Surveillance of Occupational Injuries Treated in Hospital Emergency Rooms -- United States

The National Institute for Occupational Safety and Health (NIOSH), in conjunction with the Consumer Product Safety Commission (CPSC), produces periodic estimates of occupational injuries,* based on surveillance data collected in 66 representative U.S. hospital emergency rooms (ER) (1); these facilities are part of the National Electronic Injury Surveillance System (NEISS) conducted by CPSC. The sex- and age-specific estimates are combined with estimated numbers of employees and estimated hours worked per week to produce estimated incidence rates (2). These estimates pertain only to work-related injuries treated in hospital ER and do not indicate the overall incidence of occupational injuries.

During the first 9 months of 1982, of approximately 100 million workers, an estimated 2.4 million patients with occupational injuries were treated in ER in the continental United States. Of these, 1.83 million (76%) were males and over 563,000 (24%) were females; ages ranged from 16 to over 65.

To determine any seasonal trends, estimated injury incidence rates (injuries per 100 full-time workers per year) based on monthly data by sex and age were also produced. These estimates showed marked differences among groups and times. All age groups showed seasonal variations, which were most pronounced for males aged 16-17 years and 20-24 years. The incidence appears highest in summer and lowest in winter for workers aged 20 years and older, although variations are small in older workers. The trends are similar but less obvious for younger age groups (16-17 and 18-19 years). *Acute damage resulting from exposure to physical energy (thermal, mechanical, electrical, chemical, or radiational) in the workplace. The workplace is any location where people work for compensation.

On the basis of these estimates, male workers aged 18-19 years appear at highest risk of job-related injury requiring treatment, with an average rate of 11.95. During the summer months, a male worker in this group is 5 times more likely to be injured than a male worker aged 55 years or over. Differences by sex in the estimated monthly incidence rates are also pronounced.

The largest sex-risk ratio is for the 18-19-year group in July, when the incidence rate for males is over 4 times that for females. The smallest is for workers over 65 years of age during November, when the risk for males is 36% that for females. For nearly all months, the difference in risk between males and females diminishes with increasing age. The seasonal variation of incidence is also reflected in the male-to-female ratios. Reported by the Div of Safety Research, NIOSH, CDC.

Editorial Note

Editorial Note: The estimated incidence rates reported here are for injuries treated in ER and indicated as job-related by the injured person. Although the numerators and denominators are derived from samples, the rates appear similar to other published rates for work-related injuries in the United States by month (3) and by sex (4). The numerators (estimates of occupational injuries treated in ER) should be clearly distinguished from other estimates of total injuries based on workers' compensation data (5) or other surveys (6,7).

Data from the Health Interview Survey suggest that job-related injuries treated in hospital ER represent about 36% of all job-related injuries; the remainder are treated at doctors' offices, industrial medical facilities, and elsewhere (7). Other data from this survey indicate that males initially seek ER treatment for 47% of medically treated injuries and females for 35%; persons aged 17-44 years initially seek ER treatment for 42%, while those over 45 years old do so for 36%.

Although these data clarify the role of the ER in treating job-related injuries, they do not explain the observed differences in the risk of injury between male and female workers, between younger and older workers, and among seasons of the year. Differences in job tasks and exposures specific to male and female workers most likely account for the observed differences in risk. The inexperience of younger workers may be a major factor in the higher incidence of injuries in this group. One hypothesis for the marked seasonal variation for males is that industries with characteristically higher risks of injury, such as construction, often employ their largest numbers of workers, including new workers, during the summer. In an attempt to more accurately characterize the risks of occupational injury, further analysis is under way to explore these and other factors.

References

1. CDC. Occupational injury surveillance--United States. MMWR 1981;30:578-9.

2. Bureau of Labor Statistics. Employment and earnings, February 1982. Washington D.C.: U.S. Department of Labor 1982;29(2).

3. Bureau of Labor Statistics. Occupational injuries and illnesses in the United States by industry, 1974. (Bulletin 1932). Washington, D.C.: U.S. Department of Labor 1976.

4. Office of Health Research, Statistics and Technology. Current estimates from the National Health Interview Survey: United States, 1979. Washington, D.C.: U.S. Department of Health and Human Services, Public Health Service.

5. Root N, McCaffrey D. Providing more information on work injury and illness. Monthly Labor Review 1978;101(4):16-21.

6. Bureau of Labor Statistics. Occupational injuries and illnesses in the United States by industry, 1980. (Bulletin 2130). Washington, D.C.: U.S. Department of Labor, April 1982.

7. Ries PW. Episodes of persons injured: United States, 1975. Advance Data 1978;18:1-12.

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