NH Department of Health & Human Services

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Tyler Brandow, BS, MPHIntern, NH Occupational Health Surveillance Program

Division of Public Health ServicesNH Department of Health and Human Services

tyler.b.brandow@dhhs.state.nh.us

NH Department of Health & Human Services

NIOSH: National Institutes for Occupational Safety and Health1

-Facilitates surveillance and prevention activities among State partners; funds the NH OHSP

NH OHSP (Occupational Health Surveillance Program)2

-Collects, analyzes and interprets surveillance data -Addresses the limitations of existing databases and develops new data sources -Identifies priority occupational health and safety conditions in NH -Disseminates data on the magnitude of occupational injuries and

illnesses

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1. Centers for Disease Control and Prevention, Workplace safety and health topics, Surveillance, December 28, 2011. Accessed 2/6/13. Available online: http://www.cdc.gov/niosh/topics/surveillance/

2. Armenti, K. New Hampshire Occupational Health Surveillance Program: Fundamental Program Grant # 1U60OH009853-02, Annual Report of Major Outputs and Outcomes (2011 to 2012), July 2012. Accessed 5/1/13. Available online: http://www.dhhs.nh.gov/dphs/hsdm/ohs/documents/nhapr2011-2012.pdf

NH Department of Health & Human Services

US Work-Related Injuries, 20103

-139.1 million US workers -4.1 million non-fatal injuries (3.9 cases per 100 FTE4) -3.3 million non-fatal, private sector injuries (3.6 cases per

100 FTE)

NH Work-Related Injuries -740,000 NH workers (US DOL-Bureau of Labor Statistics) -40,000 NH Workers’ Compensation claims (2011) -Average award was about $350 -Under-reporting is significant

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3. Centers for Disease Control and Prevention, Workplace safety and health topics, Traumatic Occupational Injuries, May 9, 2013. Accessed 2/6/13. Available online: http://www.cdc.gov/niosh/injury

4. US Census, Table 660. Nonfatal Occupational Injuries and Illnesses by industry: 2009, 2012. Accessed 5/1/13. Available online: http://www.census.gov/comendia/statab/2012/tables/12s0660.pdf

NH Department of Health & Human Services

NH TEMSIS5

-Receives data from 81% of NH EMS agencies -Responders are mandated to report work-related injuries -95% of private sector incidents are injuries6 -Data Fields: relative frequency averages

Location: where workers are injuredPrimary Impression: type of injury sustainedMechanism: how the injury occurredGender: burden of injury among males and femalesAge: burden of injury in specific age groups

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5 NHTEMSIS, About Us, 2011. Accessed 2/6/13. Available online: http://www.nhtemsis.org/default.cfm?page=about

6 Bureau of Labor Statistics, News Release, Workplace Injuries and Illnesses- 2011, October 25, 2012. Accessed 2/6/13. Available online: http://www.bls.gov/news.release/pdf/osh.pdf

NH Department of Health & Human Services

Inclusion Criteria-Must affirm work-relatedness-No duplicate Incident ID numbers-Eligible cases must contain data in all fields-Cases must be of working age, between 16-65

Primary Analysis-Baseline proportions of primary injury

characteristics-All data fields, all response options

Demographic Analysis-Work-related injuries by Gender-Age-Stratified: 5 Groups 16-25 26-35 36-45 46-55 56-65

Comparative Analysis-Identify TEMSIS subpopulations with increased risk of work-related injury

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NH Department of Health & Human Services

Total Incidents, 2009-2011N= 7733

Eligible Work-Related Incidents, 2009-2011N= 2168

Baseline Primary Injury Characteristics and Proportions

Data Field Most Frequent Response Proportion (%)

Gender Male 72.1%

Age Group 46-55 25.5%

Location Industrial 25.2%

Primary Impression Traumatic Injury 48.6%

Mechanism Falls 25.4%

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NH Department of Health & Human Services

Gender

Age-Stratified Cases

RelativeFrequency

Age Groups

Gender % #Male 72.1% 1564

Female 27.9% 604Total 100.0% 2168

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NH Department of Health & Human Services

Location % #Industrial 25.2% 547

Service/Trade 21.3% 462Highway 14.2% 308Residence 13.8% 299

Public Building 11.2% 243HC Facility 5.4% 117

All Other Categories 5.0% 109Recreation 3.8% 83

Total 100.0% 2168

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NH Department of Health & Human Services

Primary Impression % #Traumatic Injury 48.6% 1053

Pain 21.6% 469All Other Categories 12.6% 273Cardiac/ Chest Pain 4.8% 104Syncope/Fainting 2.6% 57

Back Pain 2.4% 51Headache 2.3% 50

Heat Stroke/Dehydration 2.2% 47Allergic Reaction 1.6% 35

Electrocution 1.3% 29Total 100.0% 2168

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NH Department of Health & Human Services

Mechanism % #Other, Not Available, Not Known,

Not Recorded 33.8% 733Falls 25.4% 550

Motor Vehicle Accident 9.6% 209Struck Against or by Blunt Object 7.5% 162

Stab/Cut/Pierce 7.0% 151All Other Categories 6.6% 144Machinery Accident 4.9% 106

Caught In 2.5% 54Electrocution 1.4% 30Foreign Body 1.3% 29

Total 100.0% 2168

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NH Department of Health & Human Services

Data Fields: Gender Age Group LocationPrimary

Impression MechanismPrimary Injury Characteristics: Males 46-55 Industrial Traumatic Injury Falls

Entire Study Population Baseline Proportions N=2168 72.1% 25.5% 25.2% 48.6% 25.4%

Males n=1564 - 24.7% 29.3% 53.9% 23.5%46-55 n=552 70.1% - 24.3% 47.6% 31.0%

Industrial n=547 83.7% 24.5% - 63.8% 17.4%Traumatic Injury n=1053 80.1% 25.0% 33.1% - 30.9%

Falls n=550 66.9% 31.5% 17.3% 59.1% -

Columns: compare the baseline primary injury characteristic proportion to the proportions of that characteristic in each subpopulation. Ex. Industrial Locations: Compared to the baseline, the proportion of industrial injuries was significantly greater for males; there were significantly more traumatic injuries at industrial locations; and there were significantly fewer fall injuries at industrial locations.Rows: show the primary injury characteristic proportions of each subpopulation and highlight significant differences from the baseline. Ex. Male Subpopulation: Compared to the baseline proportions, males have significantly more industrial injuries and traumatic injuries.

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NH Department of Health & Human Services

Gender Category Male FemaleBaseline N=2168 72.1% 27.9%Industrial n=547 83.7% 16.3%

Traumatic Injury n=1053 80.1% 19.9%Falls n=550 66.9% 33.1%

Age 46-55 n=552 70.1% 29.9%

-Males suffered more industrial work-related Injuries

-Males suffered more traumatic work-related Injuries

-Females suffered more work-related falls than was expected by their baseline injury proportion; most falls occurred at service/trade locations like bars and restaurants.

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NH Department of Health & Human Services

-Workers aged 26-35 suffered more industrial work-related injuries.

-Workers aged 46-55 suffered more work-related falls.

-Workers aged 56-65 suffered more work-related falls.

Age Group 16 - 25 25 - 35 36 - 45 46 - 55 56 - 65Baseline N=2168 19.7% 20.9% 20.2% 25.5% 13.8%

Industrial n=547 16.6% 25.0% 21.4% 24.5% 12.4%

TI n=1053 18.8% 21.6% 19.8% 25.0% 14.8%

Falls n=550 13.8% 14.5% 19.8% 31.5% 20.4%

Age Groups

Proportions (%)

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NH Department of Health & Human Services

Baseline Proportions: All work-related injuries N=2168-Males suffer more work-related injuries than females (72.1%)-Workers aged 46-55 are most likely to be injured (25.5%)-Industrial occupational settings have the greatest prevalence of work related injuries (25.2%)-Traumatic injury is the most common primary impression-type (48.6%)-Falls cause the majority of work-related injuries (25.4%)

Location: Industrial workplace Injuries n=547Compared to baseline proportions, industrial workplaces had: -Significantly more injuries in males (+11.6%) -Significantly more injuries among workers aged 26-35 (+4.1%) -Significantly more traumatic injuries (+15.2%) -Significantly fewer fall injuries (-8%)

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NH Department of Health & Human Services

Primary Impression: Traumatic work-related injuries n=1053Compared to baseline proportions, traumatic injuries were: -Significantly higher among males (+8%) -Significantly more prevalent in industrial workplaces (+7.9%) -Significantly higher among workers who suffered a fall injury (+5.5%)

Mechanism: Work-related falls n=550Compared to baseline proportions, work-related falls were: -Significantly lower among males (-5.2%) -Significantly higher among workers aged 46-55 (+6%) and 56-65 (+6.6%) -Significantly more prevalent at service locations than industrial locations (+10.9%) -Caused a significantly greater proportion of traumatic injuries (+10.5%)

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NH Department of Health & Human Services

-Males aged 26-35 working in Industrial locations could benefit from traumatic Injury prevention

-Males and females, age 46-55, working in Industrial locations could benefit from falls prevention

-Males and females, age 46-55 in Service locations like restaurants and bars could benefit from falls prevention.

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NH Department of Health & Human Services

-TEMSIS population is a subset of the study population: it is not representative of the total population suffering work-related injuries; only 81% of EMS agencies reported to TEMSIS; some are captured by Emergency Departments.

-Data quality: interpretation and documentation may depend on level of training/experience of EMS personnel.

-Event-based reporting: individuals may have more than one incident during the study period.

-Recall bias: EMS personnel enter the data retrospectively.

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NH Department of Health & Human Services

-TEMSIS is a beneficial new data source for Occupational Health Surveillance.

-Provides a broad scope of work-related injuries.

-What we learn can help us target prevention efforts.

-In order to be useful in other states, it is important to require that “work-relatedness” is captured in the data entry process.

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NH Department of Health & Human Services

Dr. Karla Armenti: Principal Investigator, NH OHSP, NH Division of Public Health ServicesDr. Lida Anderson: Chronic Disease Epidemiologist, NH Division of Public Health ServicesChip Cooper: Bureau of Emergency Medical ServicesMaryGaye Grizwin: University of New Hampshire

The NH OHSP is supported by the National Institute for Occupational Safety and Health (NIOSH) and the Council of State and Territorial Epidemiologists (CSTE). This project is supported by Grant # 5U60OH009853-02 from CDC-NIOSH. Its contents are solely the responsibility of the authors and do not represent the official views of NIOSH

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NH Department of Health & Human Services

1. Centers for Disease Control and Prevention, Workplace safety and health topics, Surveillance, December 28, 2011. Accessed 2/6/13. Available online: http://www.cdc.gov/niosh/topics/surveillance/

2. Armenti, K. New Hampshire Occupational Health Surveillance Program: Fundamental Program Grant # 1U60OH009853-02, Annual Report of Major Outputs and Outcomes (2011 to 2012), July 2012. Accessed 5/1/13. Available online: http://www.dhhs.nh.gov/dphs/hsdm/ohs/documents/nhapr2011-2012.pdf

3. Centers for Disease Control and Prevention, Workplace safety and health topics, Traumatic Occupational Injuries, May 9, 2013. Accessed 2/6/13. Available online: http://www.cdc.gov/niosh/injury

4. US Census, Table 660. Nonfatal Occupational Injuries and Illnesses by industry: 2009, 2012. Accessed 5/1/13. Available online: http://www.census.gov/comendia/statab/2012/tables/12s0660.pdf

5. NHTEMSIS, About Us, 2011. Accessed 2/6/13. Available online: http://www.nhtemsis.org/default.cfm?page=about

6. Bureau of Labor Statistics, News Release, Workplace Injuries and Illnesses- 2011, October 25, 2012. Accessed 2/6/13. Available online: http://www.bls.gov/news.release/pdf/osh.pdf

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NH Department of Health & Human Services

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