Using narrative text and coded data to develop hazard scenarios for occupational injury interventions.
OBJECTIVE
To determine whether narrative text in safety reports contains sufficient information regarding contributing factors and precipitating mechanisms to prioritize occupational back injury prevention strategies.Design, setting, subjects, and


METHODS
Nine essential data elements were identified in narratives and coded sections of safety reports for each of 94 cases of back injuries to United States Army truck drivers reported to the United States Army Safety Center between 1987 and 1997. The essential elements of each case were used to reconstruct standardized event sequences. A taxonomy of the event sequences was then developed to identify common hazard scenarios and opportunities for primary interventions.


RESULTS
Coded data typically only identified five data elements (broad activity, task, event/exposure, nature of injury, and outcomes) while narratives provided additional elements (contributing factor, precipitating mechanism, primary source) essential for developing our taxonomy. Three hazard scenarios were associated with back injuries among Army truck drivers accounting for 83% of cases: struck by/against events during motor vehicle crashes; falls resulting from slips/trips or loss of balance; and overexertion from lifting activities.


CONCLUSIONS
Coded data from safety investigations lacked sufficient information to thoroughly characterize the injury event. However, the combination of existing narrative text (similar to that collected by many injury surveillance systems) and coded data enabled us to develop a more complete taxonomy of injury event characteristics and identify common hazard scenarios. This study demonstrates that narrative text can provide the additional information on contributing factors and precipitating mechanisms needed to target prevention strategies.
War-Related Illness and Injury Study Center, Washington DC Veterans Administration Medical Center, Department of Veterans Affairs, Washington, DC 20422, USA. Andrew.Lincoln@med.va.gov
A E
AE
Lincoln
G S
GS
Sorock
T K
TK
Courtney
H M
HM
Wellman
G S
GS
Smith
P J
PJ
Amoroso
D000058:Accidental Falls / Q000517:prevention & control; D000062:Accidents, Occupational / Q000517:prevention & control; D000063:Accidents, Traffic / Q000517:prevention & control; D019567:Back Injuries / Q000209:etiology / Q000517:prevention & control*; D003625:Data Collection / Q000379:methods; D004282:Documentation; D005568:Forms and Records Control; D006801:Humans; D033181:Information Dissemination / Q000379:methods; D017770:Lifting; D008297:Male; D008889:Military Personnel; D009784:Occupational Diseases / Q000209:etiology / Q000517:prevention & control*; D012307:Risk Factors; D012449:Safety