Compliance bias is the belief that U.S. government mandates such as OSHA regulations are sufficient for most organizations to achieve injury and illness prevention objectives. This bias is outdated and dead wrong. Test your bias by answering the following question:  What portion of the 2.34 million annual occupational deaths is attributed to disease?

If you answered anything less than two million your bias shows. The leading cause for workplace deaths, at about 32 percent, is cancer, followed by circulatory diseases at 23 percent. Deaths from injury are about 19 percent. per the ILO.1

Bias is preserved through denial. The denial argument in the U.S. goes something like this. “Oh. you must be talking about occupational disease deaths in Third World economies.” No. we’re talking about occupational disease deaths that may occur the U.S. 

Country comparison

A 2014 study compared how compliance bias performs against risk-based decisions.2 True or false: Compared with the United Kingdom (risk-based approach) the U.S. (compliance bias) has ten times more occupational fatalities from exposure to — or contact with — a harmful substance? True.  Compared with the UK, the U.S. has three times as many occupational fatalities in the following categories: contact with moving machinery; struck by moving. flying/falling object; struck by moving vehicle; slips, trips or falls on the same level; falls from heights over six feet; exposure to fire; exposure to an explosion; and contact with electricity or electrical discharge. Other leading economies that favor risk-based decisions such as France, Sweden, Germany, Italy, and Spain all have lower occupational fatality rates than the U.S.  


About 27 percent of women will fall while pregnant – about the same rate as a 70-year-old person.3 Falls, for both pregnant and old, are estimated to cause 17-39 percent of trauma associated with emergency department and hospital admissions. There’s a record number and growing convergence of these demographics now in the U.S. workplace. Compliance bias won’t solve injury/illness riddles for these demographics.


Donald Trump was 70-years-old when elected president.  His daughter, Ivanka, gave birth in April, 2016 while running her business and campaigning for her father. They’re both an example of the growing workplace demographics mentioned above. How will president Trump and millennials influence workplace safety and health? One example: Ivanka influenced her dad to break from traditional Republican values and he pledged to create federal paid maternity leave – a first ever for the U.S.  Ivanka was influenced by polls that show over 90 percent of what voters’ value.4 Maternity leave. However, is a safety and health necessity, not a luxury (see this column April, 2016). 

Rise of city/state laws

Trump pledged to squeeze the growth of federal laws and reduce the federal workforce. Does president Trump want to abolish the EPA? Regardless, squeeze a balloon in one area and it will expand in another area – look for rise of city/state laws (driven by public perception) that impact occupational safety and health.

Big data

When the future comes more in focus, so does risk assessment. This column’s May, 2014 article gave a glimpse of rise of city/state laws. Two years later, the issues and conclusions briefly raised in the article were developed by someone else into a scholarly legal analysis with over 200 footnotes and citations.5 Big data grows this way. And big data can be mined so easily today. Employees that work with largely unregulated metal-working fluids (MWF) are probably mining MWF health studies now and compliance bias won’t satisfy them.

Key change

A key change with the forthcoming ISO 45001 Occupational Health and Safety Management Systems voluntary standard is Organizational Context (Clause 4). Context issues include internal/external issues that can result in risks/opportunities; cultural, political, economic, legal, and market competition; and relationships, perceptions and values of internal and external parties – among others. Needs and expectations from interested parties only become obligatory requirements for an organization if the organization chooses to adopt them.6 There’s a concern that new adopters to ISO 45001 who hold a compliance bias may tend to opt out of this important clause. If you have organizational influence, campaign strongly to adopt Clause 4.

Time changes everything

In February, 2002, I was quoted in front-page article in the USA Today saying, in part, “No one pays attention to what the risks are.”7 The quote was based on my understanding of U.S. compliance bias coupled with an awareness that European countries developed a risk-based strategy to address health and safety needs for pregnant workers in 1992.8 Only decades later are significant change in the U.S. being felt in this area. 

This tale should serve as a cautionary reminder that time may move slowly but time eventually changes everything. It’s time to overcome the U.S. compliance bias and move to risk-based decisions with strategy outlined in ISO 45001.


1.  See “The Prevention of Occupational Diseases,” International Labor Organization. 2013.—-ed_protect/—-protrav/—-safework/documents/publication/wcms_208226.pdf

2. See “Occupational Fatality Risks in the United States and the United Kingdom,” American Journal of Industrial Medicine. 2014.

3.  See “Major Public Health Issue: The High Incidence of Falls During Pregnancy,” Matern Child Health J. 2010.

4. See “Women’s economic agenda,” Democracy Corps. 2013.

5. See “Towards Reasonable: The Rise of State Pregnancy Accommodation Laws,” Michigan Journal of Gender and Law. 2016.

6.  See NSF 45001 Information Guide. 2016.

7. See “Workers take employers to court over birth defects,” USA Today. February 2002.

8. See “Pregnant Workers Directive,” European Commission. October 1992.