BACKGROUND: Syndromic surveillance has been used by state agencies to collect real-time information on disease outbreaks but has not been used to collect data in the occupational setting. Therefore, a real-time surveillance tool to track occupationally-related emergency room visits throughout the state via EpiCenter, the NJDOH’s existing real-time surveillance system, is being evaluated. Incorporating New Jersey Syndromic Surveillance data with hospital discharge data will enhance the ability to classify and capture work-related non-fatal injuries and improve efforts of prevention. Also, employing a real-time, independent data source will lead to a better understanding of the burden of non-fatal work-related injuries and illnesses and allow for quicker intervention.
METHODS: A work-related injuries and illness classifier will be developed to trigger EpiCenter to alert staff of an occupational event. Classifiers are composed of keywords related to specific events and are searchable in the chief complaint fields. Once the syndrome classification is developed and validated, preliminary alert thresholds for work-related injury or illness events based on counts of Emergency Department (ED) events which meet the occupational syndromes will be determined. Sensitivity analysis will be conducted to identify threshold cut-offs and long-term surveillance to detect trends in injuries.
RESULTS: From 2011-2014 over 25,000 non-fatal work-related injuries were reported via EpiCenter. In 2014, of the 7,759 work-related cases, the major cause of injury was falls (slips/trips, from ladder, from roof) and the body part affected most was the back. EpiCenter is also currently being used as a real-time surveillance system for occupationally related chemical exposures and has detected diverse exposures and illnesses including: exposure to toluene vapor at a nail polish manufacturing plant; six cases of pesticide exposure at a produce repacking facility; and carbon monoxide poisoning of two police officers due to exhaust problems in their vehicle.
CONCLUSIONS: The use of EpiCenter chief complaint reporting system shows it can yield real-time knowledge of incidents and local conditions to assist with and identify prevention opportunities. EpiCenter allows the identification of illnesses early so a rapid response can be initiated, reducing further risk. The use of multiple data sources can help identify populations, occupations and industries at high risk of a work-place injury and illness in real-time, along with providing data to help monitor trends of work-related injuries and illness over time.