Free field guide

The Big Three: Contact, Overexertion, Falls

The three causes behind 8 of every 10 lost-time workplace injuries, broken into seven fixable problems, with the leader's fix list for each.

By Ryan L. Rinehart, Retired Navy Veteran, 19+ years in EHS. Free PDF, no email needed.

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The list, with where to start on each

Sources: National Safety Council, 2026 National Safety Month fact sheet, top work injury causes from Injury Facts (ranking of days-away cases), based on the U.S. Bureau of Labor Statistics Survey of Occupational Injuries and Illnesses (SOII), 2023–2024 (released Jan. 22, 2026): news release Table 2 and the biennial case and demographic Tables R31 (detailed event) and R4 (industry). Counts are two-year totals for private industry, not one year. BLS now publishes detailed case characteristics every two years. Events use the BLS Occupational Injury and Illness Classification System (OIICS) version 3. * Rows marked with an asterisk are EHS Concepts calculations from the published figures.

  1. Struck by falling, swinging, or propelled objects

    • 148,340 days-away cases from being struck by falling, swinging, or propelled objects, 2023–2024
    • 100,240 of those were struck by a falling object
    • 26,350 struck by a swinging or slipping object, such as a load on a hoist or a part on a machine

    Start here: Walk every rack and shelf this week. Pull down anything heavy stored above shoulder height, and anything leaning or overhanging.

    Rules and guidance: 29 CFR 1910.176(b), 1926.250(a), 1910.135, 1910.136, 1910.212(a)(1) [GI/CON]

  2. Caught in or struck by running machinery

    • 53,760 days-away cases from contact with running powered equipment, 2023–2024
    • 1,900 days-away amputations from running equipment, 46% of all days-away amputations*
    • 10,390 struck by running equipment during maintenance, cleaning, or testing

    Start here: Pick the machine that jams most. Write its one-page lockout procedure with photos of each energy source, and post it on the machine this week.

    Rules and guidance: 29 CFR 1910.212, 1910.147, 1910.178(l) [GI]; OSH Act 5(a)(1) [BOTH]

  3. Objects handled and struck against

    • 248,560 days-away cases from contact with non-running objects and equipment, 2023–2024
    • 114,610 injured by an object being handled, such as a dropped part, a knife, or a sheet edge
    • 75,010 struck against a stationary object, such as a rack, a door, or a table corner

    Start here: Swap every open fixed-blade knife for a self-retracting cutter this month, and put fitted cut gloves next to each cutting station.

    Rules and guidance: 29 CFR 1910.132(d), 1910.138, 1910.176(a), 1910.22(a) [GI]

  4. Lifting, carrying, pushing, and pulling loads

    • 358,920 days-away cases from overexertion moving objects, 2023–2024
    • 255,390 from lifting, carrying, pushing, or pulling materials by hand
    • 55,490 from medical and custodial care, mostly moving patients and residents

    Start here: Find the heaviest item lifted from the floor most often. Put it on a pallet stand or shelf at waist height this week.

    Rules and guidance: OSH Act 5(a)(1) [BOTH]; NIOSH Lifting Equation, OSHA Safe Patient Handling [GUIDANCE]; 29 CFR 1910.178 [GI]

  5. Awkward motion and repetitive tasks

    • 124,680* days-away cases from bodily motion and repetitive motion, 2023–2024
    • 37,200 from twisting, reaching, and bending (part of bodily position and motion)
    • 32,110 from repetitive motion with microtasks, such as typing, gripping, or assembly

    Start here: Ask workers which task hurts most at the end of a shift. Change that station's height or layout this month.

    Rules and guidance: OSH Act 5(a)(1) [BOTH]; OSHA Ergonomics, NIOSH [GUIDANCE]; 29 CFR 1904 [BOTH]

  6. Same-level slips, trips, and falls

    • 310,690 days-away cases from falls, slips, and trips on the same level, 2023–2024
    • 264,920 of those were falls on the same level
    • 81,820 fall, slip, and trip cases in health care and social assistance, the most of any sector

    Start here: Map every spot where someone slipped in the last two years. Put a spill kit and a matting fix at the top three this week.

    Rules and guidance: 29 CFR 1910.22(a), (d), 1910.136, 1910.176(a) [GI]; 1926.25 [CON]

  7. Stairs, steps, and falls to a lower level

    • 165,860* days-away cases from stepping between levels and falls to a lower level, 2023–2024
    • 77,980 from slips, trips, and stumbles while stepping between levels, such as on stairs, curbs, and vehicle steps
    • 87,880 from falls to a lower level, such as from ladders, docks, and equipment

    Start here: Walk every stairway this week. Mark short or missing handrails and uneven or damaged treads, and add high-contrast nosing tape.

    Rules and guidance: 29 CFR 1910.23, 1910.25, 1910.28(b), 1910.30 [GI]; 1926.501(b)(1), 1926.1052, 1926.1053 [CON]

The full PDF adds, for each item, why it really happens, the rules in plain words, controls in hierarchy order, a 30-minute self-audit, who owns it and a toolbox talk starter.

Download the free PDF (37-page PDF)

Sources, as cited in the guide
  1. National Safety Council, 2026 National Safety Month fact sheet: top work injury causes (Injury Facts data). https://www.nsc.org/getmedia/d495295a-20ab-4796-88a1-907dc8665ca0/2026-nsm-fact-sheet-nsm-overview-injuries.pdf
  2. U.S. Bureau of Labor Statistics, Employer-Reported Workplace Injuries and Illnesses, 2023–2024 (Jan. 22, 2026). https://www.bls.gov/news.release/osh.nr0.htm
  3. BLS SOII, Table 2: DART, DAFW, and DJTR cases by selected event or exposure, private industry, 2023–24. https://www.bls.gov/news.release/osh.t02.htm
  4. BLS SOII biennial case and demographic characteristics, 2023–2024 (table index). https://www.bls.gov/iif/nonfatal-injuries-and-illnesses-tables/soii-case-and-demographic-characteristics-historical-data/2023-2024.htm
  5. BLS Table R31: cases by detailed event or exposure and nature, private industry, 2023–2024 (XLSX). https://www.bls.gov/iif/nonfatal-injuries-and-illnesses-tables/case-and-demographic-characteristics-table-r31-2023-2024.xlsx
  6. BLS Table R4: cases by industry and selected events or exposures, private industry, 2023–2024 (XLSX). https://www.bls.gov/iif/nonfatal-injuries-and-illnesses-tables/case-and-demographic-characteristics-table-r4-2023-2024.xlsx
  7. OSH Act Section 5, Duties (General Duty Clause). https://www.osha.gov/laws-regs/oshact/section5-duties
  8. OSH Act Section 11(c), anti-retaliation. https://www.osha.gov/laws-regs/oshact/section_11
  9. 29 CFR Part 1904, recordkeeping, eCFR. https://www.ecfr.gov/current/title-29/part-1904
  10. 29 CFR 1910.22, 1910.23, 1910.25, 1910.28, 1910.30, walking-working surfaces, eCFR. https://www.ecfr.gov/current/title-29/part-1910/subpart-D
  11. 29 CFR 1910.132, 1910.135, 1910.136, 1910.138, personal protective equipment, eCFR. https://www.ecfr.gov/current/title-29/part-1910/subpart-I
  12. 29 CFR 1910.176 and 1910.178, materials handling and storage; powered industrial trucks, eCFR. https://www.ecfr.gov/current/title-29/part-1910/subpart-N
  13. 29 CFR 1910.212, general requirements for all machines, eCFR. https://www.ecfr.gov/current/title-29/section-1910.212
  14. 29 CFR 1910.147, control of hazardous energy (lockout/tagout), eCFR. https://www.ecfr.gov/current/title-29/section-1910.147
  15. 29 CFR 1926.501, 1926.1052, 1926.1053, construction fall protection, stairways, ladders, eCFR. https://www.ecfr.gov/current/title-29/section-1926.501
  16. 29 CFR 1926.100 and 1926.250, construction head protection and materials storage, eCFR. https://www.ecfr.gov/current/title-29/section-1926.250
  17. NIOSH, Revised NIOSH Lifting Equation. https://www.cdc.gov/niosh/ergonomics/about/RNLE.html
  18. NIOSH, Applications Manual for the Revised NIOSH Lifting Equation, DHHS (NIOSH) Pub. 94-110 (1994). https://www.cdc.gov/niosh/docs/94-110/
  19. OSHA, Ergonomics topic page. https://www.osha.gov/ergonomics
  20. OSHA, Safe Patient Handling. https://www.osha.gov/healthcare/safe-patient-handling
  21. OSHA, Walking-Working Surfaces topic page. https://www.osha.gov/walking-working-surfaces
  22. OSHA, On-Site Consultation Program. https://www.osha.gov/consultation

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