtful integration of technology—that build a culture of safety,” Merendino said. “Insurance companies and brokers can be helpful allies in these efforts.” &

Based in Minneapolis, Minnesota, Maura Keller is a writer, editor and published book author with more than 20 years of experience. She has written about business, design, marketing, health care, and a wealth of other topics for dozens of regional and national publications. She can be reached at [email protected]

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