In mid-November 2009, the Government Accountability Office (GAO)1 released a report documenting the failure of current surveillance systems to capture the extent of work-related injury and illness in the United States. Independent assessments of the national surveillance system demonstrate that up to 80% of worker illness and injury are missed. The GAO documented that more than two-thirds of occupational health physicians report that workers fear disciplinary action for disclosing an injury or illness. More than a third of these physicians reportedly had been asked by company officials or workers to provide care that would not trigger an incident report even when it was “not sufficient to properly treat” the condition.1
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