Application of two secondary documentary sources to identify the underreporting of fatal occupational injuries in Cape Town, South Africa.

We reviewed 8,502 deaths registered at the Salt River state mortuary, Cape Town (medical examiner records) for an 18-month period (1/1/90-6/30/91). When fatal occupational injuries located from this data source were matched with the records of the occupational safety inspectorate of the Department of Manpower, it was found that 28% had not been reported in terms of statutory regulations. Unreported deaths accounted for 25% of all fatal occupational injuries in the construction industry. None of the fatal occupational injuries in agriculture and fishing had been reported. Falls constituted 45% of the unreported fatalities. High levels of unreported fatal occupational injury indicate deficiencies in current occupational safety surveillance and enforcement in South Africa.