The Use of Sentinel Injury Deaths to Evaluate the Quality of Multiple Source Reporting for Occupational Injuries
Received 24 November 2003; accepted 27 July 2004. published online 04 November 2004.
Purpose
This study sought to develop an efficient method for evaluating the validity and completeness of routinely available sources of occupational injury fatality data.
Methods
Deaths due to falls from elevations, machinery, and electrocutions were selected as sentinel injuries likely to have occurred at work. Deaths from these injuries were identified from Maryland vital statistics over 7 years. The work-relatedness of these injuries and sensitivity of reporting were determined from death certificates, medical examiner reports, the National Traumatic Occupational Fatality System (NTOF), the Maryland Occupational Safety and Health Administration (MOSH), and Workers' Compensation (WC) data.
Results
A total of 527 deaths were identified for ages 16 and above, of which, 45% were work-related. Identification of work-related deaths varied by source: medical examiner (100%), death certificates (89%), NTOF (68%), MOSH (59%), and WC (44%). Reporting differed by age, cause of injury, year, occupation, and industry.
Conclusions
Examination of work-relatedness for deaths from certain causes is an efficient means of evaluating the quality of occupational injury reporting source data. These sentinel injuries uncovered significant underreporting in sources used by national surveillance systems, resulted in improved NTOF reporting, and suggest the need to make more use of medical examiner data when available.
From the Liberty Mutual Research Institute for Safety, Hopkinton, MA (G.S.S.); Native American Cardiology Program, Indian Health Service, US Department of Health and Human Services, Flagstaff, AZ (M.A.V.); Department of Family Medicine, University of Massachusetts, Worcester, MA (K.L.B.); and SSDS, Inc., Boston, MA (K.L.B.)
Address correspondence and reprint requests to: Gordon S. Smith, M.D., M.P.H., Liberty Mutual Research Institute for Safety, 71 Frankland Road, Hopkinton MA 01748. Tel.: (508) 497-0250; Fax: (508) 435 3456.
This study was supported in part by purchase order no. 944279 from the Division of Safety Research, National Institute for Occupational Safety and Health, a FIRST Award from the National Institute of Alcohol Abuse and Alcoholism (R29AA07700), and grants from the Centers for Disease Control and Prevention to the Johns Hopkins Center for Injury Research and Policy (R49/CC R 302486).
ABSTRACT