Trends and disparities in fatal occupational injury in North Carolina

摘要 了解职业伤害的频率和分布对于伤害预防和 评估伤害预防策略。在过去的25年里，经济发生了深刻的变化， 影响工作场所安全的人口因素。在全国范围内，就业已从制造业转移 服务。尽管有积极的经济指标，但许多社区的失业率仍然很高， 越来越依赖无证工人和移民工人。就像整个美国一样，北卡罗来纳州 在过去25年中，劳动力发生了很大变化。该州从660万增长到990万 居民，就业已经从农业，纺织品和家具生产急剧转移到一个更 经济多样化，拉丁裔工人的人口增加了近400%。的 本提案的母研究详细描述了致命职业病的流行病学， 在北卡罗来纳州在1977年至1991年期间的伤害，利用国家的体检制度作为一种工具， 确定致命的职业伤害。该项目的调查结果，继续使用的伤害 流行病学家，描述了致命伤害的趋势，种族和民族的差异， 一些行业的研究和预防战略。我们建议在本研究的基础上， 提供有关东南部致命伤害的当代数据。拟议的研究将解决 致命的职业伤害的决定因素在这个东南部的大州超过40年的时间跨度。的 拟议的研究将涵盖1977年至2016年在一个州的近1000万居民 经济多元化，拉丁裔人口增长最快。我们将利用同一个案例 确定方法作为父研究，使我们能够生成一个合并的数据库， 4-人口十年后续行动-对职业流行病学的独特贡献。这一拟议 更新包括分析目标，将产生新的，高度翔实的调查结果，解决趋势， 北卡罗来纳州致命职业伤害的差异。一个主要利益攸关方咨询小组， 全州范围内首脑会议将确保成果传播给关键决策者和工作场所安全 律师研究结果将为该地区未来的职业伤害研究和预防策略提供信息。在 除了咨询小组和为期一天的全州峰会外，还将通过同行审查传播成果 科学会议上的期刊和演讲，一个项目网站和推特账号。拟定研究 利用一些现有的优势，建立在国家之间的长期合作， 卫生与公众服务部，流行病学部，以及 预防研究中心。这项工作将通过提高对伤害的理解来解决诺拉的优先事项 在广泛的工业部门，并加强伤害预防工作的基础。

ABSTRACT Understanding of the frequency and distribution of occupational injuries is crucial for injury prevention and evaluation of injury prevention strategies. The past 25 years have seen profound changes in the economic and demographic factors that affect workplace safety. Nationally, employment has shifted away from manufacturing to services. Despite positive economic indicators, unemployment remains high in many communities, and there is increasing reliance on undocumented and immigrant workers. Like the US as a whole, North Carolina’s workforce has changed substantially over the past 25 years. The state has grown from 6.6 million to 9.9 million residents, employment has shifted dramatically from agriculture, textile, and furniture production to a more diversified economy and the population of Latino workers has increased nearly four hundred percent. The parent study of the current proposal provided a detailed description of the epidemiology of fatal occupational injuries in North Carolina over the period 1977-1991, utilizing the state’s medical examiner system as a tool for identification of fatal occupational injuries. The findings of that project, which continue to be used by injury epidemiologists, described trends in fatal injuries, disparities by race and ethnicity, and informed injury research and prevention strategies in a number of industries. We propose to build upon this parent study to provide contemporary data regarding fatal injuries in the southeast. The proposed research will address determinants of fatal occupational injuries in this large southeastern state over a 40-year time span. The proposed study will encompass a population of nearly 10 million residents followed from 1977-2016 in a state with a diverse economy and the fastest growing Latino population in the US. We will utilize the same case ascertainment methodology as the parent study, allowing us to generate a pooled database with an extended 4-decade follow-up of the population -- a unique contribution to occupational epidemiology. This proposed update includes analytical aims that will yield novel, highly informative findings addressing trends and disparities in fatal occupational injuries in North Carolina. A key stakeholder advisory panel and planned statewide summit will ensure that results are disseminated to key policy makers and workplace safety advocates. Results will inform future occupational injury research and prevention strategies in this region. In addition to the advisory panel and 1-day statewide summit, results will be disseminated via peer-reviewed journals and presentations at scientific meetings, a project website and twitter handle. The proposed study leverages a number of existing strengths by building upon longstanding collaborations between the state’s Department of Health and Human Services, the UNC Department of Epidemiology, and UNC’s Injury Prevention Research Center. The work will address NORA priorities by improving understanding of injuries across a wide range of industrial sectors and strengthening the basis for injury prevention efforts.