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Injury Rate at Fresno’s Amazon Warehouse Is Triple Industry Average

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Amazon process assistant Christian Ramirez-Gallegos sorts packages at the Amazon Fulfillment Center south of Fresno. (Eric Paul Zamora/The Fresno Bee)

Amanda Caballero wishes she could go back to work at Amazon.

She made $15 an hour at the Fresno fulfillment center — several dollars more than the state’s minimum wage — and received more than three months of paid maternity leave. Her generous health insurance package covered her husband and five children, and she liked her managers.

But a wrist injury left the 31-year-old Fresno resident unable to work.

Standing on a two-step ladder during her Amazon shift last March, she was struggling to get a heavy box out of a cubby. She grabbed the box and tugged, but her glove was stuck underneath it, and as she pulled, her hand stayed in place, straining her wrist.

She recently stopped receiving workers’ compensation payments and doesn’t qualify for any available jobs, Amazon or otherwise, from nurse’s assistant to retail cashier, because she can’t lift even a gallon of milk. The family now depends on her husband’s income as a security guard, help from their family and food stamps. Despite weeks of physical therapy, it’s unclear when her wrist will heal.


Caballero’s injury was one of 307 injuries and illnesses recorded at the Fresno fulfillment center between June 2018, when it opened, and May 2019, according to federal Occupational Safety and Health Administration records.

In 2018, the Fresno warehouse’s rate of serious injuries — those that require job restrictions or days off work — was nearly 12 injuries per 100 workers, almost three times the national warehouse industry average last year, and more than double the statewide industry average, according to OSHA records.

The injury rate in Fresno ranked 10th among 28 Amazon warehouses nationwide in 2018 for which Reveal, from The Center for Investigative Reporting, obtained records. It ranked third among California’s Amazon warehouses.

The center, among the top corporate employers in the county, employs more than 2,500 people.

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The Fresno Bee spoke with more than a dozen Amazon workers, four of whom were injured and agreed to go on the record. They said the job was great, as were the pay and benefits. But they said injuries at Amazon were crippling in more ways than one.

The workers described a stressful environment, where they had to keep a breakneck pace or face write-ups from supervisors. They feared taking bathroom breaks or time off due to injuries or illnesses because they said they felt doing so would put their jobs at risk. They also said they feared or were discouraged from filing injury reports, which indicates that official rates may be undercounted.

The vast majority of injuries were described on OSHA reports as sprains and strains to the back, wrist, shoulder and ankles. The remaining workers sustained bruises, fractures or smash injuries, like crushed toes or skin irritations. The workers interviewed reported mostly sprains and strains due to repetitive motions.

While they were made to stretch before work and lunch, and “microstretch” throughout the day, employees said repeating the same motion over and over wore on their muscles and ligaments.

Some who were hurt on the job said they struggled to get and keep workers’ compensation, and still feel the physical effects of their injuries months after their benefits ended.

Amazon Responds

In an emailed statement to The Bee, an Amazon spokesperson said its injury rates appear high because the company is aggressive about recording injuries, regardless of whether they are work related. Amazon said they believe others in the industry dramatically underreport.

“You’re seeing this in the rates because we take an abundance of caution in not placing employees with work restrictions back at work before they are ready,” the spokesperson said in the email. “We know that by making a conservative choice to not place an injured associate back into a job before permitted by their work restrictions, we are increasing lost time as a company, but with the intent to benefit the associate.”

The company added that training and protocols to ensure safety are ubiquitous at Amazon. The company has spent over $55 million on capital investments specific to safety improvements, it wrote. For example, supervisors are supposed to track and audit progress on reducing physical risk, and every associate is asked to fill out a monthly safety survey.

Amazon process assistant Ivan Agcaoili works at his station. The center, among the top corporate employers in Fresno County, employs more than 2,500 people. (Eric Paul Zamora/The Fresno Bee)

Caballero doesn’t blame Amazon.

The job was the best one she’s had, and a rigorous set of safety guidelines existed, including mandated daily stretching. But she believes supervisors were under such high pressure to meet quotas, they encouraged workers to do anything for the job, regardless of the physical toll.

“They knew what was happening and they just let it happen,” Caballero said.

Amazon said they have never heard of supervisors encouraging teams to bypass safety guidelines to meet quotas.

“Like most companies, we have performance expectations for every Amazonian — be it corporate employee or fulfillment center associate and we measure actual performance against those expectations,” the spokesperson wrote. “Associate performance is measured and evaluated over a long period of time as we know that a variety of things could impact the ability to meet expectations in any given day or hour.”

A Big Win for Fresno

At 855,000 square feet, Amazon’s fulfillment center in Fresno spans about 14 football fields. It runs 24 hours a day and utilizes hundreds of robots.

A machine illuminates for workers like Caballero what items to grab from cubbies or bins, and where to place them. Robots resembling automatic vacuum cleaners underneath shelves whisk items across the floor. More than 10 miles of conveyors whisk packages from one end of the warehouse to another.

The city spent nearly a year in negotiations with Amazon to secure the state-of-the-art warehouse. Mayor Lee Brand’s Economic Expansion Act, approved by the City Council in 2016, calls for Fresno to rebate 90% of the city’s share of property taxes as well as the city’s entire share of sales, and use taxes paid by the company on purchases it makes in Fresno.

The city spent more than $1 million in broadband installation, expanded roads leading to the warehouse and modified bus routes, according to Councilman Luis Chavez, a vocal supporter of the city’s Amazon deal.

To qualify for the incentives, hard-capped at $30 million over 30 years, Amazon agreed to provide 750 new full-time jobs at the center throughout that time period.

Amazon also committed to a $53 million investment in the city, county and Fresno Unified School District over 30 years. Since opening, the company has has donated $15,000 to the Fresno Unified School District to support STEM and robotics education for more than 600 local students and $25,000 to the nonprofit WestCare Homeless Alleviation, it said.

In addition to a $15 minimum wage, Amazon offers employees comprehensive medical, vision and dental benefits, as well as a 401(k) plan with a 50% company match. Employees can receive up to 20 weeks of paid family leave. Amazon also offers nearly full tuition for employees to go back to school in high-demand fields, it said.

Chavez said Amazon’s presence has forced other warehouses, like Kraft and OK Produce, to raise hourly wages by $2 or $3 in order to compete. It also put Fresno on the map for other companies, he said.

“Now that Amazon and Ulta [a cosmetics supplier] came, there’s been a lot of interest in other companies coming to Fresno, and I think that’s been a big plus for the city of Fresno to provide more jobs for the community,” Chavez said.

However, he added the city needs to dig deeper to learn why the injury rate is “abnormally high.”

“To have 12 out of 100 employees to be injured in that span is really high,” Chavez said. “Our goal should not be the state or the national average, it should be well below that.”

In an emailed statement to The Bee, Mayor Brand said he couldn’t speak about the company’s workplace injuries, but said worker safety in general was a basic expectation.

“Since their e-commerce center opened in 2018, Amazon has had a positive effect on our community as well as our economy, providing thousands of good paying jobs that helped Fresno achieve record low unemployment and bring opportunity and advancement for Fresno families,” Brand said.

He added that regulatory agencies like Cal/OSHA closely monitor and enforce worker safety.

“I expect every business in Fresno to not only comply with worker safety laws, but also to value their employees,” he said. “Given what Amazon has done for their employees with benefits and education incentives, I expect that they also take workplace safety very seriously.”

Fear of Reporting Injuries

Most of the workers The Bee interviewed said they were scared to report injuries to their supervisors. When they did, they said they felt discouraged from filing formal injury reports.

Caballero feared reporting her injury because she had heard from her coworkers that it could result in being passed up for a promotion. She told her manager anyway, when she could no longer work with her right hand.

“I didn’t really want to have a report written for my injury and get treated differently,” she said.

Tambra Recek, 33, said she injured her back lifting boxes at the warehouse and the pain drove her to tears. At AmCare, the in-house first aid facility, she said she was told she would have to clock out to see a doctor, something she still hasn’t done because she has doesn’t have health care.

“I can’t afford to not get paid. I have kids,” Recek said. “Finally I said, ‘You know what, I’m fine. I’m fine.’ They asked, ‘Do you want to drop the case?’ So I signed those papers saying that you don’t want to go further. But you still have to pack. You still have to go fast and it’s hard when you’re in a lot of pain.”

Kelly Hoffman, a 40-year-old mother of four, said she was injured three times before she reported it because she was scared of losing her livelihood.

First, she said, a box fell on her shoulder. Then she pulled a muscle reaching for a box in a cubby. In January, her wrists began aching, but she said she only let her supervisors know months later.

Her husband, Keith, who also works at the fulfillment center, said that in July, he was picking up a flat of energy drinks from a bin to scan and put into a tray when he felt his back pop. When a manager took him to the AmCare facility during a break, he urged her to come along because she kept rubbing her wrist.

In their emailed response, Amazon officials said the health and safety of associates is their top priority and they “support employees when they have personal obligations, health matters or other life events that require support.” The company declined to discuss individual complaints to respect the privacy of employees, but said they have zero tolerance for retaliation against employees who raise concerns.

Amazon process assistant Ivan Agcaoili looks to his computer monitor as he sorts packages. (Eric Paul Zamora/The Fresno Bee)

Seeking Care

Kelly Hoffman had her wrist wrapped and returned to work. She went to the doctor the next day, and learned that the tightly wrapped bandage was constricting her nerves, worsening the injury. She was diagnosed with carpal tunnel syndrome in both wrists.

“Patient may have a baseline narrowed canal, which was aggravated by the repeated work she does at Amazon,” her medical records say.

Keith Hoffman, 43, was sent to the doctor, who later found a mild disc bulge and a narrowing between two of his vertebrae, his records show.

Both were taken out of work and put on workers’ compensation, receiving around $800 every two weeks.

They said there was no ibuprofen at the clinic or in the vending machine in the break room.

“It’s always gone because everyone goes to work sick there because you never have time,” Keith said. “I can’t tell you how many times I saw somebody throwing up in a garbage can there because they don’t want to get fired for missing work.”

While Amazon declined to comment on specific incidents, the company said onsite medical representatives “follow clear, established company guidelines for first aid treatment in accordance with local, state, and federal regulations.”

It added that no associate should ever be discouraged from seeking care. Employees receive up to five weeks of time off a year and full health benefits starting on day one, it said.

A Stressful Work Environment

Recek, the mother of two who threw out her back in March, remembers being under constant stress. The loud machinery and fans buzzed in her ears during her 10-hour shifts, with no respite. (Phones are not allowed on the floor.) She said she always felt watched by supervisors who stood on elevated platforms overlooking work stations.

If she went to the bathroom, which was about half a block and two flights of stairs from her station, she would be asked why she had taken so long off task.

Amazon countered that every employee has quick, easy access to bathrooms and is allowed to use them freely.

In April 2019, Recek broke down while packing boxes.

“I don’t know what triggered it,” she said. “I was standing there. Somebody was talking to me and I blacked out. I was bent over the counter and I just was stuck. They said they were talking to me and I wasn’t replying. My manager came over and said, ‘What happened?’ I said, ’Huh?’ I didn’t remember.”

After what she called an anxiety attack, Recek took a leave of absence. She didn’t qualify for workers’ compensation, so she received disability payments from the state until her fund ran out in December. But she said she hasn’t been able to afford medication to treat her anxiety and depression because her benefits ended in October. She has been doing food delivery through apps like Postmates to keep up with bills, but she said her back is in constant pain from the injury she never formally reported. She has no medical documents to support the reason for her leave of absence.

Hoffman and her husband also lost their health insurance, with no prior notice, when their short-term disability ended in December. They both suffer from high blood pressure, and had three kids on their insurance, so they worry about what they will do when they run out of medicine or their kids need to see their eye doctor.

“We busted our butts for these people and that’s the pay we get, is losing our benefits — while we’re injured — because of them,” Keith Hoffman said.

‘I Would Do it Again’

In spite of high injury rates, most of the workers interviewed said they enjoyed their jobs and would go back if they could.

“The opportunities are endless when it comes to working with Amazon,” said Ivan Agcaoili, a process assistant at Amazon who has not suffered any injuries. “As long as you keep your head down, you work hard, you learn the process to understand everything, you’re good to go. It’s kind of a contagious thing.”

The Hoffmans said they could barely make it outside for a cigarette on their breaks, so they still feel grateful the job helped them quit smoking.

“I would do it again. I really would,” Keith said. “But it’s really strenuous work so it does wear on you.”

This story by Fresno Bee journalist Manuela Tobias was completed with information from Reveal’s Reporting Networks.


It is part of The California Divide, a collaboration among newsrooms examining income inequity and economic survival in California.

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