How can leaders address the hidden reasons for lost time incidents (LTIs)?

Rethinking safety performance by addressing the human factors behind workplace injuries

For frontline industries, from construction and manufacturing to logistics and utilities, lost time incidents (LTI), also known as lost time injuries or lost time accidents, are a top safety metric that gets boardroom attention. They are tracked, reported, and linked to operational and financial outcomes. Yet despite years of effort, progress is stalling. In the UK, workplace injuries led to 33.7 million lost working days last year, and the same culprits persist: slips, trips, and falls account for nearly a third of incidents, according to the Health and Safety Executive (HSE). Manual handling injuries and falls from height complete the top three.

The numbers tell us safety performance has plateaued, so what can business leaders do to improve in this area? To make the next real gains, businesses must look beyond counting LTIs and start addressing the human factors that cause them.

A lost time incident refers to a work-related event that subsequently results in an employee unable to fulfil the duties or their role or requires them to take time off work. These incidents usually involve a physical accident, such as slipping or falling – but can also include psychosocial factors such as customer aggression or workplace harassment.

An LTI can trigger a cascade of negative consequences extending beyond the injured employee. Initially, direct costs such as sick pay, potential overtime, and medical expenses are incurred. Furthermore, businesses face the risk of compensation claims and potential fines or legal fees following Health and Safety Executive (HSE) investigations. Beyond these immediate financial impacts, productivity suffers through employee absence and operational disruptions.

The longer-term, compounding effects of LTIs can be even more damaging. Reduced employee morale, potential reputational harm, and increased insurance premiums can erode profitability. The loss of skills and the strain on HR and management further contribute to operational burdens. The estimated cost to the UK economy reached £21.6 billion in 2022/23, demonstrating the broad financial impact.

Ultimately, preventing LTIs through robust health and safety practices is not just a legal requirement but a fundamental business imperative. The significant financial and operational costs, coupled with the potential for reputational damage and legal repercussions, underscore the need for proactive measures. By prioritising workplace safety, UK businesses can safeguard their employees, enhance productivity, and ensure long-term sustainability in a competitive market. Ignoring these risks carries substantial consequences for both individual organisations and the wider UK economy.

At first glance, most incidents seem purely physical: a wet floor, an unstable ladder, a dropped object. But behind many of these events are underlying human and organisational factors.

Fatigue

Fatigue is one of the most consistent contributors to injury risk, yet it’s rarely acknowledged. UK research shows fatigue plays a role in up to 20% of major road accidents and is similarly present in workplace incidents, where tiredness impairs balance, reaction time, and decision-making. For workers operating at height or handling heavy loads, these impairments turn minor hazards into serious LTIs.

Stress and mental strain

Stress is another silent risk. According to the HSE, 875,000 workers in Britain suffered from work-related stress, depression, or anxiety last year, leading to 17.1 million lost days. Stressed workers are more prone to distraction, errors, and slower reactions, increasing the chance of accidents.

Everyday health issues

Common conditions such as migraines (which affect 1 in 7 adults) can cause dizziness, blurred vision, and poor coordination. Medications for allergies, blood pressure, or pain relief often have side effects like drowsiness, yet workers frequently “push through” symptoms. The result: increased risk of slips, trips, or falls that could have been prevented.

Life events and emotional load

Away from work, personal struggles like bereavement, divorce, or financial stress double the likelihood of workplace errors. But current incident reporting rarely captures this context, focusing only on the event rather than the human condition that led to it.

Let’s explore a hypothetical scenario: the unseen risk before the fall

Picture this: a utility worker starts their shift after a sleepless night. By mid-morning, they feel the onset of a migraine – dizziness, blurred vision, unsteadiness. But with a job to finish, they push through.

They’re working at height when a misstep turns a minor slip into a serious fall. Another LTI gets logged, treated as a random accident. In reality, the incident was entirely predictable — triggered by health symptoms that compromised the worker’s ability to perform safely.

Businesses have invested heavily in lone worker alarms and Alarm Receiving Centres (ARCs) to protect staff. These are important tools, but they have clear limitations:

• They are reactive, responding after a fall, collapse, or distress call.
• They track location and motion, but not a worker’s readiness to work safely.
• They provide emergency response but can’t manage upstream risks like fatigue, stress, or illness.

In other words: they are effective at managing the consequences of incidents, but not at preventing the human factors that make those incidents likely in the first place.

Traditional Employee Assistance Programmes are similarly reactive by design. They are not built to address the warning signs of human factors – like fatigue, stress or emotional strain – that can turn routine tasks into safety incidents.

• Access is delayed, and support is typically via scheduled counselling sessions, not in the moment advice during a shift.
• Usage remains low. Participation is often below 5%, meaning most workers don’t seek help before issues impact performance
• No integration with safety systems – EAPs operate separately, meaning they cannot triage a worker who feels unwell before operating equipment.

Leading businesses are now shifting to a model that addresses not just physical hazards, but also the human conditions that make those hazards dangerous.

In our scenario, a proactive system would intervene before the fall:

• The worker reports feeling “not 100%” through a structured check-in — without fear of stigma or penalty.
• They access 24/7 clinical triage, connecting with a medical professional who assesses their symptoms.
• If the worker’s dizziness is deemed unsafe, they are advised to pause and avoid high-risk tasks.
• An escalation pathway alerts the manager, and work is reassigned — preventing the LTI entirely.

A holistic safety and wellbeing platform, like Sonder, exemplifies this shift. By combining lone worker safety features (like Check on me and Track my Journey) with on-demand medical support, they enable workers to get help before incidents occur. A worker unsure whether they are fit to operate machinery due to fatigue or illness can access clinical advice 24/7 – potentially preventing an LTI entirely.

This is the smarter, next-generation model of care; recognising that many safety incidents are not random accidents, but predictable outcomes when human risk factors go unaddressed.

For safety, operations, and HR leaders, the case is now clear:

• Slips, trips, and falls, which dominate LTI reports, are often triggered by predictable human factors: fatigue, stress, or health symptoms.
• Traditional tools like alarms and ARCs are essential but reactive. They manage incidents after they happen, but they can’t detect or prevent the upstream risks that cause them.
• Proactive, human-centred systems offer a practical, scalable route to reduce incidents, protect staff, and improve operational resilience.

Reducing LTIs is no longer just about compliance and physical hazard control. It’s about managing the whole person at work — their physical, mental, and emotional readiness to perform safely.

If you’d like to take a more proactive approach to your employee health, safety and wellbeing, Sonder can help. Sonder supports leading organisations across the UK, Australia and New Zealand with proactive medical, safety and mental health solutions.

We help you meet your responsibilities around health and safety, while making support more accessible for your people.

Want to know what poor worker wellbeing is costing your organisation? Try our free EAP comparison calculator to see how much you could save by moving to a complete employee care platform.

Ready to introduce an assistance programme your employees will actively engage in? Book a free Sonder demo today and check out our Insider’s Guide to EAPs to learn more about how to track return on investment and return on value.