Trends in occupational injuries 2017 to 2023: a secondary analysis of the National Trauma Data Bank

Occupational injuries remain an important source of morbidity and mortality in the United States. Recent changes in workforce participation, employment patterns, and workplace conditions may have altered the epidemiology of occupational trauma. This study evaluated national trends in work-related traumatic injuries from 2017 to 2023 using the National Trauma Data Bank.

We performed a retrospective cross-sectional study using the American College of Surgeons National Trauma Data Bank Participant Use Files from 2017 to 2023. Work-related trauma encounters among patients aged 14 years or older were included. Temporal trends in demographic, injury, and clinical characteristics were assessed using Mann-Kendall trend testing. Multivariable regression models were used to evaluate factors associated with hospital length of stay (LOS) and mortality.

From 2017 to 2023, work-related trauma demonstrated significant demographic shifts. The proportion of occupational injuries increased among patients aged 14-19 years and those aged 60 years or older, female patients, Hispanic patients, and patients with Medicare or self-pay status. Pre- versus post-COVID period was not independently associated with hospital LOS or mortality. Longer hospital LOS was associated with older age, higher occupational hazard category, transportation-related mechanisms, penetrating trauma, major injury severity, multiple injured body regions, comorbidity burden, and positive alcohol or drug testing. Mortality was associated with older age, Black race, Medicare or self-pay status, lower trauma center level designation, penetrating trauma, major injury severity, multiple injured body regions, lower Revised Trauma Score, and comorbidity burden.

Occupational injuries treated at U.S. trauma centers changed meaningfully from 2017 to 2023, with increasing representation among younger workers, older workers, female patients, Hispanic patients, and patients without private insurance. These findings support targeted occupational injury prevention strategies and highlight the need for improved surveillance of vulnerable worker populations.