Labor Shortages and Workplace Injuries


This webinar covers a number of topics related to worker shortages and workplace injuries, including:

  • Pandemic-induced labor shortages
  • Injury volume data by industry
  • Mitigating work injuries amid labor shortages

Speaker: John Anderson, DO FACOEM, FAIHQ, Chief Medical Officer, Concentra

Welcome and Introduction of Speaker 


Hello, everyone, and welcome to the Concentra® webinar, Labor Shortages and Workplace Injuries. Today's webinar will be presented by Dr. John Anderson, chief medical officer at Concentra.

Dr. Anderson oversees delivery of care by more than 2000 medical clinicians nationwide. He also oversees quality assurance of Concentra’s medical practice based on high quality, value-based care for shorter case duration and Concentra’s early intervention model for rapid sustainable recovery. Dr. Anderson has more than 40 years of medical experience, is board-certified in occupational medicine, and has been with Concentra since 1993.

At the conclusion of the presentation, we will have a Q&A session with Dr. Anderson. You can submit your questions throughout the presentation to be answered during the Q&A. Dr. Anderson will answer as many questions as possible within the time allowed. After the webinar, a recording of the webinar and a copy of the slides will be emailed to you so you can view them again at your convenience.

Dr. Anderson, we're ready to begin.



Thank you. Welcome, and thanks to everybody for being here. I know your time is valuable, and our intention is to give you some information that will be helpful to you in managing through the labor shortages at this time that I think we're all experiencing.

We'll go over some of Concentra’s data on the subject and then try to make sense of how you, as an employer, can meet some of the challenges that you're experiencing and maybe mitigate some of the risks associated with this current labor market, which seems to be affecting every industry.

I know at Concentra, we're facing the same challenges as many of you, with workers who’ve had that time during the pandemic to consider their current employment, to consider other employment options, and to consider work-life balance as well.

We're even seeing physicians retiring early or reducing their work schedules – sometimes dramatically, sometimes going into telemedicine – so they don't have to experience workplace exposures to the virus.

Demand for higher wages seems to be pretty universal, and in a shrinking pool of qualified candidates, we're needing to meet that demand in order to remain staffed with qualified medical assistants, rad techs, advanced practice clinicians, our nurse practitioners and PAs – even front desk staff, coding, billing specialists, and all the support departments. So, it seems like we’re all in this together, considering the attendance today. So, I’ll try to make this relevant for you.

There are, however, no magic bullets – I’ll warn you in advance of that. 



Let's take a look at the agenda, beginning with a look back at the work shortages – which started even before Covid reared its ugly head – and how these ingredients for a labor pinch were brewing before the pandemic.

We'll explore some of the pandemic-induced labor shortages and some pain points that currently exist for employers.

We’ll take a look at some of the current trends in workforce behavior and how these affect your business, your current workforce, and even prospective employees.
Then we'll take a look at some of Concentra's data on common work injuries that occurred both before and during the pandemic, the injury volume data that Concentra is currently experiencing, and then some of the national injury volume data.

We’ll take a look at COVID’s influence on workers' comp claims during the pandemic and wrap up with how business leaders are facing very challenging circumstances – implementing occupational health best practices in the face of labor shortages – and the impact of all that on workplace injuries.

So, then we'll close, as she said, with a brief Q&A session, and then I'll answer as many of your questions as time might allow.

Labor Shortages: Pre-COVID


Before looking into some of the possible factors related to our current state, it's really important to recognize that labor shortages existed before the pandemic, especially for blue-collar industries. Eighty-five percent of the companies in industries with a high volume of blue-collar workers reported labor shortages and recruiting difficulties in 2019 – before COVID was even heard of. Then, as the pandemic hit very rapidly, layoffs and furloughs followed in 2020.

Employers figured out how their employees could work remotely, and some of them got very accustomed to that and began to like it very, very quickly.

So, let's talk about how the pandemic has influenced labor shortages.

Pandemic-induced Labor Shortages


Earlier this year, the U.S. Chamber of Commerce declared the country's labor shortage a national economic emergency. That's a pretty big deal, and it's an emergency that's getting worse by the day.

The Chamber also released a survey revealing that 88 percent of U.S. businesses have found it difficult to fill job vacancies since the start of the pandemic.

So, what are some of the factors that have been credited for causing an exacerbation in the labor shortages related to this pandemic? Well, before vaccines – and even therapeutics, which are soon to arrive – became available, some employees would stay away from the workplace out of fear of infection or exposure. You might recall some of the televised images early on of different industries where employees were working shoulder to shoulder in very cramped quarters. Those were pretty alarming, and it makes it understandable why people would not want to go back into those workplaces.

So, when companies reopened after the initial lockdowns and after government-imposed measures, fewer employees wanted to return – for a variety of reasons, but mostly led by fear of contagiousness and infection. And this fall, as the labor crunch was becoming even more evident, many blamed the problem on the enhanced unemployment benefits program provided through the CARES Act. Those benefits, however, expired in September in most places, and yet, we're still dealing with labor shortages. So it wasn't just that. On top of virus-related issues, many employees have been reassessing their career choices or have been acquiring new skills and advancing their education. This caused some employees to explore new job opportunities or demand higher pay – part of the trend called “The Great Resignation.”

Moreover, national and state vaccine mandates have also forced the hand of some employers, resulting in resignations and terminations over non-compliance issues. And despite wide vaccine availability and overwhelming data that support the safety and efficacy of the available vaccines, many workers still have lingering concerns over the vaccine. And even many who are fully vaccinated are concerned about exposure to those unvaccinated in the workplace, especially in jobs with high levels of person-to-person interaction.

Overall, it's really impossible to pinpoint any single factor that's causing these workforce shortages, which makes a simple solution even more elusive – maybe impossible. But let's talk about employer pain points that are influenced by some labor shortages. So, what's causing supervisors, safety and risk managers, and the like to lose sleep because of these labor shortages?

Employer Pain Points


It can start with an understanding that the many, many, many, many loyal and hard-working employees that you have (and we have) may have to now work longer shifts with fewer breaks to meet deadlines or production quotas because of the shortage. These time constraints may tempt employees to overlook safety regulations or cut corners. With fewer workers doing more, there's also the risk of less oversight and subpar work performance, which translate into more errors and inferior quality. Longer hours with higher work volume can cause fatigue and frustration, impacting employee retention and workplace morale.

Burnout is always a risk in some industries, including medicine and health care, resulting in higher-than-usual turnover rates. We know from our own physician group that those nearing retirement have retired early as a result of the coronavirus pandemic. And while fatigue, longer shifts, and overtime affect retention, they’re predictive of increased injury rates as well. Adding and training new hires puts a strain on tenured employees and also predicts the likelihood of increased injury rates in the new hire group.

Patterns in Workforce Behavior


Some of you may notice some trends in workforce behavior as well that can be influenced by the understaffing issue. Employees may feel overwhelmed by constant work demands caused by depleted workforces. Overworked and frustrated, these employees may schedule time off more often.

You may also see an increase in the number of employees calling in sick or abruptly requesting time off. More often now, new hires may reject a job offer after accepting it or simply not show up for work on their start date. That's known as ghosting.

These behaviors have a direct impact on productivity and morale, creating a vicious cycle of stressed-out employees who are spread thin. This cycle will express employees to more injuries as well. When employers need to hire more workers to stay ahead of these work demands, they can't afford to lose their existing workforce to occupational injuries or illnesses.

So, let's talk about some common work injuries that have been occurring both before and since the start of the pandemic.

Most Common Work Injuries (Pre-pandemic and Pandemic)


Understanding the nature and frequency of common injuries may help to prevent them. So, Concentra’s Clinical Analytics and Quality department has compiled injury volume and mixed data based on work injuries that our clinicians have treated before and during the pandemic. To add some context, our centers treat one out of every five reported occupational injuries in the United States. So, our database is quite large.

The highlighted groups on the left (five different groups) are also represented in the bar graph to the right and represent the top five injury types based on percent distribution. You can see that there is an exceptional amount of consistency before and during the pandemic for these injury types.

Interestingly – or maybe incredibly – there's no diagnostic group experiencing more than a 0.7 percent change in distribution during the pandemic. So, injury types have remained by and large the same. On the other hand, the pandemic impacted injuries in singular industries in considerably different ways.

Concentra Injury Volume Data by Industry


You can see at the bottom of the table the total number of new injuries treated in our centers, with an overall decrease in 2020 of about 18.5 percent. Some months in the early stages of the pandemic actually hovered in the 50 percent range in spring and early summer. While there's been an increase in injuries in 2020 and 2021, the volume has still not returned to the 2019 level, which is a good thing.

And each industry sector has had a different experience.

If you look at the hotel industry about midway down that table there, you'll see that there was a 59 percent drop in new injury volume in 2020, with only a moderate recovery in 2021. This is perhaps not surprising with staff reductions, as some hotel services may rebound very slowly or not at all. For instance, room service and daily maid services have been discontinued or curtailed. Some restaurants in hotels have closed entirely. Bar service at night has been discontinued in many hotels.

On the other hand, if you look at the top industry there (the airline industry at the top) you’ll see that in 2020, compared to 2019, the percent variance was -52.1 percent. That rebounded pretty considerably in 2021. And if you look at 2021 versus 2020, there was quite a remarkable improvement to 70.5 percent.

So, each industry has had a different experience. The only ones that really had a positive experience were the delivery industries, the retail industries, and also – to a certain extent – the warehousing industry.

National Injury Volume Data


From a more national perspective, the Bureau of Labor Statistics and the NCCI have issued some data as recently as last month. According to BLS data that was released for nonfatal private industry employers, injury and illness cases decreased by 5.7 percent, and that was due mostly to a decline in the injury rate – from 2.6 to 2.2 per hundred FTE workers. That's a pretty big drop for one year. However, at the same time, occupational illnesses quadrupled, largely due to an incredible 4000 percent increase in respiratory cases – the culprit, of course, being coronavirus infections.

In all private sectors, the total injury and illness cases decreased or remained the same, except for health care and social assistance. In those sectors, there was an increase from 3.8 to 5.5 cases per 100 FTE workers, and the healthcare industry accounted for 74 percent of the pandemic-related respiratory cases. There was a 32.4 percent increase in lost-time cases. This is really important. About a third of those were categorized as COVID-19-related illnesses. More worrisome than the increase in lost time cases, however, is that the median number of days away from work for all occupations increased from eight days to 12 days between 2019 and 2020. So, that's an increase of four days for about 1.2M lost-time cases, which means an additional loss of about 4.8M - 5M productive workdays in 2020 in private industry alone.

Some interesting stats:

  • Nursing assistants had the highest number of days-away-from-work cases; that makes sense, given the nature of the patient population that they were handling.
  • Heavy- and tractor-trailer truck drivers had a 9.4 percent decrease in the cases, probably largely because of a decrease in transportation, and there was also a decrease in their rate. But they had an increase in days away from work (from 19 to 23 days). So, four days again – pretty significant.
  • In private leisure, entertainment, and hospitality, there was a drop in overall case rate, largely driven by a decline in injuries.
  • Days-away-from-work cases for women increased 68 percent, likely related to the number of women health care workers.
  • Days-away-from-work cases for men increased – but only by 7.8 percent.

Pandemic-induced Workers’ Compensation Claims


Not unexpectedly, 75 percent of COVID-19 cases are lost-time claims. So, of the reported cases with lost time, one in three was categorized as, “other diseases due to viruses not elsewhere classified (including reported COVID pandemic-related illnesses).” In other words, coronavirus. Company leaders need to investigate workplace exposures to COVID-19 in the same manner that they would any other type of claim that might be eligible for workers' compensation. Both payors and TPAs have generally been at the forefront of establishing criteria and eligibility to qualify for compensation in the face of an exposure. So, if you have any possible work comp, COVID-type claims, lean on those resources and perhaps the local health department for guidance. And remember that these claims, once validated, are recordable as an occupational illness.

Unfortunately, your short-handed workforce could be diminished even further when an employee has been diagnosed with or exposed to COVID in the workplace. These claims for COVID can be confusing and frustrating for both the affected employee and company and only add to the list of worries for supervisors, safety and risk managers, and other company leaders.

The Burden of Leadership


So, as employers continue to pick up activity at the workplace, we shouldn't overlook the increased demands placed on those company managers and leaders who are tasked with overcoming production losses, meeting ongoing demands, and managing expectations in the face of employee attrition, fear, mistrust, and loss of morale. These same leaders are often working under the same constraints as their employees – they’re overworked, and they're frustrated.

So, how does an employer overcome these challenges? Ultimately, there's no overnight fix for the complex problem of labor shortages. But there are steps that employers can take today to mitigate the costly risks associated with preventable occupational illnesses and injuries. While you're each the expert within your own company, Concentra or other occupational health provider groups can help employers to focus on retaining and preserving their current workforce by actively addressing injury risks.

Mitigating Work Injuries/Illnesses Amid Labor Shortages


Here we can offer some occupational health best practices and measures:

  • First: being mindful of work hours. Longer shifts and overtime can cause fatigue, and fatigue results in injuries and loss of productivity. Encourage employees to take breaks during their shifts. This is important.
  • And don't just consider the length of their shifts. Also consider the scope of their work. Is it difficult? Physically demanding? Tedious? If job rotations are possible, consider that in order to reduce the possibility of overuse syndromes and boredom. Do something unexpected to make the day or the week more interesting. A little bit of fun can go a long way in preserving employee relationships.
  • Stretching programs and conditioning – especially with new employees or those returning from layoff or leave of absence – can reduce their risk of injury.
  • Rebalancing work duties among your employees to keep them interested and engaged can be helpful.
  • Finally, while we're all experiencing pandemic fatigue, it's still important for most employers to apply indoor-masking policies, hygiene protocols, and social-distancing standards for infection control. Enforcement of your safety programs may depend on your local community’s transmission rate and other factors. Many of your employees will view this positively as a message that you do care enough to promote safety in the workplace.

And there is no better way to end the pandemic than vaccination. We're currently in a pandemic of the unvaccinated, with more variants undoubtedly in our future and a very long road ahead. So, let's use and promote all of the tools we have available today to shorten and end the pandemic without further loss of life. You have more power of persuasion with your employees than you might think. Some of your employees who have been resistant or hesitant to get vaccinated are starting to reconsider their decisions. You might just tip the balance for them. So, do what you can, and keep in mind that enabling risky behavior places your workforce balance in much deeper jeopardy. We remind our clinicians regularly to promote vaccination during each of their office visits.

So, while no vaccine can offer total protection, vaccination remains the single most effective way to reduce workplace exposure risks, relieve anxiety about working on site, and reduce the number of COVID-related workers' compensation claims. This results in improving workforce productivity, worker availability, and, ultimately, your company's competitive value.

One last thought:

Remember that employee recognition and showing gratitude toward your employees, especially during the pandemic, can mean the difference between their staying or leaving for a better workplace. A sincere “thank you” – sometimes simply for showing up to work – can make a huge difference.

That concludes our presentation for today, and we will be opening it up for questions.