Richard's comment (see below) reminded me of something I observed in my 10 years as a workers' compensation claims examiner first for an insurance company and then as the Sr. Examiner for a self-insured employer (the City of Portland Oregon). (I am now an Ergonomics Consultant (for the past 10 years) and still hold the same opinion.)

I found the best predictors of the length of disability for back injuries and soft tissue injuries was the quality and nature of the relationship between the injured worker and his or her supervisor and co-workers. Good relationships early return to work, poor relationship extended disability. Some of the least physically demanding jobs were the most difficult to return people to because of poor labor/management issues.

This would speak to the previous question of importance of worker participation in prevention programs. If you have low participation then you might also have di! fficulty with returning people to work because you might have an "environmental" problem... IE and environment of hostility, bullying, and just plain old bad management.

I'd rather see material manual handling programs evaluated by percentage of good techniques or behaviors used in a observation audit than simply counting injury rates. However counting injury rates is much easier and can be done by the push of a button on a computer. Auditing behavior and use of proper methods and procedures actually requires WORK, planning, and analytical skills.

Just remember this: injury rates alone tell only a small part of the story. They only tell the story that is above the surface (things people actually report) and they only tell how something turned out AFTER the fact. If an 18 year old employee used poor body mechanics and failed to use assistive lifting devices on super heavy items for a week he might be a bit sore! but never report a problem. (Same if he fell off a roof!)

If a 55 year old employee with a history of back problems, (a beer belly, and a 2 pack a day cigarette habit with diabetes and heart disease), lifts a 10 pound box turns suddenly or twists the wrong way, he might herniate a disc and end up with a spinal fusion and be permanently and totally disabled. Considering both people work in the same company with the same "program" would you say that the 55 year old's injury was a "strike" against the effectiveness of the program? Is the 18 year old's failure to file a claim for his discomfort a "score" for the program?

The absence of claims filed or incidents reported does not prove you have an effective program. It only proves that none were reported. (Maybe the supervisor hid the reporting forms???)

Better off doing incident/accident investigations and determining roo! t causes and correcting them than relying on injury rates to tell you that your program is working.

The whole "frequency" and "severity" rates method of evaluating the effectiveness of programs is suspect in my mind. Particularly the "severity" rates part. Severity is more about the health condition of the injured worker prior to injury, the treatment options that are selected (conservative vs. surgical intervention) the quality of case management performed by the claims examiner, vocational rehabilitation counselor etc., and the nature of the job performed at injury. One person's first aid incident is another person's final straw (resulting in permanent disability).