title: Safety, incentives, and the reporting of work-related injuries among union carpenters: "you're pretty much screwed if you get hurt at work".
abstract: BACKGROUND
  In the high-risk construction industry little is known about the prevalence or effects of programs offering rewards for workers and/or their supervisors for improved safety records or those that punish workers in some way for injury.
  
  
  METHODS
  We conducted an anonymous survey of 1,020 carpenter apprentices in three union training programs to document prevalence of their exposure to such efforts. We explored associations between perceptions of the reporting of work-related injury and elements of these programs.
  
  
  RESULTS
  Fifty-eight percent (58%; n = 592) reported some safety incentive or negative consequence of work-related injuries on their current jobsite. Reporting of work-related injuries was 50% less prevalent when workers were disciplined for injury experiences. Otherwise, we saw minimal evidence of association between injury reporting practices and safety incentive programs. However, considerable evidence of fear of reprisal for reporting injuries was revealed. Less than half (46.4%) reported that work-related injuries were reported in their current workplace all or most of the time; over 30% said they were almost never or rarely reported.
  
  
  CONCLUSIONS
  There are multiple layers of disincentives to the reporting of work-related injuries that hamper understanding of risk and pose threats to workplace safety and productivity. These pressures do not arise in a vacuum and are likely influenced by a host of contextual factors. Efforts that help us understand variation across jobsites and time could be enlightening; such inquiries may require mixed methodologies and should be framed with consideration for the upper tiers of the public health hierarchy of hazard control.
authors.affiliation: Division of Occupational and Environmental Medicine, Duke University Medical Center, Durham, NC 27710, USA. hester.lipscomb@duke.edu
authors.forename: Hester J
authors.initials: HJ
authors.lastname: Lipscomb
authors.forename: James
authors.initials: J
authors.lastname: Nolan
authors.forename: Dennis
authors.initials: D
authors.lastname: Patterson
authors.forename: Vince
authors.initials: V
authors.lastname: Sticca
authors.forename: Douglas J
authors.initials: DJ
authors.lastname: Myers
mesh_terms: D000062:Accidents, Occupational / Q000517:prevention & control*; D000328:Adult; D060389:Construction Industry / Q000458:organization & administration* / Q000706:statistics & numerical data; D003625:Data Collection; D006801:Humans; D009042:Motivation; D016272:Occupational Health / Q000592:standards / Q000706:statistics & numerical data; D060051:Occupational Injuries / Q000517:prevention & control*; D017751:Safety Management / Q000458:organization & administration* / Q000706:statistics & numerical data; D014481:United States; D014942:Workers' Compensation / Q000706:statistics & numerical data*; D017132:Workplace / Q000458:organization & administration* / Q000523:psychology / Q000706:statistics & numerical data