Hiding injuries and blaming workers

I'm just back from an injured worker symposium in Toronto. It was a fantastic conference (more on it later this week). Below is the presentation I gave last Friday.

Hiding Injuries and Blaming the Worker in Alberta
Research Action Alliance on the Consequences of Workplace Injury
2011 Symposium on the Consequences of Workplace Injury, 18 November 2011
Bob Barnetson, Associate Professor,
Labour Relations, Athabasca University

Introduction
Thank you for inviting me to speak today about workplace injury in Alberta. I’m Bob, I’m a prof at Athabasca University and I’d like to talk to you today about two things. The first is systemic under-reporting of injury by the government. And the second is the tendency of the government of Alberta to blame workers for their injuries. Those two trends are important because they dampen the ability of workers to pressure employers and the government for safer workplaces.

Counting Injuries
Like many jurisdictions, Alberta counts injuries. The measures include the occurrence of time-loss injuries (where you can’t go to work the next day) and disabling injuries (can’t do your job the next day). These measures are reported as rates: X injuries per 100 person years worked. Expressing injuries as a rate is useful: it controls for changes in the size of the workforce, so numbers are comparable across time.

That said, expressing injury as a rate also obscures the actual number of injuries. So, for example, saying that we had “3.09 disabling injury per 100 person years worked” sounds a lot better than saying “this year 53,000 Albertans were injured so badly they couldn’t do their job the next day”. In effect, the way injuries are reported in Alberta makes workplaces sound safer than they actually are.

More concerning, though, is that Alberta recognizes only 1 out of every 10 injuries. An example is the easiest way to show this. In 2009, Alberta reported 28,688 lost-time injuries and 24,625 modified-work injuries for a total of 53,313 disabling-injury claims.

These 53,000 disabling injuries are all of the injuries Alberta officially “counts” when it talks about injuries. This number excludes the 95,854 medical-aid claims that Alberta has data on—injuries where a trip to the doctor or rehab was required. Adding in these numbers, we see the real number of injuries triple to 149,167.

But, again, that’s not the whole story.

We need to adjust for the 13% of the workforce that wasn’t covered by workers’ compensation—so the real number of injuries jumps to 171,456. And we need to adjust for the 40% of injuries that are not reported—so the number jumps again to 285,760.
But we’re still not done.

The number of minor injuries (those that don’t require reporting) and the number of occupational diseases (where under-reporting appears to be massive) is unclear. But an educated guess would be a further doubling of the total to roughly 500,000 injuries a year. In a workforce of about 2 million.

The discrepancy between the number of injuries the government talks about and the number of actual injuries tells us two important things:

1. Injuries are socially constructed. Alberta talks about only the most serious injuries. This creates the impression that workplaces are safer than they are.

2. Alberta’s occupational health and safety system simply does not work. No reasonable person could conclude Alberta’s health and safety system works when half a million injuries occur every year.

It is not clear that systematic underreporting is a conscious strategy by the government. But I expect both bureaucrats and politicians are aware that under-reporting helps limit the effectiveness of worker efforts to increase government enforcement activity.

Blaming Workers
The other things I wanted to talk about today is blaming. Alberta emphasizes education as its primary means of injury prevention. And, since 1985, Alberta has increasingly blamed workers for their injuries in their educational material. In 2008, Alberta launched its “Bloody Lucky” workplace safety campaign. This campaign is aimed at young workers and centres on six videos that dramatize gory injuries. They are similar to videos developed in other jurisdictions except there is greater emphasis on worker carelessness and the employer’s role in injury prevention is largely absent. Let’s look at a representative video now.



The first reaction of most lay people when they see this video is “stupid worker” (which, coincidentally, was the title of Alberta’s 2005 worker safety campaign). And you can see why people think the worker was to blame. She wore dodgy footwear, she got on a rickety ladder, she reached too far, and she fell. Stupid worker.

But what was the root cause of the worker’s injury?

The root cause was her employer arranged the workplace unsafely. Specifically, stock was stored in a manner such that she couldn’t safely retrieve it. The merchandise was placed too high and unstably stacked. The ladder provided was rickety and the light fixture was unguarded.

None of these factors are within the control of the worker. The worker’s shoes did contribute to her fall, but only because the stock retrieval system was poorly designed. Further, it’s unclear, in a shoe store, whether her employer would have consented to her wearing sensible shoes with a ladder-safe tread.

Yes, she could have refused work. But she likely would have been canned for that. Her employer is the one who is to blame here.

This video (and other government material) tells us that injuries are the result of workers making poor choices. While again it is unclear that blaming workers is an intentional strategy by the government, the careless worker narratives suggests that additional regulatory activity wouldn’t improve matters. In the words of the former-premier, “You can’t legislate common sense.”

Conclusion
The upshot of systemic under-reporting and blaming workers is that the government reduces the ability of workers to pressure for improved regulations or even effective enforcement of existing regulations. Notionally, there are simple fixes available: Alberta could report injury numbers more honestly and stop blaming workers for injuries.

But Alberta has proven reluctant to do so. My sense is that the political costs of an about-face—to both senior civil servants and politicians—will be high. Consequently, collaborative approaches in Alberta (i.e., working with government and industry) have a long history of very, very modest success.

By contrast, highlighting the true number of injuries and the ineffectiveness of enforcement have triggered more enforcement activity. Whether such a conflict-oriented approach is the most effective long-term strategy is hard to say. But, absent willingness by the government to alter its behaviour, a conflict-oriented approach is likely to continue.

For this reason, research in Alberta over the next several years will focus on documenting the prevalence and consequences of workplace injury in Alberta—hopefully this research will provide advocates with some political leverage. Of particular interest is the injury of child and adolescent workers, the interaction between worker mobility and workplace injury, and extending research done in Ontario and Quebec regarding how the operation of workers’ compensation affects, and perhaps exacerbates, workplace injuries.