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职业的安全和健康之规制
文/Sidney A. Shapiro

OCCUPATIONAL SAFETY AND HEALTH REGULATION

Sidney A. Shapiro

John M. Rounds Professor of Law

University of Kansas

© Copyright 1999 Sidney A. Shapiro

Abstract
An employer will invest in safety and health precautions until the cost is more
than the expense of paying higher wages, workers’ compensation, and other
accident and illness costs. Employees receive additional protection because
governments have chosen to augment these financial incentives with
regulation. Studies indicate that all three approaches cause employers to invest
in health and safety precautions, but the extent to which injuries and illnesses
are reduced is difficult to verify and may be limited in numerous work
situations. The literature has identified potential reforms, but the viability of
key reforms is uncertain. Thus, labor markets, compensation and regulation are
highly imperfect alternatives concerning the reduction of occupational
accidents and illnesses. As a result, continued reliance on all three approaches
is indicated.
JEL classification: K31, K32
Keywords: Occupational Safety, Occupational Health, Occupational Risk,
Workers’ Compensation

A. Introduction

1. Imperfect Alternatives

Economic theory predicts that workers will demand additional wages, or a
‘wage premium’, to compensate them for workplace safety and health risks.
Employers will respond by reducing such risks until it is less expensive to pay
workers additional compensation than it is to invest in additional health or
safety precautions. In this manner, labor markets should produce the abatement
of some safety and health hazards, and workers should be compensated for the
risks that remain.

Since the early 1900s, governments have intervened to augment these labor
market incentives. According to Darling-Hammon and Kniesner (1980),
virtually every state in the United States enacted some quasi-administrative
scheme to award compensation for workplace accidents between 1911 and
1920. Today all 50 states and the federal government administer such
programs. In 1970, Congress enacted the Occupational Safety and Health Act
(OSH Act) which established the Occupational Safety and Health
Administration (OSHA) in the Department of Labor to regulate workplace
conditions. States have the option to accept federal regulation of employers or
to administer their own safety and health regulations subject to OSHA’s
approval and supervision. Other countries have also implemented
administrative regulation. These governmental efforts indicate a political
judgment that labor markets produce insufficient protection for workers.

This essay describes how economic theory explains the role of labor
markets, compensation, and regulation in addressing occupational injuries and
illnesses. I also report on studies that have tested the effectiveness of each of
these methods, and I discuss reforms to improve the effectiveness of each
approach.

Readers seeking an overview of these issues can consult several books and
articles. Chelius (1974), Oi (1974), Rea (1983), Viscusi (1983, 1992), Dickens
(1984), Schroeder and Shapiro (1984) and Robinson (1991) offer general
comparisons of the impact of labor markets, compensation and regulation on
workplace safety and health.

This chapter confirms Komesar’s (1994) insight about options for making
society safer and healthier. When governments choose between market,
compensation, and regulatory approaches, Komesar contends that ‘[t]he choice
is always a choice among highly imperfect alternatives’. Labor markets,
compensation, and regulation are ‘imperfect’ alternatives concerning the
reduction of occupational accidents and illnesses because none of these
alternatives is reliable. Instead, each is limited by significant constraints, which
are explained below.

Reformers seek to address these constraints, but the constraints are
intractable in many instances. Thus, it appears to be necessary to rely on all
three approaches, because no one (or even two) approaches is likely to produce
an appropriate level of occupational safety and health. Together, however, labor
markets, compensation and regulation can come closer to this elusive goal.

B. Labor Markets

2. Introduction

Economic theory establishes that labor markets create several incentives for
employers to reduce occupational safety and health risks. Economic studies
confirm the existence of one such incentive: the demand by workers for
additional compensation, or a ‘wage premium’, for exposure to safety risks.
The adequacy of such wage premiums, however, is in dispute. Moreover,
analysts generally concede that workers are unlikely to be compensated for
most health risks. Governments have attempted to aid workers in obtaining
additional compensation by promoting the distribution of information about
workplace risks and by addressing workers’ lack of bargaining power.

3. Economic Theory

An employer will determine whether to prevent workplace accidents or
illnesses by comparing the cost of prevention with the cost of not taking such
action. Employers that fail to reduce workplace hazards can expect to pay
increased labor costs because workers will demand additional compensation for
enduring occupational safety and health risks. For a given level of workers’
compensation, workers will demand a wage premium that compensates for any
inadequacies in ex post compensation. In other words, assuming workers are
fully informed about job risks, they will seek compensation equal to the
expected cost of an injury or illness not covered by workers’ compensation. In
addition, the employer may have to pay for the cost of recruitment and training
of additional workers to replace those persons who are injured or killed and
other related costs. To avoid these expenses, an employer will make safety and
health improvements until the cost of additional precautions is more than
paying wage premiums and other related costs.

In this manner, labor markets should produce the abatement of some safety
and health hazards and workers should be compensated (ex ante and ex post)
for the risks that remain. The employer’s assumption of these costs will make
the market for the employer’s product or service more efficient. Because the
employer assumes these costs, the price of the product or service will reflect the
cost to society of the production of the good or service, including the cost of
occupational illnesses and injuries.

4. Empirical Evidence

Studies by Viscusi (1983) and other analysts (listed and described by Viscusi)
find that workers in risky jobs receive higher wages after controlling for
education, experience, and other market characteristics. Viscusi estimates that
average annual compensation for all job risks in the United States totals about
$400. Similarly, Robinson (1991) estimates that workers exposed to significant
risks of occupational injuries received annual wage premiums of about $300-
$500. This amounts to about a 5-8 percent increase above the earnings of
unexposed blue-collar workers. Fishback (1986) cites empirical evidence that
miners in the United States in the 1900s received risk compensation. Weiss,
Maier and Gerking (1986) discovered risk compensation in Austrian labor
markets.

By comparison, Leigh (1991), who reviewed several prior studies, found
that only variables which reflected job hazards resulting in death were
associated with compensating wages, and that among studies using death rates,
only some studies found evidence of wage premiums. Further, among studies
finding evidence of such wages, the amount of compensation paid for the risk
of death varied widely. Leigh’s own study found evidence of compensating
wages based on Bureau of Labor Statistics fatality data, but he found no
correlation based on workers’ compensation fatality data. A review by Dorman
(1996) of the literature on compensating wages, including Leigh’s study,
characterizes the evidence for wage premiums as ‘weak at best’.

5. Evaluation of Empirical Data

The empirical evidence is mixed concerning the extent to which workers obtain
wage premiums for dangerous work. Moreover, even when workers obtain
compensating wages, there is an issue of the adequacy of the compensation. As
the last section revealed, studies finding compensating wages indicate that
workers receive only modest wage premiums. Even a small wage premium,
however, is significant if workplace risks are not very large. For example,
Viscusi (1983) concludes that once analysts take into account the nature of a
risk and the population exposed to it, it is evident that workers are well paid for
the risks that they face. According to Viscusi, ‘most’ of the ‘reasonable’
estimates indicate that workers demand between $3 and $7 million
compensation for exposure to potentially fatal accidents. Workers, however,
may receive less compensation than Viscusi estimates.

First, if the risk of a fatal accident is greater than the data on which Viscusi
relies, workers receive less compensation than he estimates. McGarity and
Shapiro (1993, 1996) found that experts believe existing statistics understate
the extent of workplace fatalities (and injuries) in the United States by an
unknown and perhaps significant extent.

Second, the amount of additional compensation that a worker will seek for
hazardous work is a function of the worker’s knowledge and understanding of
existing risks. Robinson (1991) cites survey data which reveal that workers’
knowledge is incomplete. He found, for example, that 33 to 50 percent of
workers in occupations with high rates of disabling injuries and illnesses
reported that they faced no significant safety or health hazards. Carmichael
(1986) adds that because the dissemination of safety information in labor
markets takes time, workers may lack adequate information when they seek a
job. Oi (1974) notes, however, that full information by all workers is not
necessary to obtain adequate compensating wages. What is important is that the
marginal worker possess full information.

Third, workers must be able to discern marginal differences in risks to
bargain effectively for hazard pay. Yet, as Lave (1983), Dickens (1984) and
McGarity and Shapiro (1993) discuss, such distinctions are especially difficult
to make in the context of occupational illness, where huge uncertainties
befuddle attempts to predict the precise effects of health risks on longevity and
the quality of life once a disease has manifested itself.

Further, as Dorman (1996) discusses, a worker’s evaluation of risk may be
distorted by psychological effects in the way individuals process risk
information. Studies in the psychological literature suggest that people do not
process risk information in the rationale manner that economic theory assumes.
For example, people engage in several forms of ‘bounded rationality’ which
simplify and filter risk perceptions. Risk perceptions are also impacted by
attitudes towards risk, such as the fact that persons tend to fear more acutely
those risks they cannot control. Cognitive dissonance is another factor, because
it induces people to ignore or alter their perceptions of risk in order to avoid
unpleasant conflicts with established beliefs.

Fourth, the additional compensation that a worker can obtain for hazardous
work is a function of the worker’s bargaining power. Boden and Jones (1987)
point out that estimates of wage differentials are substantially higher for
unionized employees than for nonunionized employees. Moreover, Robinson
(1991) cites data indicating that only poorly educated and low-skilled
employees are likely to take dangerous jobs. His calculations reveal that
hazardous jobs pay 20-30 percent less than safe employment after taking into
account education and skill levels. He concludes that persons with training and
education avoid such jobs because safer employment pays more, and that
hazardous jobs are more likely to go to minority workers. Robinson found that
Hispanic males were 80 percent more likely to suffer a disabling injury or
illness than whites in California, and that black men were 40 percent more
likely.

McGarity and Shapiro (1993) argue that even educated and skilled workers
may hesitate to leave dangerous jobs because the hazardous pay is inadequate.
Such workers may be hesitant to change jobs because of the loss of health
benefits, pension rights, and seniority, the expense and disruption of relocation,
and the difficulty of becoming familiar with a new employer. Boden and Jones
(1987) hypothesize that these reasons explain the relatively low wage premium
received by asbestos installation workers who were familiar with the significant
risks that they faced. A study by Kahn (1987) finds that occupational safety
levels in nonunionized firms reflect only the preferences of workers with three
or less years of job tenure, who are, he presumes, the most mobile workers in
the firm.

Dorman (1996) proposes that game theory be used to study the relationship
of workers and employers concerning issues such as risk compensation. He
argues that because game theory accounts for strategic behavior, it can clarify
how cooperation and conflict inside a corporation impacts issues of public
policy such as the protection of workers.

6. Reform

Workers may be inhibited in obtaining wage premiums for workplace safety
and health risks because of the lack of information or inadequate bargaining
power. Analysts have discussed what steps governments can take to address
these problems.

Regulatory policies that increase workers’ access to risk information should
improve market performance. Government action is likely to be necessary
because, as Viscusi (1983) points out, the ‘aberrant characteristics of
information as an economic good’ inhibit the creation of market arrangements
to produce such information.

OSHA’s hazardous communication standard is a good example of this type
of government mandate. The regulation requires chemical manufacturers to
provide a material safety data sheet, based on the available literature, for each
hazardous product that they produce or use. The information is then made
available to workers who are exposed to these products. Carle (1988) proposes
improvements in OSHA’s regulation, while Viscusi (1983) supports additional
regulation. He recommends that employers be required to apprise workers of
the nature of the risks that they face, the risk level of the firm (death, injury and
illness rates), its relative risk as compared to other firms in the industry, and
other relevant risk information.

The impact of additional information will depend on the ability of workers
to use risk information. As noted in the last section, workers may have limited
cognitive capacities or psychological defense mechanisms that impede rational
use of risk information. Government can address these limitations by requiring
that employers train workers to evaluate the information that they receive.

A worker’s ability to obtain a wage premium is also dependent on the
person’s bargaining power. Workers would have more bargaining power if they
could not be fired for their refusal to undertake hazardous work. Rea (1983)
reports that some Canadian provinces have given workers the right to refuse
unsafe work. McGarity and Shapiro (1993) support similar reforms for the
United States.

C. Compensation

7. Introduction

The wage premiums received by workers constitute ex ante compensation for
occupational accidents and diseases. Workers also receive ex post compensation
through workers’ compensation and tort law.

Spieler (1994) provides a detailed description of the role of workers’
compensation in the United States. Prior to the early 1900s, workers could sue
their employers for negligence if they were injured at work, but these tort suits
were frustrated by a number of legal doctrines that prevented workers from
recovering. According to Chelius (1976), many state legislatures had abolished
some of these defenses prior to 1911. Recovery under the tort system remained
inadequate, however, which prompted the passage of workers’ compensation
laws. These laws discarded most of the remaining legal obstacles to recovery
and, as a tradeoff, established two important limitations on workers. States
prohibited workers from suing their employers under tort law, and they limited
the types and amount of damages that workers could recover. Morgenstern
(1982) has a general description of the role of compensation in other countries.

Employers should respond to higher compensation costs by investing in
safety and health improvements. Yet, analysts have been unable to establish a
clear correlation between such higher costs and a reduction in workplace
injuries and fatalities. Despite the lack of evidence, some analysts argue that
workers’ compensation provides a significant incentive to make safety and
health improvements, but other analysts dispute this conclusion. What is clear
is that workers’ compensation fails to reimburse employees for accident and
illness costs that are not paid by wage premiums. Government may improve the
function of workers’ compensation by requiring employers to pay higher
compensation, mandating that insurance rates more accurately reflect an
employer’s safety experiences, or imposing a tax-based system of
compensation.

8. Economic Theory

An employer will determine whether to prevent workplace accidents or
illnesses by comparing the cost of prevention with the cost of not taking such
action. For risks that are not prevented, the employer will be responsible for
paying workers’ compensation to injured or ill employers. A firm will invest
in safety and health precautions until the cost is more than the cost of paying
higher wages, workers’ compensation, and other accident and illness costs. If
workers are fully compensated (ex post and ex ante) for the accidents and
illnesses which are not prevented, the market for an employer’s product or
services will be more efficient. The market is more efficient because the price
of the product or service will include the cost of occupational accidents and
illnesses associated with its production. In this manner, the price will reflect the
actual cost to society of the production of the good or service. The actual cost
to the firm of paying compensation, however, will depend on the nature of its
insurance arrangements. Insurance arrangements can reduce a firm’s incentive
to prevent future accidents and illnesses as explained below.

9. Empirical Evidence

Although employers pay billions of dollars for workers’ compensation, analysts
have been unable to verify that higher costs are associated with a reduction in
workplace injuries. Some studies even find that higher costs are associated with
an increase in injuries.

The cost of workers’ compensation in the United States was about $62
billion in 1992 according to Boden (1995). Viscusi (1992) points to this cost as
evidence that workers’ compensation is more influential than OSHA in
promoting workplace safety because employers paid only about $10 million in
OSHA fines in the same year.

The empirical evidence, however, is equivocal concerning whether workers’
compensation induces employers to take safety precautions. Boden (1995)
reviewed sixteen studies (which he lists and describes) which tested the
relationship between an increase in workers’ compensation costs and workplace
injuries, as measured by injury statistics or workers’ compensation claim rates.
Most of the studies concluded that injuries increased or remained unchanged
when benefit levels rose. A study by Moore and Viscusi (1989), however,
concludes that the average fatality rate would have been 22 percent higher if
there had been no workers’ compensation. By comparison, Butler and Worrall
(1991) report that ‘virtually’ all studies of claim usage in workers’
compensation find that an increase in indemnity benefits increases workers’
compensation claim frequency.

10. Evaluation of Empirical Data

Some analysts interpret the previous data as supporting the conclusion that
workers’ compensation provides a significant incentive to make safety and
health improvements. They argue that the data do not reveal this correlation
because various actions by employees offset the reduction in compensation
claims attributable to employer safety improvements. Other analysts argue that
workers’ compensation does not create significant incentives for employers to
invest in safety and health improvements because of the impact of insurance
and other factors.

The impact of workers’ compensation on occupational safety and health also
depends on the extent to which workers are compensated for their injuries and
illnesses. Despite the large cost of workers’ compensation, employers pay for
only a portion of the cost of workplace accidents and for almost none of the cost
of occupational illness.

11. Employee Behavior

Employee behavior may explain why increases in workers’ compensation costs
may not have produced lower injury rates. According to Butler and Worrall
(1991), an increase in benefits will increase the propensity of workers to file
claims for two reasons. When benefits are increased, workers are willing to
undertake greater risk than previously and more injuries will occur. Also,
workers have a greater incentive to file a claim for any given level of risk.
Butler and Worrall characterize the former response as a ‘risk-bearing moral
hazard’ and the latter behavior as a ‘claims-reporting moral hazard’. In
addition, claims may increase because higher benefits induce additional fraud.
The additional claims which result from these three types of behavior, if large
enough, could offset any reduction in compensation claims attributable to
employer safety or health improvements undertaken in response to increased
compensation costs.

According to the ‘risk-bearing moral hazard’ theory, workers are less
vigilant and therefore suffer more (and more serious) injuries because higher
benefits diminish the personal economic risks associated with such injuries. If
such behavior offsets the impact of safety improvements by employers, as
Fishback (1986, 1987), Lyttkens (1988), Moore and Viscusi (1990) and Butler
and Worrall (1991) suggest, this theory would explain the positive relationship
between increased workers’ compensation costs and injury rates. McGarity and
Shapiro (1996) are skeptical of this explanation, however, because workers
have strong economic and other incentives to avoid injuries. As discussed
below, workers receive less, sometimes far less, than the actual costs of their
injuries and illnesses. McGarity and Shapiro also doubt the idea that the
prospect of money in the future will persuade a significant number of people to
risk severe pain, hospitalization, dismemberment, and even death in the
present.

The second explanation of employee behavior focuses on the ‘claims
reporting moral hazard’, which is also characterized as a ‘reporting’ effect.
According to this explanation, higher workers’ compensation only increases the
number of accident reports and not the absolute number of injuries. Since
workers lose less income if they miss work, they may report more injuries and
stay off work longer.

Researchers have evaluated this second type of moral hazard by focussing
on the link between workers’ compensation rates and events that should not be
subject to a reporting effect. Some studies have focussed on the relationship
between higher compensation rates and fatalities. Because fatalities are clearcut
events, there should be no overreporting. Moore and Viscusi (1990) and
Ruser (1993) found that increased benefits levels were associated with reduced
fatality rates, but Butler (1983) discovered that benefit increases were
associated with higher fatality rates. A study by Robertson and Keeve (1983)
compared the impact of benefits levels on sprains and strains as compared to
more ‘objective’ injuries, such as lacerations and fractures. This comparison
revealed that reported injuries of both types increased with benefit levels,
although the effect was stronger for sprains and strains. Kniesner and Leeth
(1989) claim to establish the validity of the reporting theory based on a
computer simulation.

A study by Butler, Durbin and Helvacian (1996) attributed most of the
significant increase in workers’ compensation claims for soft tissue injuries in
the 1980s to moral hazard responses by employees and also by physicians. A
physician in a health maintenance organization (HMO) may earn more by
misclassifying a soft tissue injury as compensable in the workers’ compensation
system, because this permits the physician to avoid a payment cap imposed by
the employee’s health insurance company.

Higher benefits might also induce more cases of fraud. For example, Staten
and Umbeck (1986) propose that the practical need for administrators to screen
compensation applicants on the basis of observable characteristics creates the
potential that workers can manipulate the evidence at critical margins. They
found evidence to support such a ‘signaling effect’ among air traffic controllers
who sought compensation for stress-induced impairment. Burton (1992),
however, concludes there is a ‘lack of supporting quantitative evidence’ and a
‘paucity of compelling qualitative analysis’ that significant fraud occurs.

12. Employer Behavior

Moral hazard behavior may explain why analysts have had difficulty finding
a correlation between higher compensation costs and a reduction in accidents
and illnesses. Another explanation is that workers’ compensation does not
create significant incentives for employers to invest in safety and health
improvements. Employers may fail to take safety precautions in response to
higher compensation costs for two reasons. First, workers’ compensation
insurance accurately reflects an employer’s safety experience only for the
largest firms. Second, there may be less expensive ways for employers to
decrease compensation costs than to make safety and health improvements.

Spieler (1994) explains that the price of workers’ compensation insurance
does not reflect, or only partially reflects, the claims experience of most
employers. The sensitivity of premiums to claims experience varies inversely
with the size of the firm. The smallest firms, which constitute the majority of
purchasers of all insurance, pay premiums that have no relationship to their
actual claims experience. Because small firms have so few employees,
insurance companies view their individual claims experience as too random to
have any predictive value. Insurance companies therefore base the cost of
insurance for small employers on the claims experience of a class of similar
employers. Thus, small employers have only a weak economic incentive to take
safety precautions because their actual claims experience will have little effect
on their future premiums.

Larger firms, which pay premiums based in part on claim losses, have a
greater incentive to engage in injury prevention. The extent to which these
firms are rated according to their claims experience depends on the credibility
or predictive value of that experience.

Only the largest employers are self-rated, which means they pay rates that
are based entirely on their claims experience. These firms, and firms that selfinsure,
therefore have the greatest economic incentive to reduce workplace
risks. According to Victor (1982), however, the incentives for prevention are
greater for self-rated firms in hazardous industries than for firms that selfinsure
in the same industries.

Analysts have compared the reduction in injuries at large and small firms
to determine if there is an ‘experience-rating effect’. Some studies have found
that higher compensation costs are associated with a decrease in injuries at
large firms as compared to small firms, but other analysts have been unable to
confirm this result. A study by Worrall and Butler (1988) revealed that reported
injuries declined more at large firms than small ones when compensation costs
increased. By comparison, Ruser (1985, 1991, found that higher benefits led
to higher rates of nonfatal injuries at large and small firms, but that these
effects were smaller for larger firms. Ruser considers this result as evidence that
experience rating does matter, and that it counteracts other incentives for
increased injuries. Another study by Ruser (1993) found an experience rating
impact for injuries, but not for fatalities. Chelius and Smith (1983, 1993) were
unable to verify an experience rating effect.

Employers will not invest in safety or health improvements if there are
lower cost methods to avoid compensation payments. The literature suggests
that employers may have two such options.

First, Spieler (1994) and Ison (1986) specify a number methods by which
employers can discourage employees from filing claims or if claims are filed,
from prevailing. Employers can pressure employees not to file claims, delay the
completion of necessary paperwork, aggressively contest claims, and persuade
employees who file claims to return to work prematurely.

Second, as Spieler (1994) documents, employers have reacted to higher
compensation costs by engaging in political activity to reduce future payments
to workers. In response, states have reduced the level of benefits for some types
of injuries, made other types of injuries noncompensable, limited allowable
medical costs, capped physician fees, adopted administrative changes to make
it easier to discontinue benefits to workers, and reduced lawyers’ fees. At the
same time, however, states have also adopted various types of injury prevention
and safety incentives or requirements. The literature does not indicate whether
the net effect of these two types of actions has been to reduce or increase the
incentive of employers to take safety precautions. The impact may vary from
state to state depending, among other factors, on the relative political strength
of employers and organized labor.

Spieler also hypothesizes that employers may seek to reduce workers’
compensation payments by methods other than safety improvements because
they ‘often perceive themselves as having less influence over the occurrence of
injuries than they in fact have’. More generally, Veljanovski (1982)
demonstrates that compensation systems will not produce optimal results under
conditions when employers, as well as workers, have imperfect and
asymmetrical information.

13. Adequacy of Compensation

Analysts debate whether the cost of workers’ compensation creates an incentive
for employers to reduce workplace accidents and illnesses. Even if it is assumed
that such an incentive exists, spending on accident and illness prevention will
not be optimal unless employers compensate employees for inadequacies in ex
ante compensation. The evidence suggests however, that workers’
compensation does not reimburse workers for the costs of an injury or illness
not covered by wage premiums.

Schroeder and Shapiro (1984), Spieler (1994) and Boden (1995) establish
that the states have established damage caps and other limitations that
significantly restrict workers’ compensation for accidents. In most states, the
level of compensation varies inversely with the seriousness of an injury.
Compensation for temporary disabilities is controlled by statutory prescribed
formulas that limit compensation to less than the direct wage losses of better
paid employees. Compensation for permanent partial disability payments often
does not equal the total wage loss of any employee. Compensation for fatalities
is often less than for temporary and permanent disabilities. Furthermore,
workers’ compensation does not include in damage calculations the loss of
fringe benefits or nonpecuniary losses to workers and their families.

Moreover, employers pay very little compensation for workplace-induced
illness. Statistics cited by Weiler (1986) indicate that states compensate only
250 cancer cases per year as compared to the thousands of cancer fatalities that
may be work related. Government studies cited in Schroeder and Shapiro
(1984) indicate that only 2-3 percent of all workers’ compensation payments
are for occupational disease.

Schroeder and Shapiro and Barth (1984) hypothesize that several factors
explain this low compensation rate. Workers and their physicians often fail to
recognize that many illness are work-related. Moreover, employers are often
successful in contesting those claims which are filed because of the difficulty
of proving causation and because many states have restrictive standards for
recovery. The few disease victims that do prevail face the same statutory
limitations on compensation amounts that apply to injury victims.

Even if more workers were compensated at higher rates, employers may still
lack a strong economic incentive to invest in health precautions. A manager’s
decision to invest in disease prevention is not based on current compensation
expenses, which result from past actions, but on the likelihood that the
investment will prevent future illness. Since occupational diseases are
frequently characterized by long latency periods between exposure and disease
onset, the manager can discount heavily the consequences and spend little or
nothing on prevention. The manager’s decision to discount the costs of future
illnesses may accurately reflect the current costs to the employer of future
illnesses. A manager, however, may be tempted to discount the cost of future
illnesses for another reason: any consequences for the employer will occur long
after the manager has retired. Moreover, managers know that many workers
will change jobs during the long latency period which frees the employer from
paying compensation when the worker becomes ill.

14. Tort Compensation

Few workers can seek additional compensation in a tort suit. Workers’
compensation laws in the United States almost always prohibit an employee
from suing an employer for a tort remedy.

As a result, a worker can seek a tort remedy only if some third party is
responsible for an accident or illness. Viscusi (1989, 1991) reports that product
liability claims for work-related injuries constitute about 13 percent of all
product liability claims. After a detailed analysis of such law suits, he concludes
that both workers’ compensation and tort liability have ‘important’ roles to play
and that further research is necessary to understand the relationships of the two
remedies. Boden and Jones (1987) found that the product liability compensation
in asbestos cases ‘may’ provide substantial incentives for manufacturers to
warn of future hazards, but that workers’ compensation provided ‘extremely’
low incentives for the control of asbestos.

Schroeder and Shapiro (1984) believe few workers are likely to receive tort
compensation for occupational illnesses. They list the array of legal hurdles that
such workers must overcome. Moreover, Wiggins and Ringleb (1992)
demonstrate that bankruptcy can be a viable shield from compensation
payments in cases involving long-term hazards.

15. Workers’ Compensation Reform

The government, as Phillips (1976) discusses, has three options to increase the
financial incentive of employers to make safety and health improvements. First,
it can require employers to pay higher amounts of workers’ compensation.
Second, it can require insurance companies to base rates to a greater extent on
the actual accident experience of employers. Finally, the government can
impose a tax on employers that would reflect the costs associated with
workplace accidents and illnesses. This last option is discussed in the next
section.

An increase in workers’ compensation payments should stimulate greater
investment by employers in safety and health precautions, but an earlier
discussion indicated that employers may not react in this manner. Moreover,
there are significant practical and legal hurdles to adopting this reform in the
United States. An increase in compensation would require action by 50 states
and overcoming the opposition of employers who could expect to pay higher
insurance costs.

Greater reliance on experience rating should encourage employers to
improve workplace safety and health because an employer’s insurance costs
would be more closely tied to the firm’s actual safety and health record. Phillips
(1976) discusses Ontario’s experience with a ‘penalty’ rating system that is
intended to increase experience rating by insurance companies. Spieler (1994)
explains that insurance companies in the United States have fought attempts to
increase experience rating because it increases their costs. Governmental
attempts to impose experience rating will therefore draw the political
opposition of both insurance companies and high injury rate employers. Low
injury rate employers, however, may support such changes.

The previous reforms would improve how workers’ compensation functions
to reduce workplace accidents. Most analysts agree with Lave (1983), however,
that it ‘seems inconceivable’ that workers’ compensation can be reformed to
handle occupational disease. Dewees and Daniels (1988) discuss the difficulties
of designing a system that addresses the constraints, discussed earlier, which
impair disease compensation.

16. Injury and Illness Taxes

Instead of reforming workers’ compensation, many analysts have expressed
interest in imposing injury and illness taxes. Analysts recommending
imposition of an injury tax include Smith (1974, 1976), Nichols and
Zeckhauser (1977), Mendeloff (1980), Rubin (1984), Sider (1984) and Sunstein
(1990). Employers can be expected to oppose vigorously a new tax. This may
explain why so few governments have tried this approach despite its theoretical
attractiveness.

An injury tax would have several advantages. It would create an additional
incentive for employers to reduce workplace accidents and illnesses. Further,
the amount that an employer would pay would be a function of its safety record.
Thus, unlike workers’ compensation, an employer’s incentive to take safety
precautions is not diluted because of the impact of insurance. As explained
earlier, the cost of workers’ compensation insurance for many firms does not
reflect, or does not fully reflect, their safety record. Finally, as compared to
OSHA regulation, a tax is a more efficient method by which to reduce
workplace risks. Under OSHA regulation, all employers must comply with the
level of safety that OSHA specifies regardless of the cost of compliance. Under
a tax approach, an employer would have the option of paying the tax if it was
less expensive that the cost of abatement of a hazard.

Shapiro and McGarity (1991) dispute that a tax would necessarily be more
efficient than regulation. First, they contend that OSHA regulation is not as
inefficient as the agency’s critics believe. They note that OSHA relies on
performance standards, which permit an employer to choose the method of
compliance, and on variances, which give employers with high costs additional
time for compliance. Second, they predict that employers are likely to engage
in the same types of tax avoidance as they now practice concerning other taxes.

A tax approach can also be used for occupational disease, but calculation of
an appropriate tax rate might not be possible. Dewees and Daniels (1988)
caution that the determination of an appropriate exposure charge would be
difficult because it would require information that is not readily available. An
exposure charge based on health effects requires knowledge of a quantifiable
dose-response function, which measures the number of workers likely to
become ill at different levels of exposure. Dose-response estimates, however,
are not available for most chemicals, and the estimates that are available often
vary by several orders of magnitude. Barth (1984) and Viscusi (1984) would
avoid this problem by financing compensation for employees with a broadbased
tax levied on their employers. This approach, however, would not
generate appropriate incentives for illness avoidance, because the tax would not
be based on extent to which individual firms exposed workers to dangerous
chemicals.

D. Regulation

17. Introduction

Labor markets and compensation of injured and ill workers create financial
incentives for employers to take safety and health precautions. Regulation offers
a more direct means to accomplish the same result.

Most of the literature on regulation addresses OSHA regulation in the
United States. OSHA’s mandate is to ‘assure so far as possible every working
man and woman in the Nation safe and healthful working conditions’. The
OSH Act requires employers to comply with safety and health regulations, or
‘standards’, promulgated by OSHA. OSHA is authorized to inspect employers
for potential violations and to assess civil penalties if violations are found.
OSHA may also seek criminal penalties in limited circumstances if an
employee has been killed.

McGarity and Shapiro (1993) and Mendeloff (1980, 1988) generally
summarize and evaluate OSHA’s role in promoting workplace safety and
health. Wilson (1985) and Kelman (1981) compare OSHA regulation to
regulation in Great Britain and Sweden respectively. Lanoie (1992a, 1992b) has
analyzed the impact of occupational safety and health regulation in Canada.

18. Economic Theory

An employer will make safety and health improvements until the cost of these
precautions is more than the cost of paying additional wages, workers’
compensation premiums (if experience rated), and other related costs. If,
however, such financial incentives fail, employers will underinvest in safety
and health improvements. Such incentives can fail for the reasons discussed
earlier, including the inability of workers to obtain full compensation for their
injuries and illnesses from wage premiums and workers’ compensation.
Regulators can address this shortfall by ordering employers to undertake
safety and health precautions improvements up to the point where the costs of
such improvements exceed their benefits. If benefits are measured as the value
of the improvements to workers, administrative regulation will produce about
the same level of investment in safety and health precautions as fully effective
financial incentives. In other words, the government would order the same level
of protection as would be produced if employers fully compensated workers for
their injuries and illnesses.

Although economic theory favors the use of such a cost-benefit approach,
Congress has chosen another standard to control health and safety regulation
in the United States. This standard requires OSHA to seek the level of
protection for workers which is available from the ‘best-available technology’
(BAT). Once OSHA establishes that a workplace hazard is a ‘significant risk’,
it must order an employer to reduce that risk to the extent that is ‘feasible’. A
standard is feasible when it is technologically achievable and when employers
can afford the cost of implementing it. A standard is not economically
infeasible because it is financial burdensome or even because it threatens the
survival of some firms in an industry. As discussed below, many analysts favor
replacing this technology-based approach with a cost-benefit standard.

19. Empirical Evidence

Analysts have attempted to confirm that OSHA’s activities have led to an
improvement in workplace safety. They have isolated OSHA’s impact on
fatality and injury rates in three types of studies. All three efforts have produced
inconsistent results.

Some studies have projected the trend of pre-OSHA injury rates and
compared the projected results with the actual results. Smith (1976) compared
the actual injury rates in several high-hazard industries that OSHA had
targeted for enforcement with projected injury rates. The comparison revealed
that actual rates were not significantly lower than projected rates. Mendeloff
(1980), by comparison, found that the actual rates were significantly lower than
the projected rates for several individual types of injuries in California. His
study, however, found that OSHA had no impact on the aggregate injury rate
for California and the nation. Curington (1986) likewise had mixed results. The
frequency rate for all injuries in manufacturing industries in New York was no
lower than the projected rate for such injuries, but there were reductions in
injuries resulting from being struck by a machine (43.6 percent) and in the
severity of all injuries (13.2 percent).

Other studies have tested the correlation between aggregate industry level
injury rates and OSHA inspection activity. For example, when Viscusi (1992)
tested whether injury rates were affected by the frequency of OSHA inspections
and penalties, he found that OSHA caused a 1.5-3.6 percent decrease in the lost
workday rate. The ‘lost workday rate’ measures the number of days of work
that an employee misses after an injury. Viscusi indicates that earlier studies
by himself and others found no measurable correlation between the number of
OSHA inspections and injury rates.

Finally, some studies have sought a correlation between individual plant
level injury data and an employer’s inspection experience. Gray and Scholz
5540 Occupational Safety and Health Regulation 613
(1993) found that an inspection imposing a penalty reduced injuries by 22
percent and lost workdays by 20 percent in the following three years. Using the
same methodology, Cooke and Gautschi (1981), Robertson and Keeve (1983),
and Scholz and Gray (1990) found similar impacts, but Smith (1979),
McCaffrey (1983), and Ruser and Smith (1991) found no association using a
different testing technique.

Other analysts have measured the relationship between OSHA inspection
activity and compliance with OSHA safety regulations. Gray and Jones (1991a),
for example, found a significant relationship between OSHA enforcement and
compliance at individual plants. Bartel and Thomas (1985) also found that
OSHA enforcement significantly increased compliance (by a total of 26 percent
relative to no enforcement), but they found only a weak link between
compliance and injury rates.

Only a few analysts have attempted to confirm that OSHA’s activities have
led to an improvement in workplace health. Gray and Jones (1991b) found that
OSHA inspections reduced the exposure of workers to hazardous substances
and increased compliance with health regulations.

20. Evaluation of Empirical Evidence

Bartel and Thomas (1985) explain there are two conflicting explanations for
the lack of empirical evidence that OSHA activity results in fewer workplace
accidents and injuries.

The ‘inefficacy’ explanation proposes that administrative regulation is
unable to address many of the causes of workplace accidents. The
‘noncompliance’ explanation proposes that the OSHA lacks the resources to
undertake effective enforcement. In addition, Mendeloff (1988) offers a theory
for the lack of effective regulation of health risks, which is considered in the
next section.

The ‘inefficacy’ theory posits that administrative regulation does not
increase workplace safety because there is a tenuous link between regulation
and the causes of accidents. Administrative regulation focusses on making
workplace equipment safer to use. Analysts argue, however, that the cause of
most accidents is a complex interaction of labor, equipment and workplace
environment. In light of this mismatch, Barcow (1980) predicts that OSHA
may be incapable of preventing more than 25 percent of all workplace
accidents. Moreover, Rea (1981) hypothesizes that moral hazard may reduce
the level of safety because workers will attempt to substitute wages for safer
jobs.

Bartel and Thomas (1985) ask why Congress has failed to reform, or even
eliminate, OSHA in light of its apparent inefficacy. They observe that OSHA
regulations may give large firms a competitive advantage over their smaller
rivals because the smaller firms are less able to afford expensive regulations.
They hypothesize that larger firms support OSHA because the gains from this
competitive advantage exceeds the costs of complying with OSHA regulations.
Bartel and Thomas (1987) offer empirical evidence that larger firms have such
a competitive advantage concerning OSHA regulations. Fuess and Loewenstein
(1990) have similar evidence for coal mine regulation. Their study finds the
imposition of expensive engineering controls shifted production to large mines
by driving smaller, less safe mines out of business. Hughes, Magat and Ricks
(1986), however, were unable to establish that OSHA’s cotton dust standards
permitted large firms to gain in profitability at the expense of smaller
producers.

Similarly, Miller (1984) asks whether organized labor is rational in support
of OSHA. He offers some empirical support for the proposition that engineering
controls may increase the demand for labor.

The ‘noncompliance theory’ proposes that OSHA lacks the statutory and
budgetary authority to enforce its standards effectively. McGarity and Shapiro
(1996) point out that OSHA inspections have had a greater impact on the injury
rates of inspected firms than on aggregate injury rates. They also point out that
the industries with the most significant decline in injuries and fatalities are the
industries with the highest levels of enforcement. They attribute OSHA’s
limited impact on aggregate injury rates to the fact that the agency’s limited
resources do not permit it to inspect the vast majority of employers that it
regulates.

21. Overregulation Causes Underregulation

The previous theories address OSHA’s impact on workplace accidents.
Mendeloff (1988) attempts to explain OSHA’s limited impact on occupational
disease. He identifies OSHA’s mandate as the cause because it requires the
strict regulation of toxic substances. The problem is that such ‘overregulation’
causes ‘underregulation’. Overregulation occurs when the costs of a regulation
exceed its benefits. Underregulation occurs when the costs of additional
regulation are less than the benefits. Mendeloff argues that strict regulation of
toxic substances causes less protection of workers than the promulgation of
more lenient regulations.

Strict regulation protects workers less then more lenient regulations because
of how employers react to each type of regulation. OSHA has been able to
promulgate very few health regulations because employers vigorously resist
overregulation. As a result, OSHA spends inordinate time and resources
defending strict standards. Mendeloff proposes that OSHA could successfully
promulgate more standards if it balanced costs and benefits. OSHA would be
more successful because industry would be less likely to challenge more lenient
regulations in court, and, if such regulations were challenged, OSHA would be
more likely to prevail. In this manner, workers ultimately would receive more
protection from a more lenient approach. Although each OSHA regulation
would be less protective of workers, the sum total of protection for workers
would be greater because the agency could promulgate more standards overall.

McGarity and Shapiro (1993) and Shapiro and McGarity (1991) object that
employers will oppose even lenient regulations. They offer evidence that
employers gain financial benefits from delaying even modest health and safety
regulations. If the problem is employer intransigence, McGarity and Shapiro
propose that Congress changes OSHA’s statutory mandate to make it easier for
OSHA to prevail when it is sued. McGarity and Shapiro (1993) and Shapiro
and McGarity (1989) also propose rulemaking reforms that OSHA can
undertake to speed up rulemaking and make it more rational. These include
improving how OSHA sets its regulatory priorities and focussing on types of
regulations that yield the greatest protection for workers.

22. Reform of OSHA’s Regulatory Standard

Mendeloff proposes that OSHA should balance costs and benefits in health
regulation because employers would be less likely to challenge more lenient
regulation in court. Other analysts favor adoption of a cost-benefit standard for
OSHA safety and health regulation because this approach is more consistent
with economic theory. Economic theory favors a cost-benefit approach for
regulation because it equates the marginal benefits of safety and health
improvements with the marginal cost of such precautions. Besides Mendeloff,
supporters of a cost-benefit approach include Viscusi (1983, 1992) and Sunstein
(1990, 1996). More generally, Litan and Nordhaus (1986) propose that
Congress establish a regulatory budget for OSHA and similar agencies which
would establish caps for the regulatory costs that the agency could impose.

Arguments that OSHA should be subject to a cost-benefit approach follow
the arguments made in general for using cost-benefit analysis to specify the
extent of safety, health and other social regulation. Sunstein (1990, 1996) and
Breyer (1993) contain a useful statement of the general arguments.

The primary benefit of the cost-benefit analysis is that it addresses safety
and health risks in light of the fact that society will always have limited
resources to spend on safety and health. Cost-benefit balancing promotes
rationality by helping to ensure that those resources are spent in the most
efficient manner possible. By comparison, critics find that OSHA regulations
often impose costs that exceed benefits sometimes by hundreds of millions of
dollars. For example, Morrall (1979) objects to OSHA’s noise regulation
because it mandated the use of expensive engineering controls rather than
much less expensive personal protection equipment such as ear plugs. Analysts
have made similar criticisms of other workplace safety regulation. French
 (1988), for example, suggests that railroad safety regulation in the United
States is inefficient because excessive burdens are imposed on firms.

A second benefit of the cost-benefit approach is that it makes agencies more
accountable to the public. Safety and health regulation will inevitably require
tradeoffs among regulatory goals because of society’s limited resources.
Without a cost-benefit approach, the public has difficulty learning about such
tradeoffs. By comparison, a cost-benefit approach requires agencies to make
these tradeoffs more explicit.

A third advantage is that the cost-benefit approach responds to the problem
of regulatory ‘perversity’. Critics of regulation, such as Sunstein (1997), warn
that an attempt to reduce one safety or health risk can increase other safety or
health risks. This would occur, for example, when the regulation of one
chemical leads manufacturers to use more dangerous substitutes. More
generally, Sunstein cites to an incipient literature that considers whether costly
regulation increases risks because such regulations reduce wealth. This
possibility is suggested by the fact that persons who are unemployed or poor
tend to be more unhealthy and to live shorter lives. Cost-benefit analysis
addresses this problem by requiring agencies to examine the ‘substitution risks’
that might result from a proposed regulatory action.

23. Support of OSHA’s Standard

McGarity and Shapiro (1993, 1996) and Shapiro and McGarity (1991) defend
the current technology-based approach to regulation. Their arguments,
summarized below, follow the arguments made in general by Cranor (1993),
McGarity (1991), Sagoff (1988) and others against using cost-benefit analysis
to specify the extent of safety, health, environmental, and other social
regulation.

One criticism is that cost-benefit analysis is too unreliable to constitute an
effective method to implement regulations. Critics point out that current risk
assessment techniques do not have the power to permit precise calculations of
the number of lives saved or injuries avoided, and that methods used to reduce
these benefits to dollars amounts are highly contestable. As a result, the costbenefit
approach ordinarily raises difficult methodological issues that are
exceedingly expensive and time-consuming for agencies to resolve and defend
in court. In comparison, a technology-based approach more simply sets
industry-wide limitations on the basis of the level of precaution that the best
performers in the industry are capable of achieving.

Supporters of a technology-based approach also deny that it leads to the type
of regulatory excesses identified by the supporters of the cost-benefit approach.
As just noted, estimates of costs and benefits are highly imprecise. In light of
this imprecision, critics of a cost-benefit approach are skeptical regarding
claims that the cost of OSHA regulation greatly exceeds the benefits.

A second criticism is that the cost-benefit approach is at its core
‘incoherent’ because it cannot yield a single numerical value. According to this
argument, the general tendency of individuals to buy and sell goods for roughly
the same price (the market price) does not apply when credible risks to health
and safety are being traded. Instead, individuals are normally willing to sell the
right to be free from increased mortality risks for considerable more money
than they are willing to pay to reduce such risks. The reason is that most
persons can demand more in a bargain in which they are asked to sacrifice
something of great value, to which they have a right, than they can afford to
pay for that same thing, if someone else has the right to take it from them.
Thus, use of a ‘willingness to sell’ measure of the benefits of a safety or health
regulation yields a different, and higher, value than use of a ‘willingness to
buy’ measure of such benefits.

Despite this incoherence, regulators must rely on a ‘willingness to buy’
measurement because it is the only one for which there are data. Estimates of
wage premiums indicate how much workers are willing to pay for a safer
workplace. When workers seek safer jobs, they will forfeit the wage premiums
paid for riskier work.

Critics also argue that reliance on a ‘willingness to buy’ measurement of the
value of human life is ethically objectionable. This argument contends that poor
people are not likely to sell the right to be safe for any less than a rich person
would. By comparison, a person’s wealth will affect the amount that he or she
can pay to purchase the right to be safe.

A fourth criticism is that discounting future benefits to present value biases
the cost-benefit approach against the prevention of occupational disease.
Although employers must immediate pay for prevention, the benefits of such
actions will not show up for years. The latency period for occupational disease
is usually 20 or 30 years. As a result, the benefits of a regulation that would
prevent such losses can be outweighed by even modest present costs.
Supporters of a cost-benefit standard defend the use of a discount rate. They
argue that if workers had the opportunity to spend money on prevention today,
which would result in lower wages, in return for a lower probability of cancer
30 years later, the workers themselves could likely discount the future costs of
the disease. In other words, individuals put different values on dying 30 years
from now and dying today. Defenders also dispute that the use of discounting
results in a lack of appropriate regulation. They assert that an investment in
abatement should earn a sufficiently large return over 30 years to justify the
protection of workers. When this is not true, evaluators should verify that they
are using an appropriate discount rate.

Finally, critics charge that use of a cost-benefit standard as the primary
decision criterion effectively elevates economic efficiency to a ‘meta-value’ that
trumps all other conflicting values. OSHA’s mandate, which reflects both
economic and noneconomic considerations, rejects the idea that the
maximization of material wealth is the only goal of a good society. Instead, it
seeks to balance ‘efficiency’, ‘fairness’, and other important social values.

24. Reform of Enforcement

An earlier discussion explained that empirical studies suggest OSHA inspection
activity has not lead to a reduction in aggregate injury rates. One explanation
is that many causes of workplace accidents cannot be addressed by safety
regulations. Another explanation is that OSHA has insufficient resources to
expand its successful enforcement efforts at some plants to most employers. The
literature on enforcement focusses on how OSHA can promote greater
compliance in light of its limited resources.

Viscusi (1986a, 1986b) analyzes this issue in terms of an employer’s
economic incentives to comply with OSHA regulations. Employers will comply
when it cost less to make safety improvements than to risk an adverse OSHA
inspection. The risk to an employer of an inspection is a function of the
likelihood that the firm will be inspected and the penalties that the firm will
suffer if violations are detected. These penalties include OSHA fines as well as
any adverse effect on the employer’s reputation. If the employer’s reputation is
adversely affected, there may be worker turnover, increased demands for wage
premiums, or other adverse consequences.

In light of these incentives, Viscusi proposes that OSHA can improve
compliance by increasing the likelihood that the most dangerous workplaces are
inspected and that large fines are assessed for serious violations. McGarity and
Shapiro (1993) support these recommendations and amplify how they might be
implemented.

OSHA can increase the likelihood that it will find the most dangerous work
conditions by focussing its inspection activity on the most dangerous employers
and its individual inspections on identifying the most serious violations.
Analysts, such as Bardach and Kagan (1982) and Howard (1994), have
criticized OSHA for zealously enforcing detailed rules in circumstances where
enforcement is counterproductive, unfair, or even nonsensical. OSHA, however,
has a potential problem in using injury records to target inspections. Ruser and
Smith (1988) show that using injury records to target inspections creates an
incentive for employers to underreport injuries in high-hazard industries. If
OSHA uses such records for purposes of targeting, it must audit employers to
reduce underreporting.

Fry and Lee (1989) propose that the ‘real teeth’ of OSHA citations may be
the impact on the stock market value of a firm. They found that the
announcement of fines produce an immediate and pronounced decline in the
value of the firm subject to the penalties. They hypothesize the decline may
reflect the additional costs a firm can expect such as the need to make safety
improvements.

Regulators might also enhance compliance with regulations by mandating
that employers establish joint employer-employee health and safety committees
to monitor workplace conditions. Such committees may improve safety by
focussing the attention of employers and employees on workplace hazards, and
by providing a forum for the exchange of information. These committees might
be especially effective in the absence of a union to give workers a voice
concerning safety issues. Spieler (1994) documents that a number of states have
instituted such a requirement. Rea (1983) discusses Canadian laws which
require such committees. He notes that because joint safety committees were
already in existence in larger unionized establishments, the main impact of the
legislation is to extend the practice to small firms and nonunionized work
places. Walters and Haines (1988) found, however, that workers in Ontario had
only weak links with their health and safety representatives, and few workers
made use of this resource.

E. Conclusions

25. Market, Compensation and Regulatory Alternatives

An employer will invest in safety and health precautions until the cost is more
than the expense of paying higher wages, workers’ compensation, and other
accident and illness costs. Employees receive additional protection because
governments have chosen to augment these financial incentives with
regulation. Economic theory would have governments order the same level of
protection as would be produced if employers fully compensated workers for
their injuries and illnesses and paid any additional accident and illness costs.
In the United States, however, Congress has established a technology-based
goal for OSHA, which requires the agency to seek the highest level of
protection which is technologically feasible.

Analysts have studied the impact of compensatory wages, workers’
compensation, and regulation on safety and health. These studies indicate that
all three approaches promote investments in safety and health protection, but
the extent of such improvement is difficult to verify and may be limited in
numerous situations. There are various explanations for this lack of efficacy,
some of which conflict, but all of which suggest that labor markets,
compensation and regulation are impeded by significant constraints.
Various reforms have been proposed to address these constraints, but the
literature has not reached a consensus concerning some key proposals. In
particular, there is a considerable debate concerning whether OSHA should be
subject to a cost-benefit test. There is also a question of political viability
concerning some reforms. In the United States, for example, reform of workers’
compensation requires action by all 50 states.

This analysis confirms that labor markets, compensation, and regulation are
highly imperfect alternatives concerning the reduction of occupational
accidents and illnesses. It also suggests that it is necessary to rely on all three
approaches. Each approach alone, even if reformed, is unlikely to produce an
appropriate level of occupational safety and health. The combination of the
three, by comparison, is more likely to move countries closer to this elusive
goal.

 


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