Identification of work-related injury emergency department visits using International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes.

INTRODUCTION: Emergency department (ED) visit discharge data are a less explored population-based data source used to identify work-related injuries. When using discharge data, work-relatedness is often determined by the expected payer of workers' compensation (WC). In October 2015, healthcare discharge data coding systems transitioned to the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM). ICD-10-CM's structure offers potential new work-related codes to enhance work-related injury surveillance. This study identified work-related ED visits using relevant ICD-10-CM work-related injury codes. Cases identified using this method were compared with those identified using the WC expected payer approach. METHODS: State ED visit discharge data (2016-2019) were analysed using the CDC's discharge data surveillance definition. Injuries were identified using a diagnosis code or an external cause-of-injury code in any field. Injuries were assessed by mechanism and expected payer. Literature searches and manual review of ICD-10-CM codes were conducted to identify possible work-related injury codes. Descriptive statistics were performed and assessed by expected payer. RESULTS: WC was billed for 87 361 injury ED visits from 2016 to 2019. Falls were the most frequent injury mechanism. The 246 ICD-10-CM work-related codes identified 36% more work-related ED injury visits than using WC as the expected payer alone. CONCLUSION: This study identified potential ICD-10-CM codes to expand occupational injury surveillance using discharge data beyond the traditional WC expected payer approach. Further studies are needed to validate the work-related injury codes and support the development of a work-related injury surveillance case definition.

Workers' compensation claims among private skilled nursing facilities, Ohio, 2001-2012.

INTRODUCTION: Skilled nursing facilities have one of the highest rates of occupational injury and illness among all industries. This study quantifies the burden of occupational injury and illness in this industry using data from a single state-based workers' compensation (WC) system. METHODS: Ohio Bureau of Workers' Compensation claims from 2001 to 2012 were analyzed among privately owned, state-insured skilled nursing facilities and are presented as claim counts and rates per 100 full-time equivalents (FTE). Worker, employer, incident, and injury characteristics were examined among all claims and by medical-only (medical care expenses and/or less than eight days away from work) and lost-time (eight days or more away from work) claim types. RESULTS: There were 56,442 claims in this population of Ohio skilled nursing facilities from 2001 to 2012. Overexertion and bodily reaction, slips, trips, and falls, and contact with objects and equipment accounted for the majority of all WC claims (89%). Overexertion and bodily reaction, and slips, trips, and falls comprised 85% of the 10,793 lost-time claims. The highest injury event/exposure rates for all claims were for overexertion and bodily reaction (3.7 per 100 FTE for all claims), followed by slip, trips, and falls (2.1), and contact with objects and equipment (1.9). CONCLUSION: Understanding the details surrounding injury events and exposures resulting in WC claims can help better align prevention efforts, such as incorporation of safe patient handling policies and lifting aids, improvement in housekeeping practices, and employee training within skilled nursing facilities to prevent worker injury and mitigate related expenses.

A multi-state examination of the victims of fatal adolescent intimate partner violence, 2011-2015.

BACKGROUND: Fatal intimate partner violence occurs among adolescents, which is often when first exposure to intimate partner violence occurs in the United States. However, research mainly examines intimate partner violence-related fatalities between adult intimate partners. Such findings document that non-intimate partners, corollary victims, are at risk for violence during intimate partner violence incidents, as well. Research examining fatal intimate partner violence among adolescents is scant. This study informs public health of the extent and circumstances of fatal adolescent intimate partner violence by quantifying the burden across a five-year span; describing fatal victims by demographics and precipitating circumstances; and examining differences by victim type. METHODS: This study used data from 17 states of the United States in the National Violent Death Reporting System to examine fatal intimate partner violence-related incidents involving at least one adolescent intimate partner (15-19 years of age) from 2011-2015. IPV-related death cases were guided by the intimate partner violence surveillance criteria prescribed by Centers for Disease Control and Prevention. Decedents were subdivided into intimate partner victims, perpetrator victims, and corollary victims. Victims were described by demographics, victim descriptors, and precipitating circumstances of death. Annual trends and descriptive statistics were calculated. RESULTS: There were 93 intimate partner violence-related fatal incidents among adolescents with 116 decedents. A firearm was the predominant weapon. Crises, arguments, jealousy, and physical fights were common precipitating circumstances. Corollary victims represented 18% of all victims, 65% were intimate partner victims, and 17% perpetrator victims. Corollary victims were primarily linked to the suspect by other intimate partners, and friends and acquaintances. CONCLUSIONS: Intimate partner violence is a preventable public health problem. This study documents that intimate partner violence among adolescents can result in deaths of intimate partners and corollary victims. Effective prevention should begin in early adolescence and incorporate shared and protective risk factors to have the greatest impact on adolescent IPV.

Missed Work Due to Occupational Illness among Hispanic Horse Workers.

Occupational illnesses are inadequately reported for agriculture, an industry dominated by a vulnerable Hispanic population and high fatal and nonfatal injury rates. Work-related illnesses can contribute to missed work, caused by a combination of personal and work factors, with costs to the individual, employer, and society. To better understand agricultural occupational illnesses, 225 Hispanic horse workers were interviewed via community-based convenience sampling. Descriptive statistics, bivariate analyses, and log binomial regression modeling were used to: (1) describe the prevalence of missed work due to work-related illnesses among Hispanic horse workers, (2) examine work-related and personal factors associated with missed work, and (3) identify health symptoms and work-related characteristics potentially associated with missed work. Key findings reveal that having at least one child (PR = 1.71, 95% CI = 1.03, 2.84), having poor self-reported general health (PR = 0.72, 95% CI = 0.48, 1.08), experiencing stress during a typical workday (PR = 2.58, 95% CI = 1.25, 5.32), or spending less time with horses (PR = 1.87, 95% CI = 1.15, 3.05) are significant predictors of missing work. Interventions can be designed to identify workers most susceptible to missing work and provide resources to reduce absenteeism. Future research should examine work-related illness in agricultural horse production, including personal and work-related factors, in order to diminish occupational health disparities among these workers, who are more likely to be employed in hazardous agricultural work.

Correction to: A Systematic Review of Community Health Workers' Role in Occupational Safety and Health Research.

The original version of this article unfortunately contained a mistake in the affiliation of co-author Ashley M. Bush.

A Systematic Review of Community Health Workers' Role in Occupational Safety and Health Research.

We systematically reviewed the literature to describe how community health workers (CHWs) are involved in occupational health and safety research and to identify areas for future research and research practice strategies. We searched five electronic databases from July 2015 through July 2016. Inclusion criteria were as follows: (1) study took place in the United States, (2) published as a full peer-review manuscript in English, (3) conducted occupational health and safety research, and (4) CHWs were involved in the research. The majority of 17 included studies took place in the agriculture industry (76%). CHWs were often involved in study implementation/design and research participant contact. Rationale for CHW involvement in research was due to local connections/acceptance, existing knowledge/skills, communication ability, and access to participants. Barriers to CHW involvement in research included competing demands on CHWs, recruitment and training difficulties, problems about research rigor and issues with proper data collection. Involving CHWs in occupational health and safety research has potential for improving inclusion of diverse, vulnerable and geographically isolated populations. Further research is needed to assess the challenges and opportunities of involving CHWs in this research and to develop evidence-based training strategies to teach CHWs to be lay-health researchers.

Employing the Precautionary Principle to Evaluate the Use of E-Cigarettes.

Electronic cigarettes (e-cigarettes) have emerged onto the public market as an alternative to tobacco cigarettes; however, science is inconclusive as e-cigarettes have not been thoroughly investigated, including their short- and long-term risks and benefits (1, 2). The question arises of whether e-cigarettes will become the future tobacco crisis. This paper connects the precautionary principle to the use of e-cigarettes in an effort to guide decision-makers in the prevention of adverse health outcomes and societal costs.

Multiple jobholder mortality patterns in Kentucky: an examination of occupational fatalities.

BACKGROUND: The percentage of multiple jobholders was elevated in Kentucky compared to the US from 2002 to 2010. METHODS: Kentucky Fatality Assessment and Control Evaluation (FACE) multiple jobholder fatality data were analyzed to identify contributing injury factors from 2002 to 2010. RESULTS: Kentucky's total occupational fatality rates were higher than US rates for all years (2002-2010). Kentucky multiple jobholder fatalities averaged 8.4 deaths per 100,000 employees compared to the total average occupational fatality rate of 6.5. Almost half of multiple jobholder fatalities (47%) occurred in the agricultural industry and management occupation as the primary industry and occupation; 67% were tractor-related. The most prevalent secondary industry and occupation were the construction industry and management occupation. CONCLUSIONS: Increased surveillance of multiple jobholder injuries is needed to improve safety and health on the job. Future investigations should include the relationship between multiple jobholding and agricultural employment as farm owners.