In This Article Expand or collapse the "in this article" section Occupational Safety and Health Administration (OSHA)

  • Benchmarking: The Importance of Counting
  • Workers’ Rights to Seek Consultation, Whistleblow, and Walk Off the Job

Public Health Occupational Safety and Health Administration (OSHA)
Jeanne Stellman
  • LAST REVIEWED: 23 March 2022
  • LAST MODIFIED: 23 March 2022
  • DOI: 10.1093/obo/9780199756797-0213


The landmark Williams-Steiger Occupational Safety & Health Act of 1970 (OSHAct) guarantees the right to a safe and healthful workplace to large swaths of the American workforce. It replaced a skimpy patchwork of federal regulations primarily governing interstate commerce and covering relatively few workers. In 1970, thousands of workers were killed or succumbed to “recognized” occupational diseases, while other uncounted thousands suffered “unrecognized” occupational diseases. Nineteen states had no workers’ compensation requirements. In states with compensation plans, many workers were ineligible and benefits were meager. Data on rates and types of accidents and injuries were woefully flawed. Workers were kept in ignorance of potential exposures on the job. There were no federal job protections for workers who reported hazardous conditions. The half-century following passage of the OSHAct has seen significant reduction in work-related deaths, injuries, and illnesses. Much of the reduction is partially attributable to OSHA, but some reflects the changing nature of employment and an increased general awareness of environmental hazards. The OSHAct is both a public health and an employment law. It created the Occupational Safety and Health Administration (OSHA) within the Department of Labor (DOL) to administer the law; the National Institute for Occupational Safety and Health (NIOSH), originally in the Department of Health, Education and Welfare, now subsumed within the Centers for Disease Control and Prevention, to provide technical support to OSHA and to actively research new knowledge about occupational safety and health; the independent Occupational Safety and Health Review Commission, with three presidentially appointed members, to decide contested citations or penalties issued by OSHA following inspections; and the National Commission on State Workmen’s Compensation Laws, to study and evaluate the nation’s compensation systems. Here the focus will be on public health aspects of OSHA itself, and a roadmap to its structure, key achievements, and setbacks, as well as to resources produced by salient professional groups that have blossomed as occupational safety and health has matured as a field, will be provided. References on relevant political activism among stakeholders will be included because every aspect of OSHA has been buffeted and constrained by political forces.

Benchmarking: The Importance of Counting

OSHA’s ability to prioritize, develop, and implement programs and measure effectiveness relies on accurate statistics on injuries and fatalities, which, in turn, rely on incident definition, enumeration, and maintenance and availability of records of injury and illness. Enumerating occupational disease and mortality is more problematic than counting injuries, which are usually readily observable. Chronic occupational disease may take years to develop, and sometimes there are multiple causative factors (e.g., smoking and asbestos act synergistically to increase lung cancer risk). Mortality studies to assess occupational causation are difficult because it is almost never listed as a either the main or underlying cause on a death certificate, unless an occupational accident is involved, and comparatively few studies on occupational causation of death and disease have been carried out. Chronic ailments and injuries thus remain undercounted. Intense academic arguments have raged over the extent to which occupation contributes to cancer mortality (see for example Doll and Peto 1981). Obtaining good incidence data on injuries, even for injuries that are obvious and instantaneous, can be problematic, although the situation has improved dramatically over time since Gordon, et al. 1971 revealed systemic undercounts attributable to case definition. Injuries were not “counted” as time-loss injuries if a worker were merely able to return to the workplace, but not their own job, or even work at all. Time-loss is an important factor for determining workers’ compensation insurance rates. The National Research Council 1987 report spurred changes in surveillance and recordkeeping. The definition now includes all injuries “requiring days away from work, job transfer or restriction.” The Bureau of Labor Statistics, also within the Department of Labor, now provides data on its accessible and well-conceived website (see Bureau of Labor Statistics n.d.). The AFL-CIO annually publishes aggregate and labeled data (see AFL-CIO 2019). Williams 2014, a study of benzene violations and the reissued 1987 benzene standard, illustrates the power of OSHA data for analyzing effectiveness of standards, policies, and guidelines. While GAO 2009 concurred on the power of accurate and well-maintained OSHA data, it still found OSHA’s audit system in need of enhancement and, as noted by Rosenman 2016, problems continue in gathering accurate data. The American Journal of Industrial Medicine devoted an issue to methodological issues, particularly as described by Spieler and Wagner 2014. State-plan data are collected through cooperative programs with OSHA and have varying potential problems in both collection and reporting.

  • AFL-CIO. 2019. Death on the job: The toll of neglect. 28th ed. Washington, DC: American Federation of Labor–Congress of Industrial Organizations.

    Valuable annual report for current and historical data that aggregates information in user-friendly form from the main data available from the Department of Labor. This report can help the user sort through the many data tables.

  • Bureau of Labor Statistics. n.d. Injuries, illnesses, and fatalities.

    Powerful website for collecting, downloading, and displaying both recent and historic data on occupational injuries and fatalities.

  • Doll, R., and R. Peto. 1981. The causes of cancer: Quantitative estimates of avoidable risks of cancer in the United States today. Journal of the National Cancer Institute 66.6: 1191–1308.

    DOI: 10.1093/jnci/66.6.1192

    Influential and controversial paper providing estimates of cancer attributable to workplace exposures by two eminent British epidemiologists.

  • GAO. 2009. Workplace safety and health: Enhancing OSHA’s records audit process could improve the accuracy of worker injury and illness data. GAO-10-10. Washington, DC: US Government Accountability Office.

    While the BLS data are powerful, OSHA’s auditing processes could use further improvement to assure that the data that BLS receives are accurate. This is one example of a GAO study that addresses the issue.

  • Gordon, J. B., A. Akman, and M. L. Brooks. 1971. Industrial safety statistics: A re-examination. New York: Praeger.

    Seminal work detailing the abuse of injury definition, leading to undercounts and decreased incentives for prevention. One powerful incentive for safety is an effort to minimize employer workers’ compensation costs, which will rise when lost-time injury rates and disability rates among employees rise.

  • National Research Council. 1987. Counting injuries and illnesses in the workplace: Proposals for a better system. Washington, DC: National Academies Press.

    DOI: 10.17226/18911

    Historic study by the National Academy of Sciences that led to major improvements in data definition and collection.

  • Rosenman, K. D. 2016. OSHA, well past its infancy, but still learning how to count injuries and illnesses. Journal of Industrial Medicine 59.8: 595–599.

    DOI: 10.1002/ajim.2262

    This work documents the history of surveillance problems in OSHA and those that still continue.

  • Spieler, E. A., and G. R. Wagner. 2014. Counting matters: Implications of undercounting in the BLS survey of occupational injuries and illnesses. American Journal of Industrial Medicine 57.10: 1077–1084.

    DOI: 10.1002/ajim.22382

    The first article in an issue of the American Journal of Industrial Medicine entirely devoted to methodological issues in accurate surveillance of occupational injuries and illnesses.

  • Williams, P. R. D. 2014. An analysis of violations of OSHA’s (1987) occupational exposure to benzene standard. Journal of Toxicology and Environmental Health, Part B 17.5: 259–283.

    DOI: 10.1080/10937404.2014.924452

    This retrospective study of benzene violations with respect to the reissued 1987 standard illustrates the power of data for evaluating OSHA performance and efficacy.

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