Background: Occupational health and safety are influenced by a range of internal and external factors, among which economic conditions are particularly salient. However, existing research has largely focused on internal determinants.

Aim: This study systematically examined the relationship between economic growth and occupational accidents, with a particular focus on the mechanisms linking macroeconomic dynamics to workplace safety outcomes.

Setting: The review drew on 19 international studies published between 2000 and 2020.

Method: A quantitative approach was adopted, employing systematic mapping to identify studies published in the following databases: EBSCOhost, DynaMed, IEEE Xplore, IOP, SAGE, Scopus, ScienceDirect, Taylor & Francis and Wiley.

Results: Only six European countries, four Asian and one in the Americas have conducted such research; these studies utilise a range of macroeconomic and occupational health and safety variables to examine the relationship between economic growth and occupational accidents.

Conclusion: Evidence from several developed and high-income countries in Europe, Asia and North America suggests a direct effect of economic growth on the incidence of occupational accidents.

Contribution: This review synthesises research from 2000 to 2020 on external economic factors and their impact on occupational accidents. The body of evidence remains sparse, despite early work dating back to 1938. Further research is needed, particularly in African and Latin American developing countries.

Keywords: economics factor; economic growth; occupational accidents; occupational safety and health; occupational accidents.

Introduction

Occupational health and safety are affected by internal factors, such as the safety climate and the management system, and external factors, such as economic and technological developments and social and political factors (Chang, Chen & Tsai 2018; Gümüş & Gülsün 2020). Occupational safety and health conditions are generally better in developed countries compared to developing nations (Song, He & Li 2011). According to the International Labour Organisation, the mortality rate per 100 000 workers is 4 in developed countries but exceeds 10 in developing ones. However, there are studies that warn of the need for greater support for prevention as a tool for reducing occupational accidents (Teixidó i Campàs 2009), given that poor occupational safety and health practices cost approximately 4% of the global Gross Domestic Product each year.

The prevention of accidents at work has its origins in the work of Heinrich (Sousa, Almeida & Dias 2014), who defined the sequential model ‘Domino Theory’, which states that an accident is the result of a series of factors, amongst them, the socioeconomic factor. Similarly, epidemiological models postulate that the occurrence of occupational accidents is influenced by multiple factors, which form a triangular structure, with the socioeconomic factor being one of the corners of this triangle (Gordon 1949; Swuste et al. 2014).

McDaid and Suhrcke (2012) point out that there are a significant number of studies on occupational health and safety management systems in various types of organisations. Similarly, Riaño-Casallas and Palencia-Sánchez (2016) note that research in this field has focused on cost–benefit analyses of interventions, the examination of costs associated with occupational accidents and diseases, and their relationship with productivity. However, these authors consider that the topic of economics and occupational health and safety remains rather underdeveloped, despite the fact that the first studies on the occurrence of occupational accidents in times of economic expansion were carried out by Kossoris (1938). He found a pro-cyclical relationship between accidents and employment in the US manufacturing sector, establishing four factors:

Subsequently, Kahraman, Akay and Kılıç (2019) identified five key factors that influence the occurrence of occupational accidents: employer, workplace, employee, public policy and economic factors. However, it can be inferred that the economic factor has a transversal impact on the others. Evidence from multiple contexts suggests that during economic expansions, occupational accident trends can vary. Some studies reported that the number of occupational accidents tends to decrease as labour becomes a scarce resource. In such contexts, employees are in a favourable position to demand and obtain improvements in working conditions (Nichols, Dennis & Guy 1995), while employers are reluctant to incur the high costs associated with absenteeism or employee turnover (Steele 1974). Conversely, during economic recessions, employees often remain persistently trapped in low-quality jobs involving hazardous tasks (Leombruni, Razzolini & Serti 2019). In this regard, the economic situation also serves as a reference framework for the state to establish laws and regulations, including those aimed at preventing occupational accidents. The implementation of such regulations constitutes a legal responsibility for both employers and employees.

The economic factor plays a crucial role in occupational accidents. Rapidly growing economies may face challenges in safeguarding workers from occupational hazards. For this reason, the objective of this study is to determine the relationship between economic growth and occupational accidents.

Literature review

Conceptualisation of economic growth

The concept of economic growth can be defined as ‘the quantitative increase or expansion of income and the value of final goods and services produced within the economic system over a given period’ (Enríquez-Pérez 2016), typically proxied by real Gross Domestic Product (GDP) or GDP per capita, over a given period. As noted by Jiménez (2011), it is a topic that generates significant interest within economics because of its impact on societal well-being. From this same perspective, Julca-Vegas (2016) and Loayza and Soto (2002) agree that economic growth is a measure of a country’s population’s well-being, encompassing the sustained increase in income. While growth is a prerequisite for development, it does not automatically yield improvements in well-being or equity; inclusive growth is necessary for development to translate into broader social gains (Mankiw 2021; Todaro & Smith 2015). The macroeconomic literature identifies a set of core growth models (Chirinos 2007; Loayza & Soto 2002):

These models are relevant to occupational safety because they shape patterns of capital investment, labour market composition and technological innovation, all of which directly influence workplace safety standards and accident risks.

Conceptualisation of occupational accidents

Starting from the premise that ‘all work is hazardous’, no occupation can be deemed entirely safe. However, the necessity of working remains (Gómez-Pineda 2014), which is why occupational safety and health have become paramount.

The initial conceptualisation of accidents, according to Aristotle’s philosophy, regarded them as occurrences without an inherent cause, not fitting within a broader metaphysical framework and from which no significant knowledge could be derived (Loimer & Guamieri 2011). This perception of accidents persisted until, between the 16th and 18th centuries, accidents were redefined under the premise that they provided insight into hidden knowledge, either as manifestations of divine will or as fortuitous revelations of natural processes. The providential understanding of accidents remained culturally dominant until the late 18th century, when the emergence of probabilistic thinking and the practice of first aid began to erode its legitimacy (Potter 1997).

By the late 19th and early 20th centuries, accidents were increasingly studied to understand how to prevent future occurrences (Vieira 2013). This shift marked a turning point in accident theory, unifying its conceptual development across four centuries. The modern understanding of an accident centres on the idea that it is an unintended and unforeseen result of a preceding cause, which can be identified and understood. It is perceived as a phenomenon that can only be comprehended through the sequential order of preceding events, with its revelation occurring solely through the construction of a narrative (Vieira 2013).

Over the centuries, the evolving epistemological assumptions inherent in the concept of accidents align with the three periods of knowledge history identified by Auguste Comte: theological, metaphysical and positive (Ñaupas-Paitán et al. 2018). However, Karl Popper’s realist approach argues that ‘descriptions of the world provided by research maintain a high degree of correspondence with reality’.

Definitions of occupational accidents agree that they cause harm to individuals in the form of injuries, illnesses, or death. However, other definitions also include other types of damage, such as damage to property, processes and the environment. From an occupational safety and health perspective, the primary goal is to preserve workers’ well-being. In this sense, the following definition of occupational accident is proposed: an unplanned event, causally related to work activity, that results in injury to one or more workers, including fatal incidents.

From this perspective, occupational accidents are not isolated events but outcomes shaped by a combination of workplace conditions, workforce characteristics and macroeconomic contexts.

Economic growth and occupational accidents

Research on occupational accidents has primarily focused on environmental and organisational factors, such as job design, working conditions, work organisation and the physical characteristics of the workplace (Christian et al. 2009; Lingard & Rowlinson 2005). Likewise, the role of personal factors – such as monthly income, age, gender, motivation and work experience – has been widely acknowledged (Gyekye 2005). However, the impact of macroeconomic variables, including economic growth, national income, unemployment and socio-cultural development, has received comparatively little attention in this field (Boone & Van Ours 2006). To the best of current knowledge, no studies have systematically examined the long-term effect of economic growth on the incidence of occupational accidents. Investigating this relationship could be valuable for anticipating accident rates and related indicators and for providing empirical evidence to support the design and implementation of more effective preventive strategies in occupational safety and health.

Methods

As part of the systematic review of the literature, systematic mapping was included. Systematic mapping is a research technique that ensures a structured review process and minimises errors that could lead to inaccurate conclusions (Petersen et al. 2008). The methodology followed these steps: definition of the research question, strategies for searching for primary studies, inclusion and exclusion criteria, data extraction and mapping of studies, determination of the classification scheme and synthesis of the evidence.

Definition of the research question

The purpose of this systematic mapping was established as a research question: what is the relationship between economic growth and occupational accidents? To this end, we sought to identify and classify the studies on this topic in the period between 2000 and 2020.

Definition of search strategies for primary studies

To design the search strategy, keywords were identified based on the research questions and the consultation of relevant documents. Table 1 presents the main keywords and related terms.

To elaborate on the final search strategy, categories T1 and T2 were combined with the Boolean operator AND, and related terms within each category were combined with the Boolean operator OR, as shown in Box 1:

The search was conducted using the electronic databases subscribed to by the Virtual Library of the National Council of Science, Technology and Technological Innovation of Peru – CONCYTEC for RENACYT users: EBSCOhost, DynaMed, IEEE Xplore, IOP, SAGE, Scopus, ScienceDirect, Taylor & Francis and Wiley.

It should be noted that the search strategy was adapted to the parameters of each database consulted, obtaining a total of 879 preliminary publications:

Definition of inclusion and exclusion criteria

Data extraction and study mapping

The selected articles were reviewed and analysed in order to extract and record their data in a matrix (Revelo-Sánchez et al. 2018; Riaño-Casallas & Palencia-Sánchez 2016). The general data of the articles and the specific data linked to the questions of the present investigation are presented below:

Determination of the classification scheme

A literature map is designed to summarise and classify the literature (Creswell & Creswell 2022). The literature map graphically represents a visual summary of research that has been conducted by other researchers. A hierarchical structure with a left-to-right presentation was used for the conceptual design.

Synthesis of the evidence

Once the data from the selected studies have been extracted, the evidence is synthesised. Given that the studies vary in terms of their designs, populations, indicators and results (known as heterogeneity), a narrative synthesis was used. The findings were grouped and compared according to pre-established criteria, such as geographical context, economic sector, severity of accidents and macroeconomic indicators used.

Ethical considerations

An application for full ethical approval was made to the Postgraduate Unit of the Faculty of Industrial Engineering, and ethics consent was received on 28 December 2020. The ethical clearance number is 470-UPG-FII-2020.

Results

The results of the literature review, which sought to provide an overview of the relationship between economic growth and workplace accidents, are presented.

Figure 1 illustrates the execution of the steps described in the previous sections using a Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 flow diagram. The search was conducted in the selected databases, yielding 879 articles. The inclusion criteria were then applied, reducing the number to 530 by retaining only original articles (I1) and those published between 2000 and 2020 (I2) and by removing duplicates across databases, keeping a single copy of each article. Subsequently, the exclusion criteria were applied: (E1) articles that do not explicitly address the relationship between economic growth and occupational accident rates; (E2) qualitative studies; and (E3) articles lacking relevant information to answer the research questions. Two cases were identified under criterion E3.

Table 2 presents the list of 19 articles that were analysed to answer the research question.

Figure 2 shows the spatial distribution of the articles by country studied, showing that this type of study was conducted in:

The studies used publicly available data covering various time periods (time series):

Prior to determining the relationship between economic growth and occupational accidents, it was necessary to identify and classify the indicators used in the respective statistical analyses (Figure 3).

For economic growth, 56 indicators were identified and classified into four dimensions:

For occupational accidents, 15 indicators were identified and classified into three dimensions:

Across the reviewed studies, GDP growth rate, GDP per capita and unemployment rate emerged as the most consistent macroeconomic predictors of occupational accident trends, while the number of fatal accidents and total incidence rate were the most commonly used safety indicators.

To relate the indicators of economic growth and occupational accidents, quantitative studies were applied using eight types of methodology, the most used being multiple linear regression (four studies), followed by the autoregressive model, neural networks, panel data regression and simple linear regression (three studies each).

A critical comparison and interpretation across studies

Research on the relationship between economic growth and occupational accidents has generated diverse and sometimes contradictory results, reflecting the complexity of the phenomenon and the influence of multiple factors, including the definition of an accident, the severity of the injury, the economic indicators used, and the geographical and sectoral context.

Pro-cyclical relationship (more accidents during economic growth)

Numerous studies find a pro-cyclical relationship, meaning that the incidence of occupational accidents tends to increase during periods of economic expansion and decrease during recessions (Asfaw et al. 2011; Chang et al. 2018; Çolak & Palaz 2017; Davies et al. 2009; Farina et al. 2018; Fernández-Muñiz et al. 2018; Kim & Park 2020; Kossoris 1938; Łyszczarz & Nojszewska 2017):

Counter-cyclical or inelastic relationship (fewer accidents during economic growth)

Some studies have found a counter-cyclical or inelastic relationship, especially for serious or fatal injuries, or in the long run (Barth et al. 2007; Çolak & Palaz 2017; Mouza & Targoutzidis 2012):

Differences by severity and industry sector

Minor injuries are consistently observed to be more sensitive to the business cycle and tend to be pro-cyclical (Asfaw et al. 2011; Boone & Van Ours 2006; Chang et al. 2018; Davies et al. 2009). Serious or fatal injuries, on the other hand, show a less clear relationship, often counter-cyclical, inelastic or not significant (Asfaw et al. 2011; Boone & Van Ours 2006; Chang et al. 2018; Davies et al. 2009; Lander et al. 2016).

The construction, manufacturing and mining sectors are consistently identified as the most sensitive to economic fluctuations and show pro-cyclical accident rates (Asfaw et al. 2011; Chang et al. 2018; Davies et al. 2009; Farina et al. 2018; Fernández-Muñiz et al. 2018; Lander et al. 2016). This may be because firms in construction are more likely to rely on temporary workers and experience disorganisation on site (Davies et al. 2009). The agriculture and trade sectors, in contrast, are less sensitive to the aggregate business cycle (Asfaw et al. 2011; Chang et al. 2018; Fernández-Muñiz et al. 2018).

Underreporting hypothesis and its impact

The underreporting hypothesis is a key point of controversy. Some researchers argue that the observed pro-cyclical relationship, especially for minor injuries, could be a spurious phenomenon. They propose that in times of economic downturn, workers are afraid of losing their jobs and therefore report fewer minor accidents (Asfaw et al. 2011; Boone & Van Ours 2006; Çolak & Palaz 2017; Davies et al. 2009). In contrast, in expansion stages, workers are more willing to report accidents because of greater job security or bargaining power (Davies et al. 2009). Fatal accident data are considered more reliable because they are less susceptible to underreporting, and thus their relationship with labour market indicators is sometimes insignificant or counter-cyclical (Barth et al. 2007; Boone & Van Ours 2006; Davies et al. 2009). However, other studies suggest that even fatal accidents may be pro-cyclical or that the change in reporting behaviour does not fully explain the relationship (Fernández-Muñiz et al. 2018; Lander et al. 2016; Song et al. 2011).

In summary, while the evidence suggests a strong correlation between economic growth and occupational accidents, the nature of this relationship (pro-cyclical, counter-cyclical or inelastic) depends largely on the severity of the injury, the industrial sector, the specific economic indicators and the time horizon (short or long term) considered in the analysis (Çolak & Palaz 2017; Mouza & Targoutzidis 2012).

Discussion

The question of the relationship between economic growth and occupational accidents reveals a complex and multifaceted interconnection that goes beyond a simple linear relationship. The results presented, although varied, allow us to identify underlying patterns and mechanisms that explain these dynamics, integrating empirical observations with economic and labour theories.

The duality of correlation: Pro-cyclical versus counter-cyclical

The empirical evidence is not unanimous, suggesting that the correlation between economic growth and occupational accidents is not inherently unidirectional but depends on moderating factors.

There is a general consensus that minor accidents or non-fatal injuries tend to show pro-cyclical behaviour (Asfaw et al. 2011; Boone & Van Ours 2006; Chang et al. 2018; Davies et al. 2009). This is observed in a number of economies, including the United States, the United Kingdom, Korea, Poland, Spain, China and Italy (Asfaw et al. 2011; Chang et al. 2018; Davies et al. 2009; Farina et al. 2018; Fernández-Muñiz et al. 2018; Kim & Park 2020; Łyszczarz & Nojszewska 2017). This pattern is particularly pronounced in high-risk sectors such as manufacturing, construction and mining (Asfaw et al. 2011; Chang et al. 2018; Davies et al. 2009; Farina et al. 2018; Fernández-Muñiz et al. 2018; Lander et al. 2016). In the short run, even fatalities may follow a pro-cyclical pattern in economies such as Turkey (Çolak & Palaz 2017) or China (Song et al. 2011).

On the other hand, the relationship becomes more complex or even counter-cyclical for severe and fatal injuries or when analysing the long term (Barth et al. 2007; Çolak & Palaz 2017; Mouza & Targoutzidis 2012). Developed countries such as Austria show a decrease in injury rates with GDP growth (Asfaw et al. 2011; Barth et al. 2007), and a multi-geographic analysis reveals that national income can reduce fatal accidents, while employment rate increases them (Kahraman et al. 2019). In the long run, in Turkey, an increase in GDP is associated with a decrease in fatal crashes (Çolak & Palaz 2017). This disparity suggests that different mechanisms operate depending on the severity of the accident and the time horizon.

This aligns with Kossoris’s (1938) early proposition that economic booms can increase accident risks through workforce changes and supports the notion that sustained growth enables investment in safer technologies and stronger regulatory frameworks.

Mechanisms driving the correlation (possible causes)

Theories proposed by Kossoris (1938) and Mouza and Targoutzidis (2012, cited by Nichols 1986, 2009), along with recent findings, offer explanations for how economic growth influences occupational safety and health:

Implications and challenges for public policy

The complexity of this relationship has direct implications for the design of occupational safety and health policies:

In summary, the discussion underlines that the relationship between economic growth and occupational accidents is a dynamic phenomenon, influenced by the interaction of economic, labour and social factors. Understanding these mechanisms is vital to develop accident prevention strategies that are effective in different economic contexts.

Conclusion

The results of the literature review confirm that yes, there is a relationship between economic growth and occupational accidents, but its nature and magnitude are complex and multifaceted, varying significantly according to the context and severity of the accident.

The most consistent evidence points to a predominantly pro-cyclical relationship for minor work injuries and for short-term analyses, particularly in high-risk sectors such as manufacturing, construction and mining. This is mainly attributed to mechanisms such as the addition of new or temporary workers with less experience, increased work intensity, overtime and employee fatigue, and reduced attention to safety measures during economic booms to meet increasing demand. In addition, a possible bias in accident reporting, where workers report more minor injuries during booms (for greater job security) and fewer during recessions (for fear of losing their jobs), may contribute to this apparent pro-cyclicality.

On the other hand, the correlation becomes more inelastic or even counter-cyclical for severe and fatal injuries or in the long-term analysis. These dynamics suggest that, with sustained economic development, countries and firms may invest more in safety technologies, training and better working conditions, leading to an overall reduction in serious accidents over time. The ‘natural selection’ of the labour market during recessions, which retains more experienced workers, can also contribute to a reduction in accident rates.

In summary, while economic growth is often associated with an increase in occupational accidents in the short term and in certain categories, the relationship is complex and non-linear. Occupational safety and health policies need to adapt to these dynamics, focusing on active prevention during economic booms, especially in high-risk sectors, and addressing potential problems of underreporting in downturns to get a more accurate picture and mitigate risks effectively.

Given the sectoral and severity-specific variations identified, occupational safety strategies should be tailored to economic conditions. Regulators should intensify inspections and training during economic booms, maintain investment in safety technologies during recessions and address underreporting across all phases of the business cycle to ensure accurate monitoring and effective prevention.

Acknowledgements

This article is partially based on the P.C.G-F.’s thesis entitled ‘La relación del crecimiento económico sobre los accidentes de trabajo – caso Peruano [The Relationship between Economic Growth and Occupational Accidents – Peruvian Case]’ towards the degree of Doctor in Industrial Engineering in the Faculty of Industrial Engineering, Universidad Nacional Mayor de San Marcos, Peru, on 21 December 2023, with supervisor Alfonso Ramón Chung Pinzás. The supervisor was not involved in the preparation of this manuscript and was not listed as a co-author. It can be found here: https://hdl.handle.net/20.500.12672/20527.

This article benefited from the use of ChatGPT5 and DeepL for grammar refinement and improving readability. The content was reviewed and edited by the author, who takes full responsibility for its accuracy.

The author declares that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.

This research was supported by Universidad Nacional Mayor de San Marcos and the Postgraduate Unit of the Faculty of Industrial Engineering with Grant number 470-UPG-FII-2020.

The data that support the findings of this study are available from the corresponding author, P.C.G-F., upon reasonable request.

The views and opinions expressed in this article are those of the author and are the product of professional research. It does not necessarily reflect the official policy or position of any affiliated institution, funder, agency or that of the publisher. The author is responsible for this article’s results, findings and content.

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Original Research

A systematic review of the relationship between economic growth and occupational accidents

Pablo C. Gutiérrez-Falcón

Abstract

Introduction

Literature review

Conceptualisation of economic growth

Conceptualisation of occupational accidents

Economic growth and occupational accidents

Methods

Definition of the research question

Definition of search strategies for primary studies

Definition of inclusion and exclusion criteria

Data extraction and study mapping

Determination of the classification scheme

Synthesis of the evidence

Ethical considerations

Results

A critical comparison and interpretation across studies

Pro-cyclical relationship (more accidents during economic growth)

Counter-cyclical or inelastic relationship (fewer accidents during economic growth)

Differences by severity and industry sector

Underreporting hypothesis and its impact

Discussion

The duality of correlation: Pro-cyclical versus counter-cyclical

Mechanisms driving the correlation (possible causes)

Implications and challenges for public policy

Conclusion

Acknowledgements

Competing interests

Author’s contribution

Funding information

Data availability

Disclaimer

References