Sears Jeanne M, Bowman Stephen M
Department of Health Services, School of Public Health, University of Washington, Seattle, WA, USA; Harborview Injury Prevention and Research Center, Seattle, WA, USA; Institute for Work and Health, Toronto, ON, Canada.
Department of Healthcare Administration, Woods College of Advancing Studies, Boston College, Chestnut Hill, MA, USA.
Public Health Rep. 2016 Nov;131(6):791-799. doi: 10.1177/0033354916669358. Epub 2016 Oct 19.
Work-related traumatic injury is a leading cause of death and disability among US workers. Occupational injury surveillance is necessary for effective prevention planning and assessing progress toward Healthy People 2020 objectives. Our objectives were to (1) describe the Washington State Trauma Registry (WTR) as a resource for occupational injury surveillance and research, (2) compare the WTR with 2 population-based data sources more widely used for these purposes, and (3) compare the number of injuries ascertained by the WTR with other data sources.
We linked WTR records to hospital discharge records in the Comprehensive Hospital Abstract Reporting System for 2009 and to workers' compensation claims from the Washington State Department of Labor and Industries for 1998 to 2008. We assessed the 3 data sources for overlap, concordance, and case ascertainment.
Of 9185 work-related injuries in the WTR, 3380 (37%) did not link to workers' compensation claims. Use of payer information in hospital discharge records along with the WTR work-relatedness field identified 20% more linked injuries as work related (n = 720) than did use of payer information alone (n = 602). The WTR identified substantial numbers of work-related injuries that were not identified through workers' compensation or hospital discharge records.
Workers' compensation and hospital discharge databases are important but incomplete data sources for work-related injuries; many work-related injuries are not billed to, reported to, or covered by workers' compensation. Trauma registries are well positioned to capture severe work-related injuries and should be included in comprehensive injury surveillance efforts.
与工作相关的创伤性损伤是美国工人死亡和残疾的主要原因。职业伤害监测对于有效的预防规划和评估实现《健康人民2020》目标的进展情况至关重要。我们的目标是:(1)将华盛顿州创伤登记处(WTR)描述为职业伤害监测和研究的资源;(2)将WTR与另外两个更广泛用于这些目的的基于人群的数据源进行比较;(3)比较WTR确定的伤害数量与其他数据源。
我们将2009年WTR记录与综合医院摘要报告系统中的医院出院记录以及1998年至2008年华盛顿州劳动和工业部的工伤赔偿申请进行了关联。我们评估了这三个数据源的重叠性、一致性和病例确定情况。
在WTR中的9185例与工作相关的损伤中,3380例(37%)与工伤赔偿申请没有关联。在医院出院记录中使用付款人信息以及WTR与工作相关的字段,比仅使用付款人信息多识别出20%的关联损伤为与工作相关(n = 720)(n = 602)。WTR识别出大量未通过工伤赔偿或医院出院记录识别的与工作相关的损伤。
工伤赔偿和医院出院数据库对于与工作相关的损伤来说是重要但不完整的数据源;许多与工作相关的损伤未被计费、报告或纳入工伤赔偿范围。创伤登记处能够很好地捕捉严重的与工作相关的损伤,应纳入全面的伤害监测工作中。