Clair McLafferty is a bartender and copywriter based in Birmingham, Ala.

(Philippe Lopez/AFP/Getty Images)

Willy Shine, 43, cues up his pre-work playlist as he stretches out each finger, then both hands. After working his way through his arms and shoulders, he stretches his legs and ankles. Then, for good measure, he pulls on compression socks and sleeves to ward off fatigue in soon-to-be stiff calves and arms.

When asked what types of injuries he’s suffered on the job, he laughs. “Let’s start with the over 75 stitches,” he said, before launching into the list: “I have tendonitis in both elbows and carpal tunnel in both wrists. I have extensive injury in my lumbar spine. I ended up with plantar fasciitis in both heels.”

But Shine’s injuries aren’t from construction carpentry, or working on a road crew. They’re from 15 years of bartending.

These days, Shine works as a bar consultant, and is more likely to be designing a menu for a bar than working behind one. But to maintain his bartending chops, he still works at bars in New York City. During a regular shift, Shine will mix upwards of 200 drinks. On a busy holiday night, that number jumps to more than 300. Over the course of 10 hours, his mixing spoons will make more than 5,000 rotations during the 50 minutes he spends stirring, irritating his wrists. Bending and twisting dozens of times to grab bottles and serve drinks will aggravate back injuries caused by these motions over time. If one of the dozens of bottles or hundreds of glasses he uses shatters, he may end up with more stitches.

Many workers in the industry have similar injury horror stories. Shine got lucky. He had health insurance or was covered by workman’s comp for the most serious incidents. But most workers aren’t that fortunate, and many on-the-job injuries go untreated and unreported.

As a result, the non-fatal injury rate published by the Bureau of Labor Statistics is deceptively low. According to its data, only 3.6 of every 100 full-time workers in the industry will face an injury. “Everything is underreported,” said Saru Jayaraman, co-director of worker advocacy group Restaurant Opportunity Centers United and director of the Food Labor Research Center at the University of California at Berkley. “There’s such an overwhelming acceptance by workers on what is normal and acceptable and tolerable in our industry. You’re made to feel that it just goes with the job.”

“Injuries are common,” says travel writer and server Chanize Thorpe, 43, of Montgomery, N.Y. “I think you’re expected to kind of suck it up and keep going.”

Though Thorpe has only been back in the industry for a few months, she’s already suffered a few small burns and almost sliced the tip off of her thumb while cutting lemons.

“My manager was more pissed about the lemon than he was about the fact that I had almost sliced my finger off,” she says. “It was really disappointing for me. He couldn’t have cared less. He just continued cooking, and I had to figure it out for myself.”

After finding a bandage, Thorpe worked the rest of her shift. “It was a mess. Every time I served a lemon, it would seep into the Band-Aid.”

Even with a culture of underreporting, food service workers (cooks, bartenders, servers, dishwashers) have the second-highest risk among all workers of injuring themselves by falling down. (Slippery floors, covered in debris and spillage, are to blame.) Full-service restaurants also have a relatively high number fatalities from violent assaults. One Los Angeles bartender sought the help of a physical therapist to evaluate his fellow bartenders’ techniques and prevent further injuries — one of his colleagues was sidelined for weeks after shaking drinks too vigorously.

Despite working conditions that present far more dangers than the typical office environment — flames, breaking glass, drunk and unruly customers, challenging motions that wear and tear the body — only 14.4 percent of employees in the industry have access to health care through their employers. In contrast, 48.7 percent of workers in other industries have access to this benefit. (The numbers aren’t in yet for how many uninsured workers have enrolled through the health care marketplace.)

Paying to treat on-the-job injuries out of pocket isn’t easy for workers making as little as $2.13 an hour, thanks to laws that decouple tipped workers from minimum wage protections the rest of the workforce enjoys. On average, the median industry wage after tips is $10. In other industries, the median is $18 per hour.

The result is an industry where one in six workers live in poverty, a rate 6.7 percent higher than the national average. Other benefits, like paid time off, are almost unheard of. Since workers only make money when they’re on shift, they’re more likely to work while sick or injured.

On the surface, the connection between injury rates and the sub-minimum wage isn’t apparent. But “these issues are intimately interconnected,” says Jayaraman. “You can’t separate workers’ experiences of health and health and safety conditions from the fact that this industry gets away with paying these workers $2.13 per hour, or from the lack of benefits, or from the experience of discrimination based on race and gender.”

The sub-minimum tipped wage also allows employers to not feel responsible for tipped workers, says Jayaraman. “The restaurant industry has tried on a number of instances to get these workers declared as independent contractors working for their tips instead of employees working for the restaurant. During the debates around health care reform, the industry tried to get workers exempted using the same argument.”

The National Restaurant Association maintains that the industry does not have a problem with injury. “[R]estaurants work diligently to be in compliance with all safety regulations, such as OSHA, and have procedures in place to deal with accidents,” says Christin Fernandez, director of media relations and public affairs for the National Restaurant Association.

November and December are the busiest months for restaurants, though hectic shifts and very physical tasks know no season. For bartender Krista Carothers, 33, of Atlanta, moving heavy cases and kegs of beer just had to be done. On top of the tendonitis in her wrists and knee pain, moving kegs caused lower back problems, she said. “If there’s no one else there, you have to move it.”

In fact, a report released this month by ROC United, U.C. Berkley’s International Human Rights Law Clinic, and U.C. Berkley’s Food Labor Research Center described how conditions caused by the sub-minimum wage constituted a violation of international human rights agreements. The report points out that two-thirds of the workforce earning the sub-minimum wage are women, and 42 percent of those earning at or below the minimum wage are people of color. As a result, these workers are most likely to experience poverty and/or sexual harassment.

Currently, workers hit with unexpected medical bills or other hardships are left to deal with them alone. In many restaurants, the staff will “pass the hat” to raise money for a co-worker who’s been seriously injured at work, but few other outlets exist. In Atlanta, workers who experience an unanticipated hardship have access to a nonprofit called the Giving Kitchen. Otherwise, workers are on their own.

The next time you want to treat your bartender well, don’t just throw down a couple extra dollars when you close your tab: Use your voice. Ask questions. Speak out against abuse or unsafe conditions. Vote. Together, these actions might provide care that a few bucks can’t buy.