The use of sentinel injury deaths to evaluate the quality of multiple source reporting for occupational injuries

Ann Epidemiol. 2005 Mar;15(3):219-27. doi: 10.1016/j.annepidem.2004.07.094.


Purpose: This study sought to develop an efficient method for evaluating the validity and completeness of routinely available sources of occupational injury fatality data.

Methods: Deaths due to falls from elevations, machinery, and electrocutions were selected as sentinel injuries likely to have occurred at work. Deaths from these injuries were identified from Maryland vital statistics over 7 years. The work-relatedness of these injuries and sensitivity of reporting were determined from death certificates, medical examiner reports, the National Traumatic Occupational Fatality System (NTOF), the Maryland Occupational Safety and Health Administration (MOSH), and Workers' Compensation (WC) data.

Results: A total of 527 deaths were identified for ages 16 and above, of which, 45% were work-related. Identification of work-related deaths varied by source: medical examiner (100%), death certificates (89%), NTOF (68%), MOSH (59%), and WC (44%). Reporting differed by age, cause of injury, year, occupation, and industry.

Conclusions: Examination of work-relatedness for deaths from certain causes is an efficient means of evaluating the quality of occupational injury reporting source data. These sentinel injuries uncovered significant underreporting in sources used by national surveillance systems, resulted in improved NTOF reporting, and suggest the need to make more use of medical examiner data when available.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.
  • Validation Study

MeSH terms

  • Accidents, Occupational / mortality*
  • Adolescent
  • Adult
  • Data Interpretation, Statistical
  • Databases, Factual / standards
  • Death Certificates
  • Humans
  • Industry / classification
  • Maryland / epidemiology
  • Middle Aged
  • Occupations / classification
  • Public Health Informatics
  • Registries / standards
  • Sentinel Surveillance*
  • State Government
  • Vital Statistics
  • Workers' Compensation / statistics & numerical data