Use of the Washington State Trauma Registry for Occupational Injury Surveillance

Details

• Personal Author:
  Sears JM
• Description:
  The goal of this project was to explore and document the Washington State Trauma Registry (WTR) as a potential resource for occupational injury surveillance and research. There were 125,625 deduplicated injury events reported to the WTR for 16+year-olds injured in Washington during 1998-2008, of which 9,185 (7.3%) were work-related. WTR records were linked to workers' compensation (WC) claims data maintained by the Washington State Department of Labor and Industries (L&I). The WTR work-related indicator exhibited 87% sensitivity and 97% specificity. Of WTR work-related injuries, 27% did not have L&I listed as an expected payer and 37% did not link to a compensable WC claim. Injured workers without a WC claim were more likely to be older, have no insurance, have been injured at home or in motor vehicle traffic, and less likely to have been injured at industrial locations or by machinery. The WTR captured about 25% of Washington's occupational fatalities. There were significant upward trends from 2003 through 2008 in age-adjusted rates of moderate and severe work-related traumatic injuries, but flat trends when minor injuries were included. We found not only a disparity in the burden of work-related traumatic injuries sustained by Latinos relative to non-Latinos, but also that the disparity increased over time. Abbreviated Injury Scale (AIS)-based injury severity measures (both those contained in WTR data and those we estimated from WC ICD-9-CM billing codes) were significant predictors of work disability and medical cost outcomes. Several findings suggested increasingly intensive efforts by trauma hospitals to identify potential payers. Among workers with L&I as a payer, workers who also had other insurance coverage had nearly twice the odds of having no WC claim. Latinos were more likely to have L&I as a payer (87% compared with 73% for non-Latinos) and less likely to have other insurance (14% compared with 31%), but were not more likely to have a linked WC claim after controlling for demographics, injury severity, and insurance. There are several important implications of this study: (1) linking injury details from WTR records with work disability and cost outcomes data from WC records enabled more comprehensive occupational injury surveillance and research; (2) AIS-based injury severity measures have rarely been used in occupational injury research but have many potential applications, including risk adjustment for program evaluation, intervention, or outcome studies and severity restriction for constructing comparison groups or case definitions; (3) additional mandatory WTR data fields should be considered, including work status (e.g., full-time or part-time traditional employment, self-employed, family business, temporary agency, contingent employment, casual/day labor, etc.), nativity, language, income, and educational level; (4) this study demonstrated the importance of considering differential access to other insurance coverage and adaptation by health care settings to financial pressures when assessing trends in occupational injury incidence and reporting, especially when using payer (WC) as a proxy for work-relatedness; (5) further research into potential cost-shifting from WC to other health insurance is indicated; and (6) the impact of severity restriction on observed injury trends is particularly provocative, with implications for surveillance methodology. [Description provided by NIOSH]
• Subjects:
  Demography Mortality Occupational Health Occupational Injuries Safety
• Keywords:
  Costs Demographic Characteristics Fatalities Injuries Occupational Accidents Surveillance Traumatic Injuries Workers Compensation
• Series:
  Grant Final Reports
• Publisher:
  National Institute for Occupational Safety and Health
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Final Grant Report
• Place as Subject:
  OSHA Region 10 ; Washington
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  OEP - Office of Extramural Programs
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  1-71
• NIOSHTIC Number:
  nn:20059120
• NTIS Accession Number:
  PB2021-100154
• Citation:
  Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, R03-OH-09883, 2012 Nov; :1-71
• Contact Point Address:
  Jeanne M. Sears, Box 354809, Department of Health Services, University of Washington, Seattle, WA 98195
• Email:
  jeannes@u.washington.edu
• Federal Fiscal Year:
  2013
• Performing Organization:
  University of Washington, Seattle
• Peer Reviewed:
  False
• Start Date:
  20100901
• Source Full Name:
  National Institute for Occupational Safety and Health
• End Date:
  20120831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:7569d025890dc58ff8fa5684296331a3ff5ee94f4c065fdef888ec329c5f6d788426f647d004f3bb76154ee7946dc3881c7f5c60c076c23789612f1502f030e5
• Download URL:
  https://stacks.cdc.gov/view/cdc/218967/cdc_218967_DS1.pdf
• File Type:
  [PDF - 1014.77 KB ]