Safety and Health at Work · Jun 1, 2026

Impact of the Serious Accidents Punishment Act on Occupational Injury Rates in Korea's Manufacturing Sector: An Interrupted Time-Series Analysis

By Lee J, Oh J, Park H et al.

BACKGROUND: The Republic of Korea introduced the Serious Accidents Punishment Act (SAPA) in 2021 to improve workplace safety by holding company leaders legally accountable for serious accidents but its impact on injury trends has not been well established. This study evaluated SAPA's effect on age-sex-standardized injury incidence rates (ASRs) in the Republic of Korea's manufacturing sector, examining differences by company size (≥50 vs. <50 employees), sex, and injury type (inpatient vs. outpatient). METHODS: Using National Health Insurance Service Cohort data (January 2011-April 2024), we employed interrupted time-series design to assess SAPA's effects from January 2022. Injury data (International Statistical Classification of Diseases and Related Health Problems, 10th Edition: S00-T88) were standardized using the 2015 Republic of Korea Statistical Information Service population. Generalized least squares regression analysis with an autoregressive moving average structure was performed to analyze ASR trends across subgroups. RESULTS: Following SAPA implementation, nonsignificant decreases in both inpatient and outpatient ASR were observed among men in companies with 50 or more employees. Among women, inpatient ASR showed opposite patterns according to company size; however, after Benjamini-Hochberg adjustment for multiple comparisons, these effects did not retain significance in the full 2011-2024 dataset. A sensitivity analysis restricted to 2017-2024 suggested that the increase in <50-employee companies may represent a robust signal in the more recent period. CONCLUSION: SAPA implementation was not associated with statistically significant changes in injury rates in most subgroups after multiple testing adjustment, consistent with the early post-implementation experience of analogous international legislation. Exploratory subgroup analyses suggested differential responses by sex and company size, necessitating longitudinal research to evaluate the law's long-term preventive effects.

doi.org/10.1016/j.shaw.2026.05.002PubMed 42856874Industry & policy