Work‐related Injuries in a Rural Emergency Department Population

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Abstract
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.

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