Nonfatal occupational traumatic brain injuries treated in U.S. hospital emergency departments: 1998-2007

Purpose: Traumatic brain injuries (TBI) can result in short-term or long-term disabilities. Little is known about TBIs occurring in the workplace. This research describes nonfatal occupational TBIs treated in emergency departments (EDs).

Methods: Nonfatal TBIs occurring to civilian workers were identified in the National Electronic Injury Surveillance System occupational supplement (NEISS-Work).TBIs were selected using the diagnosis of concussion and diagnoses of internal organ injury and fracture when the injury occurred to the head. Rates were calculated using average annual labor force estimates from the Bureau of Labor Statistics Current Population Survey. Trends in rates were analyzed using Poisson regression. Industry data were only available for 2007.

Results: From 1998 through 2007, an estimated 586,600 (95% confidence interval [CI] = ±150,000) nonfatal occupational TBIs were treated in EDs. The average rate was 4.3 (CI=±1.1) per 10,000 full-time equivalent workers (FTE). Young workers (15-24 years old) experienced the highest rate of all workers (7.7 per 10,000 FTE, CI=±5.3). Nonfatal occupational TBIs most commonly resulted from contact with objects and equipment (43%) and falls (36%). From 1998 to 2007, nonfatal occupational TBI rates increased 68% from 3.2 (CI=±0.9) per 10,000 FTE to 5.3 (CI=±1.3) per 10,000 FTE (p=0.003). TBIs from falls also significantly increased during this time period (p<0.001). In 2007, the highest industry rates were in agriculture (16.8 [CI= ±5.9]) and transportation and warehousing (8.9 [CI= ±3.9]).

Conclusions: Nonfatal TBIs occurring in the workplace have steadily increased. Increased prevention efforts are especially needed to reduce TBIs among high risk workers.