In addition, employers surveyed ranked "falls on the same level" as only their seventh-biggest concern, when in fact these types of injuries actually rank second in direct costs. The executives also overstated the importance of highway accidents on the job, ranking it third, when it was in fact seventh in terms of cost.

Employer perceptions about the relative severity of various types of workplace injuries might have been skewed by the controversy over federal ergonomics regulations that has raged the past couple of years, speculated Karl Jacobson, senior vice president of Liberty Mutual, in charge of safety and health research and product development.

The direct, insured costs of workplace injuries last year (defined as payments to injured employees and their medical care providers) rose 3.6 percent in 1999 (the latest year for which figures are available) over the year before to $40.1 billion, according to Liberty Mutual.

The top 10 causes of disabling injuries, however, accounted for 86 percent of total direct costs, noted the Boston-based carrier, which based its findings on its own data, bolstered by figures from the Bureau of Labor Statistics and the National Academy of Social Insurance.

The total financial cost of workplace injuries, including uninsured, indirect expenses (such as lost productivity and overtime pay) is estimated by Liberty Mutual at some $240 billion, "not to mention the pain and suffering endured by injured workers and their families," said Mr. Jacobson.

The order of the 10 leading causes of disabling workplace injuries (defined as those resulting in workers missing five or more days of work), ranked by direct costs, were identical to that of the prior year. "The consistency of the findings lends authority and points to the strength of the study's methodology," according to Mr. Jacobson. He said the results should encourage risk managers to compare the national injury profile to that of their own industry and particular facility, and then to direct loss control and safety resources accordingly.

The top-ranked cause of injury was overexertion, defined as injuries from excessive lifting, lowering, pushing or pulling of an object. Such injuries accounted for $10.3 billion in direct costs?25.5 percent of the total

The other nine injury causes, ranked by direct costs, are as follows:

? Falls on the same level--$4.6 billion (11.5 percent of the total).

? Bodily reaction (injuries resulting from bending, standing, reaching, and slipping or tripping without falling)--$3.8 billion (9.4 percent).

? Falls to a lower level--$3.7 billion (9.2 percent).

? Struck by an object (such as a tool falling on a worker from above)--$3.4 billion (8.5 percent).

? Repetitive motion--$2.7 billion (6.7 percent).

? Highway accident--$2.4 billion (5.9 percent).

? Being struck against an object (such as a worker walking into a doorframe)--$1.7 billion (4.3 percent).

? Becoming caught in or compressed by equipment--$1.6 billion (4.1 percent).

? Contact with temperature extremes--$400 million (1.0 percent).

The survey to assess employer perceptions about workplace injuries queried 200 executives--125 from mid-sized companies (those with between 100 and 999 employees, and commercial insurance premiums up to $2.5 million) and 75 from large firms (those with over 1,000 workers and commercial premiums of at least $2.5 million).