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Injuries, Illnesses, and Fatalities
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Scope of the Census of Fatal Occupational Injuries (CFOI)

The Census of Fatal Occupational Injuries (CFOI) is the most complete count of fatal work injuries in the United States. A workplace fatality must meet the following criteria to be included in CFOI:

  1. It must have resulted from a traumatic injury
  2. The incident that led to the death must have occurred in the United States, its territories, or its territorial waters or airspace
  3. It must be related to work

CFOI cases often have very unique circumstances. It is important to note that this document provides an overall guide for determining whether a fatality is included in CFOI. The unique circumstances of a particular case might necessitate it being coded counter to the general guidance provided herein. Please submit any questions via this page.

Criteria

1. It must have resulted from a traumatic injury

A traumatic injury is defined as any wound or damage to the body resulting from acute exposure to energy, such as heat or electricity; impact from a crash or fall; or from the absence of such essentials as heat or oxygen, caused by a specific event or incident within a single workday or shift. Included are open wounds, intracranial and internal injuries, heatstroke, hypothermia, asphyxiation, acute poisonings resulting from short-term exposures limited to the worker's shift, suicides and homicides, and work injuries listed as underlying or contributory causes of death. Heart attacks and strokes are considered illnesses and therefore excluded from CFOI unless a traumatic injury contributed to the death.

A case is included in CFOI if the injury or injuries incurred during the incident contribute in any way to the death. The injury or injuries need not be the sole, or even the primary, cause of death. So long as a traumatic injury played some role in the death, it would be included in CFOI provided the other criteria are met.

CFOI does not include data on fatal occupational illnesses. The long latency period for many fatal occupational illnesses makes it very difficult to compile a complete roster of these cases. It is also difficult to definitively link some cases to a workplace exposure — for example, a coal miner who worked 30 years in a coal mine and smoked two packs of cigarettes a day who dies of lung cancer.

CFOI examines all illness cases marked "At work" on the death certificate and those illnesses included in reports from the Occupational Safety and Health Administration (OSHA) to determine if there is an injury component. CFOI also closely reviews illnesses where heat might have played a role in the death to determine if these cases should be considered heat exposure injuries.

2. The incident that led to the death must have occurred in the United States, its territories, or its territorial waters or airspace.

Only cases where the incident occurred in the United States, its territories, or its territorial waters or airspace are included in CFOI. Note that data from territories like Puerto Rico, the U.S. Virgin Islands, and Guam are not included in the national CFOI counts but are available individually.

3. It must be related to work

In CFOI, a work relationship exists if an event or exposure results in the fatal injury or illness of a person:

  • ON the employer's premises and the person was there to work; or
  • OFF the employer's premises and the person was there to work, or the event or exposure was related to the person's work or status as an employee.

The employer's premises include buildings, grounds, parking lots, and other facilities and property used in the conduct of business. Work is defined as duties, activities, or tasks that produce a product or result; that are done in exchange for money, goods, services, profit, or benefit; and, that are legal activities in the United States.

Most cases are straight-forward, but some will fall into a gray area where there is insufficient information to definitively include or exclude from CFOI. Here is some additional information on specific aspects of how a work relationship is determined.

Type of worker

Volunteer

CFOI includes volunteer workers. Volunteer workers face the same hazards as their wage and salary or self-employed counterparts. If a worker is volunteering in a formal capacity at a planned event (e.g., a dentist volunteering her services at a regional health clinic) or for an established organization, that worker would be included in CFOI. For ad hoc volunteer opportunities (e.g., a neighbor helping another neighbor), a volunteer worker generally has to be using some specialized skill from his or her own job or experiences to be included in CFOI.

Good Samaritans

Some situations find a person acting in a "Good Samaritan" capacity. These would include someone stopping and assisting a motorist in distress, a person intervening in a violent situation, and an onlooker who goes into a burning building looking for people to rescue.

If the decedent was using skills unique to his or her job while acting as a Good Samaritan, the case would be included in CFOI. If not, the worker is likely not included in CFOI.

Undocumented workers

Fatal injuries to undocumented workers are included in CFOI provided they meet the other work-relationship criteria. In addition, the immigration status of workers has no bearing on inclusion in CFOI.

Former worker returning to the worksite

Former workers sometimes will return to their place of work. Given the circumstances, that former worker may be included in CFOI.

If the decedent committed suicide at his or her former place of employment, he/she is included in CFOI since the site of the incident is taken to mean that the suicide had some relationship to work. If the decedent was back on site for a work-related function when the fatal incident occurred, that would also be included in CFOI. If the decedent was back on site for a nonwork-related function when the fatal incident occurred, that would not be included in CFOI.

Off-duty police

Homicides occurring to off-duty police officers are generally included in CFOI provided there is some work-related component to the homicide. Other fatal injuries to off-duty police are included in CFOI if they are performing a police-related function, such as directing traffic at the scene of an accident or intervening in a public safety situation in their capacity as a police officer.

Inmates and institutionalized persons

Inmates are included in CFOI if the work that they are performing takes place outside the premises of the establishment in which they are incarcerated/institutionalized. Fatal injuries in the establishment where they are incarcerated/institutionalized are not included in CFOI. Institutionalized persons include those in mental institutions, sanitariums, and homes for the aged, infirm and needy.

Flight students

Flight instructors are included in CFOI when they are flying with a student and providing training. Students taking lessons for a private pilot license or for other personal reasons are not included in CFOI. Students taking lessons to retain or gain a certification needed to continue performing work-related flight activities are included in CFOI.

Participants in sporting events

Many sporting events feature amateur participants or those acting in a volunteer or amateur capacity. If the decedent was participating in an event where tickets were sold or a monetary prize was available, he/she is generally included in CFOI. Injuries to student athletes are generally not included in CFOI — even if compensated by the school through use of athletic scholarships. Olympic athletes are included in CFOI if they are competing or training in an official capacity.

Travel status

Commuting

Fatal occupational injuries that occur during a normal commute are not included in CFOI. Fatal injuries occurring in the employer's parking lot while arriving for or leaving from work are included in CFOI - including motor vehicle incidents. Normal commute includes both geographic and temporal criteria.

A worker is considered to be in a normal commute status if he/she is making a trip from his/her home or regular workplace to his/her regular workplace or home during his/her normal commute time. A worker is exempt from normal commute status if the following conditions are present:

  • If the decedent was undertaking travel for work that falls outside the geographic or temporal routine. See the Travel section.
  • If the worker's job location was variable because of the itinerant nature of their work and required the decedent to report to different locations on a regular basis.
    • Examples include: construction job sites, home health aides, services to homes (maintenance, installation, etc.).
  • If the decedent relied on employer-provided transportation to get to their job location.

Travel

Decedents who were killed while traveling within the United States and territories for work are generally included in CFOI so long as they are traveling or working offsite at the time. Any aspect of travel (including getting to and from the site and staying at the site) that is a necessity for discharging work duties is considered sufficient to be included in CFOI. Decedents who were engaged in purely personal activities, commit suicide, or overdose when on travel are not included in CFOI.

Crossing the street

Workers are considered to be on the worksite when they are physically on the premises of their employer — the building, the parking lot, or any other property overseen by the employer. Public streets surrounding the premises are generally not considered part of the employer's premises.

Workers killed while crossing public streets on their way into work (or leaving work) are generally considered to be commuting, and therefore, not included in CFOI. However, if crossing a street is the only means of entrance to the property and the decedent was crossing the street from employer-provided parking, the decedent is included in CFOI. If the worker is killed while crossing the street as part of a work-related errand or task then the worker would be considered at work and, therefore, included in CFOI.

Type of incident

Homicides

Homicides are included in CFOI so long as it meets the work relationship criteria above.

Suicides

Suicides are included in CFOI if:

  • the suicide occurred on the work premises
  • the suicide occurred off the work premises but can be definitively linked back to work

An example of a definitive link to work would be a suicide note that mentions that work was a factor in the suicide. Suicides are usually considered to be multicausal, meaning that a number of factors (e.g., health, personal life, professional life, etc.) factor into suicide. For this reason, suicides that occur off the work premises need to be conclusively linked to work to be included in CFOI.

More on suicides can be found on Pages 277 and 278 of the Occupational Injury and Illness Classification System (OIICS) manual here.

Suicides after a homicide

In some cases, an assailant in a workplace homicide will kill himself/herself at the scene or shortly thereafter. If the assailant had an existing or prior work relationship with the establishment or with those he/she killed, then the assailant may also be included in CFOI.

If the assailant had no prior work connection to those that he/she killed or to the worksite, a subsequent suicide by this person would not be included in CFOI. If the assailant did have a prior work connection to those he/she killed, a subsequent suicide by this person would generally be included in CFOI if the suicide occurred within a reasonable time after the homicide.

Drug overdose after an injury at work

Deaths at work that result from drug overdoses are included in CFOI regardless of when the drugs were taken, whether the drugs were medicinal or illicit, and what the reason was for taking the drugs. In other cases, an injury at work will require the injured worker to use medication to alleviate the pain from the injury. Workers will sometimes die after a reaction to or overdose of these medications.

Inclusion generally stems from two factors — how long ago was the initial injury and how closely was the medication related to treating the injury. The final determination in these cases will depend on these two factors and the other case specifics.

For the first factor, the closer to the initial injury, the more likely it will be included. An overdose of drugs 5 years after the injury will be less likely to be included than one that occurs 5 days after the injury. Drug intake 5 days after an injury is expected, while drug intake 5 years after the injury is more difficult to link back to the underlying injury.

For the second factor, the drug must be one that is generally used to treat an injury. Cocaine or alcohol, for example, would not be prescribed drugs to treat an injury.

Overexertion

Cases of overexertion are generally not included in CFOI. Overexertion is not considered a traumatic injury because the death cannot be linked back to an acute exposure.

Complications

Some deaths are the result of complications or sequelae from the original work-related injury. These complications include embolisms, allergic reactions, surgical complications, and the onset of illnesses like pneumonia. If the complication can be definitively linked back to the original work-related injury, the case would be included in CFOI.

Type of worker activity

Illegal Activity vs. Unlicensed Activity

Illegal activities are things like drug dealing, gambling (where not permitted by law), prostitution, and loan sharking. Unlicensed activities are things like an unlicensed electrician working on a residential construction site or a jitney cab driver plying his trade without certification from the taxi/livery commission.

Workers performing illegal activities are excluded from CFOI. Unlicensed workers are generally included in CFOI if performing legal work.

Nonwork activities at work/Horseplay/Breaks/Recreational activities

Oftentimes, a worker will engage in an activity at work that is not related to his/her job-related duties. Cases like this rely upon reading the unique circumstances of the case.

In general, deaths resulting from injuries that occur on the premises or while at work are included in CFOI. The activity performed does not have to be directly related to the person's job.

Killed outside of work but motivated by work

Some cases involve a decedent who was killed outside work due to work-related factors. Many of these cases involve homicides where the assailant is a co-worker or work associate. If the incident can be definitively linked back to work, it would be included in CFOI.

Ceremonial duty

In some cases, workers might be called upon to act in a formal work capacity at a ceremony of some sort. These include, but are not limited to, award presentations, funerals, parades, and dedications. If the worker is representing his or her firm in a formal capacity in one of these ceremonial duties, that worker should be included in CFOI.

Maintaining a work vehicle/equipment at home

Some workers will maintain a work vehicle or work equipment at their home. This could include repairing a work truck in their driveway or cleaning a piece of work equipment in their personal workshop.

If the work is being done on a vehicle or piece of equipment that is primarily for work use, it would be included in CFOI. If the vehicle or piece of equipment has both work- and nonwork-related uses, refer to the general determinations section.

Swimming and diving

Swimming and diving are usually recreational activities (unless the worker is a diver or someone who works in the water) and excluded from CFOI. There are some cases, however, where swimming and diving might be considered to be part of the job.

If the decedent was swimming purely for recreational purposes, either on his/her own time, during lunch, or during a break, this is not included in CFOI. If the decedent was swimming to cool down from his/her work duties and subsequently drowned, that would be included CFOI.

Eating at work

If the decedent consumed the food while in work status or while onsite (at, say, the building cafeteria), the decedent would be included in CFOI. If the decedent consumed the food offsite and not as part of an official work function (for example, a retirement party or office holiday party), the decedent is not included in CFOI. Lunch with a coworker where work is discussed is not considered to be an official work function.

On call

If a worker was on call meaning that he/she was in his/her normal work shift or on call period and was available for work if required, the decedent would be included in CFOI if the incident had some connection to work. Certain types of workers, like fire fighters, could always be considered to be on call. For these workers, it is especially important to review the incident itself to see if there was a connection to work at the time.

Killed in a secondary incident

There will occasionally be cases where a worker incurs an injury while on the job and is subsequently killed in a related but completely different incident than the incident that produced the injury. If the secondary incident can be conclusively linked to the initial work-related injury, it will be included in CFOI.

Location of incident

Employer-provided housing

Some employers provide housing for their workers. There are a few different types of this kind of housing. Employer-suggested or employer-subsidized housing is housing that the employer suggests or subsidizes (in part) but does not require or wholly provide. Employer-provided housing is housing that is provided entirely by the employer. Employer-required housing is housing that the employee is required to utilize as a condition or necessity of the work.

Incidents at employer-suggested and employer-subsidized housing are not included in CFOI unless there is another factor that ties the decedent to a work relationship. Incidents at employer-provided and employer-required housing are included in CFOI regardless of whether there is another work-related factor provided that they do not fall into another excluded category.

Home office

Workers who are killed while in their home offices generally have to be undertaking a task related to their job when the fatal incident occurs. Since those who work from home will spend a good amount of time at home while not in work status, there must be a definitive link to work for the worker to be included in CFOI.

Farms, farm houses, and hobby farms

Farmers are unique among workers in that they often reside at their place of employment. As such, it is often difficult to determine when a farmer is functioning in a work capacity and when he/she is functioning in a homeowner capacity.

If a farmer was in his/her fields or in a farm building (e.g., barn, silo, or coop) when fatally injured, the farmer is generally included in CFOI. If the farmer was in his/her farmhouse at the time or tending to his/her residential property, the farmer is generally not included in CFOI. If the worker's farm was purely for recreational use (i.e., a hobby farm), work on that farm is not included in CFOI.

Starts on premises, ends off premises

Some fatal events start on the work premises but culminate offsite. If the sequence of events that precipitates a fatal work injury begins on premises and is unbroken, these cases are generally included in CFOI. If there was a break in the sequence of events, these cases are generally not included in CFOI.

Last Modified Date: December 22, 2016