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LEXINGTON, Ky. (June 3, 2024) — Kentucky has grappled with outdated methods of tracking worker injuries, which rely heavily on workers' compensation data that fails to capture the full scope of work-related incidents. Workers' compensation data overlooks injuries covered by other forms of compensation and suffers from reporting delays. This approach not only leaves many injuries unaccounted for but also leads to significant delays in identifying emerging trends and patterns, hindering the opportunity for timely intervention efforts.

A $1.6 million award from the National Institute of Occupational Safety and Health is helping the Kentucky Occupational Safety and Health Surveillance (KOSHS) program address these challenges. 

KOSHS is housed within the Kentucky Injury Prevention and Research Center (KIPRC) at the University of Kentucky College of Public Health. As part of this project, KOSHS has taken innovative steps to improve the accuracy and timeliness of worker injury surveillance.

The Solution 

Syndromic surveillance uses rapid healthcare encounter data from participating hospitals and healthcare providers to monitor community-level public health in near real-time, making it a valuable tool for monitoring trends. 

Using this data, Andrew Farrey, the syndromic surveillance epidemiologist at KIPRC, developed a specialized Electronic Surveillance System for the Early Notification of Community-Based Epidemics (ESSENCE) query to identify workplace injuries. ESSENCE is a secure web-based platform that enables public health practitioners to access and monitor syndromic surveillance data in their jurisdiction. 

Farrey’s ESSENCE query searches for specific diagnosis codes related to work injuries, like International Classification of Diseases codes, and mentions of “workplace” in the list of symptoms that caused a patient to seek medical care.

With this tool, Farrey and the KOSHS program built an internal dashboard to monitor weekly trends and spikes in emergency department visits for work-related injuries. This dashboard breaks the data down by county, age group, sex and race/ethnicity, helping the KOSHS staff monitor the situation closely and accurately. 

“The development of this query, or syndrome definition, represents a significant advancement in our ability to identify and monitor work-related injury trends over time,” said Farrey. “By leveraging non-traditional rapid data sources and free-text search terms in addition to diagnosis codes, we can identify a broader range of work injuries, including those not typically covered by workers' compensation. This enhanced surveillance capability will allow us to provide more timely and targeted interventions, ultimately improving workplace safety and protecting the health of our workforce.”

The Results

Very quickly, the syndromic surveillance system revealed a worrying trend.

“We noticed a troubling pattern in our data, a disproportionate number of work-related injuries were occurring among workers aged 15 to 24,” said Rebecca Honaker, program director of KOSHS. “In light of this discovery, we adjusted our dashboard, enabling us to further explore the prevalence of injuries among minors and young adults. This enhancement provides us with valuable insights to better target our interventions and enhance workplace safety measures.”

Recognizing the importance of age-specific data in understanding work-related injuries among young workers, the KOSHS program took proactive steps to enhance the effectiveness of its surveillance efforts by expanding the 15 to 24 age category and breaking it into two groups: 14 to 17 year olds and 18 to 24 year olds.

This more detailed approach provides a clearer understanding of the prevalence of injuries among minors, facilitating targeted interventions and policy adjustments. The team is also thoroughly examining youth work-related injury data over multiple years to gauge the necessity for additional research and tailor intervention strategies to the specific needs of young workers in Kentucky. 

Looking ahead, the KOSHS program is committed to further enhancing its surveillance efforts to continue improving workplace safety in Kentucky. KOSHS plans to expand use of syndromic surveillance to include additional data sources and refine search criteria to capture an even broader range of work-related injuries. By remaining proactive in their approach, the KOSHS program is dedicated to safeguarding the health and well-being of Kentucky’s workforce.

This work was supported by the National Institute of Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC) of the U.S. Department of Health and Human Services (HHS), as part of cooperative agreement 5U60OH008483 totaling $1,601,266 with 0% financed with nongovernmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, NIOSH, CDC, HHS, or the U.S. government.