Identifying Work-Related Injuries in Trauma Data: A Comparison of Methods of New York State

BACKGROUND: The New York State (NYS) Trauma Registry (TR) collects information on patients with moderate to severe traumatic injuries treated in one of the 49 designated NYS trauma centers. Over 200 variables are collected in the TR, including a variable “Work-Related”. Occupational injuries have historically been identified using the Worker Compensation (WC) as the primary payer in NYS emergency department (ED) and inpatient hospital data.  

METHODS: Work related injuries were identified in the 2010-2013 TR using both the “Work-Related” variable and WC in the primary payer variable.  

RESULTS: From 2010-2013, there were 2,350 work related traumatic injuries identified with the work-related indicator and 2,437 identified with WC as the primary payer. Of these cases identified, 1,636 could be identified both by the work-related variable and WC, 801 were identified only by WC, and 714 cases were identified only by the work-related variable. Among the 801 cases that contained only WC, the leading cause of injury was motor vehicle traffic (MVT) related (47%), followed by falls (28%). In comparison, the leading cause of injury was falls (49%), followed by MVT (14%) related among the 714 cases that were identified by only the work-related variable. Among the WC exclusive group, the average injury severity score (ISS) was 14.8; 28% of these cases were identified in the NY City region; 21% in the Western NY region; the majority of the cases were male (77%) and White non-Hispanic (54%). Among those identified exclusively with the work-related variable, the average ISS was 15.6, with 24% of these cases identified in the NY City region and 20% in the Central NY region; the cases were primarily male (90%) and White non-Hispanic (58%).

CONCLUSIONS: This analysis suggests the importance of considering additional means of identifying work-related injuries in medical data, as using traditional methods result in an undercount of these injuries (714 additional work-related cases found). The main difference seen here is in the mechanism of injury. The WC exclusive group is more likely to be MVT-related and the work-related variable only group is more likely to be injured in a fall. MVT-related injuries can involve vehicle damage and a police report. WC is more likely to be used when official documentation is recorded. The work-related fall injuries without WC could be from businesses that are not required to have WC for their employees, such as small family owned and run businesses.