Tracking the prevalence of rollover protective structures on U.S. farm tractors: 1993, 2001, and 2004

Problem

Between 1992 and 2005, 1412 workers on farms died from tractor overturns. A Rollover Protective Structure (ROPS) is a proven intervention to reduce overturn deaths. However, farm characteristics that are associated with the adoption of ROPS are not well understood.

Methods

ROPS prevalence statistics were derived from National Institute for Occupational Safety and Health (NIOSH) surveys that tracked ROPS use on farms. Data were from the years 1993, 2001, and 2004.

Results

In 1993, 38% of tractors were equipped with ROPS. This increased to 51% by 2004. ROPS prevalence rates were higher on farms in the Southern region of the United States, on farms where the operator was 25-34 years old, and on farms with $100,000 or more of farm sales. Low ROPS prevalence rates were associated with farm operators 65 years old or older and with farms with less than $10,000 of farm product sales.

Summary

The increase in ROPS prevalence between 1993 and 2004 has not been sufficient to decrease the rate of tractor overturn deaths on farms. Incentive programs targeting older farm operators and low-income farm operations are suggested to increase ROPS use on tractors.

Impact on Industry

The study provides farm characteristics associated with low ROPS prevalence rates. The results can be used to target farms for future ROPS promotion activities.     

Tractor rollover fatalities,analyzing accident scenario

IntroductionIn many countries, traditional data sources for collecting injuries of workers covered by compulsory accident insurance have recently been integrated by new observatories whose results may differ. A comparative analysis of the Italian data collection systems related to fatal tractor accidents in agriculture was performed focusing on tractor rollover fatalities with the aim of analyzing the accident scenario.MethodData from the Operational Archives of the Italian Workers Compensation Authority (INAIL), which collects injuries of workers covered by compulsory accident insurance and those of the National Surveillance System (INAIL_ASL), which provides narrative text reports of work-related fatal accidents have been analyzed and compared to the information collected by the INAIL Observatory. The INAL Observatory was recently set up to complement the collection of fatal accidents involving agricultural machinery. Italian data were then compared to data available at an international level. Fatal tractor accidents vary considerably with respect to fatal accidents in agriculture, being 10.6 and 43.7% for the Operational Archives and Surveillance System, respectively. National Surveillance System records, implemented with narrative texts allowed the accident scenario to be defined.Results71.7% of fatal tractor-related accidents refer to non-ROPS equipped vehicles and of these, 26.5% involved machines originally mounted with a ROPS that had been removed or was inoperative in the folded-down position during the rollover event. Just one fatal event from a collapsed ROPS on the overturned tractor was recorded. It is interesting that 16.6% of fatal accidents involved a clear environmental factor.Practical applicationA campaign to train tractor drivers on the correct use of the combination ROPS and seatbelt can contribute to decreasing rollover events with fatal outcomes. Contemporarily a strict requirement to install ROPS and a seatbelt on tractors, combined to an official inspection at the farm level, can increase the chance of survival in a rollover accident.     

Intervention strategies for the retro-fitment of Rollover Protective Structures (ROPS) and fleet characteristic,farm tractors

Retro-fitment of Rollover Protective Structures (ROPS) on old tractors continues to be a priority for farm safety in Australia. Methods: A state wide (New South Wales (NSW), Australia) random postal survey asked farmers about awareness of, attitudes to and barriers to fitting ROPS; age and number of tractors with/without ROPS on their farm; and considerations when purchasing a tractor. Results: In NSW there are 2.5 tractors per farm ranging from new to 79 years of age (average 17 years) of which 0.4 per farm do not have a ROPS (18 430 tractors). People who knew of someone who had been injured or killed in a tractor rollover were 3.6 times (CI_95% 3.1–4.2) more likely to have all their tractors fitted with a ROPS. Those who thought ROPS were effective or knew it was a legal requirement were 1.5 (CI_95% 1.2–1.8 and 1.4–1.7 respectively) times more likely to have all their tractors fitted with a ROPS. Some of the barriers to fitting a ROPS were cost, availability of a ROPS and making ROPS a priority. The three most common considerations for farmers when purchasing a tractor are size, jobs to be undertaken and cost with safety coming in fourth. Ideas that were considered useful in prompting farmers to fit a ROPS were threat of fine or prosecution, increased awareness and high rebates. Discussion: As the average age of the primary working tractor is 17 years, any new tractor safety measure will have a long latency period if there is not some sort of retro-fitment. To increase retro-fitment rebates are a useful strategy. Any retro-fitment campaign needs to ensure that they create a need for the safety item and have addressed the barriers.     

Nonfatal bathroom injuries among persons aged ≥15 years--United States, 2008

Problem

Information about where nonfatal unintentional injuries occur is limited, but bathrooms commonly are believed to be a hazardous location.

Methods

Data from a nationally representative sample of hospital emergency departments (ED) was used to quantify and characterize nonfatal unintentional bathroom injuries among people aged ≥ 15 years.

Results

In 2008, an estimated 234,094 nonfatal bathroom injuries were treated in EDs. Most injuries (81.1%) were caused by falls and 37.3% of injuries occurred when bathing, showering, or getting out of the tub or shower. Both injury and hospitalization rates increased with age.

Summary

These results suggest that bathrooms tend to be most hazardous for persons in the oldest age groups.

Impact on Industry

Bathroom injuries among all household members might be reduced by increasing awareness about potentially hazardous activities in the bathroom combined with simple environmental changes such as adding grab bars inside and outside the tub or shower.     

Bystander injury evaluation of children from midwestern agricultural operations

Background

With more than a million youth living on agricultural operations, it is important for parents to understand the consequences of bystander injuries that children experience in these environments. We identified the childhood injuries for bystander status and compared the severity of these injuries to the working children in the Regional Rural Injury Study-II (RRIS-II).

Methods

RRIS-II followed 16,546 children (∼ 85% of eligible) from rural communities in the Midwest for two six-month recall periods in 1999 and 2001. Demographic, injury, and exposure data were collected through comprehensive computer-assisted telephone interviews. Child injuries were cataloged using narrative scenarios into four categories: (a) directly work-related; (b) indirectly work-related; (c) non-working accomplice; and (d) non-working attendant; the latter three all being bystander categories. Poisson regression modeling was used to calculate rates of bystander injuries. Frequencies were used for comparison of severity measures.

Results

Among the 463 child injuries (aged < 20 yrs), 102 were bystander injuries. Of the bystander-related injuries, 14 were identified as indirectly work-related (working bystanders), 27 as non-working accomplice (passengers/tag-alongs), and 60 as non-working attendant (playing on the operation). The overall rate of bystander injuries was 6.4 per 1,000 people, 95% CI (5.0, 8.1). Males, compared with females, had more than twice the injury rate (8.7; 95% CI 6.4-11.8, and 3.9; 95% CI 2.7-5.7, per 1,000 people, respectively). Bystanders in this population had more severe injuries with 4% having life-threatening circumstances; of these, 4% of the accomplices and 2% of the attendants subsequently died.

Conclusions

Children who live or work on agricultural operations are vulnerable to many hazards. Therefore, this study examined child injuries and found a clear difference in the consequences of these injuries between working-related and bystanding-related injuries.

Impact on Industry

Unlike occupations such as construction and mining, where laws and organizations have been created for the protection of bystanders, agricultural bystanders have remained unprotected and have had to face the consequent injury and death outcomes. As public health professionals considering these risks, it is necessary that we work to develop more intervention studies and continue to propose suggestive guidelines for child safety in these environments so as to challenge family traditions and possibly spark public policies that will give further protection to this population.     

Winter storm-related injuries in Oklahoma, January 2007

Introduction

A January 2007 ice storm occurred in Oklahoma, causing power outages and hazardous travel conditions. The objective of this investigation was to describe the nature of winter storm-related injuries among Oklahoma residents, to determine populations at risk, and to inform prevention-planning personnel.

Methods

Winter storm-related injuries were a temporarily reportable condition; all acute-care hospitals and the state medical examiner logged storm-related injuries and deaths during January 12 − 30, 2007. Medical records were retrospectively abstracted.Risk of injury was described by demographic group, injury type, and mechanism.

Results

Among 6,047 persons experiencing winter storm-related injuries, 74% were injured in falls, 13% in motor-vehicle collisions (MVCs), 8% while sledding, 1% by unintentional carbon monoxide poisoning, 1% in cleanup activities, and 3% by other mechanisms. Median age of injured persons was 39 years. Persons aged ≥ 40 years were 1.4 times more likely to experience falls as the cause of injury than those aged < 40 years, and falls were twice as likely as other mechanisms to cause fractures among persons aged ≥ 40 years. Injured persons aged < 40 years were 2.2 times more likely to experience MVC-related injuries, and 19 times more likely to experience sledding-related injuries than persons aged ≥ 40 years.

Conclusions

Younger persons were more likely injured in MVCs and sledding incidents, whereas older persons were more likely to experience falls and fractures.

Impact on industry

Prevention messages for winter storm-related injuries should target winter-driving safety tips to younger adults and precautions regarding falls to older adults.     

Predicting the performance of cost-effective rollover protective structure designs

Agricultural tractor overturns kill more than 100 workers each year in the United States. Rollover protective structures (ROPS) can prevent most of these deaths but can be expensive in retrofit applications. Cost-effective ROPS (CROPS) have been designed and built at the National Institute for Occupational Safety and Health but performance must be evaluated. This study: (1) evaluated CROPS performance, (2) developed a simulation model for probabilistic CROPS evaluation, and (3) evaluated exemplar prototype CROPS performance via simulation of testing requirements. The CROPS prototype evaluated in this study was a Ford-3000 CROPS prototype design. Simulations based on ROPS performance standard SAE J2194 (Society of Automotive Engineers) identified scenarios where the Ford-3000 CROPS might fail. No failure scenarios were identified during simulation of ROPS performance testing to Occupational Safety and Health Administration (OSHA) test procedures and performance requirements. Despite passing experimental SAE J2194 testing, computer simulations found scenarios where the Ford-3000 CROPS prototype design might fail. Re-design of the Ford-3000 concept is necessary before field implementation.     

Dogs and cats as environmental fall hazards

Problem

Falls are the leading cause of non-fatal injuries in the United States. This study assessed the prevalence of fall injuries associated with cats and dogs in the United States and describes the types of injuries sustained, the location, activity, and circumstances under which they occurred.

Methods

Data were from a nationally representative sample of emergency department visits from January 1, 2001 to December 31, 2006, available through the National Electronic Injury Surveillance System All Injury Program (NEISS-AIP).

Results

Based on 7,456 cases, an estimated 86,629 fall injuries each year were associated with cats and dogs, for an injury rate of 29.7. There were 7.5 times as many injuries involving dogs as cats and females were 2.1 times more likely to be injured than males. Injury rates were highest among people aged ≥ 75, but pets were a fall hazard for all ages. Fractures and contusions or abrasions were the most common injuries; the highest rates were for injuries to the extremities. About 66.4% of falls associated with cats and 31.3 % of falls associated with dogs were caused by falling or tripping over the pet. An additional 21.2% of falls related to dogs were caused by being pushed or pulled.

Summary

Although pets were associated with fall injuries, this risk can be reduced by increasing public awareness about situations that can lead to falls, such as dog-walking and chasing pets, and by calling attention to the importance of obedience training for dogs to minimize hazardous behaviors such as pulling and pushing.

Impact on industry

Fall injuries represent a burden to individuals, our society and our health care system. Increasing public awareness and implementing basic prevention strategies can help people of all ages enjoy their pets, reduce their chances of experiencing pet-related falls, and lessen the impact of fall injuries on our health care system.     

The effect of work hours on adverse events and errors in health care

Introduction

We studied the relationship between registered nurses' extended work duration with adverse events and errors, including needlestick injuries, work-related injuries, patient falls with injury, nosocomial infections, and medication errors.

Method

Using bivariate and multivariate logistic regression, this secondary analysis of 11,516 registered nurses examined nurse characteristics, work hours, and adverse events and errors.

Results

All of the adverse event and error variables were significantly related to working more than 40 hours in the average week. Medication errors and needlestick injuries had the strongest and most consistent relationships with the work hour and voluntary overtime variables.

Discussion

This study confirms prior findings that increased work hours raise the likelihood of adverse events and errors in healthcare, and further found the same relationship with voluntary overtime.

Impact on Industry

Legislation has focused on mandatory overtime; however, this study demonstrated that voluntary overtime could also negatively impact nurse and patient safety.     

Bicycle helmet use among children in the United States: The effects of legislation, personal and household factors

Introduction

Children ages 5-14 years have the highest rate of bicycle-related injuries in the country. Bicycle helmets can prevent head and brain injuries, which represent the most serious type of bicycle-related injury.

Objectives

This paper compares children's bicycle helmet use to that estimated from an earlier study, and explores regional differences in helmet use by existing helmet legislation.

Methods

This study was a cross-sectional, list-assisted random-digit-dial telephone survey. Interviews were completed by 9,684 respondents during 2001-2003. The subset with at least one child in the household age 5-14 years (2,409 respondents) answered questions about bicycle helmet use for a randomly selected child in their household.

Results

Almost half (48%) of the children always wore their helmet, 23% sometimes wore their helmet, and 29% never wore their helmet. Helmet wearing was significantly associated with race, ethnicity, and child age but was not associated with the sex of the child. Other significant predictors of use included household income, household education, census region, and bicycle helmet law status. Statewide laws were more effective than laws covering smaller areas. The proportion of children who always wore a helmet increased from 25% in 1994 to 48% in 2001-2002. Significant increases in helmet use from 20% to 26% were seen among both sexes, younger (5-9 years) and older (10-14 years) children, and in all four regions of the country.

Conclusions

While there has been substantial progress in the number of children who always wear their helmets, more than half do not. Further progress will require using a combination of methods that have been shown to successfully promote consistent helmet use. Impact on industry: minimal.     

Continued progress in the prevention of nail gun injuries among apprentice carpenters: What will it take to see wider spread injury reductions?

Problem

Nail guns are a common source of acute, and potentially serious, injury in residential construction.

Method

Data on nail gun injuries, hours worked and hours of tool use were collected in 2008 from union apprentice carpenters (n = 464) through classroom surveys; this completed four years of serial cross-sectional data collection from apprentices. A predictive model of injury risk was constructed using Poisson regression.

Results

Injury rates declined 55% from baseline measures in 2005 with early training and increased use of tools with sequential actuation. Injury rates declined among users of tools with both actuation systems, but the rates of injury were consistently twice as high among those using tools with contact trip triggers.

Discussion and impact

Nail gun injuries can be reduced markedly through early training and use of tools with sequential actuation. These successful efforts need to be diffused broadly, including to the non-union sector.     

Occupational accident rate in olive oil mills

Problem

This paper aims at examining the occupational accident rate in Spain in the olive oil mill industry. These mills produce olive oil by physical or mechanical, but not chemical procedures. Although Spain is the leading olive oil producer in the world with 1,200,000 tons/year and over 25% of the world olive farming area, the occupational accident rate in this sector has been little studied in the relevant scientific literature.

Method

Our study analyses all occupational accidents which occurred during 2004-2009, with or without sick leave, at 90 Andalusian olive oil mills covered by one of the biggest state insurance companies for accidents at work and occupational diseases (within the Spanish Social Security system).

Results and discussion

Slips or trips are the most frequent cause of occupational accidents in this sector, accounting for 14.86% of the cases. In second position, incorrectly coordinated bodily movements account for almost 13.51% of the accidents. Falls from height, 12.2% of the cases, are also statistically noteworthy. As for the seriousness of the injuries, entrapments are particularly important, since in 2.70% of the cases they result in the traumatic amputation of a part of the body. The analysis of accidents without sick leave reveals that a high number of incidents are caused by contact of the skin and eyes with hazardous substances (20% of the cases) and 10% of them involve superficial injuries.

Impact on the industry

This paper provides a clear and updated image of the accident rate in Spanish olive oil mills and can be a useful tool for the design and adequate adjustment of the management systems implemented in these plants to guarantee a satisfactory level of occupational health and safety by means of more efficient planning and monitoring of measures intended to reduce professional risks and improve working conditions.

Recommendations

Given not only the high incidence of falls on the same level and the potential seriousness of falls from different levels, but also the small, round fruit involved, with a high oil content and a hard round stone, it is extremely important to design and implement safe working procedures and specifically train both operatives and managers in charge of the tidiness, cleanliness and regular control of the premises and operations. The analysis of the accidents not requiring sick leave (mostly cases of contact with hazardous substances on the skin or eyes, or superficial injuries) clearly reveals that the use of suitable personal protective equipment and the relevant training are crucial issues.     

Implied-consent laws: A review of the literature and examination of current problems and related statutes

Problem

A substantial proportion of drivers arrested for DUI refuse the BAC test, thereby reducing the likelihood that they will be convicted and potentially increasing the number of high-risk multiple offenders contributing to alcohol-related crashes.

Method

This paper reviews the information on the current status of implied-consent laws (which impose a sanction on offenders who refuse the BAC test) in the 50 states and the other relevant traffic safety laws and policies that may influence state refusal rates.

Results

Although there appears to be only a weak relationship between state refusal rates and crash rates, there is strong evidence that BAC test refusals significantly compromise the arrest, prosecution, and sentencing of DUI suspects and the overall enforcement of DUI laws in the United States.

Discussion

Laws and policies that may reduce the number of refusals are discussed.

Impact on industry

Alcohol-related crash injuries are an important cost problem for U.S. industry because of property damage from crashes, crash injuries to employees that raise health costs, or the reduction of time on the job resulting from a highway injury.     

Validity of police-reported alcohol involvement in fatal motor carrier crashes in the United States between 1982 and 2005

Objective

To examine the validity of police-reported alcohol data for drivers involved in fatal motor carrier crashes.

Material and Methods

We determined the availability of blood alcohol concentration (BAC) and police-reported alcohol data on 157,702 drivers involved in fatal motor carrier crashes between 1982 - 2005 using Fatality Analysis and Reporting System (FARS) data. Drivers were categorized as motor carrier drivers if they operated a vehicle with a gross vehicle weight rating of greater than 26,000 pounds. Otherwise, they were classified as non motor carrier drivers. The sensitivity and specificity of police-reported alcohol involvement were estimated for both driver types.

Results

Of the 157,702 drivers, 18% had no alcohol information, 15% had BAC results, 42% had police-reported alcohol data, and 25% had both. Alcohol information varied significantly by driver, crash, and vehicle characteristics. For example, motor carrier drivers were significantly more likely (51%) to have BAC testing results compared to non motor carrier drivers (31%) (p < 0.001). The sensitivity of police-reported alcohol involvement for a BAC level ≥ 0.08 was 83% (95% CI 79%, 86%) for motor carrier drivers and 90% (95% CI 89%, 90%) for non motor carrier drivers. The specificity rates were 96% (95% CI 95%, 96%) and 91% (95% CI 90%, 91%), respectively.

Conclusions

The sensitivity and specificity of police-reported alcohol involvement are reasonably high for drivers involved in fatal motor carrier crashes. Further research is needed to determine the extent to which the accuracy of police-reported alcohol involvement may be overestimated because of verification bias.

Impact on the Industry

Based on the results of this study, the federal government should continue to work with states to strengthen their strategies to increase chemical testing of all drivers involved in fatal crashes.     

Injury outcomes and costs for cross-median and median barrier crashes

Introduction

The objective of this research was to quantify the injury outcomes and develop reliable and comprehensive injury costs for cross-median crashes (CMC) and median barrier crashes (MBC).

Method

A three-step methodology was developed to quantify the crash costs for each crash severity and type. All CMC and MBC between 2001 and 2007 in Wisconsin were identified and used in this analysis. The Wisconsin CODES database provided comprehensive injury costs based on the injury types and severities suffered by participants in study crashes.

Results

As expected, multi-vehicle CMC result in more total injuries and more severe injuries than single-vehicle CMC. Injury costs for the same injury level on KABCO scale are different for different crash types. Injury costs for concrete MBC are 33% to 50% less than those of multi-vehicle CMC, while the injury costs of concrete MBC for lower severities (B and C) are similar to those of single-vehicle CMC for the same severities; but for incapacitating injuries the costs are 30% less. As expected, concrete MBC result in lower severities than CMC. The costs, by crash severity, vary significantly between different crash types. Concrete median barrier injury crashes are roughly 20% of multi-vehicle CMC costs and 50% of single-vehicle CMC costs.

Conclusions

Results indicate that using one set of crash costs for all crash types biases any evaluation. Therefore, it is recommended that crash-type-specific costs be used in applications such as development of median barrier warrant where specific types of crashes are considered (CMC and MBC).

Impact on industry

Using crash specific costs can lead to a more realistic benefit-cost analysis and enable better decision-making.     

Hepatitis B virus infection among health care workers in Public Teaching Hospitals in Khartoum State, Sudan

Background

Hepatitis B virus (HBV) infection is a global public health problem. It is estimated that there are more than 300 million HBV carriers in the world.

Aim

The study aimed to examine the sero-prevalence of hepatitis B virus (HBV) markers among health care workers (HCWs) in Public Teaching Hospitals in Khartoum State, in the year 2004.

Methods

The study is an observational, cross sectional, facility-based study. It was conducted on stratified two-stage cluster random sample of 843 subjects. The study followed non-parametric statistical methods, using Z-test for single proportion.

Results

Among the 843 subjects tested for all HBV markers (Anti-HBc, HBsAg, HBsAb, and HBeAg), the prevalence of Anti-HBc, HBsAg, HBsAb, and HBeAg was found to be 57% (CI 95%:53-60%), 6% (CI 95%:4.0-8.0%), 37% (CI 95%:34-40%) and 9% (CI 95%:7-11%) respectively. P < 0.05.

Conclusion

Seroprevalence of all HBV markers (P < 0.05) was found to be significantly high, while the rate of immunity against HBV infection was low among health care workers In Public Teaching Hospitals in Khartoum State, Sudan.     

Occupational injuries of immigrant and Finnish bus drivers

Problem

With baby boomers reaching retirement age, Western countries may need more immigrant workers to ensure productivity. Many studies have suggested a higher occupational injury frequency among immigrant workers, which could considerably reduce their contribution to society. The aim of this study was to examine whether immigrant workers have a higher injury frequency compared to Finnish workers when performing the exact same tasks under the same working conditions.

Method

A total of 176 Finnish and 130 immigrant bus drivers were asked about their occupational injuries during the past 12 months via a questionnaire. In addition, the data contained 134 injuries reported by the transport firm to an insurance company.

Results

There was no significant difference in reporting occupational injuries by self-reporting or by company-records. Because there were more accident-repeaters among Finnish drivers, their injury frequency (114) was higher than that of immigrant drivers (78).

Application/Impact

This study showed that immigrant workers did not have a higher injury frequency than other workers when they worked in the exact same conditions. Immigrant workers can work as safely as native-Finnish workers, when their working conditions and job contracts are at the same level as those of the original population. Immigrant workers can compensate for the shortage of workforce caused by an aging population.     

Injuries and risk-taking behaviours in Portuguese adolescents: Highlights from the health behaviour in school-aged children survey

Aim

Injuries in adolescence are an important public health problem and a major cause of morbidity and mortality in this age group. This study aimed to determine the behaviour profile associated to risk of injury and the differences between genders, region and ethnic origin.

Methods

A cross-sectional study design of a nationally representative sample of 1581 adolescents of the Portuguese Health Behaviour in School-Aged Children study.

Results

An occurrence of one injury-related event in the previous year was reported by 21.4% of the respondents and 5.9% referred having more than one injury-related event. Boys reported higher frequency of those events when compared to girls, and non-Portuguese subjects referred higher frequency of events. Scoring higher in violence-related behaviour and psychosomatic complaints was associated to higher chances of referring more than one injury-related event.

Conclusion

Gender, social background and behaviour profile are factors that seem to influence the risk of injuries. This information should guide those involved in the planning of injuries prevention programs in youth.     

“Safety is everyone's job:” The key to safety on a large university construction site

Problem

Construction risk management is challenging.

Method

We combined data on injuries, costs, and hours worked, obtained through a Rolling Owner-Controlled Insurance Program (ROCIP), with data from focus groups, interviews, and field observations, to prospectively study injuries and hazard control on a large university construction project.

Results

Lost-time injury rates (1.0/200,000 hours worked) were considerably lower than reported for the industry, and there were no serious falls from height. Safety was considered in the awarding of contracts and project timeline development; hazard management was iterative. A top-down management commitment to safety was clearly communicated to, and embraced by, workers throughout the site.

Discussion and Impact

A better understanding of how contracting relationships, workers' compensation, and liability insurance arrangements influence safety could shift risk management efforts from worker behaviors to a broader focus on how these programs and relationships affect incentives and disincentives for workplace safety and health.     

An epidemiologic comparison of injuries presenting to a pediatric emergency department and local urgent care facilities

Problem

The objective of this study was to compare the epidemiology of injuries presenting to emergency department (ED) and urgent care (UC) facilities of a single, NEISS-affiliated hospital.

Method

Patient medical records (n = 36,811) were used to compare injury incidence, injury characteristics, and demographic characteristics between the ED, on-site UC, and off-site UC during 2006.

Results

ED presentations were more likely to be open wounds and motor vehicle-related compared to on-site UC presentations. ED presentations were more likely to be system wide/late effects, be made by an African American, or be paid through Medicaid compared to off-site UC presentations. On-site UC presentations were more likely to be made by an African American or be paid through Medicaid compared to off-site UC presentations.

Discussion

ED and UC injury characteristics and patient demographics differ. With no nationally-representative UC injury surveillance, current research likely underestimates injury incidence and presents skewed profiles. Impact on Industry: This article adds insight into the generalizability of ED-based injury surveillance to UC injuries.