Public Health Surveillance of Construction Site Injuries in Delhi, India Using the First Information Reports (FIRs) Registered by Delhi Police

Abstract

Background: An injury surveillance system can inform strategies to reduce the incidence of injuries. Aim: To explore whether the First Information Reports (FIRs) of Indian police can form the basis of an unintentional injuries surveillance system. Methods: Initially, a systematic review of literature on “The use of police records for injury surveillance” was undertaken. Three different but related studies were then conducted. The Minimum Data Set (MDS) recommended for injury surveillance was identified in the first study; a tool for the extraction of data from FIRs was also developed, and its inter-rater reliability was assessed using Cohen’s Kappa; the percentage availability of each MDS data item in the FIRs was calculated. The total numbers of fatal and nonfatal construction site injuries in the Delhi population in 2017 were estimated by applying the two-sample capture-recapture method in the second study. The third study describes the epidemiology of construction site injuries in Delhi between 2016 and 2018. Results: The systematic review of literature showed that police records are a potentially useful source of information on unintentional injuries. The first study identified 12 MDS data items for injury surveillance; FIRs were found to contain complete information on 5 MDS data items but for 7 MDS data items, information was less complete. The second study estimated that FIRs ascertained 37%, 42.6% and 30.2% of the estimated total, fatal and non-fatal construction site injuries respectively. The third study found that 1,227 construction workers sustained injuries in 939 construction site incidents. Male workers (87%) and workers in the age group of 22 to 44 years (58.77%) accounted for most of those injured. The risk of a fatal injury was higher in migrant workers. The nonfatal injury rate per 100,000 workers per year was almost 3 times higher in female workers (98.55; 95% CI 82.52 to 116.8) than in male workers (34.36; 95%CI 31.92 to 36.94). Workers were at higher risk of injury in the rainy season and during 12:00 to 16:00 hours. Electricians and plumbers were the trade groups at higher risk of injury. Construction sites of government companies, and construction through a construction company, and works related to water supply, road construction, and power generation/distribution works were associated with higher odds of fatal injuries. The head (including face and eyes) was most prone to injury. Conclusion: Information on injuries can be reliably extracted from FIRs, however FIRs occasionally have incomplete information on some of the MDS data items. Furthermore, any epidemiological estimates made using these data must be adjusted to allow for the approximately two-thirds of injuries not reported to the police. Enforcement of existing legal provisions and the training of police personnel could help to reduce the ‘missingness’ of MDS data items and help to improve the ascertainment of injuries by FIRs. Imputation of missing data may help to improve the system further.