Identification and characterization of Kentucky self-employed occupational injury fatalities using multiple sources, 1995-2004

Background: Identification and characterization of occupational injury fatalities in self-employed workers typically relies on a single data source and thus may miss some cases. Methods: Kentucky self-employed worker injury fatalities were identified using Fatality Assessment and Control Evaluation (FACE) program data (1995-2004) and compared to non self-employed worker data. Occupations and industries listed on death certificates were compared to those in which the decedent was actually engaged. Results Of 1,281 Kentucky worker injury deaths, 28% were self-employed. Death certificates failed to identify 31% of these deaths as work-related; industry and occupation were incorrectly identified in 27% and 16%, respectively. Fifty-seven percent of the deaths were in agriculture, primarily tractor-related. For Kentucky, the self-employed crude death rate was higher (27.6/100,000) than the non self-employed worker (5.4/100,000) rate or the US (11.5/100,000) self-employed rate. Conclusions: Multiple information sources improve identification of self-employed status in work-related injury fatalities. Effective prevention requires accurate surveillance and examination of contributing factors. Self-employed worker injuries in high-risk industries should be more fully examined for development of effective injury prevention programs.