4 Nonfatal Injury
Three surveillance systems provide information about the
characteristics of nonfatal occupational injuries: the Survey of Occupational
Injuries and Illnesses (SOII), the National Electronic Injury Surveillance
System (NEISS), and the National Hospital Ambulatory Medical Care Survey (NHAMCS).
SOII is based on employer-generated workplace incident logs, and NEISS and
NHAMCS are based on visits to emergency departments in hospitals. NEISS and
NHAMCS both collect data on occupational injuries, but they use different
methods.
Nonfatal occupational injuries constitute more than 90% of the
events recorded by SOII. In 1997, more than 5.7 million nonfatal occupational
injuries were estimated to have occurred in the United States, resulting in a
rate of 6.6 cases per 100 full-time, private-sector workers. Among industry
divisions, incidence rates for the total number of nonfatal injuries ranged from
a low of 2.0 cases per 100 full-time workers in finance, insurance, and real
estate to a high of 9.3 cases per 100 full-time workers in construction ( Figure
41). Rates for four of the eight industry divisions are above the average
for all industries.
Injuries treated in emergency
departments* are usually more urgent or severe than those treated in
physicians' offices or walk-in clinics. NEISS estimates that approximately 3.6
million nonfatal occupational injuries were treated in U.S. hospital emergency
departments in 1998. The average rate for all nonfatal occupational injuries
treated in emergency departments that year was 2.8 per 100 full-time workers.
The rate for men (3.4 per 100 full-time workers) was nearly twice the rate for
women (2 per 100 full-time workers) (Figure
42). Rates were higher in younger workers (aged 16 to 19), with steady
declines in both male and female workers aged 20 and older (Figure
42). Hands and fingers were the most commonly injured parts of the body,
accounting for 30% of the total (Figure
43). Lacerations and punctures (26%), sprains and strains (25%), and
contusions, abrasions, and hematomas (19%) were the most frequent types of
injuries recorded in NEISS in 1998.
Figures
44 and 45 present the average annual rates of emergency department visits related to
nonfatal occupational injuries recorded in NHAMCS for 19951997. Male workers
aged 1617 had the highest rate (nearly 10 per 100 full-time workers). The
rate for black male workers was higher than the average rate for all workers.
Overall, the rate for men exceeded the rate for women.
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To view, click on image
Figure 41. Incidence
rates for nonfatal occupational injuries in private industry by major industry
division, 1997. (Source: SOII [1999].)
To view, click on image
Figure 42. Rate
of nonfatal occupational injuries treated in emergency departments, by age and
sex, 1998. (Source:
NEISS [1999].)
To view, click on image
Figure 43. Number
of nonfatal occupational injuries treated in emergency departments, by anatomic
site and type of injury, 1998. (Source: NEISS [1999].)
To view, click on image
Figure 44. Annual
rates (and 95% CIs) of emergency department visits related to nonfatal
occupational injuries in male and female workers aged 16 and older, by age groupaveraged
for 19951997. (The rate for female workers aged 1617 does not meet the
standards of reliability or precision.) (Source: NHAMCS [1999].)
To view, click on image
Figure 45. Annual
rates (and 95% CIs) of emergency department visits related to nonfatal
occupational injuries in black and white male and female workers aged 16 and
olderaveraged for 19951997. (Source: NHAMCS [1999].)
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Nonfatal Occupational Injuries
by Industry and Cases with Lost Workdays
The total number of nonfatal occupational injuries recorded by
the Bureau of Labor Statistics (BLS) in SOII has fluctuated between 4.7 and 6.4
million per year over the last two decades. Many of these cases involved lost
workdays. The number of
cases with days away from work fluctuated during that period; however, there was
a 10-fold increase in cases with restricted work activity only (Figure
46). By 1997, 53% of cases involved no time away from work, 31% required
at least 1 day away from work, and 16% involved restricted work activity only.
The incidence rate for total nonfatal occupational injuries over
the past two decades ranged from a high of 9.2 cases per 100 full-time workers
in 19781979 to a low of 6.6 cases per 100 full-time workers in 1997 (Figure
47). The incidence rate for cases with days away from work declined
steadily from 1988 to 1997, and the incidence rate rose 120% for cases involving
restricted work activity only.
Incidence rates for lost-workday cases of nonfatal occupational
injury are shown for 19921997 by industry division in Figure
48. For all private industry during this period, the incidence rate
declined 14% to 3.1 cases per 100 full-time workers. Finance, insurance, and
real estate had the largest relative decline (27%), and construction had the
largest absolute decline (1.3 cases per 100 full-time workers). Transportation
and public utilities showed the least decline, both relatively (4%) and
absolutely (0.2 cases per 100 full-time workers). Injury cases with and without
lost workdays in 1997 (including days away from work and days of restricted
activity only) are shown by industry division in Figure
49. The number of injuries ranged from a low of 46,000 in mining to a
high of 1.7 million in manufacturing. The percentage of injury cases involving
lost workdays ranged from a low of 38% in finance, insurance, and real estate to
a high of 73% in mining.
The increasing incidence rate for cases involving restricted
work activity only (Figure
47) is presented by industry division in Figure
410 for 19921997. The percentage of cases with restricted work
activity only is shown for each industry division in Figure
411 for 1992 and 1997. In both years, manufacturing had the largest
percentage of lost-workday cases with restricted activity only (32% and 48%,
respectively).
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To view, click on image
Figure 46. Number
of nonfatal occupational injury cases in private industry by type of case, 19761997.
(Source: SOII [1999].)
To view, click on image
Figure 47. Incidence
rate of nonfatal occupational injury cases in private industry by type of case,
19761997. (Source: SOII [1999].)
To view, click on image
Figure 48. Incidence
rates for lost-workday cases of nonfatal occupational injury in private industry
by industry division, 19921997. (Source: SOII [1999].)
To view, click on image
Figure 49. Number
of nonfatal occupational injury cases in private industry without and with lost
workdays by industry division, 1997. Percentage of cases with lost workdays also
is shown. (Source: SOII [1999].)
To view, click on image
Figure 410. Incidence
rates in private industry for nonfatal occupational injury cases involving days
of restricted work activity only, by industry division, 19921997. (Source:
SOII [1999].)
To view, click on image
Figure 411. Percentage
of nonfatal occupational injury cases with lost workdays involving restricted
work activity only, by industry division, 1992 and 1997. (Source: SOII [1999].)
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Characteristics of Injury Cases
with Days away from Work
The total number of nonfatal occupational injury cases involving
days away from work for 19921997 is shown in Figure
412 for seven injury categories. Sprains, strains, and tears accounted
for the largest number of events, with approximately 799,000 cases in 1997.
Nearly half those cases (about 385,000) involved the back, accounting for more
than 80% of all traumatic injuries and disorders to the back. Other categories
accounting for many days away from work included bruises and contusions (with
nearly 166,000 cases in 1997), cuts and lacerations (with approximately 134,000
cases), and fractures (with approximately 119,000 cases). Presented separately
for each of the seven injury categories are charts showing the distributions of
cases by (1) major industries, (2) occupational groups, and (3) the sources of
the disorder, events or exposures leading to the disorder, or the body parts
affected.
To
view, click on image
Figure 412. Number
of nonfatal occupational injury cases with days away from work in private
industry by type of injury, 19921997. (Source: SOII [1999].)
Sprain, Strain, and Tear Cases
with Days away from Work, 1997
Nearly half of the approximately 799,000 cases of sprains,
strains, and tears involving days away from work in 1997 occurred in services
(27%) and manufacturing (21%) (Figure
413). Most of these injuries were experienced by operators, fabricators,
and laborers (42%) and service personnel (19%) (Figure
414). Overexertion was the most common event leading to a sprain, strain,
or tear (Figure
415). Men accounted for nearly two-thirds of the sprain, strain, and tear
cases. Half of the cases required 6 or more days away from work.
To
view, click on image
Figure 413. Number
and distribution of sprain, strain, and tear cases with days away from work in
private industry by industry division, 1997. (Source: SOII [1999].)
To view, click on image
Figure 414. Number
and distribution of sprain, strain, and tear cases with days away from work in
private industry by occupational group, 1997. (Source: SOII [1999].)
To
view, click on image
Figure 415.
Number and distribution of sprain, strain, and tear cases with
days away from work in private industry by event or exposure, 1997. (Source:
SOII [1999].)
Back, Spine, or Spinal Cord Cases with
Days away from Work, 1997
Nearly two-thirds of the approximately 472,000 back, spine, and
spinal cord cases in 1997 occurred in services (28%), manufacturing (21%), and
retail trade (16%) (Figure
416). Most of the back, spine, and spinal cord disorders were experienced
by operators, fabricators, and laborers (41%) and service personnel (19%) (Figure
417). The most common sources of cases were containers (26%), worker
motion or position (17%), and parts and materials (12%) (Figure
418). The event associated with most cases was overexertion, which
accounted for 63% of the cases.
To
view, click on image
Figure 416. Number
and distribution of back, spine, and spinal cord cases with days away from work
in private industry by industry division, 1997. (Source: SOII [1999].)
To view, click on image
Figure 417. Number
and distribution of back, spine, and spinal cord cases with days away from work
in private industry by occupational group, 1997. (Source: SOII [1999].)
To
view, click on image
Figure 418. Number
and distribution of back, spine, and spinal cord cases with days away from work
in private industry by source of disorder, 1997. (Source: SOII [1999].)
Bruise and Contusion Cases
with Days away from Work, 1997
Most of the approximately 166,000 bruise and contusion cases
with days away from work in 1997 occurred in manufacturing (24%), services
(22%), and retail trade (19%) (Figure
419). Together, operators, fabricators, and laborers and service
personnel experienced more than half of these injuries (Figure
420). The most common sources of injury were floors and ground surfaces
(26%), vehicles (15%), and parts and materials (13%) (Figure
421). Most job-related bruises and contusions resulted from workers being
struck by, struck against, or caught in objects, equipment, or materials. In
1997, a median of 3 lost workdays resulted from bruises and contusions. Nearly
9% of these injuries required 31 or more days away from work.
To
view, click on image
Figure 419. Number
and distribution of bruise and contusion cases with days away from work in
private industry by industry division, 1997. (Source: SOII [1999].)
To view, click on image
Figure 420. Number
and distribution of bruise and contusion cases with days away from work in
private industry by occupational group, 1997. (Source: SOII [1999].)
To
view, click on image
Figure 421. Number
and distribution of bruise and contusion cases with days away from work in
private industry by source of disorder, 1997. (Source: SOII [1999].)
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Cut and Laceration Cases
with Days away from Work, 1997
More than half of the approximately 134,000 cut and laceration
cases with days away from work in 1997 were in manufacturing (28%) or retail
trade (26%) (Figure
422). Operators, fabricators, and laborers experienced 42% of cuts and
lacerations, and precision production, craft, and repair personnel experienced
24% (Figure
423). The most common sources of injury were floors and ground surfaces
(25%), machinery (21%), and parts and materials (20%) (Figure
424). Finger cuts and lacerations accounted for half of all cuts and
lacerations involving days away from work. A median of 3 days away from work
resulted from cuts and lacerations.
To
view, click on image
Figure 422. Number
and distribution of cut and laceration cases with days away from work in private
industry by industry division, 1997. (Source: SOII [1999].)
To view, click on image
Figure 423. Number
and distribution of cut and laceration cases with days away from work in private
industry by occupational group, 1997. (Source: SOII [1999].)
To
view, click on image
Figure 424. Number
and distribution of cut and laceration cases with days away from work in private
industry by source of disorder, 1997. (Source: SOII [1999].)
Fracture Cases with
Days away from Work, 1997
Most of the approximately 119,000 fracture cases with days away
from work in 1997 occurred in manufacturing (25%), services (18%), and
construction (16%) (Figure
425). Most of these injuries were experienced by operators, fabricators,
and laborers (43%) and precision production, craft, and repair personnel (23%) (Figure
426). The most common sources of injury were floor and ground surfaces
(43%) and parts and materials (14%) (Figure
427). Half of the occupational fractures in 1997 required 21 or more days
away from work for recuperation. The categories struck by object and falls
on the same level each accounted for more than 30,000 fractures.
To
view, click on image
Figure 425. Number
and distribution of fracture cases with days away from work in private industry
by industry division, 1997. (Source: SOII [1999].)
To view, click on image
Figure 426. Number
and distribution of fracture cases with days away from work in private industry
by occupational group, 1997. (Source: SOII [1999].)
To
view, click on image
Figure 427. Number
and distribution of fracture cases with days away from work in private industry
by source of disorder, 1997. (Source: SOII [1999].)
Heat Burn and Scald Cases
with Days away from Work, 1997
More than half of the approximately 30,000 heat burn and scald
cases with days away from work in 1997 occurred in retail trade (39%) and
manufacturing (26%) (Figure
428). Most of these injuries were experienced by service personnel (44%)
and operators, fabricators, and laborers (30%) (Figure
429). Twenty-four percent of heat burn and scald cases affected the hand
(except fingers), 14% affected multiple body parts, and 12% affected the foot or
toe (Figure
430). A median number of 4 days away from work resulted from heat burns
and scalds.
To
view, click on image
Figure 428. Number
and distribution of heat burn and scald cases with days away from work in
private industry by industry division, 1997. (Source: SOII [1999].)
To view, click on image
Figure 429. Number
and distribution of heat burn and scald cases with days away from work in
private industry by occupational group, 1997. (Source: SOII [1999].)
To
view, click on image
Figure 430. Number
and distribution of heat burn and scald cases with days away from work in
private industry by part of body affected, 1997. (Source: SOII [1999].)
Amputation Cases with
Days away from Work, 1997
More than half of the approximately 10,850 amputation cases with
days away from work in 1997 occurred in manufacturing (51%) (Figure
431). Operators, fabricators, and laborers experienced 60% of amputations
(Figure
432). Machinery was the major source of amputation injury (57%) (Figure
433). Men accounted for 87% of occupational amputations. Nearly 10,200
amputations (93.8%) were to fingers. A median number of 18 days away from work
resulted from amputations.
To
view, click on image
Figure 431. Number
and distribution of amputation cases with days away from work in private
industry by industry division, 1997. (Source: SOII [1999].)
To view, click on image
Figure 432. Number
and distribution of amputation cases with days away from work in private
industry by occupational group, 1997. (Source: SOII [1999].)
To
view, click on image
Figure 433. Number
and distribution of amputation cases with days away from work in private
industry by source of disorder, 1997. (Source: SOII [1999].)
