Wholesale and Retail Trade

Burden

The wholesale and retail trade (WRT) sector employs more than 20 million workers [BLS 2017a,b]; this includes not only those who work in sales and material handling, but also those who work in office environments where conditions exist that can cause slips, trips, and falls (STFs). STFs are the second most common cause of lost-workday injuries in general industry [BLS 2016a,b], resulting in injuries of varying severity, including back injuries, sprains, strains, contusions, fractures, severe head injuries, paralysis, and even fatalities. Non-fatal STFs can be severe and disabling, and can result in considerable financial burden and adversely affect quality of life. STFs collectively lead in costs to businesses with over $15 billion dollars in direct costs [Liberty Mutual 2017]. In the WRT sector, STFs are the third most common cause for lost-workday injuries [BLS 2017a]. Two-thirds of the total fall injuries in WRT occur from falls on the same level [BLS 2017a]. STFs are also responsible for 15% of all work-related fatal injuries, the second leading cause of fatalities behind motor vehicles [BLS 2017b] and the third leading cause for this industry [BLS 2017c]. STFs disproportionately affect certain demographic groups. Generally, STFs are the second leading cause of death among Hispanic workers and the third leading cause for Asian workers [BLS 2017d]. In addition, 47% of fatal occupational fall victims are age 55 and above [BLS 2017d].

Need

Several industrial and government entities have called for fall prevention and protection research and practice to control the national STF burden: the Center for Construction Research and Training (CPWR), the Occupational Safety and Health Administration (OSHA), the American Society of Safety Engineers (ASSE), and the National Safety Council (NSC), among others. Over the last 20 years or so, NIOSH research has shown that most STF incidents can be prevented with proper attention to three categories of risk factors: workplace, work organization, and individual or personal factors [NIOSH 2012]. However, very few STF intervention effectiveness studies have been conducted in WRT businesses. The WRT sector is also unique because the retail workers are sharing their work space with the customers, which adds to the spills and clutter often found in food and beverage stores. Future research should include collaborations with insurers, employers, and labor organizations to assess the effectiveness of fall-related prevention strategies. Cost-benefit studies are also needed to demonstrate the economic incentive for equitable adoption of various prevention strategies. The majority of the STF literature often ignores wider systems issues in workplace STF etiology. Future evaluations of interventions should investigate work organization factors that can shape worker behavior patterns related to STFs. Communicating evidence-based STFs prevention and protective measures and graphics-based guidelines for field implementation to be incorporated into industry practice and safety standards is needed to reach all populations, including older and younger workers, workers in non-standard work arrangements, Hispanic workers and workers born outside the U.S.

Burden

Risk of death or injury in a motor vehicle crash (MVC) affects workers in all industries and occupations, whether they drive tractor-trailers, cars, pickup trucks, or emergency vehicles, and whether driving is a primary or occasional part of the job. Although there are no reliable estimates for levels of exposure to motor vehicle-related hazards, it is likely that workers in the Wholesale and Retail Trade sector spend substantial work time driving. For example, retail workers use passenger vehicles for local deliveries. However, the Wholesale Trade sub-sector, where the work involves the regular use of motor vehicles to distribute products, has the greater fatality burden, with MVCs accounting for 45.7% of all fatalities in 2015 compared to 37.3% for all sectors [BLS 2016c]. In 2015, an estimated 31,130 private-industry workers across all industries sustained non-fatal days-away-from-work injuries in work-related roadway incidents, 33.4% of which resulted in 31 or more days away from work [BLS 2016d]. Another source reported that MVCs made up 6.2% of serious non-fatal injuries at work in 2014 and an estimated $3.7 billion in workers’ compensation costs [Liberty Mutual 2017].

Need

Although the burden of large-truck (i.e. weighing more than 10,000 pounds) crashes is high, there is a strong infrastructure in the U.S. Department of Transportation (DOT) and university research centers to support trucking safety and regulatory initiatives. Other workers who do a great deal of on-the-job driving (e.g., drivers for motor vehicle and parts wholesalers and dealers) are covered by few federal driver safety regulations. Consequently, research on these populations is limited. NIOSH can make a critical contribution by balancing research on trucking safety that is unlikely to be sponsored by DOT with research focusing on these less-studied populations.

Research is needed to demonstrate effectiveness and cost-effectiveness of a range of interventions to prevent work-related MVCs, from safety management strategies to new technologies. Of particular interest are evaluations of technology and administrative interventions to mitigate known risk factors such as fatigued and distracted driving. These include the evaluation of the effectiveness of highly-automated vehicles (not yet in wide use) and currently-available active safety systems in reducing and preventing crashes. Dissemination research is needed to identify optimum methods for moving evidence-based interventions into workplace practice, in particular where small business establishments are concerned. Those who communicate safety information should consider audience needs based on health and safety literacy, socio-demographic characteristics, and preferred communication channels.