Perspectives in Disease Prevention and Health Promotion Fatal Occupational Injuries -- Texas, 1982

A review of Texas death certificates for 1982 identified 710 deaths associated with occupational injuries. The average age at death was 37.2 years (range 16-84 years). This resulted in the premature loss (before age 65) of 19,924 potential years of life.

For this analysis, a case was defined as the fatality of a civilian male, 16 years of age or older, who died in Texas in 1982 as the result of traumatic injury occurring on the job in Texas. Only deaths coded as related to "external causes" according to the International Classification of Diseases were included in the analysis (ICD codes E800-E989, 9th revision). The leading causes of death were (1) motor vehicle-associated injuries (158 (22.3% of total)); (2) machinery- and tool-related injuries (105 (14.8%)); (3) homicide and firearm injuries (99 (13.9%)); (4) falls (84 (11.8%)); and (5) electrocutions (75 (10.6%)).

Industrial categories with the highest rates of fatal injury were: (1) mining (including crude petroleum and natural gas production) (51 per 100,000); (2) agriculture (35/100,000); and (3) construction (32/100,000) (Table 1). Analysis of the 10 occupations with the highest rates of fatal injuries are given below (Table 2).

Airplane pilots and navigators: Of the 18 deaths resulting from air accidents, five (27.8%) involved helicopter pilots, and three (16.7%) occurred during crop dusting or other agricultural spraying.

Oil well drillers: Machinery- and tool-related accidents accounted for 16 (47.1%) of the 34 deaths in this category, which includes roustabouts, roughnecks, and other unskilled oil-field workers.

Structural-metal workers: All 12 deaths occurred among iron or steel workers employed in construction; 10 (83.3%) resulted from falls. Four (33.3%) of these deaths occurred as the result of a single incident.

Electrical-power installers and repairers: All 11 deaths involved electrical linemen; nine (81.8%) deaths resulted from electrocution. Seven (63.6%) of the workers were employed in the construction industry.

Construction laborers: This category includes general construction workers and nonspecialized laborers. Falls (11 cases (24.4%)) and electrocutions (8 cases (17.8%)) were the major causes of the 45 deaths recorded here.

Heavy-truck drivers: Motor vehicle-related injuries accounted for 64 (75.3%) of the 85 deaths among truck drivers. These drivers were employed in a wide range of industries, including mining, construction, manufacturing, wholesale trade, and general trucking.

Material-moving operating engineers: This category consists of heavy-equipment operators. Eight (72.7%) of the 11 deaths occurred among workers employed in construction.

Farmers, except horticultural: Farmers and ranchers are included here; farm workers and other salaried agricultural laborers are not. Machinery- and tool-related injuries caused 10 (33.3%) of the 30 deaths, and motor vehicle-related injuries resulted in 6 deaths (20.0%). Four deaths (13.3%) were caused by electrocution (1).

Police and detectives, public service: Seven (70.0%) of the 10 deaths among state and municipal police officers were caused by motor vehicle-related injuries; 2 officers were killed by handguns. In five (71.4%) of the seven motor vehicle-related deaths, the police officers were pedestrians.

Electricians: The major causes of the 18 deaths among electricians were electrocution (11 cases (61.1%)) and falls (3 cases (16.7%)). Sixteen deaths (88.9%) occurred among electricians employed in the construction industry. Reported by L Suarez, MS, WD Carroll, MPH, WE Barrington, MPH, CE Alexander, MD, State Epidemiologist, Texas Dept of Health; Div of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, CDC.

Editorial Note

Editorial Note: The National Institute for Occupational Safety and Health (NIOSH) estimates that at least 10 million persons in the United States suffer traumatic injuries on the job each year; about 3 million (30%) of these are severe, and 10,000 (0.1%) are fatal (2). In both Texas and the United States as a whole, mining, agriculture, and construction are the three industrial categories associated with the highest rates of mortality from injury.

A major impediment to the surveillance of work-related deaths is the absence of routinely coded occupation and industry information on death certificates in 22 states, including Texas. However, the accuracy of the occupation and industry information that is recorded on death certificates is generally high. In a recent examination of sample death certificates throughout the United States, data were found to be correct in 64.7% of the entries for occupation, and in 70.1% for industry (3). With the recognition of this accuracy, the review of death certificates has found increasing use as a technique for surveillance of deaths caused by occupational exposure (4,5). NIOSH and the National Center for Health Statistics have worked with state health departments extensively in recent years to develop universal coding from death certificates of data on occupation and industry; this coding is done with procedures developed by the U.S. Bureau of the Census (6).

In the present study, deaths among civilian males were included only when the answer, "yes," appeared on the death certificate in response to the question: "Injury at work?" Because of this restriction, the study probably underestimates the actual number of occupationally related deaths among males in 1982 that occurred in Texas.* However, because all the deaths studied were caused by occupational factors, and the interval between injury and death was less than 24 hours in 84% of the cases, the accuracy of these occupational data appears to be particularly high. All but 5 (0.7%) of the death certificates in this review provided information on occupation, and all but 25 (3.5%) provided an entry for industry.

The prevention of deaths caused by occupational injury is a major priority of NIOSH (2). Efficient prevention of such deaths requires that research and intervention be targeted to those industries and occupations that present the highest risk (7). The data from this study indicate that a periodic review of death certificates provides an accurate and easily accessible approach to the surveillance of deaths caused by occupational injuries.

References

1. CDC. Irrigation-pipe-associated electrocution deaths--Washington. MMWR 1983;32:169-71.

2. CDC. Leading work-related diseases and injuries--United States. MMWR 1984;33:213-5.

3. Steenland K, Beaumont J. The accuracy of occupation and industry data on death certificates. J Occup Med 1984;26:288-96.

4. Milham S. Occupational mortality in Washington state, 1950-1979. Cincinnati: National Institute for Occupational Safety and Health, 1983. (DHHS (NIOSH) publication no. 83-116).

5. Dubrow R, Wegman DH. Occupational characteristics of cancer victims in Massachusetts, 1971-1973. Cincinnati: National Institute for Occupational Safety and Health, 1984. (DHHS (NIOSH) publication no. 84-109).

6. U.S. Bureau of the Census. 1980 census of population: classified index of industries and occupations. U.S. Bureau of the Census, 1980.

7. Baker SP, Samkoff JS, Fisher RS, Van Buren CB. Fatal occupational injuries. JAMA 1982;248:692-7. *Forty-seven deaths associated with occupational injuries were also identified among females but were not analyzed with the males.

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