Workplace Injuries and Illnesses in Grocery Stores
by Cynthia M. Clarke
Bureau of Labor Statistics

Originally Posted: December 19, 2003

Grocery stores are familiar to nearly everyone.¹ They sell an array of fresh and preserved foods, primarily for preparation and consumption at home. They often sell prepared food such as hot entrees or salads for takeout meals. Stores range in size from supermarkets, which may employ hundreds of workers and sell numerous food and nonfood items, to convenience stores with small staffs and limited selections.

Specialty food stores, such as meat and fish markets; fruit and vegetables markets; candy, nut, and confectionery stores; dairy products stores; retail bakeries; and health and dietetic food stores are not considered grocery stores. Thus, they are not covered in this article. Also excluded are eating and drinking establishments that sell food and beverages for consumption on the premises.²

Grocery stores are found in many locations--urban, suburban, and rural--although the size of the establishment and range of goods and services offered varies. Inner-city stores, for example, traditionally have been small and have offered a limited selection, although larger stores are now being built in many urban areas. Suburban stores tend to be large supermarkets with a more diverse stock. Many offer household goods, health and beauty care items, automotive supplies, greeting cards, and clothing among a growing range of nonfood items sold. Some of the largest supermarkets house cafeterias or food courts, and a few feature convenience stores. In addition, grocery stores may offer basic banking services and automated teller machines (ATMs), postal services, on-site film processing, dry cleaning, video rentals, and catering services.³

Grocery stores are the dominant retailers of food for home preparation and consumption. In 2000, grocery stores employed 88 percent of the total workers in the food store industry, with the remainder working in specialty food stores. Employment in grocery stores increased from roughly 2.9 million in 1991 to about 3.1 million in 2000.⁴

The BLS Survey of Occupational Injuries and Illnesses (SOII) ranked grocery stores as one of the nine industries having 100,000 or more injury and illness cases in 2000.⁵ (See table 1.) These nine industries accounted for 29 percent of the 5.6 million cases reported for all private industry that year. This article identifies and examines nonfatal injuries and illnesses in the grocery store industry using data from the Survey of Occupational Injuries and Illnesses. In addition, it looks at occupational fatalities in the industry using data from the BLS Census of Fatal Occupational Injuries (CFOI).

Frequency of injuries and illnesses

The grocery store industry’s injury and illness rate⁶ for total recordable cases was 8.4 per 100 full-time workers in 2000, compared with rates of 5.9 for all retail trade and 6.1 for private industry as a whole. Over the 10-year period from 1991 to 2000, the total recordable case rate for grocery stores decreased from 11.9 per 100 full-time workers to 8.4. Similar downward trends occurred in retail trade and total private industry. (See table 2.)

Approximately 187,400 total injury and illness cases were recorded for grocery stores during 2000, with more than half (54 percent) involving cases without lost workdays. Of the 86,000 cases that did involve lost workdays,⁷ 55,000 required workers to miss one or more days of work, while 31,000 required workers to be restricted to light duties or to work a shortened schedule. The rate for all lost workday cases in the grocery store industry was 3.8 per 100 workers in 2000, substantially lower than the 5.2 rate in 1991.

During this period, the rate for cases involving days away from work decreased while the rate for cases with days of restricted work increased. (See chart 1.) As with the injury and illness rates, similar trends occurred in both retail trade and private industry as a whole. These data may suggest that the type of injuries or illnesses that workers are incurring are becoming less severe, or that establishments are making more effort to reassign workers to other duties in lieu of days off from work.⁸

The data also show that injury and illness rates in the grocery store industry vary considerably among the individual States.⁹ For example, the rates for total recordable cases ranged from a high of 18.4 per 100 full-time workers in Maine to a low of 3.6 per 100 full-time workers in Louisiana. (See table 3.)

Injuries versus illnesses

About 96 percent of the grocery store cases occurring in 2000 were classified as occupational injuries; the remaining 4 percent were illnesses. Repeated trauma cases accounted for 73 percent of the total number of illness cases in the industry, considerably higher than the proportion for all retail trade industries (50 percent). Repeated trauma includes carpal tunnel syndrome and other motion-related disorders and usually involves the hand, wrist, elbow, or shoulder.¹⁰ For the past 5 years, the grocery store industry has ranked among the industries with the highest number of repeated trauma cases.

Case characteristics

The Survey of Occupational Injuries and Illnesses identifies four basic characteristics of the injury or illness cases that involve days away from work: (1) The nature of injury or illness names the principal physical characteristic of a disabling condition, such as sprain/strain, cut/laceration, or carpal tunnel syndrome. (2) The part of body affected is directly linked to the nature of injury or illness cited--for example, back sprain, finger cut, or wrist and carpal tunnel syndrome. (3) The source of injury or illness is the object, substance, exposure, or bodily motion that directly produced or inflicted the disabling condition cited. Examples are a heavy box, a toxic substance, fire/flame, and bodily motion of the injured/ill worker. (4) The event or exposure signifies the manner in which the injury or illness was produced or inflicted, such as overexertion while lifting or falling from a ladder.

The most prevalent nature of injury or illness was strain and sprain, which accounted for about 45 percent of the grocery store cases in 2000. (See table 4.) Other leading categories were cuts, lacerations, and punctures, with 15 percent; bruises and contusions, with 11 percent; and soreness or pain, with 6 percent of the industry's total cases. Conditions of the nervous system--including those affecting the nerves and peripheral ganglia, such as carpal tunnel syndrome--accounted for 4 percent of the cases.

The parts of the body that were most frequently injured were the trunk (particularly the back), the upper extremities, and the lower extremities, with 35, 30, and 22 percent of the cases respectively.

The major sources of injury were containers (boxes, crates, and cartons), which accounted for 27 percent of the cases; worker motion or position, which accounted for 17 percent; floor (ground surface), which also accounted for 17 percent; and machinery, which accounted for 11 percent.

The predominant events or exposures contributing to injuries and illnesses in grocery stores were overexertion (primarily in lifting), which accounted for 28 percent of the cases, fall on same level (14 percent), struck by object (14 percent), and struck against object (9 percent).

Musculoskeletal disorders (MSDs)

There is considerable interest among employers, workers, and safety and health professionals in work-related ailments associated with ergonomics. "Ergonomics" is a term that can have various meanings. Most often, this term is associated with work-related musculoskeletal disorders (MSDs) and the working conditions that may cause them.

Musculoskeletal disorders are cases in which the nature of injury or illness is sprains, strains, tears; back pain, hurt back; soreness, pain, and hurt, except the back; carpal tunnel syndrome; hernia; or musculoskeletal system and connective tissue diseases and disorders. Such disorders also have as the event or exposure leading to the injury or illness bodily reaction/bending, climbing, crawling, reaching, twisting; overexertion; or repetition.

The Survey of Occupational Injuries and Illnesses can identify as MSD cases only those that require recuperation away from work. This is because BLS identifies MSD cases based on employer responses to questions on the nature of the injury or illness and the events or exposures, and these questions are asked only for cases that involve days away from work. In 2000, there were 20,778 MSD cases involving days away from work in the grocery store industry. (See table 5.)

Worker characteristics

In addition to case characteristics, the survey also provides worker characteristics, such as the gender, age, length of service, and occupation of those involved in the incidents. These characteristics can be used to help identify workplace hazards faced by various groups of workers.

In 2000, women accounted for nearly half of all the hours worked in the grocery store industry, and two-fifths of all the hours worked in private industry as a whole.¹¹ However, their share of injury and illness cases in grocery stores (almost half) was greater than their share of the cases in private industry as a whole--about a third. (See table 6.)

Women probably face more hazards in the grocery store industry than in private industry overall because of the types of jobs they hold in grocery stores. The majority of women are employed in sales positions, such as cashiers and clerks. They tend to be on their feet most of their work day scanning and bagging customer purchases.

Table 7 presents the distribution of hours worked and the distribution of injuries and illnesses sustained for the occupations that are prevalent in the grocery store industry. A comparison between the hours worked and the injuries recorded indicates those occupations that are more at risk. For example, grocery store managers worked 25 percent of the hours and sustained 9 percent of the injuries. In contrast, cashiers and sales workers worked 18 percent of the hours, but had 28 percent of the injuries. The share of hours worked and injuries incurred for kitchen workers, butchers and meat cutters, and stock handlers and baggers were about the same.¹²

The characteristics of injuries and illnesses incurred by the occupations within the grocery store industry help to identify the specific hazards encountered by these occupations. For example, grocery store managers, cashiers and sales workers, and stock handlers and baggers experienced mostly sprains and strains, whereas kitchen workers and butchers and meat cutters were susceptible to cuts and lacerations as well as sprains and strains. Kitchen workers and butchers and meat cutters suffered finger injuries most frequently, while cashiers and sales workers, grocery store managers, stockhandlers and baggers, and laborers incurred back injuries most frequently. (See table 8.)

Fatalities

The Census of Fatal Occupational Injuries (CFOI) covers all fatal work injuries incurred by wage and salary earners in private industry and government, as well as the self-employed. The CFOI program has collected occupational fatality data nationwide since 1992. Data are compiled from various federal, state, and local administrative sources, including death certificates, workers' compensation reports and claims, reports to various regulatory agencies, medical examiner reports, and police reports. The data also come from news sources and other non-governmental reports.¹³

In 2000, 128 fatalities occurred in the grocery store industry, which accounted for 22 percent of the fatalities in retail trade as a whole.¹⁴ The vast majority (91 percent) of the grocery store fatalities resulted from assaults or violent acts, mostly homicides.¹⁵ (See table 9.) In 78 percent of the homicide cases, robbery was the motive. Transportation incidents accounted for 5 percent of the events contributing to fatalities in the grocery store industry.

Conclusion

Considerable progress has been made over the last decade in reducing the rate of injuries and illnesses in grocery stores. Employment in this industry is expected to increase about 6 percent from 2000 to 2010, as the population increases and as more grocery stores offer a wider array of goods and services.¹⁶ Safety and health training will continue to be a priority in reducing workplace injuries and illnesses in the grocery store industry.¹⁷

Cynthia M. Clarke
Economist, Office of Safety, Health, and Working Conditions, Bureau of Labor Statistics.
Telephone: 202-691-6178; E-mail: Clarke.Cynthia@bls.gov

Notes

1 This article updates research by Bureau of Labor Statistics economists Sarah O. Campany and Martin E. Personick. See Sarah O. Campany and Martin E. Personick, "Profiles in safety and health: retail grocery stores," Monthly Labor Review, September 1992, pp. 9-16; available on the Internet at http://stats.bls.gov/opub/mlr/1992/09/art2full.pdf.

2 Under the Standard Industrial Classification (SIC), grocery stores are designated as industry group 541. See Standard Industrial Classification Manual: 1987 (Executive Office of the President, Office of Management and Budget, 1987), p. 319.

3 "Grocery Stores," Career Guide to Industries, 2002-03 Edition, Bulletin 2541 (Bureau of Labor Statistics), on the Internet at http://stats.bls.gov/oco/cg/home.htm, visited November 7, 2002.

4 The employment figures for grocery stores are annual averages from the BLS Current Employment Statistics (CES) survey under the Standard Industrial Classification (SIC) system. See Discontinued BLS Databases, Employment, Hours, and Earnings from the Current Employment Statistics Survey (National), on the Internet at http://www.bls.gov/data/archived.htm. With the release of May 2003 data on June 6, 2003, the basis for industry classification changed from the SIC system to the 2002 North American Industry Classification System (NAICS). For more information on this change, see NAICS Conversion at http://www.bls.gov/ces/cesnaics.htm#naics.

5 The Survey of Occupational Injuries and Illnesses is a Federal-State program in which employer reports are collected from private industry establishments and processed by State agencies cooperating with the Bureau of Labor Statistics. The 2000 survey--the most recent survey conducted when this article was completed--collected data from 176,000 establishments. Occupational injury and illness data for coal, metal, and nonmetal mining and for railroad activities were provided by the Department of Labor's Mine Safety and Health Administration and the Department of Transportation's Federal Railroad Administration. The survey measures nonfatal injuries and illnesses only and excludes the self-employed, farms with fewer than 11 employees, private households, federal government agencies, and--for national estimates--employees of State and local government agencies. For more information on the background of the survey, see Workplace Injuries and Illnesses in 2000, USDL-01-472 (U.S. Department of Labor), December 18, 2001. For a current listing of industries with high rates of workplace injuries and illnesses, see the BLS Injuries, Illnesses, and Fatalities (IIF) website, Industry Incidence Rates and Counts, Supplemental News Release Tables, on the Internet at at http://stats.bls.gov/iif/home.htm.

6 Incidence rates represent the number of injuries and illnesses per 100 full-time workers, and were calculated as follows: (Number of injuries and illnesses X 200,000) / Employee hours worked.

7 Total lost workday cases involve days away from work, days of restricted work activity, or both.

8 The Survey of Occupational Injuries and Illnesses does not provide sufficient information to analyze this trend further.

9 National and State estimates are based on a scientifically selected probability sample. Sampling variability is greater for State estimates than for national estimates. Not all States publish estimates for injury and illness rates for grocery stores.

10 The category "disorders associated with repeated trauma" includes conditions due to repeated motion, vibration, or pressure, such as carpal tunnel syndrome; noise-induced hearing loss; synovitis, tenosynovitis, and bursitis, and Raynaud's phenomena.

11 The hours worked figures are annual average estimates of total hours worked by private industry wage and salary earners 16 years of age and older from the Current Population Survey (CPS). To maintain consistency with the CPS, injuries and illnesses incurred by workers under the age of 16 and cases for which the age of the worker was unspecified were not included in any comparisons with the hours data.

12 The occupational group referred to as "grocery store managers" includes managers and administrators, not elsewhere classified, and supervisors and proprietors, sales occupations. The group referred to as "cashiers and sales workers" includes cashiers and sales workers, other commodities. The group referred to as "kitchen workers" includes cooks, food counter workers, kitchen workers, miscellaneous food preparation workers, bakers, and food batchmakers.

13 Diverse sources are used because studies have shown that no single source captures all job-related fatalities. Source documents are matched so that each fatality is counted only once. To ensure that a fatality occurred while the decedent was at work, information is verified from two or more independent source documents or from a source document and a follow-up questionnaire. Approximately 30 data elements are collected, coded, and tabulated, including information about the worker, the fatal incident, and the machinery or equipment involved. See, National Census of Fatal Occupational Injuries, 2000, USDL-01-261 (Bureau of Labor Statistics, August 14, 2001).

14 Fatally injured workers under the age of 16 were not included to maintain consistency with the nonfatal estimates from the Survey of Occupational Injuries and Illnesses (SOII).

15 Homicides accounted for 96 percent of the fatalities due to assaults of violent acts, which also include suicides and attacks by animals. For homicides, "bullet" is the primary source and "perpetrator" is the secondary source. The primary source of injury or illness is the object, substance, element, or bodily motion which directly produced the injury or illness previously identified in the nature of injury or illness classification. If the event is "assaults and violent acts," the secondary source is the person who committed the act.

16 Occupational Outlook Handbook, 2002-03 edition, Career Guide to Industries, p. 7 (of 9), http://www.bls.gov/oco/cg/cgs024.htm, visited November 7, 2002.

17 On May 9, 2003, the Occupational Safety and Health Administration (OSHA) published an article in the Federal Register entitled "Prevention of Musculoskeletal Disorders: Guidelines for Retail Grocery Stores." The article provides industry-specific ergonomics guidelines. These guidelines are designed as a tool for reducing ergonomic-related injuries and illnesses and will not be used for enforcement purposes. Still, the article suggests that ergonomics will continue to be an area of concern for the grocery store industry.