Surveillance of Work-Related Concussions

Background/Purpose: Concussion is the most common form of mild traumatic brain injury. Concussion symptoms are often not recognized and medical help may not be sought, leading to increased risk for further injury and protracted recovery. According to the Bureau of Labor Statistics (BLS), the median days away from work for concussion injuries in Kentucky decreased from 5 in 2006 to 1 in 2010, while the concussion rate increases. The goal of our study was to establish comprehensive surveillance of work-related concussion injuries in Kentucky using multiple data sources. Methods: The Kentucky workers' compensation (WC) database was used to identify work-related concussions. Kentucky inpatient hospital discharge (HD) uniform billing electronic records, emergency department (ED) visit records, and trauma registry (TR) were used to supplement WC data. Work-related concussions in ED, HD, and TR databases were identified using ICD-9 diagnosis codes 850.0-850.9 with WC as the primary payer billed. Results/Outcomes: The BLS Survey of Occupational Injuries and Illnesses estimated 80 concussions with days away from work in Kentucky during 2010 (all ownerships). Using WC data, 125 concussions with lost time were reported in 2010; 50% due to falls, slips, or trips; 32% in service industry. The linkage between WC and the other surveillance systems (HD, ED, TR) identified 368 additional concussions not reported to WC or not identifiable as concussions in WC. Conclusions: These results illustrate the need to educate employers and workers on physical, cognitive, and behavioral concussion symptoms and support the development of needed rehabilitation strategies during the post-concussive period.