Oil and Gas Industry Can Benefit from Occupational Health

Michelle Hopkins

Making a commitment to safety

The oil and gas industry – while inherently filled with potential risks – has made notable progress in improving work-related safety for employees.1 This progress has come through the Oil and Gas Extraction Program of the National Institute for Occupational Safety and Health (NIOSH)2, efforts by the American Petroleum Institute (API), which sets standards for the oil and gas industry3 for the safety of 10.3 million employees in the United States4, and the actions of oil and gas companies that have resulted in safety improvements.5

API’s Workplace Safety Report (2010-2019) uses injury and illness rates from the U.S. Bureau of Labor Statistics, supplemented by data from the Pipeline and Hazardous Materials Safety Administration and the Bureau of Safety and Environmental Enforcement, to illustrate the safety performance of the oil and gas industry compared to private industry.6 The report shows:

The rate of job-related, nonfatal injuries and illnesses in the total private sector was:

  • 2.8 per 100 full-time equivalent (FTE)

Compare this to the oil and gas industry:

  • 0.5 per 100 FTE overall
  • 0.8 per 100 FTE in U.S. exploration and production
  • 0.3 per 100 FTE in offshore exploration and production

The report also compared oil and gas industry segments with comparable industries and found oil and gas safety performance ranging from comparable to significantly better:

  • Petroleum refinery (0.4 per 100 FTE) compared to U.S. manufacturing (3.3 per 100 FTE)
  • U.S. oil and gas pipelines (0.0 per 100 FTE) compared to U.S. transportation and warehousing (4.4 per 100 FTE)
  • Natural gas distribution (2.3 per 100 FTE) compared to U.S. utilities (2.2 per 100 FTE)

So, the industry’s attention to safety risks from equipment and machinery, as well as job conditions and requirements has produced results.

Now, as the publication Occupational Health and Safety says, attention needs to turn elsewhere: “Just as dangerous to industry workers is the risk of developing physical and mental health problems due to their, by nature, intensive workplaces.”7 Mitigating employees’ work-related health problems is the domain of occupational health clinicians; thus, occupational health is the next partner the oil and gas industry can enlist to achieve additional improvements in work-related health and safety.

How occupational health can help oil and gas

In the oilfield or on an offshore rig, you never want to call in someone with the expertise of Red Adair, the legendary Texas oil firefighter, who died of natural causes at age 89 in 2004.8 That would mean you have an emergency on a scale so great that few people in the world could handle it. While no one wishes for such an emergency, no oilfield supervisor would pass on having such a valuable relationship; that is, knowing exactly who to call for just the right expertise for an emergency.

In situations usually not as dramatic as those Red Adair faced, occupational health offers expertise for work-related employee health issues that arise. The value of an established relationship with occupational medicine experts was amply demonstrated in 2020. Businesses that had an established relationship with the medical community were better able to respond effectively, rapidly, and accurately to the challenges of the COVID-19 pandemic.9

A relationship to help reduce costs, recordables, and lost time

Besides emergent issues, the expertise of an occupational health clinician can help employers avoid unnecessary Occupational Safety and Health Administration (OSHA) recordable injuries. They do this by rendering first aid treatment that meets employees’ needs instead of medical treatment, which would make an injury recordable.

“There are 14 treatments that are considered first aid, and medical treatment is anything that is not first aid. At Concentra, we ensure our clinicians have expertise in these treatments and also periodically send them messages and reminders about OSHA recordability because it’s not something that is typically taught during medical training,” said Maja Jurisic, MD, CPE, vice president and medical director of strategic accounts, in a webinar, “Understanding OSHA Recordables.”10

“It’s our goal to avoid medically unnecessary disability whenever possible. Concentra clinicians are instructed to treat an injury with first aid, if they can appropriately do so. This is the right thing to do for the employee. We know from the medical literature that keeping people’s lives and activities as normal as possible is the best way to promote recovery,” Dr. Jurisic explained.11

Also, by using an early-intervention model of care, like Concentra’s, occupational health clinicians help employers reduce major cost factors associated with the treatment of musculoskeletal injuries.12

  • Indemnity and medical expenditures
  • Lost work time
  • Use of opioid pain medication and injections
  • Expensive imaging and specialist referrals 

The case study of a large drilling contractor with a high insurance deductible helps illustrate the high cost of lost workdays and recordable injuries – and why oil and gas employers want to avoid them. An analysis of the land drilling contractor’s workers’ compensation data over a five-year period showed that the average cost of a lost workday case was $200,000 in direct costs. The average direct cost of a recordable injury (including medical treatment and/or work restrictions) was $12,500 per event.13

An ongoing relationship with an occupational health provider can help reduce or avoid these costs.

Preventing musculoskeletal injuries before they occur

Oil and gas employees often work extended hours in remote locations. This makes access to medical care difficult at best and impossible at worst. So, preventing injuries is paramount. An occupational health professional who can meet this need is an athletic trainer, whose roots are in sports medicine.

Today, the athletic trainer works in a variety of occupational settings as diverse as a manufacturer’s factory floor to an electric utility’s transmission line. The advantage of an athletic trainer being able to prevent injury stems from the relationship the athletic trainer builds with the employees.

“Frequently, I work with strong, very physical men who have been in their jobs a long time and are used to doing things a certain way, so there is a need to build rapport to help transition to other ways that are better for preventing injury,” says a Concentra athletic trainer who works in remote areas with the employees of an electric power company. “In sports medicine, when you want a team to trust you, you go to the practices. You watch and support them. I do the same thing here. I go to the job site and watch what they do, how they do it, and all the physical requirements. I am interested in them, keeping them safe, and making their life better. Seeing me there shows them I am interested in them as people, and that helps build trust.”14

Chris Studebaker, DPT, OCS, PT, national director of onsite therapy and athletic trainers for Concentra, says a licensed, trained, and certified athletic trainer has education, training, and clinical experience in:

  • Injury prevention
  • Pathology of injuries and illnesses
  • Orthopedic clinical examination and diagnoses
  • Medical conditions and disabilities
  • Diagnosis and treatment of acute, chronic, and emergent conditions
  • Physical therapeutic modalities
  • Conditioning and rehabilitative exercise
  • Pharmacology
  • Nutritional aspects of injuries and illnesses
  • Health care administration

Depending on location, an athletic trainer may cost 30 percent less than an occupational nurse.15

“In addition, pre-employment functional testing that quantifies an employee’s capabilities to handle physical work tasks is popular in the oil and gas industry and can help prevent musculoskeletal injuries,” says Studebaker. “Musculoskeletal screening, early reporting programs, exercise programs, and worksite health promotion are also beneficial.”

Other means of preventing injuries

Occupational health clinicians are seasoned experts in understanding the impact the work environment can have on employee health; conversely, they are familiar with potential fears employees harbor about health conditions interfering with their ability to work.

In the oil and gas industry, long hours and intense concentration required to operate heavy equipment with precision can lead to fatigue. The fact that oil and gas employees frequently work long distances from lodging sites leads to highly fatigued employees getting behind the wheel to drive lengthy commutes after an extended shift. This results in vehicle crashes being a major cause of injury and death for oil and gas employees.16

“The impact of sleep on function and participation is incorporated into the repertoire of occupational therapy practitioners and addressed across the lifespan. Prevention and intervention strategies lie within the scope of practice for occupational therapy and represents another way in which the profession approaches clients from a holistic perspective to help them live life to the fullest,” according to the American Occupational Therapy Association.17

Physicians in occupational medicine, such as Michael Berneking, MD, of Concentra, participate in research into criteria and screening of commercial motor vehicle drivers for sleep apnea and other sleep disorders, and can help advise industries on fatigue-related injuries.18 Equally important, clinicians in occupational medicine can discuss sleep habits and sleep hygiene with employees to promote restorative sleep quality, which is essential for alertness at work.

Sleep deprivation, which affects almost 35 percent of people regularly19, contributed at least partially, if not substantially, to major 20th century disasters, including the grounding of the Exxon Valdez oil tanker and the nuclear reactor meltdowns at Three Mile Island and Chernobyl.20 The disintegration of the Space Shuttle Challenger on January 1986 is another. While 85 percent of Americans knew of the tragedy within an hour after it happened, few people ever learned the official finding that severe sleep deprivation of NASA managers was to blame.21

Employees sometimes worry a health condition may prevent them from working. This is common among commercial motor vehicle drivers in non-excepted interstate commerce who must meet medical certification requirements of the Federal Motor Carrier Safety Administration (FMCSA).22 Certain medical conditions disqualify a driver outright but not all. In some cases, certification may be granted for a short duration, based on the medical examiner’s discretion, and the condition carefully monitored and improved upon with care.23 It is important for employees to discuss their concerns with an occupational health clinician who understands their working environment and can advise them appropriately.

There are many types of drivers in the oil and gas industry, of course. These include semi-truck drivers who carry explosives or flammable materials, string truck drivers who transport pipe, drilling rig transport drivers who move an oil rig from one location to  another and unload machinery, and water truck and gravel truck drivers who provide essential supplies to maintain roads in and around the drilling site.24 While most of these drivers don’t require FMCSA certification, they, too, may benefit from the care an occupational health clinician provides.

Mental health in the oil and gas industry

A new horizon for employees in the oil and gas industry is attention being given to mental health. “Long stints away from home, feelings of isolation, and a heavily stressful job can all lead to poorer mental health in the oil industry. It is imperative that oil companies start implementing mental health support and provisions in exactly the same way that they do physical (health support),” says an article in Occupational Health and Safety.25

While behavioral health care is an emergent business trend, employee health issues related to stress, depression and other mental health concerns, along with substance use (alcohol or drugs) have been a long-simmering problem that boiled over during the pandemic.26 Mental health platforms, like one initiated for frontline health care employees during the pandemic, could become more commonplace in other industries, as well.27

In the interest of providing research-based information on behavioral health and substance use and testing, Concentra has several articles on these topics in an online Resource Center. Here are a few:


The oil and gas industry is vital to economic growth, business investment, and energy security, and has also brought back to the United States more than $100 billion a year in operations investments.28 Occupational health care is well-positioned to help protect the health and safety of oil and gas employees through intensive knowledge about job stresses and expertise to prevent injuries, reduce costs, and avoid unnecessary disability and lost work time. By partnering with occupational health care, oil and gas can explore new inroads into even better safety performance than the industry has already achieved.


  1. How Safety Has Become a Priority for the Oil Sector.” Occupational Health and Safety. September 1, 2020.
  2. Oil and Gas Extraction Program. The National Institute for Occupational Safety and Health (NIOSH). Centers for Disease Control and Prevention (CDC).
  3. API Occupational Safety and Health Standards. American Petroleum Institute.
  4. A Look at U.S. Workplace Safety, 2010-2019. American Petroleum Institute.
  5. How Safety Has Become a Priority for the Oil Sector.” Occupational Health and Safety. September 1, 2020.
  6. Adair, Paul Neal (Red) (1915-2004). Texas State Historical Association Handbook of Texas.
  7. COVID-19 Pandemic Guidance: Onsite Medical Experts Are Poised to Help Manufacturers. November, 9, 2020.
  8. Understanding OSHA Recordables. Webinar. August 21, 2019.
  9. WCIRB Studies Support Concentra’s Early Intervention Model of Care. December 21, 2020.
  10. Numbers show: Good safety is good business. Drilling Contractor. January 16, 2012.
  11. Is an Athletic Trainer the Answer to Work Injury Déjà vu? Concentra white paper. September 2, 2020.
  12. New Hope in Fighting Fatigue as a Cause of Work Injury. April 26, 2021.
  13. Occupational Therapy’s Role in Sleep. American Occupational Therapy Association.
  14. Gurubhagavatula I, Patil S, Meoli A, Olson R, Sullivan S, Berneking M, Watson NF. Sleep Apnea Evaluation of Commercial Motor Vehicle Operators. Journal of Clinical Sleep Medicine. March 15, 2016; 12(3).
  15. Lack of Sleep’s Impact on the Body. Sleep.org. March 16, 2021.
  16. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. 2006.  
  17. To Sleep or Not to Sleep? NASA.gov. April 14, 2009.
  18. How do I determine which of the 4 categories of commercial motor vehicle (CMV) operation I should self-certify to with my State Driver Licensing Agency (SDLA)? Federal Motor Carrier Safety Administration.
  19. What Are DOT Disqualifying Medical Conditions. August 19, 2019.
  20. What Truck Drivers Do. OilJobFinder.
  21. How Safety Has Become a Priority for the Oil Sector.” Occupational Health and Safety. September 1, 2020.
  22. The future of behavioral health. Innovating across sectors to address the global crisis. Deloitte. January 7, 2021.
  23. New Mental Health Platform Provides Support for Healthcare Workers. Penn Medicine News. May 28, 2020.
  24. Oil and Natural Gas: Supporting the Economy, Creating Jobs, Driving America Forward. American Petroleum Institute.