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What this paper adds Amputations are among the most serious injuries that occur at work. Many of these may be prevented via Occupational Safety and Health Administration (OSHA) inspections.
A multisource surveillance system for work-related acute traumatic fatalities doubles the number of fatalities identified.
By referring worksites to OSHA in a timely manner, a surveillance system can have a direct impact on identifying and remediating hazardous working conditions.
A multisource surveillance system based on medical records and workers' compensation claims results in much greater sensitivity than a single data source.
Background
An amputation is one of the most serious injuries an employee can sustain at work. A worker who has had an amputation may lose time from work, have permanent impairment that limits activity at home as well as at work, or be unable to return to their original job.
Data on the incidence of work-related amputations is essential for targeting prevention activities. In its Survey of Occupational Injuries and Illnesses (SOII), the Bureau of Labor Statistics (BLS) collects data in nearly all states on work-related injuries from a sample of employers. For 2012, they estimated that 5280 amputations resulting in days away from work occurred nationally with 26 median lost workdays for amputation cases compared to 8 days for all work-related injuries. 1
Reducing the incidence of work-related amputations is a priority, nationally and in Michigan. In 2011, the federal Occupational Safety and Health Administration (OSHA) proposed amending rules requiring employers to report hospitalised and fatal work-related injuries to them, which would include reporting of hospitalised work-related amputations. 2 The Michigan OSHA (MIOSHA) strategic plan for 2004-2008 included an objective to reduce amputations by 20%. 3 Michigan's surveillance data on work-related amputations is used in targeting MIOSHA worksite inspections in specific facilities. 4
Preliminary work with data from 1997 showed the feasibility of performing multisource surveillance. 5 This report describes Michigan's work-related amputation surveillance system, summarises cases identified by the system since its inception (2006-2012), and describes how the data are used to prevent additional amputations in worksites identified from case reports. Data from 1 year (2008) of the system were previously published. 6
Methods
Sources of data were Michigan hospitals, including inpatient and emergency departments, and the Workers' Compensation Agency (WCA) within the...