Trends and Disparities in Fatal Occupational Injuries in North Carolina

Understanding the frequency and distribution of occupational injuries is crucial for injury prevention and evaluation of injury prevention strategies. Like the United States 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.

Trends and Disparities in Fatal Occupational Injuries in North Carolina is an occupational cohort study of fatal occupational injuries among workers in North Carolina. The primary goal of this NIOSH funded study is to strengthen our understanding of fatal occupational injuries in North Carolina, with a particular interest in:

Injury trends and their economic determinants
Disparities in injury rates by race and ethnicity
Deaths among older workers

This study is a continuation of the highly successful parent study, Occupational Injury Fatalities in North Carolina[Loomis PI] which 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 for a number of industries.

Trends and Disparities in Fatal Occupational Injuries in North Carolina is a major 25-year update of data [1992-2017] on fatal occupational injuries among Southern workers, implementing state-of-the-art methods for analyses and quantitative inference. As in the parent study, this study will utilize data from the North Carolina Office of the Chief Medical Examiner to identify fatal occupational injuries. This study will substantially improve our understanding of injury rates, disparities, and special populations of interest relevant to future prevention efforts.

This research is supported by the National Institute for Occupational Safety and Health [1 R01OH011256-01-00].

Richey M, Golightly Y, Marshall SW, Novicoff, W, Keil, A, Nocera M, Richardson DB. Trends in Fatal Occupational Injury Rates Among Older Workers Before and After the Great Recession of 2008. Occupational & Environmental Medicine (OEM). 30 January 2023.[Online ahead of print] doi:10.1136/oemed-2022-108587

McClure ES, Gartner DR, Bell RA, Cruz TH, Nocera M, Marshall SW, Richardson DB. Challenges with Misclassification of American Indian/Alaska Native Race and Hispanic Ethnicity on Death Records in North Carolina Occupational Fatalities Surveillance. Front. Epidemiol. 2:878309. doi: 10.3389/fepid.2022.878309

Richey M, Marshall S, Nocera M, Golightly Y, Richardson DB. Trends in fatal occupational injuries in Latino/a workers relative to other groups, North Carolina 2000-2017Am. J. Ind. Med. 2022; 65(4):242-247. PMID: 35128690

Rowe R, Marshall S, Richardson DB, Cantrell J, Nocera M, Ranapurwala, SI. Unintentional Occupational Electrocution Fatalities in North Carolina: 1992 -2017: Data and Trends. Poster presentation. American College of Preventive Medicine 2022 June 15-18 Denver CO

David Richardson, PhD, Principal Investigator

Dr. Richardson is a faculty member in the UNC Department of Epidemiology. His research focuses on occupational and environmental epidemiology, with a special emphasis on occupational and environmental carcinogens. Dr. Richardson leads the team for managing disease through linking electronic data within the Research and Innovation Solutions Gillings Innovation Lab. Learn more.

Stephen W. Marshall, PhD, Co-Investigator

Dr. Marshall is an epidemiologist and the Director of the University of North Carolina Injury Prevention Research Center. For the past 30 years he has worked in many diverse areas of injury control and prevention, including: opioid overdose, homicide and violence prevention, surveillance methods, occupational injury, sport-related injuries and musculoskeletal conditions, traumatic brain injury, transportation injury, and injuries in the military. As an epidemiologic methodologist, Dr. Marshall’s research has included randomized and observation study designs for the evaluation of interventions, time-to-event models and longitudinal data analysis, and assessment of modification. He is committed to research-practice integration and the ongoing translation of research findings into policy, programs, and practice, and using systems thinking and systems perspective to advance to research-practice integration goals. Learn more.

Shabbar Ranapurwala, PhD, MPH, Co-Investigator

Dr. Ranapurwala conducts advanced analytical research in injury and violence prevention. His work utilizes a diverse set of epidemiological study designs including cluster randomized trials, retrospective cohorts, case control and ecologic studies. His substantive areas of research include the prevention of opioid poisoning, violence, and occupational injury. Learn more.

John Cantrell, MA, Data Analyst

Mr. Cantrell is currently pursuing a Master’s degree in Biostatistics at UNC Chapel Hill and has worked at the IPRC since 2014. He analyzes data for various public health studies, including multiple studies focused on injury prevention (at the IPRC) as well as a study on pediatric dental disease (at UNC’s Dental School). Previously, Mr. Cantrell worked as a data analyst in the UNC School of Public Health – Health Policy and Management Department, a Data Manager at UNC School of Medicine, a Mechanical Engineer and a Medical Technologist.

Amelia Martin, Graduate Research Assistant

Amelia Martin is a doctoral student in the Department of Epidemiology investigating occupational fatality trends and disparities in North Carolina. Prior to coming to UNC, she received her B.S. in Biology and a secondary-major in Global Health from Duke University. She has worked on projects examining the impact of e-waste exposure on maternal and child health, the relationship between green space access and chronic health outcomes, and infectious disease community transmission. Her current research interests include air pollution and heavy metal exposure, pesticide exposure, and occupational health.

Chelsea Martin, PT, DPT, SCS, Graduate Research Assistant

Dr. Martin is a doctoral student in the Department of Epidemiology where she is contributing to research projects at the Injury Prevention Research Center and the National Catastrophic Center for Sport Injury Surveillance on topics of workplace violence, musculoskeletal injuries, and catastrophic injuries. Her interests include injury mitigation in sport injuries and musculoskeletal conditions. She is a physical therapist and a board-certified sports specialist. Prior to pursuing her PhD, she contributed to research investigating clinical measures of the adolescent overhead athlete, collegiate athlete health and well-being, and injury surveillance utilizing publicly available data among American professional leagues.

Libby McClure, PhD, Research Collaborator

Libby McClure is a health data analyst with DataWorks NC, a Durham-based nonprofit whose mission is to conduct community-driven research, and a research associate with the North Carolina Occupational Safety and Health Education and Research Center at the University of North Carolina at Chapel Hill. Her work is focused on the ways in which historical and structural inequalities produce health disparities. She seeks involvement in social and environmental justice-focused research that both critically complicates traditional study of health and illness while also supporting social change.

Maryalice Nocera, MSN, Project Director

Ms. Nocera is a Senior Research Project Manager at the University of North Carolina Injury Prevention Research Center. For the past 18 years, she has managed complex, multi-site injury prevention research studies in communities and healthcare settings. She has overseen seven multi-site studies on workplace violence prevention, funded by the National Institute for Occupational Safety and Health.