Use of multiple data sources for surveillance of work-related amputations in Massachusetts, comparison with official estimates and implications for national surveillance.
BACKGROUND
Accurate surveillance of work-related injuries is needed at national and state levels. We used multiple sources for surveillance of work-related amputations, compared findings with Survey of Occupational Injuries and Illnesses (SOII) estimates, and assessed generalizability to national surveillance.


METHODS
Three data sources were used to enumerate work-related amputations in Massachusetts, 2007-2008. SOII eligible amputations were compared with SOII estimates.


RESULTS
787 amputations were enumerated, 52% ascertained through hospital records only, exceeding the SOII estimate (n = 210). The estimated SOII undercount was 48% (95% CI: 36-61%). Additional amputations were reported in SOII as other injuries, accounting for about half the undercount. Proportionately more SOII estimated than multisource cases were in manufacturing and fewer in smaller establishments.


CONCLUSIONS
Multisource surveillance enhanced our ability to document work-related amputations in Massachusetts. While not feasible to implement for work-related conditions nationwide, it is useful in states. Better understanding of potential biases in SOII is needed.
Occupational Health Surveillance Program, Massachusetts Department of Public Health, Boston, Massachusetts.
Letitia K
LK
Davis
Kathleen M
KM
Grattan
Sangwoo
S
Tak
Lucy F
LF
Bullock
Al
A
Ozonoff
Leslie I
LI
Boden
D000293:Adolescent; D000328:Adult; D000368:Aged; D000673:Amputation, Traumatic / Q000191:economics / Q000453:epidemiology*; D059019:Clinical Coding; D003625:Data Collection; D003953:Diagnosis-Related Groups / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008499:Medical Records; D008875:Middle Aged; D060051:Occupational Injuries / Q000191:economics / Q000453:epidemiology*; D062486:Public Health Surveillance / Q000379:methods*; D014942:Workers' Compensation / Q000706:statistics & numerical data; D055815:Young Adult
injury surveillance; undercounting; underreporting; work-related amputations