Using a Severity Threshold to Improve Occupational Injury Surveillance: Assessment of a Severe Traumatic Injury-Based Occupational Health Indicator Across the International Classification of Diseases Lexicon Transition

Details

• Personal Author:
  Borjan M ; Bowman SM ; Fletcher A ; Marsh, Suzanne M. ; Reilly A ; Sears JM ; Victoroff TM
• Description:
  Background: Traumatic injury is a leading cause of death and disability among US workers. Severe injuries are less subject to systematic ascertainment bias related to factors such as reporting barriers, inpatient admission criteria, and workers' compensation coverage. A state-based occupational health indicator (OHI #22) was initiated in 2012 to track work-related severe traumatic injury hospitalizations. After 2015, OHI #22 was reformulated to account for the transition from the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) to ICD-10-CM. This study describes rates and trends in OHI #22, alongside corresponding metrics for all work-related hospitalizations. Methods: Seventeen states used hospital discharge data to calculate estimates for calendar years 2012-2019. State-panel fixed-effects regression was used to model linear trends in annual work-related hospitalization rates, OHI #22 rates, and the proportion of work-related hospitalizations resulting from severe injuries. Models included calendar year and pre- to post-ICD-10-CM transition. Results: Work-related hospitalization rates showed a decreasing monotonic trend, with no significant change associated with the ICD-10-CM transition. In contrast, OHI #22 rates showed a monotonic increasing trend from 2012 to 2014, then a significant 50% drop, returning to a near-monotonic increasing trend from 2016 to 2019. On average, OHI #22 accounted for 12.9% of work-related hospitalizations before the ICD-10-CM transition, versus 9.1% post-transition. Conclusions: Although hospital discharge data suggest decreasing work-related hospitalizations over time, work-related severe traumatic injury hospitalizations are apparently increasing. OHI #22 contributes meaningfully to state occupational health surveillance efforts by reducing the impact of factors that differentially obscure minor injuries; however, OHI #22 trend estimates must account for the ICD-10-CM transition-associated structural break in 2015. [Description provided by NIOSH]
• Subjects:
  Emergency Responders Epidemiology Occupational Health Safety
• Keywords:
  Author Keywords: International Classification Of Diseases Emergency Treatment Hospital Discharge Data Injury Surveillance Occupational Health Occupational Injuries Surveillance Trauma Severity Indices Traumatic Injuries Workers' Compensation Workers Compensation

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• ISSN:
  0271-3586
• Document Type:
  Text
• Funding:
  Grant ; Cooperative Agreement
• Genre:
  Journal Article
• Place as Subject:
  Arkansas ; Louisiana ; New Jersey ; New York ; OSHA Region 10 ; OSHA Region 2 ; OSHA Region 3 ; OSHA Region 6 ; Washington ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  WSD - Western States Division ; DSR - Division of Safety Research
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  18-30
• Volume:
  67
• Issue:
  1
• NIOSHTIC Number:
  nn:20068639
• Citation:
  Am J Ind Med 2024 Jan; 67(1):18-30
• Contact Point Address:
  Jeanne M. Sears, PhD, MS, RN, Department of Health Systems and Population Health, University of Washington, Box 357660, Seattle, WA 98195, USA
• Email:
  jeannes@uw.edu
• Federal Fiscal Year:
  2024
• Performing Organization:
  University of Washington
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  American Journal of Industrial Medicine
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:7b13211824e89afcd4fe69014ff3bf2d1fa53f0634722d17007cdb296e4246997c855ab0d048d674cf9949a143a8e24ee73b7d514987ea0fdd033fe62bbbc361
• Download URL:
  https://stacks.cdc.gov/view/cdc/207240/cdc_207240_DS1.pdf
• File Type:
  [PDF - 1011.42 KB ]