Abstract
The overall incidence rate of occupational injuries in the United States has increased 10% from 1983 to 1992. The improved understanding of the causes of these injuries is necessary for the selection and implementation of future interventions. The causes of many occupational injuries are often categorized simply as manual materials handling, falls, and struck by/against/caught. Injury events like illness outcomes have multiple antecedents that can only be determined by repeated analytic studies of risk factors for injury. This paper describes the rationale for using analytic epidemiological studies of the causes of occupational injuries. It describes both case-control and prospective study designs including some of the methodological problems in conducting such studies at the worksite. It introduces a new study design to occupational injury researchers: the case-crossover study. The case-crossover design may be used to assess acute events in relation to intermittent exposures that have transient effects such as physical exertion or unusual work practices. A hypothetical epidemiological study of low back pain disability using both prospective and case-crossover study designs is discussed. Further work is needed to plan and conduct these studies with the help of safety professionals and epidemiologists from industry, academia, labor and government.
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