Understanding work-related injuries in children: a perspective in West Virginia using the state-managed workers' compensation system

Background/purpose

Little data exist that defines the consequences of occupational injuries in children. Traditional assessment of work-related injury is coupled with disability payments based on salary, which give little insight into etiology and severity. The authors hypothesize that the risk and pattern of occupational injuries in young workers are different then adults.

Methods

Claims from 1996 through 2000 were analyzed from the West Virginia Bureau of Workers Compensation. To define the significance of an injury, child and adult groups were subdivided into injuries that required surgery (ie, serious injuries). Current Procedural Terminology (CPT) codes for anesthesia and surgical procedures were cross referenced with the claims to ensure group designation. Relative risks (RR) were used to compare groups.

Results

Between 1996 and 2000, 364,063 claims were submitted, 14,093 in workers ≤19 years of age. Two hundred seventy claims in children required surgery. Serious injuries in children occur more often in boys 2.2× mainly in the (16 to 24 hours) evening (48% v 23.13%; P < .05) and in July/August (26.5 v 18.4; P < .001). Falls were the main mechanism of injury. Proportionately fingers (1.70×) and hands (1.64×, 1.6 to 1.7) were injured in children. Lacerations (3.4×), fractures (1.4×), and amputations (3.75×) frequently resulted in general anesthetic procedures, and the RR of these injuries were increased versus adults. Service, manufacturing, construction, and agriculture were the main injury-related occupations in children.

Conclusions

For any job category, injuries in children have unique features, tend to be more serious, and require a surgical intervention proportionately more frequently than adults.