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APHA Scientific Session and Event Listing

Julia F. Costich, JD, PhD¹, Terry L. Bunn, PhD¹, and Valerie J. Nicholson, MD, MHA². (1) College of Public Health, University of Kentucky, Kentucky Injury Prevention and Research Center, 333 Waller Ave., Lexington, KY 40504, 859-257-6712, julia.costich@uky.edu, (2) Department of Emergency Medicine, University of Kentucky, 800 Rose St., Lexington, KY 40536

Labor market restructuring has led to an increase in the proportion of workers who are not covered by worker compensation (WC), particularly in high-risk industries. Emergency departments routinely identify work-relatedness in their intake documentation but do not include it in standard reports. Data on 12 consecutive months of work-related occupational injury patient encounters (n=1020) at an academic health center's emergency department were reviewed for third-party coverage status, demographic variables, mechanism of injury (e-code), comorbidities, and discharge destination. Approximately 26% (208/1020) of patients reporting work-related diagnoses were not covered by WC. Racial and ethnic minority workers were significantly more likely to lack WC (25% versus 11%). The large majority (92%) of injured workers without WC had no health insurance coverage of any kind. In analysis of a random sample, workers without WC were found to be more frequently injured in falls (29% vs. 21%), overexertion presenting as musculoskeletal injury (19% vs. 10%), and cutting/piercing injuries (18% vs. 14%). In addition to descriptive statistics, logistic regression analysis will be conducted to identify relationships among variables. These preliminary findings suggest that reliance on WC data alone understates aggregate incidence of occupational injury, most markedly for high-risk occupations, populations, and job tasks. Work-relatedness indicators collected routinely in ED and outpatient settings should be incorporated into accessible reporting systems to facilitate more accurate and comprehensive surveillance and better-targeted interventions.

Learning Objectives:

• Recognize deficiencies in occupational injury surveillance that relies on worker compensation data
• Identify occupational injury disparities in patients with and without worker compensation coverage
• Describe strategies to develop a more complete assessment of occupational injury from which more effective interventions can be developed

Keywords: Data/Surveillance, Workers' Compensation

Presenting author's disclosure statement:

Not Answered