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BACKGROUND: Since 1998, NIOSH has collected data on occupational injuries and illnesses treated in emergency departments through an occupational supplement to the National Electronic Injury Surveillance System (NEISS-Work). Shifts in types of occupational injuries and illnesses captured over many years of NEISS-Work data collection have resulted in case criteria that were too broad and vague and quality assurance processes that were progressively laborious. To improve data validity and increase data processing efficiency, the NEISS-Work case criteria were revised and implemented in January 2015.
METHODS: Changes to the case criteria were identified from issues noted during routine NEISS-Work data cleaning and processing, extensive analyses and reviews of recently collected NEISS-Work data, and results from telephone interview studies completed with workers identified via NEISS-Work.
RESULTS: Prior to 2015, cases involving workers with chronic conditions and illnesses represented about 5-10% of NEISS-Work. These cases also accounted for the largest portion of cleaning and processing time due to difficulty determining the work-relatedness of each case. During recent telephone interview studies, many workers treated in the emergency department for chronic conditions or illnesses stated that while their symptoms or illnesses manifested at work, the underlying causes were not work-related. Therefore, NIOSH shifted the focus of NEISS-Work case criteria to capture acute, traumatic injuries and largely eliminated the capture of chronic health conditions and illnesses beginning in 2015. Additionally, prior NEISS-Work guidance for data abstractors indicated that injuries or illnesses identified for NEISS-Work should have a causal link to work. This critical point has been overlooked with increasing frequency in more recent years. Thus, recently revised NEISS-Work guidance clearly emphasizes the need for a causal link in order for a case to be reportable, and more succinctly describes the revised case inclusion/exclusion criteria.
CONCLUSIONS: The impact of the changes to the NEISS-Work case criteria will be closely monitored during the ongoing NEISS-Work quality assurance process. Our expectation is that these changes will shorten the time needed for data cleaning and processing as well as improve the validity of data captured.