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Prevention through Design logo

Input: Economic Factors

In 2007, 5,488 workers in the United States died from injuries sustained at work (1); an estimated 49,000 annual deaths have been attributed to work-related diseases (2). In 2007, an estimated 4.0 million private-sector workers had a nonfatal work-related injury or illness; approximately half of these workers required a job transfer, work restrictions, or time away from their jobs (3). An estimated 3.4 million workers were treated in emergency departments in 2004 because of occupational injuries, and approximately 80,000 were hospitalized (4).

In 2006, employers spent 87.6 billion dollars for workers’ compensation programs that provide medical and wage replacement benefits to workers who had an identified work-related illness or got hurt on the job (5). This figure does not include employers’ costs of worker absences or lower productivity due to working while injured or ill, nor does it include costs to workers, their families, and society overall. The annual direct and indirect costs of work-related injuries, illnesses, and fatalities have been estimated to range from $128 billion to $155 billion (6). In addition, workers’ compensation does not cover some of the injuries and most of the illnesses sustained by workers. For example, it was estimated that in 1999, deaths missed by workers’ compensation and attributed to work-related illness resulted in $8 billion to $23 billion in medical costs, which represented substantial cost shifting from workers’ compensation to private medical insurance, as well as to individual workers, their families, and taxpayers through Medicare and Medicaid (7).

The overall impact of occupational illness and injury on the healthcare system is poorly understood, when examined through medical services provided to workers by worker’s compensation and medical services provided to workers and their family members through group medical insurance. However, the impact seems to be very large and increasing. For example, nationwide, medical costs in workers’ compensation are growing faster than the medical consumer price index (8).

Recent studies in Australia implicate design as a significant contributor to 37% of work-related fatalities (9). Evidence suggests that the successful implementation of prevention through design concepts can greatly improve worker health and safety, reducing expenses associated with workers’ compensation.

However, the business value of PtD does not end there. In the Value of the Industrial Hygiene Study, “Demonstrating the Business Value of Industrial Hygiene,” also known as The Value Study, (10), significant business costs savings are associated with hazard elimination and the application of engineering controls to minimize risks. The Value Study demonstrates that as businesses adopt hazard control measures higher in the “hierarchy of controls,” i.e., designing-out hazards and minimizing risks, business value increases. These improvements in business value are related to faster time to market, improved operational efficiency, improved employee morale, decreased employee absenteeism and turnover, higher product quality, and increased market share.


  1. US Department of Labor, Bureau of Labor Statistics. National census of fatal occupational injuries in 2007. Washington, DC: US Department of Labor; 2008. Available at
  2. Steenland K, Burnett C, Lalich N, Ward E, Hurrell J. Dying for work: the magnitude of U.S. mortality from selected causes of death associated with occupation. Am J Ind Med 2003;43:461–82.
  3. US Department of Labor, Bureau of Labor Statistics. Workplace injuries and illnesses in 2007. Washington, DC: US Department of Labor; 2008. Available at
  4. CDC. Nonfatal occupational injuries and illnesses—United States, 2004. MMWR 2007;56:393–7.
  5. Sengupta I, Reno V, Burton JF Jr. Workers’ compensation: benefits, coverage, and costs, 2006. Washington, DC: National Academy of Social Insurance; 2008. Available at
  6. Schulte P, Rinehart R, Okun A, Geraci C, Heidel D. National Prevention through Design (PtD) Initiative. J Safety Research, 2008 39(2): 115 – 121.
  7. Leigh JP, Robbins JA. 2004. Occupational Disease and Workers’ compensation: Coverage, Costs, and Consequences. The Milbank Quarterly;82(4):689-721.
  8. National Council on Compensation Insurance. Workers Compensation 2009 Issues Report. Boca Raton, FL: National Council on Compensation Insurance, Inc.; 2009.
  9. Driscoll T, Harrison JE, Bradley C, Newson RS. The Role of Design Issues in Work-Related Fatal Injury in Australia, 2008 J Safety Research 39(2): 209 – 214.
  10. American Industrial Hygiene Association. Strategy to Demonstrate the Value of Industrial Hygiene, 2008. Available at: