Piloting a Multi Datasource Surveillance System for Work-related Amputations and Carpal Tunnel Syndrome

The Bureau of Labor Statistics (BLS) Survey of Occupational Injury and Illness (SOII) provides estimates of the numbers and rates of non-fatal occupational injury and illness (OII) in the US by relying exclusively on employer reporting of their OII on the employers OSHA 300 logs. If there is incomplete reporting of OII by employers on the OSHA 300 logs, the BLS SOII would underestimate the number of non-fatal OII in the U.S. In the 1990's, improvements in occupational fatality surveillance were made by expanding case ascertainment from a single reporting source to multiple data sources. To improve non-fatal OII surveillance, some researchers have proposed using multiple state based data sources, to supplement employer reporting on the BLS SOII. Recently, the BLS has funded three States – California, Massachusetts, and Washington to work in collaboration with BLS and each other to pilot multisource surveillance systems for work-related amputations and carpal tunnel syndrome (CTS). This presentation will report on the initial work of the BLS State workgroup. We will discuss the following challenges associated with using multiple data sources for amputation and CTS surveillance, specifically: 1. Reconciling case selection criteria when using different case classification systems, e.g ICD-9 and the Occupational Injury and Illness Classification System; 2. Limited access to information which further characterizes the injury, i.e. the medical record or longitudinal information related to injury outcome; and 3. Issues of matching cases from multiple data sources to BLS survey data.