Investigating the culture and practice of reporting occupational incidents in Iranian industries: a mixed-methods study

Abstract

Background

Effective Reporting, Registration, and Investigation of Occupational Incidents (RRIOI) are essential for monitoring incident frequency, identifying root causes, and implementing control measures to improve workplace safety. While RRIOI systems have been successfully adopted in many countries, challenges persist, particularly in developing countries such as Iran. This study investigates the culture and practices of RRIOI process within industrial workplaces in West Azerbaijan province, Iran.

Methods

A mixed-methods approach was used, involving 631 participants from diverse companies to assess the culture of RRIOI. Additionally, in-depth interviews were conducted with 20 Occupational Health and Safety (OHS) experts to explore internal and external factors affecting the RRIOI process. Quantitative data were analyzed using t-tests, Spearman correlations. Hierarchical linear regression applied to investigate the predictive capacity of independent variables on RRIOI culture. The content analysis was employed to analyze the qualitative data.

Results

The overall RRIOI culture score averaged 3.09 (± 0.35). Among the sub-factors, corrective actions scored highest (3.27 ± 0.64), whereas barriers for under-reporting scored lowest (2.90 ± 0.54). A t-test revealed that OHS training and prior experience with occupational accidents were positively associated with RRIOI culture scores. Hierarchical regression indicated that management role positively influenced RRIOI culture, while industry type had a negative effect. Telephone communication was the most common method for reporting incidents. Notably, reporting of low-severity incidents and near-misses was markedly deficient across organizations. Participants also highlighted a lack of feedback from OHS authorities. Furthermore, this study identified key factors contributing to reluctance in incident reporting.

Conclusions

This is the first study in Iran to systematically examine RRIOI culture across multiple industries using a mixed-methods approach. The integration of stakeholders’ perspectives provides a comprehensive understanding of the systemic and cultural challenges hindering effective incident reporting. The findings highlight the need for national policies to foster a non-punitive reporting culture, implement integrated electronic incident reporting systems, enhance workforce training, and ensure adequate resource allocation. These insights offer actionable guidance for strengthening RRIOI frameworks in Iran.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-025-25332-1.

Background

Occupational injuries represent an important problem within human societies, leading to substantial human and economic losses worldwide. Annually, work-related accidents and diseases account for an estimated 2.78 million fatalities and approximately 374 million non-fatal injuries [1]. The burden of occupational injuries is disproportionately higher in developing countries compared to industrialized nations [2]. However, these global estimates primarily depend on reported data, which are widely recognized to be subject to substantial under-reporting, particularly in regions lacking robust systems for Reporting, Registration, and Investigation of Occupational Incidents (RRIOI). Under-reporting constitutes a major barrier to accurately understanding the prevalence, nature, and causes of occupational incidents. Notably, this phenomenon is not uniform across all types of incidents: severe or fatal accidents are less likely to be omitted due to their visibility and consequences, whereas minor incidents suffer from higher levels of under-reporting [3, 4]. This pattern suggests that the perceived severity of incidents significantly influences reporting behavior. A well-structured RRIOI system can substantially improve workplace safety by facilitating the systematic monitoring of incidents, identification of underlying causes, and implementation of evidence-based prevention and management strategies. The absence of standardized and integrated RRIOI systems continues to impede meaningful cross- country comparisons and the advancement of global occupational safety, highlighting a critical need for their development and implementation worldwide.

Under-reporting occurs at two primary levels: (1) individual-level, when workers fail to report injuries or near-misses to their employers, and (2) organizational-level, when employers neglect to log or disclose reportable incidents to regulatory authorities [5, 6]. This dual-layered problem distorts official statistics, impairs safety management, and leads to the misallocation of safety resources. Despite differences in socioeconomic status, under-reporting has been documented across both high-income and low- to middle-income countries. For example, in 1998, only 3.9% of global occupational accidents were reported to the International Labor Organization (ILO) [7]. In the United States, national surveillance systems such as the Occupational Safety and Health Administration (OSHA) and the Bureau of Labor Statistics (BLS) have been shown to miss up to 68% of workplace incidents [3, 4]. Furthermore, research indicates that between 20% and 91% of injured workers fail to report incidents to employers or compensation systems [5, 8]. In some Middle Eastern countries, the reporting rate is estimated to be less than 1% [7]. Although cross-country comparisons remain difficult due to the lack of standardized and integrated RRIOI systems [9], researchers continue to analyze available data to draw tentative conclusions. Collectively, the evidence highlights under-reporting as a persistent global challenge that significantly hampers accurate surveillance and effective safety interventions.

Numerous individual-level factors contribute to this under-reporting, including age, job tenure, fear of reprisal or job loss, fatalistic beliefs about injury inevitability, lack of clear definitions for occupational incidents, poor motivation systems, peer pressure, and job insecurity. At the organizational level, under-reporting is associated with company size, industry sector, production pressures, insufficient management responsiveness, and deficient safety climates [3, 4, 6, 10, 11]. Broader economic factors such as recessions exacerbate the problem, increasing both the incidence of workplace injuries and the likelihood of under-reporting due to heightened job insecurity [12, 13]. These individual, organizational, and economic factors create a complex and persistent environment in which under-reporting of occupational injuries and illnesses remains widespread and difficult to address.

Cultural and organizational barriers also play a critical role. Complex and burdensome reporting procedures, inappropriate managerial beliefs, limited worker awareness, and lack of trust in reporting mechanisms discourage disclosure. Moreover, fear of punishment, negative regulatory feedback, and frustration with ineffective safety interventions further reduce the willingness to report [8, 14–16]. The regulatory context also significantly influences reporting behavior; weak enforcement and inadequate labor protections increase worker vulnerability and discourage reporting, especially in environments where punitive responses prevail [17–21]. Despite increasing recognition of this issue, predicting and preventing under-reporting remains a persistent challenge [6]. Establishing a robust safety culture is essential to overcoming these barriers. A positive reporting culture—an integral component of safety culture—requires that employees routinely and accurately report incidents and near-misses, thereby enabling data-driven decision-making [22–25]. Additionally, organizations should foster a learning-oriented culture that treats incident reporting as an opportunity for improvement rather than blame, helping to reduce future risk [16, 26]. Addressing the cultural, organizational, and regulatory barriers to incident reporting is critical for cultivating a proactive safety culture and ensuring continuous improvement in workplace safety.

Several high-income countries, including the United States, the United Kingdom, and EU member states, have implemented structured and legally mandated RRIOI frameworks supported by electronic platforms, standardized classifications, and integration with regulatory enforcement bodies [27, 28]. Iran’s Occupational Health and Safety (OHS) regulations require the reporting of workplace accidents to the Ministry of Labor or the Iranian Social Security Organization (ISSO) within 72 h. However, compliance is inconsistent, particularly in high-risk sectors such as construction. The absence of a centralized electronic RRIOI system, reliance on manual and fragmented processes, and uneven enforcement across provinces have led to widespread under-reporting and diminished data reliability [29–31]. Consequently, the absence of a standardized and integrated RRIOI system continues to limit both the effectiveness of national prevention strategies and the potential for meaningful international comparisons.

Accurate and complete RRIOI data are crucial for hazard identification, trend analysis, and the formulation of targeted safety interventions. Despite a growing international literature on under-reporting, most research has focused on high-income countries, leaving significant gaps in our understanding of these dynamics in low- and middle-income settings [32]. A recent systematic review by Kyung et al. (2023) highlights the urgency of exploring context-specific factors that contribute to under-reporting in such environments [8]. Addressing this gap is essential for effective resource allocation and strategic planning aimed at injury prevention. This study draws on a large-scale mixed-methods investigation conducted in the industrial sectors of Iran’s West Azerbaijan province. The primary objectives are to evaluate the prevailing culture of RRIOI among employees and to identify the internal and external factors that influence reporting behaviors. By understanding why incidents frequently go unreported, this research aims to inform policy and organizational strategies for enhancing occupational safety outcomes.

Methods

Quantitative study

This study included the participation of employees from various industries, including construction, manufacturing, mining, and hospitals. Upon establishing contact with different organizations, a total of four construction companies, four manufacturing companies, three mines, and four hospitals expressed an interest to participate in the research attempt. A sample size of 631 individuals was recruited through a random sampling method from several workplace sectors to participate in the study. The participants were duly informed regarding the objective of the study and the assurance of confidentiality pertaining to the acquired information. Subsequently, they freely provided their explicit consent to take part in the study.

The data was collected by the administration of a questionnaire that focused on investigating cultural of RRIOI. The questionnaire was developed based on previous validated instruments and relevant literature [2–4, 15, 33–37]. The translation of the questionnaire from English to Persian was performed by a bilingual translator. To ensure content validity, the initial version of the questionnaire was reviewed by three OHS experts, who assessed the relevance, clarity, and completeness of each item. Face validity was evaluated by two additional OHS professionals, who ensured that the items were understandable and appropriately reflected the intended constructs in both Persian and English. Based on their feedback, minor wording changes and clarifications were made before finalizing the instrument. To evaluate reliability, Cronbach’s alpha was calculated using data from the study sample (n = 631). The overall Cronbach’s alpha coefficient for the 68-item questionnaire was 0.85, indicating high internal consistency. These steps ensured that the questionnaire used in this study was both valid and reliable for assessing the culture of RRIOI. The questionnaire consisted of demographic queries and a total of 68 items categorized into six distinct factors: identification and response, reporting, incident investigation, corrective actions, learning, and barrier to reporting (Supplementary 1). The participants indicated their level of agreement with the statements by using a Likert scale consisting of five points, ranging from highly disagree to strongly agree. The demographic characteristics of the participants were assessed, and their scores on RRIOI culture were calculated.

A t-test was employed to assess the relationship between the participants’ training and accident experiences, and the scale factors within the organizations. The study employed hierarchical linear regression analysis to investigate the predictive capacity of independent factors on the RRIOI culture. Prior to entering the variables into the regression model, independent samples t-tests were conducted to assess the associations between gender, marital Status, employment status, ownership, management role, accident experience, and safety training with the mean RRIOI culture score. Furthermore, one-way ANOVA was used to evaluate the relationships between education level, age groups, work experience groups, nature of job, and type of industry with the mean RRIOI culture score.

A hierarchical linear regression analysis was conducted to examine the factors predicting RRIOI culture. The dependent variable was the overall RRIOI culture score, while the independent variables included management role (safety manager vs. non-manager), employment status (permanent vs. temporary), organizational ownership (public vs. private), and industry type (hospital, manufacturing, mining, and construction). The estimated regression equation was specified as follows:

Where Y represents the RRIOI culture score, β₀​ is the intercept, β₁…β₄​ are the regression coefficients associated with each predictor, and ϵ is the error term.

The hierarchical regression was performed in two steps. In the first step, management role and employment status were entered into the model. In the second step, ownership and industry type were added to assess their incremental contribution to the variance explained in RRIOI culture.

Qualitative study

The participants of this part of study consisted of 20 OHS experts, who were selected from various OHS authorities (six OHS inspectors), industrial companies (three OHS officers, two supervisors, five employees, and one Physician), and administrative organizations (one bank clerk, one municipality worker, and one municipality OHS officer). The interviews conducted to find the internal and external organizational factors that influence the process of RRIOI. Several organizations and companies within the West Azerbaijan province were contacted. The inclusion criteria for participation in this study were a demonstrated interest in engaging with the subject matter and a minimum of five years of work experience related to the RRIOI. All participants were provided with information regarding the objective of the study and were advised of their right to withdraw from participation at any point. Furthermore, the participants were assured that all transcripts would be maintained in utmost confidentiality and anonymity. The participants granted their verbal informed consent to participate in the research and record the interviews.

The incident records within the industrial companies were examined to get familiarity with the process of RRIOI and to identify any problems associated with the process. Interview guides were developed subsequent to an in-depth review of the existing literature. Subsequently, a series of individual semi-structured interviews were carried out inside the boundaries of the participants’ workplaces. The primary inquiries that guided the research were: (1) Is there an established RRIOI procedure inside your organization? (2) What is the implementation procedure for RRIOI inside your organization? Is there a designated group responsible for conducting incident investigations? 4) What is the process for reporting and recording OHS incidents? Do you document and report incidents of minor consequence, unsafe conditions, and unsafe acts? What are the further steps taken following an accident? Do you have any suggestions for enhancing the RRIOI? Data collection was conducted until the point at which no new data could be obtained.

All interviews were conducted by the second author with the presence of other co-authors, excluding the first author. The interviews were recorded in audio format and subsequently transcribed verbatim. The duration of the interviews ranged from 15 to 45 min. The analysis of the interview materials was conducted subsequent to the initial interview. The transcribed interviews were analyzed using a conventional content analysis approach, allowing patterns and themes to emerge inductively from the data. The analytical process began with repeated readings of the transcripts to achieve deep familiarization with the content. Subsequently, a line-by-line open coding procedure was conducted by all authors except the first one to identify meaningful units relevant to the research objectives, which were then assigned initial codes. These codes were systematically organized into broader categories representing both internal and external factors affecting the RRIOI process. In the final phase, these categories were synthesized into main themes that summarized the organizational culture surrounding RRIOI and its underlying factors within the studied context. Subsequently, the first author reviewed both the transcripts and the resulting codes, making necessary revisions to the coding framework.

To ensure the rigor and trustworthiness of the qualitative analysis, multiple strategies were employed throughout the study. The research team engaged in prolonged interaction with the data and maintained a detailed audit trail documenting coding decisions and thematic development, thereby enhancing the transparency and trustworthiness of the findings. Triangulation was achieved by collecting data from a broad range of participants across various organizational roles and sectors, enabling the capture of diverse perspectives on the issue under investigation. Investigator triangulation further strengthened the analysis, as three researchers independently conducted initial coding before collaboratively comparing and refining codes and themes, with any discrepancies resolved through discussion and review by a senior author. Member checking was conducted by inviting selected participants to review coded transcripts and emerging themes, thereby validating the researchers’ interpretations and enhancing the study’s credibility. Prolonged engagement allowed the research team to develop a deep understanding of the data and its contextual nuances through extended involvement in both data collection and analysis. Additionally, an audit trail was maintained to document the coding process and thematic development in detail, ensuring transparency and enabling replication or external review.

Results

The findings of the quantitative study

A majority of the participants (78.4%) identified as male, whereas 65.5% reported being married. The participants’ mean age was 33.8 years (± 8.86), while their average working experience was 8.85 years (± 7.37). A large percentage of the participants (49.1%) became under the age range of less than 30 years, while 33.8% reported having acquired 1–5 years of work experience. Approximately 34% of the participants had a university education, whereas 508 (80.5%) participants were working in contractual employment. A total of 84 (13.3%) participants were participates from the safety units, whilst the remaining 547 participants (86.7%) were employed in other work units. The last group of participants had an average of 7.88 (± 6.46) years of work experience and were employed across several sectors, including four hospitals (28.5%), three mining companies (23.9%), four construction companies (24.3%), and three manufacturing companies (23.2%). All hospitals, a mine, a manufacturing, and two construction companies were state-owned organizations. A substantial amount of the workforce (57.6%) employed in manufacturing or service jobs. A total of 129 (23.6%) employees reported having prior accident experiences. Additionally, 43.3% of the participants indicated that they had received safety training, as shown in Table 1.

Table 1.

Personal and occupational profile of the participants

n = 631
Variable	N	%
Gender
Male	495	78.4
Female	136	21.6
Marital Status
Married	420	65.5
Single	211	34.5
Employment Status
Permanent	123	19.5
Temporary	508	80.5
Education
Elementary	130	20.6
Secondary	144	22.8
High-school	118	18.7
University	239	37.9
Age (years)
< 30	310	49.1
30–39	171	27.1
40–49	118	18.7
50–59	28	4.4
≥ 60	4	0.6
Working Experience (years)
< 1	58	9.2
1–5	213	33.8
6–10	153	24.2
> 10	207	32.8
n = 547
Nature of job
Production/service	315	57.6
Maintenance	74	13.5
Office	60	11
Warehouse	17	3.1
	81	13.9
Accident experience
Yes	129	23.6
No	418	76.4
Training
Yes	237	43.3
No	310	56.7

The mean score for culture of RRIOI was 3.09 (± 0.35). The highest score (3.27(± 0.64)) was obtained by corrective actions, whereas the lowest score (2.90(± 0.54)) was achieved by barriers to reporting (Table 2).

Table 2.

Number of items, mean, and standard deviation (n = 631)

Factors	N of items	Mean	SD
Identification and response	8	3.15	0.55
Reporting	9	3.04	0.51
Incident investigation	8	3.05	0.53
Corrective actions	5	3.27	0.64
Learning	6	3.16	0.64
barriers to reporting	33	2.90	0.54
Mean	68	3.09	0.35

The findings from the independent t-test analysis revealed a statistically significant difference in the mean score of the culture of RRIOI between employees who received training courses (M = 3.02) and those who did not (M = 3.11) (t ₍₅₄₅₎ = −2.88, p < 0.001). The results of the study indicated that training was shown to have statistically significant associations with incident reporting (t ₍₅₄₅₎ = −3.65, p < 0.001), incident investigation (t ₍₅₄₅₎ = −2.20, p < 0.05), and barriers to reporting (t ₍₅₄₅₎ = −5.47, p < 0.001). Employees who did not have any previous experience of occupational accidents (M = 3.10) had higher scores on the culture of RRIOI compared to employees who had prior occupational accident experience (M = 2.98), t ₍₂₄₂₎ = −3.45, p < 0.001. The results indicate that there were significant correlations between identification and response (t ₍₂₃₅₎ = −3.88, p < 0.001), corrective actions (t ₍₂₄₃₎ = −3.43, p < 0.001), and learning (t ₍₂₇₇₎ = −3.33, p < 0.001) with accident experience. Safety managers (M = 3.25) demonstrated significantly higher RRIOI culture scores compared to general employees (M = 3.07), t₍₆₂₉₎ = −4.34, p < 0.001. Furthermore, management role was significantly associated with multiple dimensions of the RRIOI culture, including identification and response (t₍₆₂₉₎ = −3.27, p < 0.001), reporting (t₍₆₂₉₎ = −2.69, p < 0.001), incident investigation (t₍₆₂₉₎ = −4.29, p < 0.001), and organizational learning (t₍₆₂₉₎ = −3.42, p < 0.001) (Table 3).

Table 3.

Results of the relationship between the factors of the culture of RRIOI with the variables of training, accident experience, and management role

Factors	Training				Accident experience				Management role
	Mean	SD	t	P value	Mean	SD	t	P value	Mean	SD	t	P value
Identification and response	3.15	0.52	−1.20	0.23	3.17	0.57	−3.66	0.001	3.34	0.45	−3.27	0.001
Reporting	3.08	0.51	−3.65	0.001	3.03	0.51	−1.34	0.18	3.18	0.53	−2.69	0.007
Incident investigation	3.05	0.52	−2.20	0.02	3.03	0.54	−1.41	0.16	3.27	0.65	−4.29	0.001
Corrective actions	3.26	0.63	−0.18	0.85	3.30	0.65	−3.43	0.001	3.39	0.63	−1.91	0.56
Learning	3.11	0.61	0.79	0.43	3.17	0.66	−3.33	0.001	3.38	0.67	−3.42	0.001
Barriers to reporting	3.01	0.50	−5.47	0.001	2.88	0.54	1.02	0.31	2.93	0.62	−0.52	0.60
Mean	3.11	0.33	−2.88	0.004	3.10	0.36	−3.45	0.001	3.25	0.30	−4.34	0.001

The one-way ANOVA results indicated a statistically significant variation in RRIOI culture across participants from different industry sectors (F_{(3, 627)} = 3.19, p < 0.05). Further analysis revealed that RRIOI culture dimensions also differed significantly among industry groups, including identification and response (F_{(3, 627)} = 6.39, p < 0.001), corrective actions (F_{(3, 627)} = 7.57, p < 0.001), and barriers to reporting (F_{(3, 627)} = 3.3, p < 0.05). Although Tukey’s post hoc comparisons were conducted to explore inter-industry differences, no statistically significant pairwise differences were found. Given its relevance and importance, employment status was included in the regression model. In contrast, accident experience and safety training were excluded, as the corresponding data had not been collected from safety managers.

A hierarchical linear regression analysis conducted to predict the culture of RRIOI based on variables such as management role, employment status, ownership, and type of industry (Table 4). In the first step of the analysis, the job characteristics were found to explain 3% of the variance in the culture of RRIOI (F _{(2, 628)} = 9.42, p < 0.001). The study found that the organizational characteristics explained 4% of the variance in the culture of RRIOI, as indicated by the statistical analysis (F _{(4, 626)} = 6.56, p < 0.001). The results of the study also indicated that the type of management had a positive effect on the culture of RRIOI (ß= 0.21, t = 4.95, p < 0.01), while the type of industry had a negative effect on it (ß= −0.11, t = − 2.23, p < 0.05).

Table 4.

Hierarchical linear regression for the culture of RRIOI

Independent variable	Model 1	Model 2
Safety manager VS non-manager	0.17**	0.21**
Permanent VS temporary	0.00	0.05
Public VS private		0.02
Type of industry		−0.11*
R 2	0.03	0.04
F	9.42	6.56
P	0.001	0.001

*p < 0.05

**p < 0.01

The Table 5 presents various reasons for under-reporting occupational incidents and the perceived consequences of reporting. Among the most cited reasons for under-reporting were personal incentives tied to safety awards, with the highest mean score of 3.32, suggesting that employees may avoid reporting to maintain a record of zero accidents. Additionally, incidents perceived as minor or common were often deemed unnecessary to report (mean = 3.08), while concerns about negatively affecting coworkers’ performance scores (mean = 3.02) and uncertainty regarding what constitutes a reportable incident (mean = 2.97) also played significant roles. A lack of trust in corrective action (mean = 2.96) and a desire to protect an accident-free record (mean = 2.93) further contributed to this trend. These findings suggest that both organizational incentives and individual perceptions significantly influence the decision not to report incidents.

Table 5.

The reasons for under-reporting and perceived consequence for reporting accidents

	Item	Mean
	Reasons for Under-reporting
51	1. I want to receive a safety award for having no accidents.	3.32
44	2. The circumstances that led to the incident or its outcomes (such as common events with minor consequences) often make reporting seem unnecessary.	3.08
65	I believe that reporting the incident may negatively affect my coworkers’ safety performance scores.	3.02
43	I am not sure which types of incidents need to be reported.	2.97
61	3. I believe no corrective action will be taken to address the reported problem.	2.96
45	As long as employees learn from the incident, I see no need for further discussion.	2.94
64	I did not want to be the one who broke the unit’s accident-free record.	2.93
46	Reporting undesirable incidents has minimal perceived impact on my work quality.	2.92
55	Filing an incident report or a compensation claim is complicated.	2.91
40	I do not know who is responsible for writing the incident report.	2.91
48	I do not report injuries because they are too minor.	2.91
38	When I am busy with work, I forget to report occupational incidents.	2.90
53	4. The time required to report an injury discourages me from reporting it.	2.79
57	Management discourages me from reporting injuries.	2.78
62	I felt the incident was not significant enough to report.	2.74
59	I fear that by reporting an incident, I may prevent my coworkers from receiving performance-related rewards.	2.68
58	I do not have medical insurance to cover injury-related expenses.	2.65
	Consequences of reporting
42	5. I do not want to become the subject of discussion in meetings.	3.18
39	I dislike the potential legal follow-ups associated with reporting occupational incidents.	3.09
41	If I report an occupational incident, my coworkers may not support me.	3.06
37	I am concerned about regulatory consequences when I report an occupational incident.	3.04
47	New employees are often blamed when undesirable incidents occur.	3.01
50	I am worried that my supervisor will view me as a complainer if I report an incident.	2.97
60	I dislike the follow-up interviews and questioning that occur after an incident is reported.	2.86
63	I thought reporting the incident would create discomfort or awkwardness at work.	2.86
56	6. If I report an incident, management will reprimand me.	2.84
52	I am afraid that reporting my injury will lead to new safety regulations that make my job more difficult.	2.82
67	Incident reporting may lead to tension and conflict between departments.	2.81
66	7. Reporting an incident may cause problems for my coworkers.	2.80
54	Employees worry that their coworkers will ridicule them for not being strong enough.	2.78
49	I do not report incidents because I fear losing my job.	2.72
68	I do not report incidents because they become part of my employment record.	2.57

Regarding perceived consequences, social and organizational pressures emerged as key deterrents. The highest-rated concern was becoming the subject of discussion in meetings (mean = 3.18), followed by apprehension about legal consequences (mean = 3.09) and a lack of peer support (mean = 3.06). Employees also expressed concern over being viewed negatively by supervisors (mean = 2.97) and discomfort with post-incident investigations (mean = 2.86). Fear of management reprimand (mean = 2.84) and the potential for new, more burdensome safety regulations (mean = 2.82) were additional deterrents. These results reflect a workplace culture where incident reporting is not only discouraged by procedural burdens but also by social stigma and fear of retaliation, highlighting the need for cultural and systemic reforms to encourage transparent reporting practices.

The analysis of the causes of under-reporting and the implications of reporting occupational incidents revealed that the primary challenges may originate from both organizational and external sources. To gain a deeper understanding of these problems, a qualitative study was carried out to identify their underlying causes.

The findings of the qualitative study

The analysis of interview data showed that the reporting occupational incidents within organizations is commonly carried out by telephone communication, however in certain cases, it may also be performed via face-to-face interaction. Industry, mine and trade organization; electricity power distribution, telecommunication company, water and sewage company, oil products distribution company, bank, Urmia municipality, gas company, and a hospital use phone calls to report work-related incidents. Upon receiving notice of the accident, safety officer in the majority of organizations promptly arrived at the incident site and proceeded to fulfil the necessary administrative duties by completing the social security accident reporting forms. Within a small number of organizations, there was a unique format employed for internal accident reporting, in addition to the standard social security accident reporting form. In the majority of organizations, there is a notable lack of reporting for low-severe incidents and near-misses. Incidents with low severity, near-misses, unsafe activities and conditions are typically addressed during safety inspections.

The majority of cases of severe accidents are reported to safety departments and then transmit to labor inspection and social security offices. Given that the labor inspection, social security along with the health centers serve as legal authorities responsible for inspecting OHS matters, it is imperative for organizations to duly record and investigate any reported incidents. The participants assert that they have not been provided with feedback by the authorities. Accidents are documented inside the internal automation system of four distinct organizations, including a water and sewage company, electricity power distribution, and a gas company. In contrast, hospitals, the tobacco industry, energy power distribution companies, and the Urmia municipality utilized paper-based forms for the purpose of documenting occupational accidents. The reported incidences were also recorded by health centers using a paper-based system. A safety manager in a manufacturing company expressed the belief that:

“The implementation of a digital reporting and registration system for workplace incidents has the potential to provide significant assistance in the process of incident registration”.

In the typical sequence of incidents, the safety officer participates with the accident investigation team at the scene of the accident to gather the necessary evidence to prepare paperwork. This occurs subsequent to the safety officer’s notification of the incident to the relevant organizations, namely the Urmia municipality, oil products distribution company, gas department, and electricity power distribution. Nevertheless, the task of investigating the incident was exclusively assigned to the safety officer inside many organizations, including hospitals, water and sewage company, telecommunication company, and banks. Particular sectors, such as the healthcare sector encounter problems pertaining to the proper recording and reporting of incidents. According to the health officer of a hospital, “the incomplete accident reports can be attributed to the absence of an OHS officer in site and a lack of sufficient attention towards workplace incidents that considered unimportant”.

The Labor inspection office and social security accident investigation teams were present at the scene of claimed severe work-related incidents. The composition of the team is dependent upon the nature of the accident.

In various organizations, including industry, mining and trade organization; electricity power distribution, Urmia municipality, telecommunication company, tobacco company, oil products distribution company, and gas company, the investigation of the incident involved the active participation of individuals who hold diverse positions within these organizations. The accident investigation team comprised an occupational health expert and a safety officer, as well as members of the committee for technical protection and health at work in organizations. Following the receipt of the report by many organizations, including tobacco company, electricity power distribution company, water and sewage company, Urmia municipality, and telecommunication company, an accident investigation team was promptly sent to the location. The analysis of accident investigation reports revealed that a significant proportion of these investigations are conducted in a superficial manner, sometimes failing to adequately identify the underlying causes of accidents. According to a labor office inspector, it was believed that:

“It is recommended that the safety officer within each organization should act as a member of the health center or labor inspection office personnel, rather than as an employee of the company. By doing so, the execution of OHS functions would be improved”.

Based on the research findings, several factors have been identified as contributing to the reduced importance and hesitancy to engage in RRIOI. These factors include a limited understanding of the importance of RRIOI, inadequate training, a reluctance to engage in accident insurance matters, reduced industry and office scores resulting from inaccurate accident reporting, which impacts employers’ interests, and employees’ fear regarding potential job loss. According to a safety expert, the problems pertaining to RRIOI can be attributed to the insufficient efforts made by the OHS authorities in enhancing OHS practices:

“Inspectors from the OHS authorities employ bureaucratic and dictatorial methods that develop a negative attitude among companies and encourage them to take less responsibility for workplace accidents. It is important that both workers and employers receive appropriate training, while simultaneously developing a culture throughout all sectors of society that promotes heightened awareness of workplace incidents across different workplaces”.

Table 6 summarizes stakeholder perspectives on the RRIOI framework, revealing both strengths and systemic weaknesses. While OHS officers are recognized for prompt responses and investigative commitment, they often operate without digital tools or adequate support. Employees demonstrate some protocol awareness but face barriers such as fear of reprisal and limited RRIOI knowledge, leading to under-reporting. Supervisors engage in investigations but inconsistently apply procedures and focus narrowly on severe incidents, reflecting training and implementation gaps. OHS inspectors, though legally empowered, are often seen as punitive, which may discourage transparency. Administrative staff support documentation but are excluded from planning and constrained by paper-based systems. Overall, the findings highlight fragmented practices and emphasize the need for integrated digital infrastructure, targeted training, and a shift toward a just, inclusive safety culture.

Table 6.

Summary of strengths and weaknesses in RRIOI identified by stakeholder groups

Group	Strengths Identified	Weaknesses Identified
OHS Officers	- Prompt incident site response - Familiarity with reporting forms - Active in investigations	- Often responsible alone for investigations - Lack of digital systems - No feedback from authorities
Employees	- Awareness of formal incident protocols in some organizations	- Fear of job loss - Lack of RRIOI knowledge - Under-reporting of minor incidents and near-misses
Supervisors	- Participation in investigation teams in select organizations	- Inconsistent use of forms - Lack of training - Focus mainly on severe incidents
OHS Inspectors	- Legal authority to oversee and ensure compliance - Participation in major accident investigations	- Perceived as bureaucratic and punitive - Seen as discouraging full organizational accountability
Administrative Staff	- Handle official paperwork post-incident	- Often not involved in safety planning - Paper-based systems slow data access and analysis

Discussion

The evaluation of RRIOI’s culture revealed that corrective actions had the highest score, whereas barriers to reporting had the lowest score. Employees who received OHS training had a lower score for the RRIOI culture than those who did not receive safety training. Employees who experienced occupational accidents exhibited a significantly lower scores on the culture of RRIOI than other respondents. The findings also revealed a positive association between type of management and RRIOI culture; the type of industry had a negative correlation with it. In many cases, occupational accidents within organizations are reported via telephone communication. In the majority of companies, there is a notable lack of reporting for low-severe incidents and near-misses. The participants asserted that they were not provided any feedback by the OHS authorities regarding the incidents they had reported. Additionally, this study identified factors contributing to participants’ reluctance to report workplace incidents.

Corrective actions received the highest score among RRIOI culture dimensions, while barriers to reporting received the lowest. The high score for corrective actions reflects participants’ recognition of their importance in mitigating the recurrence of similar accidents. However, this perceived priority is undermined by limited investigative depth and incomplete reporting, especially of low-severity incidents and near-misses. In many organizations, incident reporting is still informal—often conducted via telephone—with little to no follow-up or feedback from OHS authorities. This gap between corrective action and systematic incident investigation suggests that meaningful safety improvements remain inconsistent and reactive. Given the high incidence of under-reported low-severity accidents, addressing their root causes is essential. Participants prioritized corrective action, assigning it the highest importance. However, limited incident reporting and superficial investigations—shaped by individual and organizational perceptions—remain significant barriers, reflected in the lowest score for reporting-related factors. Without thorough post-incident investigations and corrective measures, similar events are likely to recur, highlighting the need for systemic organizational commitment to learning from incidents.

Employees who received OHS training reported significantly lower RRIOI culture scores than those who did not. While counterintuitive, this finding may indicate that the current training programs are not adequately aligned with RRIOI objectives. If training lacks relevance or depth regarding incident reporting and investigation, it may fail to shift perceptions or behaviors [38]. Participants should engage in supervised practice to reinforce behavioral change and foster a positive safety culture. Training unrelated to RRIOI appeared to have no measurable impact on participants’ perceptions. This study also found a significant relationship between training and perceived barriers to reporting, further highlighting the need to reevaluate training content and delivery methods. As Cooke et al. [33] noted, reporting alone does not lead to organizational learning—there must also be mechanisms for timely investigation and dissemination of findings.

Employees with prior accident experience also scored lower on RRIOI culture measures. This implies that the experience of an occupational accident does not necessarily lead to improved safety behaviors or reporting attitudes. Instead, such experiences may foster disillusionment if organizational responses are inadequate. This finding aligns with research suggesting that accident experience, in the absence of a strong safety culture, may erode trust in reporting systems rather than reinforce them [39–41]. These results emphasize the critical need for organizations to foster a trustworthy and responsive safety culture to ensure that accident experiences contribute to RRIOI engagement.

Hierarchical regression analysis revealed that management role positively influenced RRIOI culture, while the type of industry had a negative effect. This suggests the critical role of safety managers in fostering a robust reporting culture. Implementing a comprehensive safety management system is vital for formalizing incident reporting and investigation. Cultivating a strong safety culture is key to enhancing system effectiveness and promoting safety-positive behaviors, particularly in the RRIOI process [42–45]. While RRIOI is a key component of safety standards like OHSAS 18,001 and ISO 45,001, their voluntary nature means organizations are not obligated to fully meet RRIOI objectives [46, 47]. Prior Iranian studies similarly report difficulties in safety culture development and the implementation of safety management frameworks, especially in industries with limited infrastructure or regulatory oversight [48, 49]. Enhancing safety culture significantly reduces occupational incidents [50] and improves the RRIOI process, but requires sustained commitment and effort [51]. Differences in RRIOI culture across industries are unsurprising given the variance in organizational structures, safety management maturity, and resource availability. Formal sectors such as healthcare and large-scale manufacturing tend to have more developed RRIOI procedures, supported by trained personnel and internal policies. In contrast, sectors like construction often lack these systems, leading to fragmented and informal reporting. Previous studies have confirmed that organizational and industry-level factors significantly influence safety behaviors and attitudes [52–55]. Therefore, sustained commitment to strengthening safety culture and formalizing RRIOI practices is essential for improving occupational safety outcomes across industries.

The analysis of qualitative data in this study revealed that low-severity incidents and near-misses are rarely reported, echoing international findings on under-reporting [3, 4]. This is particularly problematic in middle-income countries like Iran, where comprehensive national-level data are scarce [30]. The lack of a centralized, integrated RRIOI system not only distorts national statistics but also prevents effective accident prevention planning. The continued use of retrospective safety indicators—based on flawed or incomplete data—further impairs organizational decision-making. Since reporting errors can be estimated but recording errors cannot, improving data accuracy must become a national priority.

Compared to structured models in countries like the U.S. and the U.K., Iran’s RRIOI system is largely informal, decentralized, and reactive. These systems abroad benefit from legal enforcement, standardized processes, digital tools, and feedback mechanisms—elements currently lacking in Iran. Establishing a national digital RRIOI platform, supported by legal mandates and organizational incentives, could dramatically improve data reliability and safety outcomes. Mobile-based reporting tools, for example, could enhance accessibility, timeliness, and transparency in the reporting process.

Despite existing regulations, there is ambiguity in Iran regarding which incidents must be reported, to whom, and by whom. This confusion contributes to inconsistent practices and insufficient accountability. Encouraging a just culture—one in which employees can report without fear of reprisal—is essential for improving RRIOI participation. Organizations must foster a culture where learning from incidents is prioritized over assigning blame.

Strengths and limitations

This study is the first known mixed-methods investigation of RRIOI culture in Iranian industries. It combined a large-scale quantitative survey (n = 631) with qualitative interviews (n = 20), enabling triangulation of findings and offering a comprehensive understanding of the cultural and procedural dimensions of RRIOI. The inclusion of multiple sectors—such as construction, mining, manufacturing, and healthcare—supports the generalizability of the results across industry sectors. However, the study has limitations. First, self-reported data may be influenced by social desirability or fear of retaliation, even though researchers were present to clarify responses. Second, organizational reluctance due to the sensitivity of the topic may have restricted access to some information. Finally, the cross-sectional design prevents causal inference; future longitudinal research is needed to track changes over time.

Although the study explored RRIOI across industries, it did not explicitly examine variations in safety management systems. Given the negative association between industry type and RRIOI culture in the regression model, future studies should investigate how organizational size, leadership, and the maturity of safety management systems contribute to these differences. Incorporating variables such as safety climate and accident history may enhance predictive accuracy. However, due to sample size constraints and the desire to avoid model over fitting, this study focused on four factors. Future research should consider broader, more complex models to capture the full range of influences on reporting behavior.

Access to regulatory data from organizations such as the Labor Inspection Office or Social Security Organization is essential for conducting more robust studies. However, authorization barriers and data unavailability limited our ability to directly assess the extent of under-reporting [30]. Moreover, the precarious employment conditions in certain sectors—characterized by short-term contracts and low job security—may have impacted participant willingness to disclose incidents.

Conclusions

This study revealed critical gaps in the culture and practice of RRIOI within Iranian industries. Notably, participation in general safety training and personal experience with workplace accidents did not lead to stronger RRIOI culture. This finding highlights the need to reassess training content, post-incident procedures, and overall safety culture. Without effective feedback and learning systems, these interventions fail to translate into behavioral change. The findings also suggest that industry-specific approaches are essential, as RRIOI practices vary considerably by sector. Developing a national digital RRIOI infrastructure—supported by mobile applications and supervised by the Labor Inspection Office—could significantly improve incident tracking, data accuracy, and feedback systems.

To address under-reporting and improve safety outcomes, organizations must move beyond mere compliance and adopt a more proactive approach. This involves establishing clear and user-friendly reporting channels, providing targeted training that addresses RRIOI-related behaviors and beliefs, and ensuring that all incidents—including near-misses—are thoroughly investigated with lessons learned shared across the organization. Equally important is the cultivation of a just and learning-oriented safety culture that encourages openness, accountability, and continuous improvement.

Future research should employ longitudinal designs and include a broader range of industries to better capture the dynamics of RRIOI over time. Despite the logistical challenges, nationwide studies using verified data are urgently needed to quantify under-reporting and guide evidence-based safety reforms. By institutionalizing transparency, feedback, and accountability, it can move toward a more effective and proactive safety system.

Abbreviations

BLS

Bureau of Labor Statistics

OHS

Occupational Health and Safety

OSHA

Occupational Safety and Health Administration

RRIOI

Reporting, Registration, and Investigation of Occupational Incidents

Authors’ contributions

AG was responsible for conceptualization, formal analysis, writing – original draft, and methodology.ZS was responsible for data gathering, formal analysis, and writing – original draft.MM and FA were responsible for data gathering and formal analysis.

Funding

This research is part funded by Urmia University of Medical Sciences.

Data availability

Data will be made available on request.

Declarations

Ethics approval and consent to participate

The research protocol was approved by the ethics committee of Urmia University of Medical Sciences, Iran (IR.UMSU.REC.1397.77). This investigation was performed based on the Helsinki statement and ethical aspects of human research. The participants were assured that the data would remain anonymous and confidential. Informed consent was obtained from all participants.

Consent for publication

໿Not applicable.

Competing interests

The authors declare no competing interests.