Report: 75% of Small Businesses Had Workplace Injuries, Mental Health A Growing Concern

Three-quarters of small businesses reported a workplace injury in the past year, while mental health-related injuries grew to become the most common workplace injury, a report using data from more than 1,000 small business owners shows.

The report examines the evolving safety landscape for small businesses across the U.S using data from business owners and decision-makers. It sought to get to the bottom of how businesses are responding to shifts in safety trends, including rising mental health challenges, preventable injuries, employee resistance and the adoption of Artificial Intelligence-powered safety technology.

According to Pie Insurance’s 2025 State of Workplace Safety Report, half of the workplace injuries were reported as preventable, more than 30% of small businesses reported spending in excess of $20,000 on injury-related costs in the past year and an injuries resulted in an average of four lost employee workdays and three full business days of disruption annually, according to the report.

Other findings include:

• Mental health-related workplace injuries surged to 22%, surpassing physical injuries such as slips, trips, and falls (20%) as a leading risk.
• 42% of businesses with commercial vehicles reported auto-related incidents in the past year, each costing an average of $5,725 per accident.
• 81% of small businesses are open to adopting AI tools to enhance safety.
• 42% of business owners cited employee resistance as a barrier to adopting new safety measures. The most common reason employees gave for not following safety protocols is that they don’t think it’s necessary (36%) or they forget (32%).

“Mental health is emerging as a critical concern for workplace safety, with an increasing number of businesses recognizing its profound impact on employee well-being and productivity,” the report states. “46% identified mental health as the greatest workplace safety risk. This represents a significant shift in perspective as employers increasingly acknowledge the complex challenges posed by stress, burnout and mental health-related injuries.”

Pie Insurance commissioned YouGov PLC to conduct a 15-minute online survey. The total sample size was the owners or decision-makers at 1,018 U.S. small businesses (defined at two to 500 employees), who were interviewed about commercial insurance and workers’ compensation insurance between Jan. 9 and Jan. 18.