From 2000 to 2001, the Index found that the frequency of work-related injuries dropped 6 percent. This drop is the largest decline in the four years of the study.

Between 1999 and 2000, the number of injuries fell 1.3 percent; it rose 0.2 percent between 1998 and 1999.

The cost of those injuries, however, grew to $45.8 billion in 2001 from $44.2 billion in 2000.

"The most surprising part was that the total cost of injury continues to go up, despite a lower frequency of disabling injuries," said Karl Jacobson, senior vice president of loss prevention, Liberty Mutual in Boston. "So we have counterintuitive dynamics."

Mr. Jacobson continued that the previous study, released in the spring of this year, revealed a fairly flat frequency, but a significant escalation in cost. In the current study, however, "we have a little less of a dramatic increase in cost but a significantly lower frequency [of injuries]."

What is paying off "is that business is paying attention to lowering the number of disabling injuries," he said. "Fatalities are down as well."

Mr. Jacobson said several things account for higher costs, such as more treatment and more expensive treatments for the injuries that occur.

He added that health care in general is getting more expensive. "Also, we're dealing with the more serious injuries here?those that result in an employee being away from work six or more days."

While fraud continues to exist, the amount of fraud "hasn't changed that much and it is not the majority of costs," he said.

The real payoff in terms of safety is loss prevention, he said. Though larger organizations traditionally have been more involved in loss prevention, "As your cost of insurance goes up, the interest level goes up on the part of smaller and middle-size businesses," he said.

Businesses are recognizing that injuries are a controllable cost with dedication of some resources and programs in place, he said.

"Larger businesses have more to gain, but now middle and smaller businesses are seeing that benefit can be obtained," he noted. "So safety programs are becoming more effective in smaller businesses today than five or 10 years ago because the costs are much larger now," he observed.

He said that agents and brokers are also leaning on owners and risk managers of organizations to keep costs down through loss control.

One method that is increasingly effective is benchmarking. "Businesses are so competitive that they are interested in how they are doing compared to their competition," he said. "That is a terrific tool to influence a company into taking action."

He explained that brokers and carriers are benchmarking "almost all of our policyholders now. It's fairly routine for us to not only do a loss analysis like you see in the index, we do this for our customers every year to determine what are the causes of accidents."

Clients, he said, are told how they compare to their peers. "We parade that out, sometimes in very tangible terms, like how much product they would have to produce to be competitive with their industry."

Mr. Jacobson said that a new trend evident in the safety index is that, "when you look at the causes of loss, the top 10 are so large that they don't change order or change magnitude very much?they represent 89 percent of the total."

Also, he noted that for the first time the top three injuries?overexertion, falls on the same level and bodily reaction (injury from bending, climbing, tripping or slipping without falling)?accounted for 50.1 percent of the injuries.

For the most part, the top 10 injuries have remained the same, which he said "points to the fact that the data is solid and this is a continuing problem that has to be focused on."