As the title indicates, you probably realize we must be talking about acute injuries, as it's very difficult to kill yourself from doing too many key strokes or mouse clicks per day. Or, if you think of the highway, where there are 10–20 times more accidental fatalities than in workplaces or factories - it's easy enough to hurt your back if you've got a bad car seat and you drive a lot, but it's unlikely that the bad car seat will ever kill you. So, if there was a question as to whether we're talking about acute injuries or repetitive strain injuries, the answer is easy.

We're talking about acute injuries. However, the important question, "What really causes acute injuries?" isn't so easy to answer. What if the answer is much different than what we've been taught? And finally, how do you know - or how do you prove - that it is reality? A fairly tall order, to be sure.

Let's start with what you knew before you ever started working or working in the EH&S profession. You knew how you had been hurt. And you knew when and how often - although you might not remember much below age 6 or 7. Then, you learned about occupational health and safety including the legal aspects and compliance issues. Probably the importance of management "commitment" was stressed. Then we learned about unsafe acts, unsafe conditions, risk pyramids and multiple factor accident causation models. Question: "How many unsafe acts does it take to cause a fatality?" Answer: a. 30,000 b. 300,000 c. just one.

And when we learned about all of this (in my case, 20 years ago), did we hear about how an employee's "attitude" causes these deliberate unsafe acts? And how these unsafe acts caused over 90% of the workplace injuries? Unfortunately, a lot of us did hear this, and we heard it over and over. And we heard it from lots of people (although very few people around today ever heard it from Heinrich himself). (See Figure #1.)

Figure #1. Risk Pyramid (available in full paper).

Now, one of the problems with hearing things over and over - from lots of different "experts" is that pretty soon some people stop questioning what they're hearing. Even if what they're hearing is different from what they know for sure: how and when they got hurt. Which is understandable (or forgivable) because while we may know exactly, for sure, definitely, etc. how and when we've been hurt - we know that our own personal injuries are only a small number compared to the millions and millions of injuries that occur every day around the world (if you count all of the cuts, bruises, bumps and scrapes).

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