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Non-fatal occupational injuries and illnesses treated in hospital emergency departments in the United States
  1. L L Jackson
  1. National Institute for Occupational Safety and Health, Division of Safety Research, 1095 Willowdale Road, M/S H-1812, Morgantown, WV 26505, USA
  1. Correspondence to:
 Dr Jackson


Objectives—To estimate the number and rate of occupational injuries and illnesses treated in hospital emergency departments and to characterize the nature, event, and source of injury and illness.

Setting—Twenty four hour emergency departments in hospitals in the United States.

Methods—Surveillance for occupational injuries and illnesses was conducted in a national probability based sample of hospital emergency departments through the National Electronic Injury Surveillance System (NEISS). Worker demographics, nature of injury and disposition, and incident circumstances were abstracted from emergency department medical records, typically within 24–72 hours of treatment.

Results—Approximately 3.6 million occupational injuries and illnesses were treated in emergency departments in 1998. Younger workers, particularly males, continue to have the highest rates of work related injuries. Together, lacerations, punctures, amputations, and avulsions represented one fourth of the emergency department treated injuries, mostly to hand and fingers. Sprains and strains, largely to the trunk, also accounted for one fourth of the injuries. The three leading injury events were contact with objects, bodily reactions and exertions, and falls.

Conclusions—Despite apparent decreases in rates, youth continue to have a high burden of injury in the workplace. However, three fourths of all emergency department treated injuries occur to workers 20–44 years of age. Emergency department surveillance is particularly amenable to capture of young worker injuries and provides a wealth of injury details to guide prevention efforts—efforts that will likely reduce occupational injuries as these workers age. Emergency department surveillance also provides injury estimates with few demographic or employer constraints, other than the medical venue used.

  • surveillance
  • emergency department
  • National Electronic Injury Surveillance System (NEISS)
  • occupational injury

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  • * The Consumer Product Safety Commission (CPSC) operates NEISS. The National Institute for Occupational Safety and Health (NIOSH) has collaborated with CPSC to collect work related injuries and illnesses treated in an emergency department (without regard to consumer product involvement) during 1981–87, 1992–95 (with age or industry restrictions), and 1996 through the present (without restrictions).

  • The NEISS sample design for work related emergency department visits was updated in October 1997 based on the 1995 listing of hospitals in the United States (SMG Marketing Group, Chicago, IL). This resulted in changes in the makeup of hospitals within each size stratum in the sample and the statistical weight for cases that are used to extrapolate to national estimates compared with earlier reports.9, 10

  • Work related injury and illness information was collected at two thirds of the 101 NEISS hospitals utilized by the CPSC for the collection of product related injuries and illnesses. The 67 hospital sample was distributed proportionately across the strata similar to the larger CPSC sample and weighted to appropriately account for the smaller sample size.

  • § Because of the NEISS sampling frame update in 1997 and minor procedural modifications, the previously reported estimate (3.3 million) for 1996 is crudely estimated to be 4% lower (NIOSH and CPSC unpublished data).