Just in the wrong place...? Geographic tools for occupational injury/illness surveillance

Background: Geographic analysis is now integral to public health surveillance, but has been underused for occupational injury/illness. Methods: Mapping and spatial statistics are used to examine national county-level mean establishment Lost Workday Injury/Illness (LWDII) rates in the Occupational Safety and Health Administration (OSHA) Data Initiative (ODI), 1997-2001. The following questions are explored: Does occupational injury/illness vary geographically at the county level?; Does variation remain after accounting for industry hazard?; Where are rates higher or lower than expected? Results: The methods provide evidence of geographic variation in nonfatal occupational injury/illness rates, including after adjusting for industry hazard. Conclusions: Geographic analyses can improve intervention targeting, suggest risk factors for investigation, and make the case for targeting resources to prevention in hard-hit areas, as well as improving ongoing surveillance.