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Using narrative reports to identify factors contributing to construction injury.

Bondy-J; Glazner-JE; Lezotte-DC; Guarini-K; Lipscomb-HJ
NOIRS 2003-Abstracts of the National Occupational Injury Research Symposium 2003, October 28-30, Pittsburgh, Pennsylvania. Pittsburgh, PA: National Institute for Occupational Safety and Health, 2003 Oct; :58
While occupational injury rates can identify high risk groups, they have limited value in explaining injury etiology because obtaining precise measures of relevant exposures, which may be complex and transient, is difficult. In contrast, even short narrative descriptions have been shown to contain useful information about factors contributing to injury. We applied an adaptation of Haddon's Matrix to injury report narratives for 4148 injuries sustained in the construction of Denver International Airport (DIA) to determine whether its systematic application could elucidate factors contributing to construction injuries. Reports were coded into a qualitative software package (QSR N5) in two stages. First, a single reviewer coded base information about the injury: body part, nature of injury, and a single "mechanism of injury event (MOIE)," which refers to the initial energy exchange leading to injury (e.g., the "slip/trip" leading to a fall was coded rather than "fall."). Second, injury reports were organized by MOIE and coded independently by two reviewers for all Haddon Matrix factors contributing to the injury event. Coding differences that the two reviewers could not resolve were referred for adjudication to other members of the research team and then to DIA safety experts. 236 injuries could not be coded for MOIE and contributing factors. Of the remaining reports, reviewers coded up to 12 factors per report, with a mean of 2.7. Given the brief nature of the narratives and complexity of the factors being inferred, use of multiple coders and involvement of safety experts were critical. Haddon's Matrix forced reviewers to examine narratives more thoroughly than they otherwise would have, eliciting more information. Flexible coding software accommodated the evolution of both MOIE categories and Haddon's Matrix over the course of the project. Organizing review of contributing factors around MOIEs improved the efficiency and quality of review.
Construction; Construction-industry; Construction-workers; Injuries; Occupational-hazards; Occupational-accidents; Etiology; Occupational-exposure
Publication Date
Document Type
Abstract; Conference/Symposia Proceedings
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Identifying No.
Priority Area
Research Tools and Approaches: Surveillance Research Methods
Source Name
NOIRS 2003-Abstracts of the National Occupational Injury Research Symposium 2003, October 28-30, Pittsburgh, Pennsylvania
Performing Organization
University of Colorado, Health Services Center, Denver, Colorado