A comparison of fatal occupational injury event characteristics from the Census of Fatal Occupational Injuries and the Vital Statistics Mortality System

Using hospitalization data for injury surveillance in agriculture, forestry and fishing: a crosswalk between ICD10CM external cause of injury coding and The Occupational Injury and Illness Classification System

BACKGROUND

While statistics related to occupational injuries exist at state and national levels, there are notable difficulties with using these to understand non-fatal injuries trends in agriculture, forestry, and commercial fishing. This paper describes the development and testing of a crosswalk between ICD-10-CM external cause of injury codes (E-codes) for agriculture, forestry, and fishing (AFF) and the Occupational Injury and Illness Classification System (OIICS). By using this crosswalk, researchers can efficiently process hospitalization data and quickly assemble relevant cases of AFF injuries useful for epidemiological tracking.

METHODS

All 6810 ICD-10-CM E- codes were double-reviewed and tagged for AFF- relatedness. Those related to AFF were then coded into a crosswalk to OIICS. The crosswalk was tested on hospital data (inpatient, outpatient, and emergency department) from New York, Massachusetts, and Vermont using SAS9.3. Injury records were characterized by type of event, source of injury, and by general demographics using descriptive epidemiology.

RESULTS

Of the 6810 E-codes available in the ICD-10-CM scheme, 263 different E-codes were ultimately classified as 1 = true case, 2 = traumatic/acute and suspected AFF, or 3 = AFF and suspected traumatic/acute. The crosswalk mapping identified 9969 patient records either confirmed to be or suspected to be an AFF injury out of a total of 38,412,241 records in the datasets, combined. Of these, 963 were true cases of agricultural injury. The remaining 9006 were suspected AFF cases, where the E-code was not specific enough to assign certainty to the record's work-relatedness. For the true agricultural cases, the most frequent combinations presented were contact with agricultural/garden equipment (301), non-roadway incident involving off-road vehicle (222), and struck by cow or other bovine (150). For suspected agricultural cases, the majority (68.2%) represent animal-related injuries.

CONCLUSIONS

The crosswalk provides a reproducible, low-cost, rapid means to identify and code AFF injuries from hospital data. The use of this crosswalk is best suited to identifying true agricultural cases; however, capturing suspected cases of agriculture, forestry, and fishing injury also provides valuable data.

[Factors associated with quality of work accident records in Brazil's Mortality Information System]

This study aimed to identify factors associated with the quality of fatal work accident records in the Brazilian Mortality Information System in individuals 18 to 65 years of age from 1998 to 2013. The quality of the record of possible causal relationship between accidents and the work <acidtrab>, a field that appears on death certificates and is exclusive to accidents among external causes, was analyzed with two variables: (1) record "ignored" (R-IGN, yes/no); (2) missing or inconsistent records (R-AUS, yes/no). A total of 665,531 deaths were located, of which 67.7% of the <acidtrab> records showed poor quality. Factors associated with record "ignored" were: male sex; white skin color; schooling less than university; non-blue-collar workers or non-farmers; death certificate issued by the Forensic Medical Office (IML); Southeast and Northeast regions of the country; and death in hospital. Missing or inconsistent records were associated with: age greater than 34 years; non-white skin color; no schooling; all regions of Brazil except the Southeast; death in hospital or at home; police report as the source of information; and death certificate issued by the IML. The factors independently associated with poor quality of completion of the field <acidtrab> included individual dimensions, source issuing the death certificate, place of death, and geographic variables. The findings reveal the need to improve the quality of death records in hospitals, the IML, and police reports, besides training and supervising teams throughout Brazil.

Right-to-Carry Laws and Firearm Workplace Homicides: A Longitudinal Analysis (1992-2017)

Objectives. To examine the impact of right-to-carry (RTC) firearm laws on firearm workplace homicides (WPHs) in the United States from 1992 to 2017.Methods. We employed 2 longitudinal methods to examine the average effect (pooled, cross-sectional, time-series analysis) and the state-specific effect (random effects meta-analysis) of RTC laws on WPHs committed by firearms from 1992 to 2017 in a 50-state panel. Both methods utilized a generalized linear mixed model with a negative binomial distribution.Results. From 1992 to 2017, the average effect of having an RTC law was significantly associated with 29% higher rates of firearm WPHs (95% confidence interval [CI] = 1.14, 1.45). No other state-level policies were associated with firearm WPHs. Sensitivity analyses suggest robust findings. State-specific estimates suggest that passing an RTC law during our study period was significantly associated with 24% increase in firearm WPH rates (95% CI = 1.09, 1.40).Conclusions. This is the first study to our knowledge to examine the link between RTC firearm laws and firearm WPHs. Findings indicate that RTC laws likely pose a threat to worker safety and contribute to the recent body of literature that finds RTC laws are associated with increased incidence of violence.

The recording of fatal work-related injuries in information systems in Brazil

This study aims to identify information systems having fatal work-related (ATF) data in Brazil, describing their characteristics, flows and barriers to information quality. Using a documental research approach, we found: the Mortality Information System (SIM), the Hospital Admission Register from the Unified Health System (SIH-SUS), the Notifiable Diseases Information System (SINAN) and the Violence and Injuries Surveillance Program (VIVA) from the Health Ministry; the Work-related Injuries Reporting System (SISCAT) of the Ministry of Social Insurance; and the Annual Report of Social Information (RAIS), Ministry of Labour and Employment. A lack of key common variables limits the construction of a single database composed by all ATF recorded cases. From several barriers identified, the most relevant for data quality was the lack of work-relatedness recognition and recording, a task performed by the health team.

Using multiple coding schemes for classification and coding of agricultural injury

BACKGROUND

Agricultural safety and health researchers have used a variety of classification and coding schemes to identify and categorize injury, illness, and disease associated with agricultural hazards. This paper demonstrates how the Farm and Agricultural Injury Classification (FAIC) and Occupational Injury and Illness Classification System (OIICS) coding schemes can be used in tandem for all agricultural injuries.

METHODS

Specific cases from the AgInjuryNews.org database were selected to illustrate how the FAIC and OIICS codes can be applied to agricultural injury, and to illustrate limitations that still exist with each coding scheme.

RESULTS

Using the FAIC and OIICS together provided a clearer picture of an injury incident by combining more explicit occupational and non-occupational exposures with incident type details in a single table.

CONCLUSIONS

Both FAIC and OIICS coding schemes depend on sufficient information being available from injury reports. This paper concluded with suggestions for improving coding of agricultural injury.

Acidentes de trabalho fatais em Palmas, Tocantins, Brasil: oportunidades perdidas de informação

Resumo Objetivo: estimar o sub-registro de acidentes de trabalho fatais (ATF) nos sistemas de informação do Ministério da Saúde, Secretaria Estadual de Segurança Pública (SSP), Ministério do Trabalho e Secretaria da Previdência Social, de 2007 a 2015, em Palmas, Tocantins. Métodos: para identificação dos casos de ATF, as fontes de dados foram o Sistema de Informação sobre Mortalidade (SIM), o Sistema de Informações Hospitalares do Sistema Único de Saúde (SIH-SUS), o Sistema de Informações de Agravos de Notificação (SINAN), a Relação Anual de Informações Sociais (RAIS), o Sistema de Informação de Comunicação de Acidentes de Trabalho (SISCAT), os boletins de ocorrência (BO), Guias de Encaminhamento Cadavérico (GEC) e Laudo de Exame Cadavérico (LEC). Para calcular a subnotificação de cada sistema, uma base de dados única foi criada com os registros de todas as fontes, eliminando-se repetições. Resultados: foram identificados 114 casos. Os sub-registros encontrados foram: SIM, 28,9%; SINAN, 44,7%; SSP, 55,3%; RAIS, 73,1%; SISCAT, 65,4%, para trabalhadores segurados. Conclusão: o melhor desempenho de registro é o do SIM. Observou-se extenso sub-registro em todas as demais fontes. Registros de mortalidade por ATF são subestimados. Ações de melhoria dos registros, especialmente no SIH-SUS, RAIS, SISCAT, SSP, seguidos pelo SINAN e SIM, são necessárias.

Quality of the record of data on fatal workplace injuries in Brazil

OBJECTIVE

To evaluate the quality of the data on fatal workplace injuries in Brazil, in the Mortality Information System (SIM) and the Information System of Notifiable Diseases (SINAN-AT), analyzing the spatial and temporal distribution between 2007 and 2012.

METHODS

We identified fields related to fatal workplace injuries, which were examined for completeness and the use of the "ignored" option. From the SIM, we extracted the records of deaths from external causes, which require the completing of the <acidtrab> field about their relation with work. From the SINAN, we analyzed the <evolution> field, which allows us to identify fatal cases among s severe workplace injuries.

RESULTS

In the SIM, from 469,121 records, the <acidtrab> field was left unfilled or filled as ignored in 84.2% of them; the Brazilian region with the highest proportion was the Northeast (79.1%), from which the state of Alagoas (94.4%) had the highest amount. There was a 5.5% decreasing trend between 2007 (86.6%) and 2012 (81.8%). Among the 251,681 records found in the SINAN-AT, 28.3% had unfilled or ignored responses for <evolution>, varying from 39.7% in 2007 to 23.2% in 2012, a 41.6% decrease.

CONCLUSIONS

The quality of the records on the fields of interest needed to identify fatal workplace injuries is poor in the SIM, but gradually improving. Recording quality was better for SINAN-AT, which has also been strongly getting better lately.