The $49.9 Billion Top 10

The list, with where to start on each

Source: Liberty Mutual Workplace Safety Index 2026 (2023 data), as reported with the full top-10 list by Safety+Health magazine (National Safety Council), Sept. 28, 2026. We could not check these figures against Liberty Mutual's own 2026 report. Costs are direct workers' compensation costs (medical and lost wages) for injuries that kept people off work more than five days. Order and dollar figures are Liberty Mutual's. Percentages other than the 26% for No. 1 are EHS Concepts calculations against the $49.9B top-10 total, rounded.

1. Overexertion involving outside sources

   What the data shows: $13.1B · 26% (lifting, pushing, pulling, holding, carrying, throwing)

   Start here: Raise the bottom pallet: an empty pallet or a $150 spring-loaded positioner puts the load in the safe zone. Fix the broken lift table this week and log who approved the spend.

   Rules and guidance: OSH Act 5(a)(1) [BOTH] · NIOSH Lifting Equation [GUIDANCE]

2. Falls on the same level

   What the data shows: $9.9B · about 20%

   Start here: Walk the site at shift change with a phone. Photograph every wet spot and trip point. Put one name on each. Fix the top three this week.

   Rules and guidance: 1910.22 [GI] · 1926.25 [CON] · 1910.176(c) [GI]

3. Struck by object or equipment

   What the data shows: $6.2B · about 12%

   Start here: Paint or tape pedestrian lanes and crossings this week, and add a physical barrier at the busiest crossing. Pull the top tier off any rack bay above a walkway.

   Rules and guidance: 1910.28(c), 1910.135, 1910.176(b), 1910.178(m), 1910.212 [GI] · 1926.100 [CON]

4. Falls to a lower level

   What the data shows: $5.2B · about 10%

   Start here: Buy one platform ladder for each building and retire the worst stepladder today. Install a self-closing gate at the mezzanine.

   Rules and guidance: 1910.23, 1910.28(b), 1910.30 [GI] · 1926.501, 1926.503, 1926.1053 [CON]

5. Slip or trip without a fall

   What the data shows: $3.8B · about 8%

   Start here: Buy hose reels for the three most-used air and water lines this month. Paint every single step and threshold yellow.

   Rules and guidance: 1910.22(a) [GI] · 1910.176(a), (c) [GI] · 1926.25 [CON]

6. Other exertions or bodily reactions

   What the data shows: $3.23B · about 6% (bending, reaching, twisting, climbing, kneeling)

   Start here: Put the floor bins on a $40 riser this week. Ask each crew to name the one reach or bend they hate most, and fix the top one.

   Rules and guidance: OSH Act 5(a)(1) [BOTH] · 1910.23(b)(11)–(13) [GI] · OSHA and NIOSH ergonomics guidance [GUIDANCE]

7. Roadway incidents involving motorized land vehicles

   What the data shows: $3.22B · about 6%

   Start here: Change one rule today: dispatch sends the next job before the driver leaves the last one, or waits for a call back. Put it in writing.

   Rules and guidance: 49 CFR 392.80, 392.82 [FMCSA] · 1926.601(b) [CON] · OSH Act 5(a)(1) [BOTH] · OSHA/NHTSA/NETS guidelines [GUIDANCE]

8. Struck against object or equipment

   What the data shows: $1.79B · about 4%

   Start here: Walk the site with a tall person and a roll of striped tape. Mark and pad every point they have to duck.

   Rules and guidance: 1910.176(a), (e) [GI] · 1910.22(a)(3) [GI] · 1926.25(a) [CON]

9. Intentional injury by person

   What the data shows: $1.75B · about 4%

   Start here: Ask front-line staff: when have you felt unsafe here? Fix the top answer this month. Put a lock on the staff door today.

   Rules and guidance: OSH Act 5(a)(1) [BOTH] · Cal. Labor Code 6401.9 [STATE] · OSHA 3148 [GUIDANCE] · 1904 [BOTH]

10. Repetitive motions involving microtasks

    What the data shows: $1.6B · about 3%

    Start here: When a product or package changes, count motions per minute before and after. If it goes up, change the rate or the method.

    Rules and guidance: OSH Act 5(a)(1) [BOTH] · OSHA ergonomics guidelines [GUIDANCE] · NIOSH [GUIDANCE]

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 (49-page PDF)

Sources, as cited in the guide

1. Liberty Mutual Insurance, 2026 Workplace Safety Index (landing page). https://business.libertymutual.com/workplace-safety-index/
2. Safety+Health magazine (National Safety Council), “Injuries and illnesses cost U.S. employers $58.7 billion in 2023, insurer's index shows,” Sept. 28, 2026 (full 2026 top-10 list and method quote). https://www.safetyandhealthmagazine.com/injuries-and-illnesses-cost-u-s-employers-58-7-billion-in-2023-insurers-index-shows/
3. WorkCompWire, “Liberty Mutual Releases 2025 Workplace Safety Index,” July 17, 2025 (25-year trend; 2025 figures). https://www.workcompwire.com/2025/07/liberty-mutual-releases-2025-workplace-safety-index/
4. Liberty Mutual, 2023 Workplace Safety Index (PDF; category definitions). https://business.libertymutual.com/wp-content/uploads/2023/07/WSI_1000_2023.pdf
5. OSH Act Section 5, Duties (General Duty Clause). https://www.osha.gov/laws-regs/oshact/section5-duties
6. OSH Act Section 11(c), anti-retaliation. https://www.osha.gov/laws-regs/oshact/section_11
7. 29 CFR 1904 (recordkeeping), incl. 1904.7 and 1904.39, eCFR. https://www.ecfr.gov/current/title-29/part-1904
8. 29 CFR 1910.22, walking-working surfaces, general requirements, eCFR. https://www.ecfr.gov/current/title-29/section-1910.22
9. 29 CFR 1910.23, ladders, eCFR. https://www.ecfr.gov/current/title-29/section-1910.23
10. 29 CFR 1910.28, duty to have fall protection and falling object protection, eCFR. https://www.ecfr.gov/current/title-29/section-1910.28
11. 29 CFR 1910.30, training requirements (walking-working surfaces), eCFR. https://www.ecfr.gov/current/title-29/section-1910.30
12. 29 CFR 1910.135, head protection, eCFR. https://www.ecfr.gov/current/title-29/section-1910.135
13. 29 CFR 1910.136, foot protection, eCFR. https://www.ecfr.gov/current/title-29/section-1910.136
14. 29 CFR 1910.176, handling materials, general, eCFR. https://www.ecfr.gov/current/title-29/section-1910.176
15. 29 CFR 1910.178, powered industrial trucks, eCFR. https://www.ecfr.gov/current/title-29/section-1910.178
16. 29 CFR 1910.212, general requirements for all machines, eCFR. https://www.ecfr.gov/current/title-29/section-1910.212
17. 29 CFR 1926.25, housekeeping (construction), eCFR. https://www.ecfr.gov/current/title-29/section-1926.25
18. 29 CFR 1926.100, head protection (construction), eCFR. https://www.ecfr.gov/current/title-29/section-1926.100
19. 29 CFR 1926.501 and 1926.503, fall protection duty and training (construction), eCFR. https://www.ecfr.gov/current/title-29/section-1926.501
20. 29 CFR 1926.1053, ladders (construction), eCFR. https://www.ecfr.gov/current/title-29/section-1926.1053
21. 29 CFR 1926.601, motor vehicles (construction), eCFR. https://www.ecfr.gov/current/title-29/section-1926.601
22. 49 CFR 392.80, prohibition against texting (CMV), eCFR. https://www.ecfr.gov/current/title-49/section-392.80
23. 49 CFR 392.82, hand-held mobile telephone use (CMV), eCFR. https://www.ecfr.gov/current/title-49/section-392.82
24. OSHA, Ergonomics safety and health topic page. https://www.osha.gov/ergonomics
25. OSHA, Ergonomics FAQs (General Duty Clause citation criteria; guidelines are advisory). https://www.osha.gov/ergonomics/faqs
26. NIOSH, Revised NIOSH Lifting Equation. https://www.cdc.gov/niosh/ergonomics/about/RNLE.html
27. NIOSH, Applications Manual for the Revised NIOSH Lifting Equation, Pub. 94-110 (revised Sept. 2021). https://www.cdc.gov/niosh/docs/94-110/
28. OSHA, Walking-Working Surfaces topic page. https://www.osha.gov/walking-working-surfaces
29. OSHA, Motor Vehicle Safety topic page. https://www.osha.gov/motor-vehicle-safety
30. OSHA/NHTSA/NETS, Guidelines for Employers to Reduce Motor Vehicle Crashes (PDF). https://www.osha.gov/sites/default/files/publications/MOTOR_VEHICLE_GUIDE.pdf
31. OSHA, Workplace Violence topic page (no specific OSHA standard; 2023 CFOI figures). https://www.osha.gov/workplace-violence
32. OSHA 3148, Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers (PDF). https://www.osha.gov/sites/default/files/publications/osha3148.pdf
33. Cal/OSHA, Workplace Violence Prevention for General Industry (Labor Code 6401.9, SB 553). https://www.dir.ca.gov/dosh/Workplace-Violence/General-Industry.html
34. OSHA, On-Site Consultation Program. https://www.osha.gov/consultation
35. OSHA, Recommended Practices for Safety and Health Programs. https://www.osha.gov/safety-management