Article Reviewed by a licensed insurance professional: Sam Meenasian (CA dept of insurance license #0F75955).
Estimated reading time: 11 minutes
Key takeaways
- Sprains, strains, and tears still drive the largest share of lost-time workplace injuries in the U.S.
- Overexertion, contact with objects or equipment, and falls are the biggest nonfatal injury risks across most industries.
- Construction is not always the highest in nonfatal frequency, but it remains one of the clearest leaders in fatal severity.
- Retail, healthcare, hospitality, and field-service businesses often underestimate violence, same-level falls, and manual-handling injuries.
- The best comparison is not “which industry is safest,” but which injuries occur most often, which ones keep people out of work the longest, and which ones turn deadly.
If you run a small business, the real question is not whether workplace injuries happen. It is which injuries are most likely to happen in your operation, how severe they tend to become, and how quickly a “small” incident can turn into lost time, restricted duty, overtime, delayed jobs, and a workers’ compensation claim. That is the lens we use at USA Business Insurance and throughout our business insurance blog: frequency matters, but severity and downtime matter just as much.
U.S. private employers reported about 2.5 million nonfatal workplace injuries and illnesses in 2024, down 3.1% from 2023, with a total recordable case rate of 2.3 per 100 full-time workers. Fatal injuries across all sectors totaled 5,070 in 2024, down from 5,283 in 2023, with a fatal injury rate of 3.3 per 100,000 full-time equivalent workers. The broad trend improved, but the injury burden is still large enough that owners should not confuse “better than last year” with “low risk.”
For source quality, one detail matters: BLS publishes industry counts and rates annually, but the detailed event-and-exposure breakdown is released biennially. So the industry comparisons below use 2024 data, while the latest national injury-pattern data use the combined 2023–2024 case-characteristics release. Also, the employer-reported nonfatal survey excludes the self-employed, private household workers, volunteers, federal government workers, and farms with 10 or fewer employees, which means some owner-operator trades can look lighter in the official nonfatal data than they feel in day-to-day business.
What injuries are most common right now?
If you want the plain-English answer, the most common workplace injuries are still musculoskeletal injuries and falls. BLS says days-away-from-work cases involving sprains, strains, and tears reached 568,150 in 2024. Back-related cases alone accounted for 248,180 days away from work, and falls, slips, and trips accounted for 479,480. These are the injuries that show up in loading areas, stockrooms, production lines, kitchens, service vans, and job sites every week.
Using the broader DART measure — cases involving days away from work, job restriction, or transfer — overexertion, repetitive motion, and bodily conditions were the largest category in 2023–2024, with 946,290 cases. Contact with objects or equipment came next at 860,050, followed by falls, slips, and trips at 721,720. Exposure to harmful substances or environments reached 224,450 cases, transportation incidents 121,330, and violent acts 78,340. The biggest injury engine in U.S. business is still not a rare dramatic event. It is routine force, repetition, awkward movement, and people handling objects in ways that accumulate strain.
Severity explains why these cases matter so much. Median DART time was 24 days for overexertion cases, 21 days for transportation incidents, and 20 days for falls, slips, and trips. Contact injuries came in at a median of 10 days, and exposure cases at 5. That is why owners routinely underestimate strains and slips. They do not always look dramatic on day one, but they can keep an employee off normal duty for weeks and create replacement labor, rescheduling, and production problems that last longer than the medical treatment.
The fatal side looks different. Transportation incidents caused 1,937 fatal work injuries in 2024, more than any other event category. Falls, slips, and trips caused 844 deaths, contact incidents 756, violent acts 733, and exposure to harmful substances or environments 687. So the national pattern is fairly stable: overexertion and falls dominate nonfatal claims, while vehicles and falls dominate the deadliest ones.
Cost data point the same way. Liberty Mutual’s 2025 Workplace Safety Index, which reflects 2022 serious-loss data, says the top ten causes of serious workplace injuries accounted for more than 86% of total workplace injury cost, or $58.78 billion. Overexertion involving outside sources ranked first at $13.7 billion, fell to the same level as the second-ranked category at $10.5 billion, and struck-by incidents plus falls to a lower level together accounted for nearly $11.6 billion. The familiar injuries are still the ones draining the most money.
How the major industries compare in 2024
The cleanest apples-to-apples nonfatal comparison is the 2024 BLS industry table below.
| Industry | Nonfatal cases (2024) | Rate per 100 FTE workers |
| Agriculture, forestry, fishing, and hunting | 36,900 | 3.9 |
| Construction | 167,100 | 2.2 |
| Manufacturing | 332,600 | 2.7 |
| Wholesale trade | 126,800 | 2.2 |
| Retail trade | 339,800 | 3.0 |
| Transportation and warehousing | 261,500 | 4.4 |
| Professional, scientific, and technical services | 71,600 | 0.7 |
| Administrative/support/waste management | 97,500 | 1.8 |
| Health care and social assistance | 553,800 | 3.4 |
| Accommodation and food services | 234,800 | 2.6 |
| Other services (except public administration) | 63,900 | 1.9 |
Source: BLS 2024 nonfatal industry counts and rates.
The big takeaways from that table are straightforward: health care and social assistance had the largest number of cases, retail and manufacturing were also very high by volume, and transportation and warehousing had the highest mainstream injury rate at 4.4. Construction, by contrast, sits closer to the middle in terms of nonfatal frequency than many owners expect.
Fatality risk changes the ranking. In 2024, construction recorded 1,034 fatal work injuries with a rate of 9.2 per 100,000 workers. Transportation and warehousing recorded 865 with a rate of 12.2. Agriculture, forestry, fishing, and hunting recorded 475 with a rate of 20.9. Manufacturing recorded 353 at a rate of 2.4, and retail recorded 258 at 1.8. That is the classic comparison mistake: owners look only at case frequency when the bigger business question is often severity.
Where the injury mix changes by industry
🛒 Retail
Retail reported 339,800 nonfatal cases in 2024 with a rate of 3.0. Fatalities in retail totaled 258, and the largest fatal category was violent acts at 104, ahead of transportation incidents at 65 and falls at 40. Retail is one of the clearest examples of an industry where the public-facing exposure changes the loss picture. It is not just boxes, ladders, and slick entry mats. It is also cash handling, parking lots, late hours, customer conflict, and employee interaction.
Retail owners often focus on cuts and obvious accidents, but the more expensive pattern is usually less dramatic: unloading, stocking, carrying, stepping off ladders, and slipping in stockrooms or receiving areas. Liberty Mutual’s retail-specific index, based on 2020 serious-loss data, found overexertion as the top direct-cost driver in retail, followed by same-level falls, struck-by injuries, falls to a lower level, and awkward-posture injuries.
🛠️ Construction
Construction reported 167,100 nonfatal cases in 2024 and a rate of 2.2, but it also recorded 1,034 fatal injuries. Falls, slips, and trips alone accounted for 389 of those deaths. Transportation incidents caused 244 construction deaths, exposure events 187, and contact incidents 161. In specialty trades, the pattern gets sharper: roofing contractors recorded 120 fatalities in 2024, with 96 tied to falls; electrical contractors recorded 59, including 17 falls; plumbing, heating, and air-conditioning contractors recorded 75, including 23 falls and 22 exposure-related deaths.
This is why contractors such as plumbers, electricians, welders, and handymen should compare both frequency and consequence. A ladder slip or short-exposure event can escalate quickly because the claim is only the first layer. Then come lost labor, schedule drift, and possibly an OSHA reporting duty. Under OSHA rules, a work-related case becomes recordable if it results in death, days away from work, restricted work or job transfer, medical treatment beyond first aid, or loss of consciousness. Fatalities must be reported to OSHA within 8 hours, and inpatient hospitalizations, amputations, and loss of an eye must be reported within 24 hours.
🗜️ Manufacturing
Manufacturing reported 332,600 nonfatal cases in 2024, with a rate of 2.7. Fatal manufacturing injuries totaled 353, with a rate of 2.4. Owners in manufacturing usually understand machine hazards. What they often overlook is the steady churn of lifting, reaching, pushing, awkward posture, and repetitive movement around the machine. A production employee does not need a catastrophic event to generate a meaningful claim; a shoulder strain from handling or a back injury from material movement can be enough.
Liberty Mutual’s industry analysis points to something distinctive: manufacturing was the only one of its eight major sectors in which caught-in or compressed-by injuries ranked among the top five cost drivers. That makes sense operationally. Manufacturing blends overexertion with machine interaction, so claims often involve a mix of strain and contact injuries rather than one or the other.
🚐 Transportation and warehousing
Transportation and warehousing reported 261,500 nonfatal cases in 2024, but its rate of 4.4 was the highest among the large mainstream sectors in the BLS table. It also recorded 865 fatalities in 2024 and a fatality rate of 12.2. Truck transportation alone accounted for 577 deaths, including 438 transportation-related deaths, and general freight trucking accounted for 404, including 304 transportation-related deaths.
The hidden problem in this sector is that many companies focus on “vehicle risk” and overlook the warehouse floor. Liberty Mutual’s transportation-and-warehousing analysis found overexertion, same-level falls, roadway incidents, awkward-posture injuries, and falls to lower levels among the top serious-loss drivers. The common claim path is not always a highway crash. It can be a driver stepping down badly, a warehouse employee handling freight awkwardly, or a technician loading gear into a van.
🚑 Health care, hospitality, and service businesses
Health care and social assistance produced the single largest number of nonfatal cases in 2024 at 553,800, with a rate of 3.4. Liberty Mutual’s industry review says healthcare and social assistance was the only major sector in its eight-industry set in which intentional injury by a person ranked among the top five direct-cost drivers, alongside overexertion, same-level falls, and harmful-substance exposure. On the fatal side, hospitals recorded 20 work deaths in 2024, including 11 violent acts, while home health care services recorded 14 deaths, including 5 transportation incidents.
Accommodation and food services reported 234,800 nonfatal cases in 2024 with a rate of 2.6. Fatalities in accommodation and food services totaled 185, including 86 violent acts, 48 exposure-related deaths, and 27 falls. Restaurants, hotels, and similar businesses sit at the intersection of fast pace, slippery surfaces, sharp tools, hot surfaces, and public contact. That is why a service business can appear “less hazardous” than construction yet still exhibit a stubborn injury pattern.
Professional, scientific, and technical services posted a relatively low overall rate of 0.7 in 2024, but that average can be misleading for service-related businesses with field work. Liberty Mutual’s Professional & Business Services index found same-level falls, overexertion, falls to lower level, struck-by injuries, and roadway incidents among the top serious-loss drivers. Office averages pull the sector down, while the field-service piece still behaves like a manual-risk business.
That same masking effect shows up in trade-like service categories. BLS reported a 3.0 injury rate for landscaping services in 2024 and a 5.6 rate for carpet and upholstery cleaning services, compared with 1.9 for “other services” overall. So if you operate businesses such as hood cleaners, cleaners, maintenance contractors, or landscapers, the sector average may not accurately reflect your actual exposure.
Agriculture deserves its own caution flag. Nonfatal employer-reported cases were 36,900 in 2024, with a rate of 3.9, but fatal injuries reached 475, and the fatality rate was 20.9, one of the highest in the country. Because the BLS nonfatal survey excludes farms with 10 or fewer employees, agriculture is one of the clearest sectors where the official nonfatal picture can understate how hard the work really is on smaller operations.
What actually turns these incidents into claims
Many claims start earlier than owners think. Under OSHA recordkeeping rules, a work-related injury becomes recordable if it leads to days away from work, restricted work, transfer to another job, medical treatment beyond first aid, death, or loss of consciousness. Restricted work exists when the employer or clinician prevents the employee from performing one or more routine functions or from working a full normal day. Just as important, recording or reporting an injury does not mean the employer was at fault, that an OSHA rule was violated, or that the employee is automatically eligible for workers’ compensation benefits.
In a small company, that is where the snowball starts: a strain that looked minor on Friday becomes restricted duty on Monday; a same-level fall that seemed like “just a bruise” becomes therapy and modified work two weeks later; a vehicle incident creates both an injury claim and a scheduling problem at the same time. The data help explain three common mistakes. Retail loss patterns are heavily influenced by overexertion and same-level falls, not just customer incidents. Construction severity is driven by falls, but strains and restrictions still fall within the broader picture of overexertion. Service businesses may label themselves as low-risk even when fieldwork adds roadway, ladder, and handling exposure.
The practical lesson is straightforward. Compare your business on three levels at once: how often the injury occurs, how long it tends to keep people off full duty, and how severe it becomes when it goes wrong. That is a much better management view than a single industry rate.
At USA Business Insurance Services, Inc., we work with contractors, retailers, manufacturers, restaurants, warehouses, professional firms, and service businesses across all 50 states, including plumbers, electricians, HVAC contractors, welders, and handymen. We look at injury exposure the same way owners experience it: as a mix of people, operations, contracts, vehicles, job sites, and day-to-day workflow.
