Apparently, the hotel industry is bloody dangerous.

Dr. Eric Lis is a physician, gamer, and author of the Skirmisher Publishing LLC sourcebook, Insults & Injuries.

If there's one experience common to most adventurers, it's that of staying in an inn. The tavern, and by extension the inn, is one of the staples of medieval fantasy and our games in general. It's something that's evolved well beyond a trope, to become a running joke. Any time a bunch of adventurers go to the local tavern, they almost take it as a given that they'll encounter a shadowy figure who's eager to hand them a new quest, or a clue, or possibly a new reason to be hunted down by the town guard. In our capacities as player characters, we all know what to expect from the inn... including the injuries that come with the experience, such as the knuckle-shaped bruises, the splinters from broken chairs, and the occasional loss of limb that comes from learning that the bartender is a retired twentieth-level fighter. Contrary to what we might imagine, however, these common health hazards are not the most common injuries that people sustain in inns. As PCs, we easily forget that there are other characters out there, namely the poor suckers with whom the storyteller populates the place. What kinds of injuries most commonly plague those who maintain the hotels and motels of your campaign worlds?

To begin answers this question, I turn to the American Journal of Industrial Medicine, and specifically, this article and this one. Both of these articles are about 5 years old, but I'm going to assume that the hotel industry hasn't changed terribly much in the intervening three and a half years, or at least, it hasn't become any more unlike a medieval inn than it already was. One of these studies looked at data from about 50 hotels from across the US while the other focused on five hotels in Las Vegas. All the studied hotels in both studies were unionized, which right away would suggest to me that their employees are better treated than at non-unionized places, but this may not be a valid assumption.

So here's something really interesting that I never knew before today: the hotel industry is bloody dangerous. Apparently, a hotel employee is about 40% more likely to sustain a workplace related injury than someone in any other service sector job. While this means that hotel workers aren't being compared to, say, factory machinists or police or whatever, it still means they're being injured more than cooks or cab drivers, which I would have assumed had higher rates. The authors of these papers speculate that a big part of this is that people who work in modern American hotels tend to be some of society's most vulnerable: immigrants or members of underprivileged minorities (in the larger study, 80% of the individuals studied were “non-white”), without the benefit of education (in the smaller study, 88% of individuals had a high school education or less), often working minimum wage and not necessarily rich in social capital. These are often individuals who have to take whatever work they can get to support dependents; in the smaller study, for example, almost all respondents reported being responsible for either a child or an elder.

The majority of medical problems found were acute trauma, followed by other more chronic musculoskeletal injuries. Housekeepers had the highest injury rates overall (close to 80% in the past year, about half of whom had missed work because of it), but acute trauma was most common as in kitchen staff. It's relatively good to be a waiter; they had the lowest rates of injury. Hispanic workers had the highest rates of injury, which mostly reflects that they were the predominant ethnicity in the housekeeping departments. Upper limb injuries were most common in every job, followed by more chronic back problems.

For the most part, injuries were related to the highly physically demanding nature of the jobs. Hotel staff are by and large subjected to work which is not only intense and aerobic, but highly repetitive and straining. Housekeepers especially are subjected to heavy loads, uncomfortable postures, and strenuous work without much respect in return. The hotel jobs all tended to be very high stress, with a lot of time pressure ad very little job control. The authors note some very large differences in injury rates at different hotels studied, meaning that while the work itself has risks, management practices can make those risks smaller or larger.

Neither study commented to my satisfaction on rates of injuries caused by guests. From looking at their measurement tools, I think this was mostly because they didn't try to tease apart injuries that were part of the job versus injuries caused by violence. I would like to think this means there were few or no guest-related injuries, but I can't say for certain.

Some of this data applies to our games, and some less so. On the one hand, the housekeeping industry hasn't changed that much in some ways: sheets still need to be changed, trash taken out, and so forth. In some ways, the work has probably become more pleasant – I would hope that few Las Vegas hotels still use chamber pots, for example – but in others I'm sure it's gotten harder, since your average medieval inn didn't have hundreds of rooms that all had to be serviced within the space of an hour or two. I'm not sure if modern tools such as vacuum cleaners make the work safer or more dangerous, but I'll wager that there were fewer kitchen injuries when scalding water wasn't so easily obtainable. The biggest difference between these hotels and the ones in our games is unquestionably the bar fights. Bar brawls break out constantly in games that I'm in, often as a direct result of PC actions, and I'm fairly sure that this isn't the case at a Quality Inn in New York. Still, this does give us some idea of what sorts of things can happen at a real inn, and sheds a bit of life on what goes right and what goes wrong in some of the more humble NPCs that your players might otherwise not stop to think about.