This paper represents the first study to estimate counts of individual occupational injuries and claims over long spells of working life (up to 13 years) in the USA. It explores data from the National Longitudinal Survey of Youth 1979. I found that 37% of all surveyed workers who had experienced one on-the-job accident reported at least one additional injury, but only 56% of all occupational injuries and illnesses resulted in workers' compensation claims. I estimated different count models to assess the effect of different individual worker and job characteristics on individual injury counts and workers' compensation claims counts. Lower educational levels, less tenure, work in dangerous industries and unskilled occupations, and job demands are found to be important determinants of multiple on-the-job injuries. The most interesting results, however, refer to the role played by individuals' pre-injury characteristics: early exposure to dangerous jobs is among the main determinants of higher counts of occupational injuries later in life. Early health limitations are also significant predictors of recurrent workers' compensation claims. These results provide new evidence about the important role played by both the health and the socioeconomic status of young people as determinants of their future occupational injuries.