Along with Bureau of Labor Statistics (BLS) injury and illness data, the annual release of worker fatality data has historically been one of the best measurements of worker safety and health on the job. The BLS Census of Fatal Occupational Injuries (CFOI) reported that in 2020, worker fatalities declined almost 11 percent, from 5,333 in 2019 to 4,764.

Taken by itself, that seems like great news, but it comes with one very big caveat – the BLS fatality data doesn’t include any deaths from COVID-19. As noted in its press release, “CFOI reports fatal workplace injuries only. … CFOI does not report any illness related information, including COVID-19.” Unfortunately, that means the thousands of health care workers and other essential workers who died from COVID-19 in 2020 due to exposures in the workplace aren’t being counted by the BLS. This is a longstanding weakness of the CFOI data, which is only set up to count acute injuries.

“The occupational safety and health community has been pointing out this problem for years. COVID-19 is just the latest example where there’s a failure to show the relationship between occupational illness, worker health and workplace fatalities,” says Walter Jones, the LHSFNA’s Director of Occupational Safety and Health. “The same issue happens with work-related deaths caused by silica, asbestos and other hazardous substances. This is a continuation of the inaccurate belief that if it isn’t an acute fatality, it’s not work-related.”

If there’s any upside to COVID-19 deaths not being included in the BLS data, it’s the opportunity to make year-over-year comparisons that are much closer to apples to apples than they would be otherwise. At a time when employers and workers were largely focused on COVID-19, we can see how worker safety and health fared in other areas. For example, we can examine whether deaths from workplace violence, which were spiking even prior to the pandemic, rose further in 2020 or stabilized.

Fatalities in the Construction Industry

In the construction industry, the total number of fatalities dropped five percent, from 1,061 in 2019 to 1,008 in 2020. To put this in context, however, we have to look at the total number of hours worked. The construction industry was less impacted by COVID-19 than many other businesses across the U.S., but the total number of work hours in 2020 still decreased nine percent from 2019 levels.

With the percentage of hours worked dropping more than the percentage of worker deaths, the result is a 2020 fatality rate for construction workers that actually went up, from 12.9 to 13.5. Looking specifically at construction laborers, the jump in fatality rate was even steeper, going from 15 in 2019 to 18.1 in 2020 (an increase of 17 percent). So while the total number of construction workers killed on the job did decline between 2019 and 2020, that’s not a sign of the construction industry being any safer for workers.

The causes of the 1,008 construction worker deaths in 2020 break down into the following categories:

The percentages for each of these categories are almost identical to the 2019 breakdown. For example, falls, slips and trips fell from 38.3 percent to 36.5 percent, while transportation incidents rose from 23.7 percent to 25.5 percent.

These results seem to indicate that the increased awareness on COVID-19 precautions on construction jobsites – including hand hygiene, social distancing and facial coverings – didn’t lead to improvements in other areas of safety and health. If anything, it’s possible that the time, energy and effort spent training workers to stop the spread of COVID-19 left safety managers and other safety personnel with less time to devote to other ongoing hazards. Another possible culprit is that in 2020, many contractors were dealing with reduced crew sizes due to workers being sick or exposed to COVID-19. Risk increases when there aren’t enough workers for the task being performed, especially if there’s no one to fill key safety roles such as having a spotter when vehicles are backing.

Ensuring All Worker Fatalities Get Counted

The lack of COVID-19 fatality data in this year’s BLS release highlights one of several weaknesses in how worker deaths are treated here in the U.S. The CFOI system’s narrow focus on only acute injuries means disease-related deaths don’t get counted. Meanwhile, this year’s BLS injury and illness report does include COVID-19 infections, creating a clear data discrepancy between infections and deaths within the agency.

We have CDC and state health department data on the number of people who died from COVID-19, but that data doesn’t include a person’s occupation. With COVID-19 and other diseases, the difficulty has always been determining to what extent the exposure was work-related. That very complicated question remains, but the fact is that right now, the BLS and CDC aren’t even asking those questions. It’s time for the BLS to start collecting and reporting on all types of workplace deaths, even if they aren’t caused by acute injuries.

Every single worker who dies from COVID-19 or another work-related disease deserves to be counted. To create practices and interventions that successfully prevent worker deaths, we have to understand how workers are losing their lives on the job.

[Nick Fox]