Estimation of Agricultural and Logging Injury Incidence in Maine Using Electronic Administrative Data Sets

Abstract

Agriculture and forestry rank among industries with the highest rates of occupational fatality and injury. Establishing a nonfatal injury surveillance system is a top priority in the National Occupational Research Agenda. Recently, new sources of data such as Pre-Hospital Care Reports (PCRs) and hospitalization data have transitioned to electronic databases. Using narrative free text and location codes from Maine PCRs, along with International Classification of Diseases (ICD)-9 External Cause of Injury Codes (E-codes) in Maine hospital data, researchers are designing a surveillance system to track farm and forestry injury that utilizes electronic match-merging of the two data sources. For 2008, PCR records produced a total of 104 true agricultural cases. Of these, 66 (63%) were identified from the keyword/visual inspection process alone, 25 (24%) were identified by the farm checkbox only, and the remaining 13 (13%) by both methods. For the 150 unique injury events found in hospitalization data, 146 had the initial episode of care documented in only one of the three hospital files. The emergency department (ED) file had the largest number of these (123/146 = 84.2%), followed by the outpatient file (12/146 = 8.2%) and the inpatient file (11/146 = 7.5%). Of the 250 unique agricultural injuries identified (100 PCR only + 146 hospital only + 4 from both), 66 (26%) would not have been identified without free text review of PCR narrative. The false-positive rate (97.14%) keyword searches underscores that without visual inspection, it is not an effective strategy. Both sources of data (PCR and hospital data) need to be used in a continued surveillance system.

Multisource surveillance for non-fatal work-related agricultural injuries

“…13 The Maine agricultural and logging data were derived from administrative data for ambulance runs and hospitalizations and did not distinguish work and non-work related injuries (2008). 14 The Minnesota data were derived from an administrative hospital discharge database and did not distinguish work and non-work related injuries (2000–2011). 15 We found that the use of administrative data without the review of medical records would lead to a 65% over count.…”

Regional surveillance of medically-attended farm-related injuries in children and adolescents

“…Efforts were also made to identify recreational activities that took place in the farm location (e.g., riding horses or ATVs). Medically-attended farm-related injuries were ascertained based on adaptations of injury surveillance models outlined by Landsteiner et al ( 23 ) and Scott et al ( 24 , 25 ). Injury details were extracted from medical diagnoses observed during emergency, inpatient, urgent care, or outpatient encounters in the MCHS electronic data repository.…”

What about the Rest of Them? Fatal Injuries Related to Production Agriculture Not Captured by the Bureau of Labor Statistics (BLS) Census of Fatal Occupational Injuries (CFOI)

“…National surveillance systems that apply uniform definitions and coding schemes provide value to stakeholders and facilitate collaborations between researchers nationally and internationally. 12,[14][15][16][17] Yet, gaps remain in national statistics, and support is needed to supplement current national surveillance to be more inclusive and comprehensive, recognizing the whole spectrum of agriculturerelated injury and fatality cases.…”