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Conceptual and definitional issues in occupational injury epidemiology.

Hagberg-M; Christiani-D; Courtney-TK; Halperin-W; Leamon-TB; Smith-TJ
Am J Ind Med 1997 Aug; 32(2):106-115
Issues concerning occupational injury research were considered. The conceptual breakthrough in injury modeling was described as the consideration of energy as the agent of injury. The new conceptual model of energy transfer and injury allowed for a broad view of injury morbidity, which revealed itself morphologically, physiologically, and/or subjectively. Adverse health effects were considered to be caused by a chain of events depending on numerous individual and environmental factors. A pathophysiological model of tissue effects and damage and tissue recovery and repair was also reviewed. The lack of clear, consistent definitions in the field of occupational injury research was viewed as problematic. These inconsistent definitions developed from the use of various administrative and exposure detection methods. The term occupational injury was defined as any damage inflicted to the body by energy transfer during work. Terms like cumulative trauma disorder and repetitive strain injury were considered to be misleading. When adequately defined, the concept of exposure included dose metrics and a time frame. Exposure studies, based on either hazard surveillance or exposure assessment related to an adverse outcome, were discussed. The variables chosen for an occupational injury study, such as work conditions, exposures, risk factors, and injuries, were considered to be influenced by the injury process, a cascade of events linking work conditions, the injurious incident, the injury itself, impairment, and disability. This model of the injury process revealed a tradeoff; the prospective sample size increased with decreasing probability of detection and decreasing specificity of data. The establishment of research priorities was influenced by the severity of the problem, the incidence rate, risk ratio, and the population at risk. The authors conclude that the use of the multidimensional models and specific definitions provided in this paper may improve the study of occupational injury.
NIOSH-Author; Occupational-exposure; Epidemiology; Occupational-hazards; Occupational-accidents; Analytical-models; Traumatic-injuries; Physiological-effects; Environmental-factors; Work-environment; Occupational-health; Author Keywords: accidents; biomechanics; human engineering; occupational health; prevention; public health; terminology; work-related injury
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American Journal of Industrial Medicine
Page last reviewed: September 2, 2020
Content source: National Institute for Occupational Safety and Health Education and Information Division