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Identification of Work-Related Injuries in a State Trauma Registry

Sears, Jeanne M. PhD, MS, RN; Bowman, Stephen M. PhD, MHA; Silverstein, Barbara A. PhD, MPH, RN; Adams, Darrin BS

Journal of Occupational and Environmental Medicine: March 2012 - Volume 54 - Issue 3 - p 356–362
doi: 10.1097/JOM.0b013e3182444fe7
Original Articles

Objective: Many state trauma registries contain work-related information but are underutilized for occupational injury research/surveillance. We assessed three methods of identifying work-related injuries in the Washington State Trauma Registry (WTR).

Methods: State-designated trauma facilities report traumatic injuries meeting specific inclusion criteria to the WTR. The WTR reports from 1998 to 2008 were linked to workers' compensation claims to generate sensitivity estimates.

Results: The sensitivity of the WTR work-related indicator was 87%, varying significantly by injury mechanism/location. Sensitivity was 89% for payer and 60% for an indicator based on International Classification of Diseases–9th Revision–Clinical Modification external cause codes.

Conclusions: The WTR work-related indicator is highly sensitive and may identify injuries that occur in the course of exempt/excluded employment, are not reported to workers' compensation, and/or are work-related using definitions that go beyond WC coverage. Judicious use of external cause codes may identify additional work-related injuries.

From the Departments of Health Services (Dr Sears) and Environmental and Occupational Health Sciences (Dr Silverstein), School of Public Health, University of Washington, Seattle, Wash; Center for Injury Research and Policy, Department of Health Policy and Management (Dr Bowman), Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Md; and Safety and Health Assessment and Research for Prevention, Washington State Department of Labor & Industries (Dr Silverstein and Mr Adams), Olympia, Wash.

Address correspondence to: Jeanne M. Sears, PhD, MS, RN, Department of Health Services, University of Washington, Box 354809, Seattle, WA 98195 (

This study was funded by the National Institute for Occupational Safety and Health (NIOSH), grant 1R03OH009883. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of NIOSH. Authors Sears, Bowman, Silverstein, and Adams have no commercial interest related to this research. Author Bowman consults for the Arkansas Department of Health regarding trauma system evaluation, and, in the past, provided expert testimony for a legal firm regarding an all-terrain vehicle injury case (payment went to his institution).

©2012The American College of Occupational and Environmental Medicine