Overexertion, falls, and being struck by objects or equipment were the top causes of employers’ workers’ compensation costs, according to Liberty Mutual’s 2024 Workplace Safety Index, released June 11.

The report from the insurer’s Risk Control Services ranked the top 10 causes of the most serious workplace injuries—those causing an employee to miss more than 5 days of work—by their direct medical costs and lost-wage payments.

The 2024 report is based on data from the prior 3 years, including 2021. Because last year’s report included data from 2020 and the initial COVID-19 outbreak, “exposure to other harmful substances,” including infectious disease particles, was the #6 cause of injury and illness costs.

In the 2024 report, the top 10 causes, costing U.S. businesses $47.93 billion per year, were:

• Overexertion involving outside sources (carrying, holding, lifting, pulling, pushing, or throwing objects);
• Falls on the same level;
• Falls to a lower level;
• Struck by objects or equipment;
• Other exertions or bodily reactions (awkward postures like bending and twisting, climbing, crawling, kneeling, reaching, sitting, standing, running, and walking);
• Vehicle crashes—roadway incidents involving a motorized land vehicle­;
• A slip or trip without a fall;
• Caught in or compressed by equipment or objects;
• Striking an object or equipment—hitting in-place equipment or objects; and
• Repetitive motions involving microtasks.

Injuries or conditions due to awkward postures, overexertion, and repetitive motions are collectively referred to as musculoskeletal disorders (MSDs). The National Safety Council this week released a report examining the relationship between MSDs, which are the most common workplace injuries, and racial disparities in the workplace.

Liberty Mutual identified falls, especially slips, trips, and falls on the same level, and roadway incidents as causes of injuries that require renewed employer vigilance.

Falls on the same level moved up from the fourth to the third most costly cause of loss for the construction industry. For the first time, same-level falls overtook overexertion injuries as the top-ranked cause of loss in health care and social assistance, according to Liberty Mutual. Falls on the same level remained the top cause of loss for leisure and hospitality, with an increased injury count compared with last year’s index.

Both the count and the average cost of falls on the same level increased in manufacturing. Falls on the same level moved up from the third- to the second-ranked cause of loss in the wholesale sector. Falls on the same level remained at least a top-two cause of loss in all other industries.

Roadway incidents entered the wholesale industry’s top five causes of loss for the first time. Roadway incidents ranked fourth for health care and social assistance, entering the industry’s top five list for the first time since 2016. Roadway incidents rose from the fifth- to the fourth-ranked cause of loss for both professional and business services and transportation and warehousing.

Because overexertion is the leading cause of workers’ compensation costs, back injuries were associated with the highest total costs, according to Liberty Mutual. Worldwide, back pain is responsible for more years lived with a disability than any other condition.