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Enhanced surveillance to detect severe nonfatal occupational injuries.

Dischinger-PC; Auman-KM; Ho-SM; Braver-ER
NORA Symposium 2006: Research Makes a Difference! April 18-26, 2006, Washington, DC. Washington, DC: National Institute for Occupational Safety and Health, 2006 Apr; :200
Importance: Although there have been many studies of fatal occupational injuries, relatively few surveillance efforts have included the most severe nonfatal occupational injuries, including hospitalizations. Purpose: This project seeks to develop and evaluate a model surveillance system to identify the entire spectrum of injury severity occurring in occupational settings and describe the specific types of injury and their circumstances. The first step was the creation of a comprehensive database to examine the incidence of occupational injury statewide. Methods: Work-related injuries were detected in a variety of ways: mechanism of injury (for example, falls from heights >15 feet), location (farm, mine, quarry), emergency/hospital treatment in which the payor was Workers' Compensation, and sources that explicitly identified occupational etiology such as death certificates and the state trauma registry. Commercial motor vehicle crashes also were identified. Using probabilistic linkage techniques, databases were joined and a final incident-specific database was created for 2001. Overall, 44,555 injured workers were identified in 2001. Over 60% were younger than 40. Teenagers comprised 6% and 20-29 year-olds comprised 26%. About 70% were male. Falls were more common among those > age 50. About 5 percent of all injury hospitalizations were for occupational injury, resulting in 2,364 admissions. A total of 1,293 workers were treated in trauma centers, suggesting a large number of high-energy events. Among this group, falls and motor vehicle crashes were the predominant mechanisms of injury. Among all injured workers, upper extremity, lower extremity and back were the top three injured regions. Hospitalized workers had a different pattern, with a higher proportion of head, thorax, abdominal, and lower extremity injuries. For upper extremity injuries, ED visits primarily involved finger lacerations whereas those who were hospitalized commonly had forearm fractures. For lower extremity injuries, ankle fractures were the most common injury among hospitalized workers, but knee sprains were the most frequent ED-treated injury. How Findings Advance Research: This study is one of the most comprehensive efforts to conduct a statewide surveillance of occupational injury using multiple data sources. Data on the entire spectrum of injury severity previously were sparse, particularly for moderate to severe WR injuries. Implications for Improving Workplace Safety: Many of the more severe injuries incur high medical costs and long-term disability. Greater priority should be placed on preventing such injuries.
Accidents; Injuries; Traumatic-injuries; Medical-treatment; Medical-care; Surveillance-programs; Statistical-analysis; Humans; Men; Women; Adolescents; Occupational-accidents
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NORA Symposium 2006: Research Makes a Difference! April 18-26, 2006, Washington, DC
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University of Maryland, Baltimore