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At the beginning of this century, workers in the United States faced remarkably high health and safety risks on the job. Through efforts by individual workers, unions, employers, government agencies, scientists such as Dr. Alice Hamilton and others, considerable progress has been made in improving these conditions. Despite these successes, much work remains, with the goal for all workers being a productive and safe working life and a retirement free from long-term consequences of occupational disease and injury.

The decline in occupational fatalities in mining and other industries reflects the progress made in all workplaces since the beginning of the century in identifying and correcting the etiologic factors that contribute to occupational health risks. If today's workforce of approximately 130 million had the same risk as workers in 1933 for dying from injuries, then an additional 40,000 workers would have died in 1997 from preventable events (CDC, unpublished data, 1999). The declines can be attributed to multiple, interrelated factors, including efforts by labor and management to improve worker safety and by academic researchers. Other efforts to improve safety were developed by state labor and health authorities and through the research, education, and regulatory activities undertaken by government agencies (e.g., the Occupational Safety and Health Administration [OSHA] , and NIOSH). Efforts by these groups led to physical changes in the workplace, such as improved ventilation and dust suppression in mines; safer equipment; development and introduction of safer work practices; and improved training of health and safety professionals and of workers.

MMWR June 11, 1999 / 48(22);461-469