Work-related injuries in a rural emergency department population.
OBJECTIVE
To describe the spectrum of work-related injury evaluated in a rural ED population.


METHODS
An ED-based injury surveillance system (EDBISS) was used to collect injury data for all ED patients seen over a 1-year period. A patient was classified as injured if his or her record contained an ED log injury code, an ICD-9 N-code between 800 and 995 in any diagnostic field, an E-code, or an entry in the trauma registry. An injury was considered work-related if the patient reported that the injury had occurred while at work.


RESULTS
Work-related injuries accounted for 1,539/12,321 (12.5%) of all injuries. The mean age of patients injured on the job was 33.8 years (range, 16-77 years), compared with a mean age of 27.7 years for all the injured patients. Males accounted for 1,026/1,537 (67%) of the work-related injury visits, compared with 57% of all the injury visits. The most common mechanisms of work-related injuries were: overexertion (313; 20%); cut or pierced by sharp implements (248; 16%); falls (250; 16%); struck by object (202; 13%); and transportation-related injuries (71; 5%). Sprains and strains were the most common type of injury sustained (415; 27%), followed by wounds to upper limbs (283; 18%), contusions (182; 12%), and fractures (151; 10%). Of the 1,539 patients presenting with occupational injuries, 178 (12%) presented to the ED via ambulance. Most (1,401; 91%) were treated and released from the ED, with the remainder (136; 9%) hospitalized. The mechanisms of injury that most commonly resulted in hospitalization included struck by an object (28; 21%), transportation (26; 19%), falls (27; 20%), crushing mechanism (13; 10%), and machinery (20; 15%). Of those requiring hospitalization, 132/136 (97)% were male, and the average length of stay was 4.4 days. Four of the hospitalized persons died of their work-related injuries. Known medical charges incurred by patients injured at work were as high as $62,622. The average charge for those treated and released was $273; the average charge for those who required hospitalization was $10,910.


CONCLUSIONS
Occupational injuries contribute significantly to the overall incidence of injuries seen in this ED and are responsible for significant medical charges each year.
Williams
J M
JM
West Virginia University, Department of Emergency Medicine, Morgantown 26506-9151, USA. jwilliam@wvuem1.hsc.wvu.edu
Higgins
D
D
Furbee
P M
PM
Prescott
J E
JE
D000062:Accidents, Occupational / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D017721:Hospital Costs; D006751:Hospital Information Systems; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology; D011159:Population Surveillance / Q000379:methods*; D012189:Retrospective Studies; D012423:Rural Health; D014903:West Virginia / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000209:etiology