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Blurring the distinctions between on and off the job injuries: similarities and differences in circumstances
  1. G S Smith1,
  2. G S Sorock2,
  3. H M Wellman1,
  4. T K Courtney1,
  5. G S Pransky1
  1. 1Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA
  2. 2Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
  1. Correspondence to:
 Dr G Smith
 Liberty Mutual Research Institute for Safety, 71 Frankland Road, Hopkinton, MA 01748, USA; Gordon.Smith{at}


Objectives: To compare the causes of non-fatal work and non-work injuries and the places or environments where they occur. It has been suggested that many injuries may have similar etiologies on and off the job and thus involve some common prevention strategies. However lack of comparable data on work relatedness has prevented testing this proposition.

Methods: The National Health Interview Survey (NHIS) now collects information on the cause, location, and work relatedness of all medically attended injuries. National US estimates of non-fatal work and non-work injuries were compared by cause and place/location for working age adults (18–64 years).

Results: Overall 28.6% of injuries to working age adults were work related (37.5% among employed people). The causes and locations of many work and non-work injuries were similar. Falls, overexertion, and struck/caught by were leading causes for work and non-work injuries. Motor vehicle injuries were less likely to be work related (3.4% at work v 19.5% non-work) and overexertion injuries more likely to be work related (27.1% v 13.8%). Assaults were less than 1% of work injuries and 1.8% of non-work injuries. Both work and non-work injuries occurred in every location examined—including the home where 3.5% of injuries were work related.

Conclusions: Work and non-work injuries share many similarities suggesting opportunities to broaden injury prevention programs commonly restricted to one setting or the other. Comprehensive efforts to prevent both non-work and work injuries may result in considerable cost savings not only to society but also directly to employers, who incur much of the associated costs.

  • BLS, Bureau of Labor Statistics Surveys
  • CAPI, Computer Assisted Personal Interview
  • ICD-9CM, International Classification of Diseases, Clinical Modification
  • IRR, incidence rate ratio
  • NCHS, National Center for Health Statistics
  • NHDS, National Hospital Discharge Survey
  • NHIS, National Health Interview Survey
  • interview surveys
  • causes
  • place
  • location
  • work and non-work
  • occupational
  • adults

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  • Competing interests: none.

  • The Liberty Mutual Research Institute for Safety Institutional Review Committee approved this study.