Online Program

Use of multiple data sources to enumerate work-related amputations and carpal tunnel syndrome in Massachusetts, California, and Washington

Tuesday, November 5, 2013 : 2:50 p.m. - 3:10 p.m.

Letitia Davis, ScD, Occupational Health Surveillance Program, Massachusetts Department of Public Health, Boston, MA
Robert Harrison, MD, MPH, Division of Occupational and Environmental Medicine, University of California, San Francisco, San Francisco, CA
David Bonauto, MD, MPH, Safety and Health Assessment and Research for Prevention (SHARP) program, Washington State Department of Labor & Industries, Olympia, WA
Kathleen Grattan, MPH, Occupational Health Surveillance Program, MA Department of Public Health, Boston, MA
Rachel Roisman, MD, MPH, Occupational Health Branch, California Department of Public Health, Richmond, CA
Sara Wuellner, MPH, SHARP Program, WA State Dept. Labor & Industries, Olympia, WA
Background: Given evidence of undercounting in the Survey of Occupational Injuries and Illness (SOII), the Bureau of Labor Statistics funded Massachusetts, California, and Washington to assess feasibility of using multiple data sources to enumerate work-related amputations and carpal tunnel syndrome.

Methods: Researchers across states collaborated to develop common surveillance case definitions and criteria for identifying cases. Data sources used varied by state depending on availability,legal access and size of population studied. Sources included SOII, workers' compensation claim and statewide hospitalization data (all states; emergency department data(MA); medical records (WA, MA; CA sample). Cases were matched across datasets and demographic/employment characteristics of cases by data source described. Total enumerated cases and the subset of SOII eligible cases were compared to SOII estimated cases during the study periods (MA,CA:2007-2008; WA 2006 - 2008.)

Results: Multisource surveillance consistently indentified more cases than any single source and more than the SOII estimates. This was partially explained by capture of case ineligible for SOII. However, all states found that SOII underestimated the number of SOII eligible cases. Estimates of the undercount varied by health condition and state and ranged from 30 - 64% for amputations and from 13-72% for CTS. Changes in case status over time and reporting of cases as other types of injuries in the SOII explained some but not all undercount.

Conclusion: Multisource surveillance substantially improves our capacity to characterize the burden of work-related injuries and illness but poses practical challenges that vary by state and currently limit aggregating data across states.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Occupational health and safety
Public health or related public policy

Learning Objectives:
Describe some of advantages and challenges of multisource surveilalnce for work-related amputations and carpral tunnel syndrome Characterize the range of the estimated undercount of work-related ampuations and carpal tunnel syndrome in the SOII

Keyword(s): Occupational Surveillance, Injury

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have conducted research on surveillance of work-related injuries and illnesses for over 20 years and oversee a number of state based occupational health surveillance systems.
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.