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Original research
Fatal occupational injuries in North Carolina, 1992–2017
  1. Amelia T Martin1,
  2. Elizabeth S McClure1,2,
  3. Shabbar I Ranapurwala1,2,
  4. Maryalice Nocera2,
  5. John Cantrell2,
  6. Stephen W Marshall1,2,
  7. David B Richardson3
  1. 1 Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
  2. 2 Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
  3. 3 Environmental and Occupational Health, University of California Irvine, Irvine, California, USA
  1. Correspondence to Amelia T Martin, The University of North Carolina at Chapel Hill Department of Epidemiology, Chapel Hill, North Carolina, USA; amartin6{at}unc.edu

Abstract

Objectives After declining for several decades, fatal occupational injury rates have stagnated in the USA since 2009. To revive advancements in workplace safety, interventions targeting at-risk worker groups must be implemented. Our study aims to identify these at-risk populations by evaluating disparities in unintentional occupational fatalities occurring in North Carolina (NC) from 1992 to 2017.

Methods Our retrospective cohort study drew on both the NC Office of the Chief Medical Examiner system and the NC death certificate data system to identify unintentional fatal occupational injuries occurring from 1992 to 2017. Unintentional fatal occupational injury rates were reported across industries, occupations and demographic groups, and rate ratios were calculated to assess disparities.

Results Among those aged 18 and older, 2645 unintentional fatal occupational injuries were identified. Fatal occupational injury rates declined by 0.82 injuries/100 000 person-years over this period, falling consistently from 2004 to 2009 and increasing from 2009 to 2017. Fatal injury rates were highest among Hispanic workers, who experienced 2.75 times the fatal injury rate of non-Hispanic White workers (95% CI 2.42 to 3.11) and self-employed workers, who experienced 1.44 times the fatal injury rate of private workers (95% CI 1.29 to 1.60). We also observed that fatal injury rates increased with age group and were higher among male relative to female workers even after adjustment for differential distributions across occupations.

Conclusions The decline in unintentional fatal occupational injury rates over this period is encouraging, but the increase in injury rate after 2009 and the large disparities between occupations, industries and demographic groups highlight the need for additional targeted safety interventions.

  • Occupational Health
  • Accidents
  • Epidemiology
  • Public health

Data availability statement

No data are available. The medical examiner data were obtained through a restricted data use agreement with the Office of the Chief Medical Examiner, North Carolina Department of Health and Human Services, and are not available for public dissemination.

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Data availability statement

No data are available. The medical examiner data were obtained through a restricted data use agreement with the Office of the Chief Medical Examiner, North Carolina Department of Health and Human Services, and are not available for public dissemination.

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Footnotes

  • Contributors ATM is the guarantor of this work. ATM led the conceptualisation and design of the study, the implementation of all statistical analyses, and the preparation of all portions of the manuscript. ESM contributed to the study design and preparation of the manuscript. SIR contributed to the study design and preparation of the manuscript. MN assisted in the administration, coordination and supervision of the study, contributed to the data collection process and assisted in the preparation of the manuscript. JC contributed to the curation of study data, assisted in implementing statistical analyses and assisted in the preparation of the manuscript. SWM contributed to the study design and the preparation of the manuscript. DBR contributed to the study design, coordination and supervision of the study, data collection process and preparation of the manuscript.

  • Funding Financially supported by awards T42 OH008673 and R01 OH011256-01A1 from the National Institute for Occupational Safety and Health, US Centers for Disease Control and Prevention.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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