Hand Injuries of Coal Miners in Southern West Virginia: A Pilot Study on Health-Care Resources in Southern West Virginia.

INTRODUCTION: Distance and other factors may play a significant role in both the implementation of care and the number of secondary health outcomes. The distance from an injury site can play a substantial impact on the mortality of different injuries and access to health-related services. Within this study, we sought to understand the effect of the site to treating center distance and access to relevant health-care services on effect and secondary injuries of coal mining-related injuries. METHODS: We evaluated patient demographics, coal mining locations, and patient outcomes. This study is a retrospective review of patients with coal mining hand injuries included in our Level 1 trauma database as well as the amount of health-related resources defined by WV GIS Health Care (Hospitals). The sample consists of coal mine workers. All patients had to meet the study criteria and were admitted during the study period of January 1, 2005, through March 31, 2015. We then were able to locate the coal mines where these coal miners were injured based on information from their medical records and the availability of health-care resources (hospitals) around the zones of injury, as well as health-related resources from the WV GIS database. The sample size was n = 104. Data were collected in an Excel spreadsheet. Stata 11.2 was used to conduct a multinomial logistic regression. A hub analysis was performed to understand the overall distance associated with the injury site and care using Arch GIS 10.6. A hotspot analysis was also performed in order to understand the differences of different zones of concern of injury sites in Southern West Virginia, from January 1, 2005, to March 31, 2015. RESULTS: Variables collected are as follows: a total number of coal miners were 104, with an average age of miners being similar in age demographics at 19-62. Coal mines are registered on the map with relevance to injury based on location; severity scale is presented. The most common injuries were fractures at 42.3% (47/104) followed by amputations at 26.9% (28/104). The index finger had an overall higher rate of injury at 28.8% (30/104). To understand the overall impact of specific injuries of coal miners based on the location, we peered into the number of injuries sustained at particular sites over the 10 years. Within this, the attached group, the average distance per injury to a medical center that was able to assist with hand injuries, was 46.1 miles. The shortest distance was within one mile of the center, and the most prolonged distance was 83.3 miles. The highest concentration of coal mining injuries were over 5 miles away from any health care organizations. The at-risk area of coal mining injuries was identified at (P = 0.001) and outside of health-care resources that can be seen within the hotspot analysis tested within this analysis. CONCLUSION: Specific injuries appear to be more at risk on different portions of the hand, as described in our initial data analysis. We also found that particular coal mines seem to harbor more coal mining hand injuries. Rural health care has the challenge of injuries occurring at extended distances and requires that treatment becomes as efficient as possible to maximize the chances of a full recovery. AIM AND OBJECTIVES: The objective of this study is to understand if the distance between the location of injury and trauma center plays a role in the outcome of coal mines related to hand injuries treated at Charleston Area Medical Center.