Pransky G, Snyder T, Dembe A, Himmelstein J
Department of Family and Community Medicine, University of Massachusetts Medical Center, Worcester 01655-0309, USA.
Ergonomics. 1999 Jan;42(1):171-82. doi: 10.1080/001401399185874.
Accurate reporting of work-related conditions is necessary to monitor workplace health and safety, and to identify the interventions that are most needed. Reporting systems may be designed primarily for external agencies (OSHA or workers' compensation) or for the employer's own use. Under-reporting of workplace injuries and illnesses is common due to a variety of causes and influences. Based on previous reports, the authors were especially interested in the role of safety incentive programmes on under-reporting. Safety incentive programmes typically reward supervisors and employees for reducing workplace injury rates, and thus may unintentionally inhibit proper reporting. The authors describe a case study of several industrial facilities in order to illustrate the extent of under-reporting and the reasons for its occurrence. A questionnaire and interview survey was administered to 110 workers performing similar tasks and several managers, health, and safety personnel at each of three industrial facilities. Although less than 5% of workers had officially reported a work-related injury or illness during the past year, over 85% experienced work-related symptoms, 50% had persistent work-related problems, and 30% reported either lost time from work or work restrictions because of their ailment. Workers described several reasons for not reporting their injuries, including fear of reprisal, a belief that pain was an ordinary consequence of work activity or ageing, lack of management responsiveness after prior reports, and a desire not to lose their usual job. Interviews with management representatives revealed administrative and other barriers to reporting, stemming from their desire to attain a goal of no reported injuries, and misconceptions about requirements for recordability. The corporate and facility safety incentives appeared to have an indirect, but significant negative influence on the proper reporting of workplace injuries by workers. A variety of influences may contribute to under-reporting; because of under-reporting, worker surveys and symptom reports may provide more valuable and timely information on risks than recordable injury logs. Safety incentive programmes should be carefully designed to ensure that they provide a stimulus for safety-related changes, and to discourage under-reporting. A case-control study of similar establishments, or data before and after instituting safety incentives, would be required to more clearly establish the role of these programmes in under-reporting.
准确报告与工作相关的状况对于监测工作场所的健康与安全、识别最急需的干预措施而言是必要的。报告系统的设计可能主要是为了供外部机构（职业安全与健康管理局或工伤赔偿机构）使用，或者供雇主自己使用。由于多种原因和影响，工作场所伤害和疾病的报告不足情况很常见。根据以往的报告，作者们对安全激励计划在报告不足方面所起的作用特别感兴趣。安全激励计划通常会因工作场所伤害率降低而奖励主管和员工，因此可能会无意中抑制正确报告。作者们描述了几个工业设施的案例研究，以说明报告不足的程度及其发生原因。对三个工业设施中从事类似任务的110名工人以及几名经理、健康和安全人员进行了问卷调查和访谈调查。尽管在过去一年中不到5%的工人正式报告过与工作相关的伤害或疾病，但超过85%的人出现过与工作相关的症状，50%的人有持续的与工作相关的问题，30%的人报告因疾病导致工作时间损失或工作受限。工人们描述了不报告受伤情况的几个原因，包括害怕报复、认为疼痛是工作活动或衰老的正常后果、此前报告后管理层没有回应，以及不想失去自己的日常工作。对管理层代表的访谈揭示了报告方面的行政和其他障碍，这些障碍源于他们想要实现无伤害报告的目标，以及对可记录性要求的误解。企业和设施的安全激励措施似乎对工人正确报告工作场所伤害有间接但显著的负面影响。多种影响因素可能导致报告不足；由于报告不足，工人调查和症状报告可能比可记录的伤害日志提供更有价值和更及时的风险信息。安全激励计划应精心设计，以确保它们为与安全相关的变革提供激励，并抑制报告不足。需要对类似企业进行病例对照研究，或者研究实施安全激励措施前后的数据，以便更清楚地确定这些计划在报告不足方面所起的作用。
