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Twenty-five year occupational homicide mortality trends in North Carolina: 1992–2017
  1. Chelsea L Martin1,2,
  2. David Richardson3,
  3. Morgan Richey4,
  4. Maryalice Nocera5,
  5. John Cantrell6,
  6. Elizabeth S McClure2,6,
  7. Amelia T Martin6,
  8. Stephen W Marshall7,8,
  9. Shabbar Ranapurwala9
  1. 1Department of Epidemiology, Gillings School of Global Public Health, UNC-Chapel Hill, Chapel Hill, North Carolina, USA
  2. 2Injury Prevention Research Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
  3. 3Susan and Henry Samueli College of Health Sciences, University of California Irvine, Irvine, California, USA
  4. 4National Foundation for the Centers for Disease Control and Prevention Inc, Atlanta, Georgia, USA
  5. 5University of North Carolina Injury Prevention Research Center, Chapel Hill, North Carolina, USA
  6. 6Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
  7. 7Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
  8. 8Injury Prevention Research Center, The University of North Carolina at Chapel Hill Injury Prevention Research Center, Chapel Hill, North Carolina, USA
  9. 9Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
  1. Correspondence to Dr Chelsea L Martin, Department of Epidemiology, Gillings School of Global Public Health, UNC-Chapel Hill, Chapel Hill, NC 27599, USA; martinlc{at}unc.edu

Abstract

Introduction Determining industry of decedents and victim–perpetrator relationships is crucial to inform and evaluate occupational homicide prevention strategies. In this study, we examine occupational homicide rates in North Carolina (NC) by victim characteristics, industry and victim–perpetrator relationship from 1992 to 2017.

Methods Occupational homicides were identified from records of the NC Office of the Chief Medical Examiner system and the NC death certificates. Sex, age, race, ethnicity, class of worker, manner of death, victim–perpetrator relationship and industry were abstracted. Crude and age-standardised homicide rates were calculated as the number of homicides that occurred at work divided by an estimate of worker-years (w-y). Rate ratios and 95% CIs were calculated, and trends over calendar time in occupational homicide rates were examined overall and by industry.

Results 456 homicides over 111 573 049 w-y were observed. Occupational homicide rates decreased from 0.82 per 100 000 w-y for the period 1992–1995 to 0.21 per 100 000 w-y for the period 2011–2015, but increased to 0.32 per 100 000 w-y in the period 2016–2017. Fifty-five per cent (252) of homicides were perpetrated by strangers. Taxi drivers experienced an occupational homicide rate that was 110 times (95% CI 76.52 to 160.19) the overall occupational homicide rate in NC; however, this rate declined by 76.5% between 1992 and 2017. Disparities were observed among workers 65+ years old, racially and ethnically minoritised workers and self-employed workers.

Conclusion Our findings identify industries and worker demographics that experienced high occupational homicide fatality rates. Targeted and tailored mitigation strategies among vulnerable industries and workers are recommended.

  • Occupational injury
  • Firearm
  • Violence
  • Descriptive Epidemiology

Data availability statement

Data may be obtained from a third party and are not publicly available. Fatality data may be available from the North Carolina Office of the Chief Medical Examiner (ocme.data.request@dhhs.nc.gov) or from the North Carolina State Center for Health Statistics (SCHS) (schs.info@dhhs.nc.gov).

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Data availability statement

Data may be obtained from a third party and are not publicly available. Fatality data may be available from the North Carolina Office of the Chief Medical Examiner (ocme.data.request@dhhs.nc.gov) or from the North Carolina State Center for Health Statistics (SCHS) (schs.info@dhhs.nc.gov).

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Footnotes

  • Twitter @ChelseaMartinPT

  • Contributors CLM is the guarantor. CLM: Conceptualization, methodology, formal analysis, investigation, writing. MR: Methodology, investigation, writing. DBR: Conceptualization, methodology, investigation, project administration, funding acquisition, writing, resources, supervision. MN: Conceptualization, methodology, visualization, project administration, funding acquisition, writing. JC: Conceptualization, investigation, data management, formal analysis. ESM: Conceptualization, methodology, formal analysis, investigation, writing. ATM: Conceptualization, methodology, investigation, writing. SWM: Conceptualization, methodology, investigation, project administration, funding acquisition, writing, resources. SIR: Conceptualization, methodology, investigation, project administration, funding acquisition, writing, resources, supervision.

  • Funding This study was supported by awards T42 OH008673 and R01 OH011256 from the National Institute for Occupational Safety and Health. The University of North Carolina Injury Prevention Research Center is partially supported by award R49/CE002479 from the National Center for Injury Prevention and Control, Centers for Disease Control and Prevention. Mortality data were provided by the Office of the Chief Medical Examiner, North Carolina Department of Health and Human Services. Author ATM is supported additionally by NIOSH T42OH008673.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.