178316 Statewide surveillance of occupational injury hospitalizations in Maryland: Benefits of data linkage

Tuesday, October 28, 2008: 3:15 PM

Gordon S. Smith, MD, MPH , National Study Center Trauma & EMS, University of Maryland, Baltimore, MD
Patricia C. Dischinger, PhD , National Study Center for Trauma and EMS, University of Maryland School of Medicine, Baltimore, MD
Shiu M. Ho, MS , National Study Center for Trauma & EMS, University of Maryland School of Medicine, Baltimore, MD
Kim Auman , National Study Center Trauma & EMS, University of Maryland, Baltimore, MD
Joseph Kufera, MA , National Study Center for Trauma & EMS, University of Maryland School of Medicine, Baltimore, MD
Karen Murdock , National Study Center Trauma & EMS, University of Maryland, Baltimore, MD
We sought to develop and evaluate model surveillance systems for hospitalized occupational injuries. Data linkage using probabilistic linkage techniques identified hospitalized work-related injuries in Maryland, using indicators of work-relatedness in hospital records, EMS reports, autopsy records, death certificates, and police reports to create incident-specific records for 2001-2004. Validation studies examined agreement between sources and reviewed charts. Hospital payor source Workers' Compensation (WC) identified 4.5% of injury admissions as work-related, increasing to 5.3% after linkage (19% increases in counts and rates). WC identified 77%, with a further 6% identified with industrial place of occurrence. Place of occurrence as farm, only identified 56 additional cases. Falls from 15 or more feet from EMS data, brought in an additional 5%. Finally, trauma registry linkage added 6 %( the most severe of the injuries requiring hospitalization). Identification of work-related injuries due to motor vehicle crashes was relatively low. Using police reported data on drivers of commercial vehicles as the “gold” standard 65% of the inpatient data gave an indication that injuries were work-related. Chart review of sentinel injuries suggest that even with our data linkage, there is still considerable under-reporting of work-relatedness using available data. Further examination of the fall reporting by EMS seems to indicate that it may not be specific enough to indicate work-related injuries, especially in the extremes of age. This is the first US study to attempt to use available data to estimate population-based work-related injury hospitalizations. Data linkage is a useful tool for surveillance of serious occupational injuries.

Learning Objectives:
Describe data linkage methods for improving surveillance of work injuries Evaluate sources of data on work-relatedness Recognize the value of data linkage

Keywords: Occupational Injury and Death, Injury

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I participated in conducting the study and coordinated writing up the study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.