Work-related injuries and illnesses (WRII) presenting to Illinois hospitals, 2017−2021: The importance of emergency department (ED) data

Objectives

Research characterizing work-related injuries and illnesses (WRII) has predominantly focused on inpatients and deaths, despite evidence that 4% of WRII are admitted as inpatients and deaths are less than 0.2% of acute WRII. Our aim is to determine the usefulness of incorporating emergency department (ED) hospital data into current occupational health surveillance systems.

Methods

Data on ED and admitted WRII treated in Illinois hospitals from 2017 to 2021 were analyzed. Demographic characteristics, primary diagnosis, procedures undertaken, and unique patient estimates are described. Multivariable logistic regression models were developed to evaluate predictors of treatment in the ED and multivariable median regression models determined associations of total hospital charges.

Results

Between 2017 and 2021 there were 488,033 hospital presentations (95.9% nonadmissions) for WRII in Illinois, equating to a crude annual population rate of 1502.1/100,000. Non-Hispanic Whites (NHW) were disproportionately treated for illnesses, while Hispanic or Latino workers were disproportionately treated for injuries. African-Americans had the highest rate of ED emergent presentations (incident rate ratio [IRR] = 1.3, ref = NHW) and were less likely to be admitted for emergent presentations (IRR = 0.7, ref = NHW). ED presentations were more likely to be female, present with an injury, and at a rural, versus urban, hospital. Radiological investigations compromised the majority of procedures for nonadmitted patients (n = 403,317), and 94.8% were coded for a body region

Conclusion

Between 2017 and 2021 in Illinois, there were nearly 500,000 hospital visits charged to workers' compensation totaling over US$ four billion. ED data provide additional insights into work-related chronic conditions, health disparities, and the usage of diagnostic and therapeutic procedures for WRII.