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PubMed2004

Using narrative text and coded data to develop hazard scenarios for occupational injury interventions.

OBJECTIVE: To determine whether narrative text in safety reports contains sufficient information regarding contributing factors and precipitating mechanisms to prioritize occupational back injury prevention strategies.Design, setting, subjects, and MAIN OUTCOME MEASURES: Nine essential data elements were identified in narratives and coded sections of safety reports for each of 94 cases of back injuries to United States Army truck drivers reported to the United States Army Safety Center between 1987 and 1997. The essential elements of each case were used to reconstruct standardized event sequences. A taxonomy of the event sequences was then developed to identify common hazard scenarios and opportunities for primary interventions. RESULTS: Coded data typically only identified five data elements (broad activity, task, event/exposure, nature of injury, and outcomes) while narratives provided additional elements (contributing factor, precipitating mechanism, primary source) essential for developing our taxonomy. Three hazard scenarios were associated with back injuries among Army truck drivers accounting for 83% of cases: struck by/against events during motor vehicle crashes; falls resulting from slips/trips or loss of balance; and overexertion from lifting activities. CONCLUSIONS: Coded data from safety investigations lacked sufficient information to thoroughly characterize the injury event. However, the combination of existing narrative text (similar to that collected by many injury surveillance systems) and coded data enabled us to develop a more complete taxonomy of injury event characteristics and identify common hazard scenarios. This study demonstrates that narrative text can provide the additional information on contributing factors and precipitating mechanisms needed to target prevention strategies.

Accidental Falls↗
PubMed2005

Costs of occupational injury and illness within the health services sector.

Knowledge of costs is essential to allocate medical resources efficiently. The authors' goal was to estimate and compare costs across occupations, industries, gender, race, and types of nonfatal injuries and illnesses. This is an incidence study of nationwide data, 1993. Nonfatal incidence data were drawn from the Bureau of Labor Statistics Annual Survey. Medical costs were from the Detailed Claims Information data set. Productivity (wage) costs were calculated using the Current Population Survey. Pain and suffering costs were estimated from data on jury verdicts. Injuries and illnesses to nursing aides and orderlies cost 2,200 million dollars; costs were 900 million dollars for registered nurses and 40 million dollars for licensed practical nurses. The ranking of health services industries in terms of costs was: hospitals (52 percent of all costs), nursing care facilities (38 percent), home care services (6 percent), physicians' offices (4 percent), and laboratories (<1 percent). Types of injuries (sprains, strains, fractures) were similar across occupations and industries, but types of illness (carpal tunnel syndrome, respiratory diseases) varied. The most costly injured body parts were: back, shoulder, knee, wrist, and neck. Injuries and illnesses comprised roughly 90 percent and 10 percent, respectively, of total costs. The hospital industry was the third most expensive of 313 U.S. industries. Costs of occupational injury and illness in the health services industry were high and varied across occupation, industry, disease, race, and gender.

Accidents, Occupational↗
PubMed2002

Occupational injury and illness surveillance: conceptual filters explain underreporting.

Occupational health surveillance data are key to effective intervention. However, the US Bureau of Labor Statistics survey significantly underestimates the incidence of work-related injuries and illnesses. Researchers supplement these statistics with data from other systems not designed for surveillance. The authors apply the filter model of Webb et al. to underreporting by the Bureau of Labor Statistics, workers' compensation wage-replacement documents, physician reporting systems, and medical records of treatment charged to workers' compensation. Mechanisms are described for the loss of cases at successive steps of documentation. Empirical findings indicate that workers repeatedly risk adverse consequences for attempting to complete these steps, while systems for ensuring their completion are weak or absent.

Accidents, Occupational↗