Series 10

No. 202

Injury and Poisoning Episodes

and Conditions: National

Health Interview Survey, 1997

July 2000

Vital and

Health Statistics

From the CENTERS FOR DISEASE CONTROL AND PREVENTION / National Center for Health Statistics

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics
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Suggested Citation

Warner M, Barnes PM, and Fingerhut LA. Injury and poisoning episodes and

conditions; National Health Interview Survey, 1997. Vital Health Stat 10(202).

2000.

Library of Congress-in-Publication Data

Injury and poisoning episodes and conditions: National Health Interview Survey,

1997.

p.; cm.—(Vital and health statistics. Series 10, Data from the National

Health Survey ; no. 202) (DHHS publication ; no. (PHS) 2000-1530)

‘‘June 2000.’’

Includes bibliographical references.

ISBN 0-8406-0563-3

1. Wounds and injuries—United States—Statistics. 2. Poisoning—

United States—Statistics. 3. United States—Statistics, Medical. I. National

Center for Health Statistics (U.S.) II. Series. III. Series: DHHS publication ; no.

(PHS) 2000-1530.

[DNLM: 1. National Health Interview Survey (U.S.) 2. Wounds and

Injuries—United States—Statistics. 3. Health Surveys—United States.

4. Poisoning—United States—Statistics. W2 A N148VJ no, 202 2000]

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Injury and Poisoning Episodes

and Conditions: National

Health Interview Survey, 1997

Series 10:

Data From the National Health

Interview Survey

No. 202

Hyattsville, Maryland

July 2000

DHHS Publication No. (PHS) 2000-1530

Vital and

Health Statistics

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics
National Center for Health Statistics

Edward J. Sondik, Ph.D., Director

Jack R. Anderson, Deputy Director

Jack R. Anderson, Acting Associate Director for

International Statistics

Jennifer H. Madans, Ph.D., Associate Director for Science

Lester R. Curtin, Ph.D., Acting Associate Director for

Research and Methodology

Jennifer H. Madans, Ph.D., Acting Associate Director for

Analysis, Epidemiology, and Health Promotion

P. Douglas Williams, Acting Associate Director for Data

Standards, Program Development, and Extramural Programs

Edward L. Hunter, Associate Director for Planning, Budget,

and Legislation

Jennifer H. Madans, Ph.D., Acting Associate Director for

Vital and Health Statistics Systems

Douglas L. Zinn, Acting Associate Director for

Management

Charles J. Rothwell, Associate Director for Data

Processing and Services

Office of Analysis, Epidemiology, and Health Promotion

Jennifer H. Madans, Ph.D., Acting Associate Director for

Analysis, Epidemiology, and Health Promotion

Lois A. Fingerhut, M.A., Special Assistant for Injury

Epidemiology

Division of Health Interview Statistics

Jane F. Gentleman, Ph.D., Director

Susan S. Jack, M.S., Acting Chief, Illness and Disability

Statistics Branch

Cooperation of the U.S. Bureau of the Census

Under the legislation establishing the National Health Survey, the Public Health

Service is authorized to use, insofar as possible, the services or facilities of other

Federal, State, or private agencies.

In accordance with specifications established by the National Center for Health

Statistics, the U.S. Bureau of the Census, under a contractual arrangement, participated

in planning the survey and collecting the data.
Contents

Abstract ................................................................................................. 1

Highlights................................................................................................ 1

Introduction ............................................................................................. 2

Methods ................................................................................................ 2

Source of Data ....................................................................................... 2

Capturing Episodes of Injury and Poisoning ............................................................... 2

Analysis Fields ....................................................................................... 4

Sample Size and Response Rates ........................................................................ 4

Data Files ........................................................................................... 4

Units of Analysis, Annual Estimates, and Rates ............................................................. 4

Variance Estimation and Significance Testing .............................................................. 5

Age-adjusted Rates .................................................................................... 5

Results ................................................................................................. 6

Age, Sex, and Race/Ethnicity ........................................................................... 6

Leading External Causes of Injury ....................................................................... 6

Injury Conditions ..................................................................................... 8

Place of Injury ....................................................................................... 8

Activity at Time of Injury .............................................................................. 9

Hospitalization ....................................................................................... 9

School- and Work-loss Days ............................................................................ 9

Limitations After Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Strengths of the Redesign . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Limitations and Lessons Learned . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Comparability with Prior Years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Appendixes

I. NHIS Questionnaire, Family Core: Section II—Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

II. Matrix for External Cause of Injury Mortality and Morbidity Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

III. Injury Morbidity Matrix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34

Codes for Body Region of Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34

Codes for Nature of Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37

IV. Technical Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38

Detailed Tables

1. Number, percent distribution, standard error, and annual rate of injury and poisoning episodes by selected demographic

characteristics: United States, 1997 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

iii
2. Annual rate and standard error of leading external causes of injury and poisoning episodes by sex and age:

United States, 1997. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

3. Number, percent, and standard error of fall-related episodes and percent by type of fall and sex: United States, 1997 . . 19

4. Number, percent, and standard error of transportation-related episodes by selected characteristics and sex:

United States, 1997 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

5. Number of poisoning episodes, number and percent of poisoning episodes involving a call to a poison control center,

and standard error by sex and age: United States, 1997 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

6. Annual rate and standard error of conditions by the nature of the injury and sex and age: United States,

1997. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

7. Annual rate and standard error of injury conditions by body region injured and sex and age: United States, 1997 . . . . 22

8. Number, percent, and standard error of injury episodes by place of occurrence, activity engaged in, and sex:

United States, 1997 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

9. Number, percent, and standard error of injury and poisoning episodes involving hospitalization by sex and age:

United States, 1997 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

10. Number, annual rates, and standard error of injury episodes resulting in time lost from work or school:

United States, 1997. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

11. Number, percent, and standard error of injury episodes by whether persons required help with daily routine activities

or personal care and age and sex: United States, 1997 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

List of Figures

1. Injury and poisoning episode rates by age: United States, 1997 ............................................. 5

2. Injury and poisoning episode rates by age and sex: United States, 1997 ...................................... 6

3. Injury and poisoning episode rates by age, race, and ethnicity: United States, 1997 .............................. 6

4. Age-adjusted external cause of injury and poisoning episode rates by mechanism of injury and sex: United States,

1997 ............................................................................................. 7

5. Injury episode rates for falls by age and sex: United States, 1997 ........................................... 7

6. Injury episode rates for being struck by or against an object or person by age and sex: United States, 1997 ......... 8

7. Injury episode rates for transportation-related injuries by age and sex: United States, 1997........................ 8

8. Injury episode rates for overexertion by age and sex: United States, 1997 ..................................... 9

9. Injury episode rates for cutting and piercing injuries by age and sex: United States, 1997 ........................ 9

10. Poisoning episode rates by age and sex: United States, 1997 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

11. Age-adjusted injury condition rates by nature of injury and sex: United States, 1997. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

12. Injury condition rates for sprains and strains by age and sex: United States, 1997 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

13. Injury condition rates for open wounds by age and sex: United States, 1997 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

14. Injury condition rates for fractures by age and sex: United States, 1997 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

15. Injury condition rates for contusions by age and sex: United States, 1997 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

16. Age-adjusted injury condition rates by body region and sex: United States, 1997 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

17. Upper extremity injury condition rates by age and sex: United States, 1997 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

18. Lower extremity injury condition rates by age and sex: United States, 1997. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

19. Percent of injury episodes by place of injury and sex: United States, 1997 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

20. Percent of injury episodes by activity at the time of injury and sex: United States, 1997. . . . . . . . . . . . . . . . . . . . . . . . . . 15

iv
Objective

This report provides a descriptive

overview of the first year of data from

the injury section of the redesigned

National Health Interview Survey. It

documents the Survey’s design

methodologies and presents detailed

national estimates of nonfatal injury and

poisoning episodes for 1997.

Methods

Data for the U.S. civilian

noninstitutionalized population were

collected using Computer Assisted

Personal Interview (CAPI). The data on

all medically attended injuries and

poisonings occurring to any family

member during the 3-month period prior

to the interview were obtained from an

adult member of the family.

Results

In 1997, 34.4 million

medically-attended episodes of injury

and poisoning were reported, resulting

in an age-adjusted rate of 128.9

episodes per 1,000 persons. Injury

episodes resulted in 40.9 million injury

conditions for a rate of 153.7 conditions

per 1,000 persons. Falls were the

leading external cause of injury,

followed by episodes resulting from

being struck by or against a person or

an object, transportation, overexertion,

cutting and piercing instruments, and

poisoning. Sprains and strains were the

most frequently reported injury condition

followed by open wounds, fractures,

and contusions. Upper extremity and

lower extremity injuries were the

leading body regions for these

conditions. Leisure activities and paid

work were most often reported as the

activities the person was engaged in

when the injury episode occurred, and

the home was the most likely place for

the injury to have occurred.

Conclusion

The redesigned NHIS is a useful

source of information about medicallyattended nonfatal injuries and

poisonings. A single year now provides

enough data to produce stable national

estimates on details of injury and

poisoning episodes.

Keywords: National Health Interview

Survey c injury episodes c poisoning

episodes c injury conditions

Injury and Poisoning Episodes

and Conditions: National Health

Interview Survey, 1997

by Margaret Warner, Ph.D., Offıce of Analysis, Epidemiology, and

Health Promotion; Patricia M. Barnes, M.A., Division of Health

Interview Statistics; and Lois A. Fingerhut, M.A., Offıce of Analysis,

Epidemiology, and Health Promotion

Highlights

+ In 1997, there were 34.4 million

medically-attended episodes of

injury and poisoning reported among

the U.S. civilian noninstitutionalized

population at a rate of 129 episodes

of injury and poisoning per 1,000

persons (similar for crude and

adjusted rates). The injury and

poisoning episodes resulted in 40.9

million conditions, at a rate of 154

conditions per 1,000 persons (similar

for crude and adjusted rates).

+ The age-adjusted injury and

poisoning episode rate for males

was 21% higher than the rate for

females.

+ The age-adjusted injury and

poisoning episode rate was higher

for non-Hispanic white persons than

for either non-Hispanic black or

Hispanic persons.

+ In 1997, falls were the leading

external cause of injury; 11.3

million episodes of falls were

reported at an age-adjusted rate of

43.1 per 1,000 persons. Falls were

followed by episodes resulting from

being struck by or against a person

or an object, transportation,

overexertion, cutting and piercing

instruments, and poisoning.

+ In 1997, sprains and strains were

the leading injury conditions

reported followed by open wounds,

fractures and contusions; the

respective age-adjusted rates were

38.5, 29.0, 23.7, and 19.0 per 1,000

persons.

+ The home was the most frequently

reported place of injury, with 24%

of injuries occurring inside the

home, and another 18% outside the

home. Females were located inside

the home at the time of the injuries

almost twice as often as males.

+ Leisure activities and paid work

were most often reported as the

activities the person was engaged in

when the injury episode occurred,

accounting for 22% and 19%,

respectively, of all episodes of

injury. The percent of people

engaged in leisure activities were

similar for males and females, while

males were engaged in paid work

almost twice as often as females.

+ Respondents reported that the

injured was hospitalized in 2.5

million episodes or about 7% of the

injury and poisoning episodes.

+ After the injury, about 7% of the

injured needed help in handling their

daily routine, such as household

chores and shopping, and about 6%

needed help attending to their

personal care such as eating and

bathing. The percent of persons with

limitations in both personal care and

daily routine increased with age.

We would like to thank Nathaniel Schenker and Van Parsons of the Office of Research Methodology for

their help with the technical aspects of this analysis and Jennifer Madans and Jane Gentleman for their

constructive comments. This report was edited by Klaudia M. Cox, and typeset by Jacqueline M. Davis of

the Publications Branch, Division of Data Services.

Page 1
Introduction

The National Health Interview

Survey (NHIS) has been used to

make estimates of the frequency

and rate of nonfatal injuries and

poisonings in the civilian

noninstitutionalized population since its

inception in 1957. Prior to 1997, the

injury and poisoning statistics extracted

from the NHIS were limited because

there was very little detail about the

circumstances of the injuries and

poisonings and because the annual

sample sizes were, in general, too small

to make reliable estimates with a single

year of data (1). However, because the

NHIS was potentially such a rich source

of data about nonfatal injuries, and

because there were no other comparable

national data, the number of questions

related to injuries and poisonings was

expanded when the questionnaire was

redesigned in 1997 in order to answer

basic epidemiological questions about

the injuries and the circumstances of the

traumatic event causing the injuries.

National estimates of nonfatal injury

rates in the United States are available

from several data systems operated by

the National Center for Health Statistics

(NCHS). This includes the National

Hospital Ambulatory Medical Care

Survey and the National Ambulatory

Medical Care Survey, which capture

data from ambulatory care settings

(2–4), and the National Hospital

Discharge Survey, which captures data

from inpatient settings (5,6). Data from

these sample surveys are based on

medical records, rather than personal

interviews. The ambulatory care surveys

obtain data on both the external cause

and the diagnosis of injury-related visits

to emergency departments, outpatient

clinics, and physicians’ offices. The

inpatient hospital survey obtains detailed

diagnostic information on injuries, but

relatively poor information on the

external causes. None of the surveys

have detailed information on the

circumstances of the injury or on other

relevant variables, such as place or

activity at the time of the injury.

The National Electronic Injury

Surveillance System (NEISS) from the

U.S. Consumer Product Safety

Commission is another national source

of nonfatal injury data (7,8). The

estimates from NEISS are of consumer

product-related injuries treated in a

sample of emergency departments and

are based on information abstracted

from medical records. Consumer product

injuries are those resulting from

products such as toys, appliances, and

lawn mowers. It also includes injuries

where any kind of sports equipment is

mentioned (8). Certain products, such as

firearms and motor vehicles, are

specifically excluded from the NEISS

system. However, work is currently

underway to expand the scope of NEISS

to include all injuries treated in

emergency departments (9).

The NHIS injury estimates for 1997

are not directly comparable to estimates

of injury conditions or episodes from

prior years of the NHIS. When the

NHIS questionnaire was redesigned in

1997, extensive changes were made in

the way injury and poisoning data were

collected. Differences between 1997 and

previous years include changes to: a) the

questions that screen for injuries and

poisonings; b) the inclusion criteria; c)

the recall period; d) the severity

threshold; and e) the phasing,

placement, and number of questions.

The changes were introduced to increase

the level of detail available on injury

episodes and to enable the user to make

more reliable annual estimates by

increasing the sample size.

This report presents detailed

national estimates of nonfatal injury and

poisoning episodes and injury conditions

from the first year of the redesigned

NHIS. In addition, detail is provided on

the design, methodologies, and rationale

used in making these estimates and a

discussion of the strengths and

weaknesses of the new design.

Methods

Source of Data

The NHIS, conducted by the

National Center for Health

Statistics, collects demographic

and health data on a nationally

representative sample of the civilian

noninstitutionalized population residing

in the United States. The NHIS has

conducted face-to-face interviews

continuously since its inception in 1957.

In 1997, the NHIS was extensively

redesigned, including the introduction of

computer-assisted personal interviewing

(CAPI).

The new Basic Module will remain

largely unchanged from year to year and

functions in a similar manner to the

previous core questionnaire. The Basic

Module contains three components: the

Family Core, the Sample Adult Core,

and the Sample Child Core (10).

The Family Core component

collects information on all members of

the family residing in the home at the

time of the interview and will serve as a

sampling frame for additional integrated

national surveys. Information collected

in the Family Core includes household

composition and sociodemographic

characteristics, tracking information,

information for matches to

administrative databases, and basic

indicators of health status and utilization

of health care services (10). The Injury

Section, which contains questions

pertaining to both injuries and

poisonings, is in the Family Core; thus

the questions on injuries and poisonings

will be asked annually about every

person in the family.

Capturing Episodes of

Injury and Poisoning

Data are collected from an adult

member (18 years or older) of the

household about medically-attended

injuries and medically-attended

poisonings occurring in the previous

3-month period to any member of the

family residing in the home at the time

of the interview. If other adult members

of the family are present during the

interview, they can respond for

themselves. The Injury Section of the

Family Core of the NHIS survey

questionnaire is included as appendix I.

The focus of the redesigned injury

section is a medically-attended injury

episode or poisoning episode rather than

an acute condition resulting from the

Page 2 [ Series 10, No. 202
episode, as was the case prior to 1997

(1). An injury episode refers to the

traumatic event in which the person was

injured one or more times from an

external cause (e.g., fall downstairs,

motor vehicle traffic crash). An injury

condition is the acute condition or the

physical harm caused by the traumatic

event (e.g., a fracture or a sprain). An

injury episode can result in multiple

conditions to the same person. If two

people from the same household are

injured seriously enough to require

medical attention in the same episode

(e.g., a car crash), the episode will be

counted for each person injured.

Poisoning episodes include

ingestion or contact with harmful

substances and overdoses or wrong use

of any drug or medication. The

instructions to the respondent

specifically exclude illness such as food

poisoning and poison ivy. Food

poisoning is an intestinal infectious

disease, and poison ivy is classified as a

dermatological condition (11). The

International Classification of Diseases,

Ninth Revision, Clinical Modification

(ICD–9–CM) was relied upon for the

definitions of injury and poisoning

conditions and for the classification of

external causes of the injury conditions

used in the questionnaire and during the

editing process (11).

A medically-attended injury or

poisoning is one for which a health care

professional was contacted either in

person or by telephone for advice or

treatment. Calls to poison control

centers are considered contact with a

health care professional and are included

in this definition of medical attendance.

The questions that screen for the

injuries and poisonings (appendix I) are:

‘‘During the past three-months,

were you or anyone in your family

injured seriously enough that you got

medical advice or treatment?’’ and

‘‘During the past three-months,

were you or anyone in your family

poisoned seriously enough that you got

medical advice or treatment?’’

The two important changes in the

screening questions in the 1997 redesign

to highlight are that the recall period

was increased from 2 weeks to 3

months and that the severity threshold

was changed from events resulting in at

least half a day of restricted activity

and/or medical attendance to only events

resulting in medical advice or treatment.

The recall period was increased to

capture more events on which to base

national estimates. Increasing the recall

period allows more episodes to be

captured from the same number of

people interviewed. With a longer recall

period, the respondents may be more

likely to forget events that happened

further in the past (that is, memory

decay), and the events more frequently

forgotten are likely to be less severe

events (12). Therefore, to

counterbalance the increase in the recall

period, the severity threshold was

increased to include only episodes

resulting in a visit or advice from a

medical professional, as events of this

severity may be better remembered.

During the editing process, injury

episodes were limited to those including

at least one health condition classified as

an injury as defined by ICD–9–CM

nature-of-injury codes 800–959 and

990–999 (11,13). Using CAPI to

conduct the interview facilitated the

collection of verbatim text information

on how the injury happened, the body

part injured, and the type of injury. This

information, along with responses to

questions about specific types of injury

episodes, place of occurrence, and

activity was used to assign ICD–9–CM

diagnostic and external cause codes for

all injury episodes.

For poisoning episodes in 1997, the

cause of the poisoning was recorded in

a precategorized list of causes rather

than as a verbatim response. Therefore

there are no external cause codes

(E-codes) for the poisoning episodes.

However, there was an option for the

respondent to choose the open-ended

category ‘‘something else.’’ If that

response was chosen, the interviewer

entered the respondent’s verbatim

description of the cause. During the

editing, the descriptions were reviewed

and recategorized. Episodes involving

illnesses such as food poisoning or

poison ivy were sometimes reported and

recorded, despite specific instruction to

the interviewer not to include them.

Therefore, episodes of this type were

excluded during the editing process. In

addition, the tables in this report

showing poisoning episodes do not

include the 47 cases (unweighted) coded

as ‘‘Allergic/adverse reaction to medical

or other substance’’ or ‘‘Something

else—NOT poisoning.’’ For additional

information, refer to the NHIS Survey

Description that is on the NHIS Web

site (10).

While editing the 1997 injury data,

it was discovered that respondents and

interviewers sometimes had a difficult

time differentiating between injuries and

poisonings even with the available

‘‘help screens.’’ Poisonings or toxic

effects within ICD–9–CM, (i.e.,

diagnosis codes 960–989 and external

cause codes E850.0–E869.9,

E950.0–E952.9, E962.0–E962.9,

E980.0–E982.9, and E972) were

sometimes reported following the

screening question focusing on injuries,

and thus the respondents answered the

questions pertinent to injuries. When

these injury episodes were assigned

ICD–9–CM codes, the coders gave these

episodes ‘‘flags’’ to indicate they were

poisonings. In addition, the question on

cause of poisoning contained a response

category ‘‘a venomous animal or plant.’’

Coders also flagged injury episodes that

appeared to fit into this cause of

poisoning category. All episodes flagged

as poisonings in the injury file were

moved to the poisoning file. After

editing was completed, it was

discovered that seven episodes coded as

E905.0–E905.9 (venomous animals and

plants as the cause of poisoning and

toxic reactions) were not given flags to

indicate they were poisonings and,

therefore, were not moved from the

injury file to the poisoning file.

Respondents were not asked about

the health conditions resulting from

poisoning episodes and, therefore, it is

not possible to count the number of

poisoning conditions. However, for this

report, it was assumed that there was

only a single condition per poisoning

episode to estimate the total number of

injury and poisoning conditions. This

assumption may result in an

underestimate of the number of

poisoning conditions. Beginning with

data year 2000, there will be one set of

questions for injury and poisoning

episodes. This will allow ICD external

cause codes and diagnostic codes to be

Series 10, No. 202 [ Page 3
assigned for both injury and poisoning

episodes. From that point, the inclusion

criteria will rely entirely on the ICD

classification codes.

Analysis Fields

The injury-specific questions on the

NHIS elicit information on the external

cause of the injury episode, the injury

diagnoses, what the person was doing at

the time of the injury episode, place of

occurrence, and whether the injury

episode caused any limitation of activity.

Edited verbatim response to the question

on how the injury occurred (up to 336

characters) and the four responses to the

question on the body part injured (up to

34 characters each) and four responses

to the question on the kind of injury (up

to 44 characters each) are available in

the verbatim text file. The descriptions

were edited to protect the injured

person’s confidentiality. Grammatical

and/or spelling errors were not

corrected. Poisoning-specific questions

include the external cause of the

poisoning and whether a poison control

center was contacted.

Questions asked about both injuries

and poisonings include the date of the

episode, whether the person was

hospitalized, and whether the person

missed any days from work or school.

The month and year of the date of

episode are available for analysis.

During the editing process, an elapsed

time (i.e., recall period) variable was

derived from the date of the episode and

the date of the interview.

The NHIS collects detailed

information on the four most recent

injury episodes and the four most recent

poisoning episodes. Up to four ICD–9–

CM injury diagnosis codes and three

E-codes were assigned for each injury

episode and are available for analysis in

the data files. Tables and figures include

the first-listed external cause and include

all conditions reported (11).

The external cause code categories

in table 2 are based on the mechanism

axis of the recommended framework for

presenting injury data with the exception

of the transportation category (13)

(appendix II). The transportation category

includes the external cause codes for

most modes of transportation

(i.e, ‘‘Motor vehicle traffic;’’ ‘‘Pedal

cyclist, other;’’ ‘‘Pedestrian, other;’’ and

‘‘Transport, other).’’ These codes were

selected because they correspond with

several additional questions asked only

for transportation episodes. The external

causes are categorized by mechanism of

injury regardless of intent.

There are no questions in the injury

section that specifically address the

question of intentionality because when

the questionnaire was tested in the

NCHS Cognitive Questionnaire Lab

during the early phases of its design, it

was determined that the setting of the

interview was not conducive to

identifying assaults and intentionally

self-inflicted injuries.

The ICD–9–CM diagnosis codes

used to categorize the injury conditions

in tables 3 and 4 are based on a matrix

of nature of injury by body region

injured developed by Mackenzie and

Champion (14). This matrix cross

classifies the ICD–9–CM diagnosis

codes 800–994 by nature of injury (e.g.,

fracture, sprain/strain) and by body

region injured (e.g., upper extremity,

abdomen). The diagnosis codes used are

shown in appendix III.

Selection of the age groups used in

this report—under 12 years, 12–21

years, 22–44 years, 45–64 years, 65–79

years, and 80 years and over—were

based on a graphical analysis of the

1997 injury episode rate by single year

of age. The groups were determined by

compromise between the observed

pattern of the data and standard age

groups often used by NCHS (figure 1).

The age groups will be reconsidered

when more data are available.

Data by race and ethnicity are

shown for non-Hispanic white,

non-Hispanic black and for Hispanic

persons, but not for persons of other

races, because sample sizes were not

large enough to make reliable estimates.

Sample Size and Response

Rates

The interviewed sample in 1997

consisted of 39,832 households, which

yielded 103,477 persons in 40,623

families. The total noninterview rate was

approximately 8.2%: 5.0% due to

respondent refusal and the remainder

primarily due to failure to locate an

eligible respondent at home after

repeated calls or unacceptable partial

interviews (10).

Injury and poisoning information

was reported for 2,949 people having

3,114 episodes of injury or poisoning.

These episodes resulted in 3,712

conditions including 3,533 injury

conditions and 179 poisoning conditions

(assuming one poisoning condition per

poisoning episode). Ninety-five percent

of the people had only one episode

reported during the 3-month period.

Data Files

Data on injuries are in three public

use data files—the Person file, Injury

Episode file, and the Injury Verbatim

file. Data on poisonings are found in

two files—the Person file and the Poison

Episode file. Each of these files can be

linked so that information about the

injury or the poisoning can be combined

with any of the other variables from the

NHIS.

Units of Analysis, Annual

Estimates, and Rates

Weighted data are used to estimate

the number of injury and poisoning

episodes, the injury and poisoning

conditions, and the size of the

population. The Final Annual Weight

available on the data tape is based on

information from the sample design and

sampling ratio and is adjusted for

nonresponse and post-stratified based on

census totals for sex, age, and

race/ethnicity.

The injury and poisonings episodes

are collected with a 3-month recall. To

annualize the estimate, each 3-month

estimate should be multiplied by 4.

Estimates shown in the figures and

tables are based on the number of

episodes and conditions occurring in 1

year. Rates are calculated either as the

annual number of injury and poisoning

episodes per 1,000 population or as the

annual number of injury conditions per

1,000 population.

It is not possible to estimate the

number of people injured or poisoned

Page 4 [ Series 10, No. 202
annually using the NHIS. Although the

number of persons who were injured

during the 3-month recall period is

known, this number cannot be assumed

to be uniform over a 12-month period.

For example, if it is known that 100

people responded that they were injured

during the 3-month recall period, one

cannot assume that 400 different people

were injured in a 12-month period

because some people may be injured

multiple times and some may be injured

once. On the other hand, it is

appropriate to estimate the number of

injuries over the 12-month period (by

multiplying the 3- month estimate by 4)

because that figure is the same whether

or not individuals had multiple injuries.

Variance Estimation and

Significance Testing

Variance estimates were produced to

indicate the reliability of point estimates.

The NHIS data are obtained through a

complex sample design involving

stratification, clustering, and multistage

sampling. The variance estimates were

calculated using the SUDAAN software

package and incorporated the design

information available on the public use

data tapes. The Taylor series

linearization method was chosen for

variance estimation in SUDAAN. Taylor

series linearization is used to

approximate the functions of linear

statistics. SUDAAN then computes the

design-specific variance for the

linearized values (15).

Standard errors are shown for all

rates and percents in tables. Rates or

percents with relative standard errors

greater than 30% are considered

unreliable and are indicated with an

asterisk. The relative standard errors are

calculated as follows:

Relative standard error = (SE/EST)100

where SE is the standard error of the

estimate and EST is the estimate.

Data points in the figures are shown

with 95% confidence intervals (i.e., error

bars) that were calculated as follows:

PE ± 1.96(SE)

where PE is the point estimate, SE is

the standard error of the estimate, and

1.96 is the reliability coefficient

corresponding to a confidence level of

95%.

While statistical tests of differences

among the point estimates were not used

in this report, confidence intervals are

given to graphically display the stability

of the individual point estimates. The

objective of the analysis is to identify

patterns or trends in the data by

investigating variation in specific injury

rates or proportions by age, race,

ethnicity, and sex as displayed in the

figures. Variability in the rates is

summarized by the standard errors and

confidence intervals provided. Key

results are highlighted in the text when

large differences in rates were observed.

See appendix IV for more specific

information on issues of statistical

testing.

Age-Adjusted Rates

Data were age-adjusted by the

direct method to the 2000 projected

population. The age groups used to

adjust are the same ones used in the

age-specific analyses in this report:

under 12 years, 12–21 years, 22–44

years, 45–64 years, 65–79 years, and 80

years and over. Age adjustment is used

to adjust for differences in the age

distribution of populations being

compared. Age adjustment is often done

Figure 1. Injury and poisoning episode rates by age: United States, 1997

Series 10, No. 202 [ Page 5
when trends are being analyzed or when

populations being compared are known

to have different age distributions. The

NCHS standard for age adjustment was

recently changed from the 1940 standard

to a 2000 standard (16). Age-adjusted

and crude rates of injury and poisoning

in 1997 are similar.

Results

I

n 1997, there were 34.4 million

episodes of injury and poisoning

reported among the U.S. civilian

noninstitutionalized population at a rate

of 129 episodes of injury and poisoning

per 1,000 persons (similar for crude and

adjusted rates) (table 1). The injury and

poisoning episodes resulted in 40.9

million conditions, at a rate of 154

conditions per 1,000 persons (similar for

crude and adjusted rates).

Age, Sex, and

Race/Ethnicity

The age-adjusted injury and

poisoning episode rate for males was

21% higher than the rate for females

(140.5 and 115.7 per 1,000 persons,

respectively). In general, age-specific

episode rates for males were higher than

for females among persons younger than

age 45 years, but were lower at the

older ages (figure 2). The age-adjusted

injury and poisoning episode rate was

higher for non-Hispanic white persons

than for either non-Hispanic black or

Hispanic persons (142.8 and 109.1 and

89.3 per 1,000 persons, respectively)

(table 1). Rates for persons under 22

years of age were generally higher for

non-Hispanic white persons than for

others. For persons 22–64 years, it

appears that Hispanic persons have

lower episode rates than other persons

(figure 3).

Leading External Causes

of Injury

In 1997, falls were the leading

external cause of injury; 11.3 million

episodes of falls were reported at an

age-adjusted rate of 43.1 per 1,000

persons (table 2). Falls were followed

by episodes resulting from being struck

by or against a person or an object,

transportation, overexertion, cutting and

piercing instruments, and poisoning. The

external cause category transportation

includes most modes of transportation

(i.e., motor vehicles, pedal cyclist,

pedestrian, and other transportation).

Falls is the only category of

external causes for which the

age-adjusted rate for females exceeded

that for males (47.2 versus 37.6 per

1,000 persons, respectively) (figure 4).

The higher episode rate for falls among

females results from the higher rates for

persons older than 45 years and

especially for those 65 years and older

where the rate for females was more

than twice the rate for males (figure 5).

Figure 2. Injury and poisoning episode rates by age and sex: United States, 1997

Figure 3. Injury and poisoning episode rates by age, race, and ethnicity: United States,

1997

Page 6 [ Series 10, No. 202
The fall was on level ground in

35–40% of the episodes. In 25% of the

falls, the type of fall did not fit into one

of the predefined categories of falls

(table 3).

Sex differences in the rate for being

struck by or against an object or person

are largest at ages 12–21 years; the rate

for males at that age was 3.5 times the

rate for females (figure 6). The rates for

males 22–44 years old were

considerably lower than for males 12–21

years old, but were still more than twice

the rates for females at ages 22–44

years.

The transportation-related injury

episode rates were higher for persons

12–21 and 22–44 years old than for

younger or older persons (figure 7).

Although transportation-related episodes

include most modes of travel, 75% of

these episodes could be classified as

motor vehicle traffic-related

(E810–E819). About 58% of

transportation-related episodes involved

drivers of vehicles, 27% involved

passengers, 10% involved bicycles, and

3% involved pedestrians (table 4). Of

those injured as drivers or passengers,

nearly 70% were in passenger cars,

13% were in light trucks, and 6% were

on motorcycles. Over three quarters

(78%) of those injured as drivers or

passengers in passenger cars, light

trucks, or large trucks, were reported to

be restrained at the time of the incident

by wearing a seatbelt or by being

buckled into a safety seat. Only about

40% of those injured while riding a

bicycle, motorcycle, an all-terrain

vehicle, or a snowmobile were reported

to be wearing a helmet (table 4).

The rates of reported overexertion

episodes were higher among persons

ages 12–64 years than among the

younger or older age groups (figure 8).

Although the rates were much lower,

patterns for injuries associated with

cutting and piercing instruments were

similar to those for being struck by

something (figures 6 and 9).

Poisoning episode rates were higher

for children under 12 years than for

others with no other readily observable

patterns by age or by sex (figure 10).

For about 45% of all reported poisoning

episodes, a call was made to a poison

control center—about 877,000 calls in

1997 (table 5). This number is less than

half the number of reported calls made

as reported by the American Association

of Poison Control Centers (17).

However, there are differences in the

reporting methods between the two

surveillance systems. NHIS estimates

are based on reporting by the patient or

other family member with a 3-month

recall and the other is based on direct

reporting by the poison control centers.

Nonetheless, both data systems show

higher proportions of calls involving a

young child compared with older

persons. Based on NHIS data, about 3

out of 4 poisonings involving a child

less than 6 years old results in a call to

a poison control center regarding the

incident.

Figure 4. Age-adjusted external cause of injury and poisoning episode rates by

mechanism of injury and sex: United States, 1997

Figure 5. Injury episode rates for falls by age and sex: United States, 1997

Series 10, No. 202 [ Page 7
Injury Conditions

In 1997, sprains and strains were

the injury condition most frequently

reported followed by open wounds and

fractures and contusions. The

age-adjusted rates were 38.5, 29.0, 23.7,

and 19.0 per 1,000 persons, respectively

(table 6). For each of these conditions,

with the exception of open wounds,

there were no rate differences by sex

(figure 11). The age-adjusted open

wound rate for males was about twice

the rates for females.

The condition rate for sprains and

strains were lower for children under 12

years than for others. Rates generally

declined with age, starting at ages 12

and older (figure 12). Among elderly

females, the rate was about twice that

for elderly males.

Sex differences in open wound rates

at ages 12–21 years were far higher than

for almost any other condition (table 6).

The rate for males was close to 6 times

that for females. At ages under 12 years

and 22–44 years, the rates for males

were about twice those for females

(figure 13).

The age distribution for fracture

rates was bimodal with peaks at 12–21

years and at 65 years and over

(figure 14). Finally, rates for contusions

were higher for persons 65 years and

over and for females, in particular, than

for younger persons (figure 15).

In addition to the nature of the

injury, the body region injured can also

describe the condition. Upper extremity

and lower extremity injuries were the

most often reported sites of the

conditions (with age-adjusted rates of

43.2 and 40.3 per 1,000 persons,

respectively) followed by injuries to the

spine and back, face, and skull and

brain (table 7). Both upper and lower

extremity injury condition rates were

higher than those for other regions of

the body (figure 16).

Upper extremity injury rates were

higher for males 12–44 years old than

for males of other ages or for females of

any age (figure 17). The rate for lower

extremity injuries for males 12–21 years

old was 1.5 times higher than for

females of the same age, but at ages 45

years and older, lower extremity injuries

were more likely among females than

males (figure 18). For females 65 and

over, the rate was 3 times that for their

male counterparts. The rate of skull and

brain injuries among males under 12

years old was 3 times that for females,

and for males 22–44 years, the rate was

closer to 2 times that for females

(table 7).

Place of Injury

The home was the most frequently

reported place of injury with 24% of

injuries occurring inside the home, and

another 18% outside the home (table 8).

Females were located inside the home at

the time of the injuries almost twice as

often as males (32% vs. 18%). Injuries

Figure 6. Injury episode rates for being struck by or against an object or person by age

and sex: United States, 1997

Figure 7. Injury episode rates for transportation-related injuries by age and sex:

United States, 1997

Page 8 [ Series 10, No. 202
occurring while on the street and

highway accounted for a further 13% of

the episodes with no difference between

males and females (figure 19). Injuries

occurring at sport facilities, industrial

and construction areas, schools, and

trade/service areas each accounted for

6–7% of the injuries. Males were

reported as injured at sports facilities

more often than females (10% vs. 4%).

Male-female differences were greatest at

industrial/construction sites, with 11%

of male injury episodes occurring at

these sites compared with 2% of their

female counterparts. Eight percent of

male injuries, compared with 5% of

female injuries, occurred at schools, a

location where equal exposure is expected.

Activity at Time of Injury

Leisure activities and paid work

were most often reported as the

activities the person was engaged in

when the injury episode occurred,

accounting for 22% and 19%

respectively of all episodes of injury

(table 8). The percent of persons

engaged in leisure activities were similar

for males and females (figure 20). Males

were engaged in paid work at the time

of injury almost twice as often as

females (24% vs. 14%) Injuries resulting

during sport-related activities were

reported for 14% of the episodes, more

than twice as often by males than by

females (18% vs 8%). Working around

the house or the yard was reported for

about 10% of the injury episodes,

somewhat more often for females than

for males. For 8% of the episodes,

driving was the reported activity and for

3%, attending school was reported.

Hospitalization

Respondents reported that the

person was hospitalized in 2.5 million

injury and poisoning episodes, or about

7% of the episodes (table 9). For those

hospitalized, the number of days in a

hospital ranged from 1–70 days.

However, 62% of those hospitalized had

a 1–3 day stay and 90% were in the

hospital for 2 weeks or less. The percent

of persons hospitalized increased with

age with 4% of those under 22 years

hospitalized after the episode compared

with 15% of those ages 65 and over.

School- and Work-Loss Days

There were 3.3 million injury and

poisoning episodes resulting in time lost

from school. About 85% of the episodes

with school loss occurred among 5–24

year olds at a rate of 36 episodes per

1,000 persons (table 10). For those ages

5–24 years, about 22% of the episodes

with time lost from school resulted in

less than 1 day lost, 65% resulted in 1–5

days lost, and 13% resulted in 6 days or

more lost.

There were 10.1 million injury and

poisoning episodes resulting in time lost

from work. About 99% of the episodes

with work loss occurred among 14–75

year olds at a rate of 51 episodes per

Figure 8. Injury episode rates for overexertion by age and sex: United States, 1997

Figure 9. Injury episode rates for cutting and piercing instruments by age and sex:

United States, 1997

Series 10, No. 202 [ Page 9
1,000 persons. For those ages 14–75

years, about 17% of the episodes with

time lost from work resulted in less than

1 day lost, 46% in 1–5 days lost, and

37% in 6 days or more lost.

Limitations After injury

After the injury, about 7% of the

injured people needed help in handling

daily routines such as household chores

and shopping, and about 6% of injured

people needed help attending to

personal care such as eating and bathing

(table 11). The percent of persons with

limitations in both personal care and

daily routine increased with age. At ages

65 years and over, 21% of the injured

persons needed help with daily routine

compared with 2% at ages 5–21 years.

At these same ages, 19% needed help

with personal care compared with 4% at

the younger ages. A higher percent of

females were limited after injuries than

males were; 10% of females were

limited in their daily routine versus 5%

of males.

Discussion

This report provides national

estimates of injury and poisoning

episodes and conditions for the

first year of the redesigned National

Health Interview Survey. The first year

of any ongoing survey is a time of

learning for everyone, from the

interviewers and data processors to the

analysts. Analyses are for a single year,

so it is possible that some of the

findings presented will change in

subsequent years as more data are

accumulated. The following discussion

presents the strengths and limitations of

the redesign and some methodological

issues for consideration.

Strengths of the Redesign

With only 1 year of data, reliable

national estimates can be made for

many age, sex, and cause-specific rates

of injury and poisoning episodes and

conditions. This is the result of

increasing the recall period to 3 months

because it increases the likelihood that a

person will have had an injury or

poisoning. Therefore, although the same

numbers of people are interviewed, there

are more episodes on which to make the

national estimates.

An acknowledged limitation of the

NHIS prior to 1997 was the limited

information on the circumstances of the

injury (18). In the redesigned survey,

there are multiple questions on the

circumstances of the injury episode,

including cause, place, activity, and

outcome of the injury. In addition, for

certain cause-specific injuries, there are

additional questions that address issues

related to that cause. Work-related and

sports-related injury episode rates can be

estimated on the national level from the

activity and place fields. Detail on

transportation-related episodes is

Figure 10. Poisoning episode rates by age and sex: United States, 1997

Figure 11. Age-adjusted injury condition rates by nature of injury and sex: United States,

1997

Page 10 [ Series 10, No. 202
available and will make the data

compatible with the Tenth Revision of

the ICD (19). For example, for persons

injured in transportation-related

incidents, questions on the type of

vehicle, if the person was the driver or

passenger and on the type of vehicle if

the person was a pedestrian struck by it.

A narrative description of how the

injury occurred, the part of the body

injured, and the nature of the injury are

available for analysis. These narratives

are the verbatim responses to the

interviewer’s queries with minimal

editing for confidentiality. The injury

data were ICD coded for NCHS

purposes, but researchers can code them

according to other cause or diagnostic

classification schemes. In addition, it is

possible to search for text strings of

words of interest (20, 21, 22). The

analyst should be cautioned, however,

against making estimates based on small

numbers of observations.

Limitations and Lessons

Learned

In 1997, there are separate sets of

questions for injuries and poisonings,

although some questions are common to

both categories. In general, there is

more detail for injuries than for

poisonings. For example, the narrative

field is available for injury episodes

only. Not having all the questions asked

of all respondents limits the

completeness of the analysis. In

addition, respondents did not always

understand the subtle distinctions that

separate an injury from a poisoning, so

occasionally injuries were reported as

poisonings and poisonings as injuries.

These problems were addressed in the

data editing process, but editing was

limited by missing responses when

injuries and poisonings were

inappropriately reported. The confusion

between an injury and a poisoning is

understandable because there is often

disagreement among injury researchers

about appropriate categorization. For

example, are venomous bites or stings

poisonings? The ICD–9–CM does not

include them in the section of codes for

‘‘accidental poisonings’’ although the

text descriptions of the appropriate

ICD–9–CM code includes the words ‘‘as

the cause of poisoning or toxic

reaction.’’ Because of these difficulties,

the injury and poisoning questions were

modified for the year 2000 survey so

there is one set of questions for all

persons injured or poisoned.

In 1997, respondents were asked if

anyone in the family had any injuries.

However, there was variability in what

respondents considered to be an injury.

For example, while repetitive motion

injuries or carpal tunnel syndrome were

reported in response to the screening

question, these are not injuries according

to ICD–9–CM and were not included in

Figure 12. Injury condition rates for sprains and strains by age and sex: United States,

1997

Figure 13. Injury condition rates for open wounds by age and sex: United States, 1997

Series 10, No. 202 [ Page 11
this data set. It is important to remember

that the NHIS is not based on physician

diagnoses, but on descriptions of injuries

provided by the respondents. Thus,

estimates should be made only on broad

injury categories rather than specific

diagnoses.

Respondents were prompted to

choose an activity to best fit what they

were doing at the time of injury. A

review of the verbatim responses,

however, indicated that some of the

‘‘other’’ responses fit into one of the

predefined categories such as ‘‘driving’’

and ‘‘leisure’’ activities. Some of the

categories in the activity were also

difficult for the respondent to interpret.

For example, if the injured person was

doing housework at the time of the

injury, two categories were suitable:

‘‘Working around the house or yard’’ or

‘‘Unpaid work (including housework,

shopping, volunteer work).’’ As a result,

new guidelines were given to

interviewers to select the first category

if the response involved ‘‘housework’’

and the response categories are being

evaluated for future years.

Comparability With Prior

Years

Estimates of all injury conditions

for 1997 are not directly comparable to

estimates from prior years of the NHIS.

As discussed in the Methods section of

this report, differences between 1997

and previous years include changes to

the screening questions; the inclusion

criteria; the recall period; the severity

threshold; and the phasing, placement,

and number of questions. The following

discussion is a brief introduction to

comparisons between the redesign and

previous years. A more detailed analysis

will be provided in the near future.

An evaluation of changes in the

1995 and 1997 injury and poisoning

condition rates requires that data from

the two surveys be reanalyzed. To make

the 1995 data more comparable to the

1997 data, injuries that were not

medically attended and adverse effects

and complications of medical care

(ICD–9–CM 995.0–995.4, 995.6,

995.86, 995.89–999 and E870–E878,

and E930–E949) were excluded from

the 1995 estimates. Comparisons were

made with 1995 because only a partial

year of data is available for 1996.

In the redesigned 1997 survey,

where respondents were asked directly

about injury conditions, there were only

four reported conditions (unweighted)

that were coded to ‘‘adverse effects’’ or

‘‘complications of surgical and medical

care’’ (ICD–9–CM 995.0–995.4, 995.6,

995.86, and 995.89–999), accounting for

0.1% of all injury conditions. In

contrast, in 1995, 13% of all acute

injury conditions (about 7.5 million

conditions) in the NHIS were adverse

effects or complications. This finding

mirrors the many discussions among

injury researchers and prevention

specialists, including those participating

in the International Collaborative Effort

Figure 14. Injury condition rates for fractures by age and sex: United States, 1997

Figure 15. Injury condition rates for contusions by age and sex: United States, 1997

Page 12 [ Series 10, No. 202
on Injury Statistics (1996) and in the

injury data committee of the Injury

Section of the American Public Health

Association (1996), in which it was

agreed that these conditions and their

comparable external causes (E870–E878

and E930–E949) were not injuries that

could be prevented in the same manner

as injuries resulting, for example, from

motor vehicle crashes or falls (13, 23).

Thus, they have been excluded from

some recent counts of injuries and

injury deaths published by the National

Center for Health Statistics (24, 25).

When limited to the medically

attended injuries and excluding the

adverse effects and complications of

surgical and medical care, the 1995 rate

of 19.0 injury and poisoning conditions

per 100 persons is 25% greater than the

1997 rate of 15.4 injury and poisoning

conditions per 100 persons. However,

the 1995 estimate does not address the

increased recall period. Analysis of

recall bias was complicated by missing

values in the date of injury field, but

will be addressed in a forthcoming

report.

Preliminary analyses comparing

specific injury conditions between 1995

and 1997 show similar numbers of

fractures and sprains and strains, but

differences in the numbers of

‘‘superficial injuries’’ as classified by the

ICD (appendix III). This suggests that

the recall of less severe injuries may be

playing a role in the decrease in

estimated number of injuries. However,

the estimates were made more stable

with the 3-month recall because of the

greater number of observations on

which the estimates are based.

Conclusion

The redesigned NHIS is a useful

source of information about medicallyattended nonfatal injuries and poisonings

occurring in the United States. A single

year of data provides enough data to

produce stable national estimates on

details of injury and poisoning episodes.

With each successive year of data, the

amount of information about the causes

and diagnoses of nonfatal injuries will

increase and thus so should the ability

to expand and enhance prevention

efforts.

For complete documentation and

data tapes, see: http://www.cdc.gov/nchs/

nhis.htm

Figure 16. Age-adjusted injury condition rates by body region and sex: United States,

1997

Figure 17. Upper extremity injury condition rates by age and sex: United States, 1997

Series 10, No. 202 [ Page 13
Figure 18. Lower extremity injury condition rates by age and sex: United States, 1997

Figure 19. Percent of injury episodes by place of injury and sex: United States, 1997

Page 14 [ Series 10, No. 202
References

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estimates from the National Health

Interview Survey, 1995. National

Center for Health Statistics. Vital

Health Stat 10(199). 1998.

2. Burt CW, Fingerhut LA. Injury visits to

hospital emergency departments: United

States, 1992–95. National Center for

Health Statistics. Vital Health Stat

13(131). 1998.

3. Burt CW. Injury-related visits to

hospital emergency departments:

United States, 1992. Advance data from

vital and health statistics; no 261.

Hyattsville, Maryland: National Center

for Health Statistics. 1995.

4. Woodwell, DA. National Ambulatory

Medical Care Survey: 1997 Summary.

Advance Data: no 305. Hyattsville,

Maryland: National Center for Health

Statistics. 1999.

5. Hall MJ, Owings MF. Hospitalizations

for injury and poisonings in the United

States, 1991. Advance data from vital

and health statistics; no 252.

Hyattsville, Maryland: National Center

for Health Statistics. 1994.

6. Lawrence, L, Hall, MJ. 1997 Summary:

National Hospital Discharge Survey.

Advance data from vital and health

statistics; no 308. Hyattsville,

Maryland: National Center for Health

Statistics. 1999.

7. US Consumer Product Safety

Commission, Consumer Product-Related

Statistics Page, http://www.cpsc.gov/

library/data.html.

8. US Consumer Product Safety

Commission, National Electronic Injury

Surveillance System Coding Manual,

Washington, DC, 1997.

9. Quinlan KP, Thompson MP, Annest JL,

et al. Expanding the National

Electronic Injury Surveillance System

to Monitor All Nonfatal Injuries

Treated in US Hospital Emergency

Departments. Annals of Emergency

Medicine. 1999; 34: 637–645.

10. 1997 National Health Interview Survey

(NHIS) Public Use Data Release, NHIS

Survey Description, Division of Health

Interview Statistics, National Center for

Health Statistics, Hyattsville, MD,

Centers for Disease Control and

Prevention, U.S. Department of Health

and Human Services, February 2000

(http://www.cdc.gov/nchs/nhis.htm

#1997 NHIS.)

11. Public Health Service and Health Care

Financing Administration. International

Classification of Diseases, 9th Revision,

Clinical Modification. Washington:

Public Health Service. 1991.

12. Harel Y, Overpeck MD, Jones DH, et

al. The effects of recall on estimating

annual nonfatal injury rates for children

and adolescents. American Journal of

Public Health. 1994; 84: 599–605.

13. McLoughlin E, Annest JL, Fingerhut L,

et al. Recommended framework for

presenting injury mortality data. MMWR.

Centers for Disease Control and

Prevention. 1997; 46 (no. RR-14):1–32.

14. Mackenzie EJ, Champion H. Injury

diagnosis morbidity matrix. In:

Proceedings of the International

Collaborative Effort on Injury Statistics,

Vol 3. Hyattsville, MD: National Center

for Health Statistics. 2000.

15. Shah BV, Barnwell BG, Bieler GS.

SUDAAN User’s Manual, Release 7.0,

1st edition, Research Triangle Institute,

Research Triangle Park, NC. 1996.

16. Anderson RN, Rosenberg HM. Age

Standardization of Death Rates:

Implementation of the Year 2000

Standard. National Center for Health

Statistics. National Vital Statistics

Reports. 47(3). 1998.

17. Litovitz TL, Klein-Schwartz W, Dyer KS,

et al. 1997 Annual Report of the

American Association of Poison Control

Centers Toxic Exposure Surveillance

System. American Journal of Emergency

Medicine, Vol 16 (5). 1998: 443–497.

18. Baker SP, O’Neil B, Ginsburg MJ, Li G.

The Injury Factbook. 2nd Edition. New

York: Oxford University Press. 1992.

19. World Health Organization. International

Statistical Classification of Diseases and

Related Health Problems, 10th Revision.

Geneva: World Health Organization. 1992.

20. Jenkins EL, Hard DL. Implications for

the use of E codes of the International

Classification of Diseases and narrative

data in identifying tractor-related deaths

in agriculture, United States,

1980–1986. Scandinavian Journal of

Work, Environment, and Health 1992;

18 Supp. 2: 49–50.

21. Langley JD. Experiences using New

Zealand’s hospital based surveillance

system for injury prevention research.

Methods of Information in Medicine

1994; 34: 340–344.

22. Sorock GS, Smith GS, Reeve GR, et al.

Three perspectives on work-related injury

surveillance systems. American Journal of

Industrial Medicine 1997; 32: 116–128.

23. Proceedings of the International

Collaborative Effort on Injury Statistics

Volume 1. National Center for Health

Statistics, Hyattsville, MD. DHHS

publication number (PHS) 95–1252.

1995.

24. Fingerhut LA, Warner M. Injury

Chartbook. Health, United States,

1996–97. Hyattsville, MD: National

Center for Health Statistics. 1997.

25. Hoyert DL, Kochanek KD, Murphy SL.

Deaths: Final Data for 1997. National

Vital Statistics Reports; Vol 47 no 19.

Hyattsville, Maryland: National Center

for Health Statistics. 1999.

Driving

Attending school

Unpaid work

Working

(house/yard)

Sports

Working paid job

Leisure

0 5 10 15 20 25 30

Percent of episodes

NOTE: Persons could indicate up to two activities per episode.

Male

Female

95% Confidence

Figure 20. Percent of injury episodes by activity at the time of injury and sex:

United States, 1997

Series 10, No. 202 [ Page 15
Table 1. Number, percent distribution, standard error, and annual rate of injury and poisoning episodes by selected demographic

characteristics: United States, 1997

Selected demographic

characteristic

Number of

episodes in

thousands

Percent

distribution

Standard

error

(percent)

Rate per

1,000

population

Standard

error

(rate)

Sex and age

Both sexes:

All . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34,383 100.0 . . . 129.0 2.6

All, age-adjusted . . . . . . . . . . . . . . . . . . . . . ... ... ... 128.9 2.6

Under 12 years. . . . . . . . . . . . . . . . . . . . . . 5,384 15.7 0.7 112.2 5.9

12–21 years. . . . . . . . . . . . . . . . . . . . . . . . 6,542 19.0 0.9 171.4 8.4

22–44 years. . . . . . . . . . . . . . . . . . . . . . . . 12,766 37.1 1.1 136.4 4.5

45–64 years. . . . . . . . . . . . . . . . . . . . . . . . 5,470 15.9 0.8 99.7 5.1

65 years and over . . . . . . . . . . . . . . . . . . . . 4,221 12.3 0.7 131.9 7.0

65–79 years . . . . . . . . . . . . . . . . . . . . . . 2,850 8.3 0.6 114.9 7.7

80 years and over . . . . . . . . . . . . . . . . . . 1,371 4.0 0.4 190.5 19.4

Male:

All . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18,544 53.9 1.1 142.4 4.0

All, age-adjusted . . . . . . . . . . . . . . . . . . . . . ... ... ... 140.5 4.1

Under 12 years. . . . . . . . . . . . . . . . . . . . . . 3,063 8.9 0.6 125.1 8.2

12–21 years. . . . . . . . . . . . . . . . . . . . . . . . 4,394 12.8 0.7 225.3 13.3

22–44 years. . . . . . . . . . . . . . . . . . . . . . . . 7,406 21.5 0.9 160.3 7.1

45–64 years. . . . . . . . . . . . . . . . . . . . . . . . 2,483 7.2 0.6 93.5 7.3

65 years and over . . . . . . . . . . . . . . . . . . . . 1,197 3.5 0.4 88.9 9.8

65–79 years . . . . . . . . . . . . . . . . . . . . . . 800 2.3 0.3 73.3 9.4

80 years and over . . . . . . . . . . . . . . . . . . 397 1.2 0.3 155.3 34.0

Female:

All . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15,840 46.1 1.1 116.1 3.4

All, age-adjusted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115.7 3.4

Under 12 years. . . . . . . . . . . . . . . . . . . . . . 2,320 6.7 0.5 98.7 7.7

12–21 years. . . . . . . . . . . . . . . . . . . . . . . . 2,149 6.2 0.6 115.1 11.1

22–44 years. . . . . . . . . . . . . . . . . . . . . . . . 5,360 15.6 0.8 113.1 5.8

45–64 years. . . . . . . . . . . . . . . . . . . . . . . . 2,988 8.7 0.5 105.5 6.9

65 years and over . . . . . . . . . . . . . . . . . . . . 3,023 8.8 0.6 163.1 10.4

65–79 years . . . . . . . . . . . . . . . . . . . . . . 2,050 6.0 0.5 147.5 11.7

80 years and over . . . . . . . . . . . . . . . . . . 973 2.8 0.3 209.9 24.3

Race/ethnicity and age

White non-Hispanic:

All . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27,299 79.4 0.8 141.8 3.3

All, age-adjusted . . . . . . . . . . . . . . . . . . . . . ... ... ... 142.8 3.3

Under 12 years. . . . . . . . . . . . . . . . . . . . . . 4,096 11.9 0.7 133.4 8.2

12–21 years. . . . . . . . . . . . . . . . . . . . . . . . 5,329 15.5 0.8 208.6 11.4

22–44 years. . . . . . . . . . . . . . . . . . . . . . . . 9,747 28.3 1.0 147.3 5.7

45–64 years. . . . . . . . . . . . . . . . . . . . . . . . 4,381 12.7 0.7 101.9 5.9

65 years and over . . . . . . . . . . . . . . . . . . . . 3,745 10.9 0.6 138.2 8.0

65–79 years . . . . . . . . . . . . . . . . . . . . . . 2,489 7.2 0.5 119.6 9.0

80 years and over . . . . . . . . . . . . . . . . . . 1,256 3.7 0.4 199.8 21.5

Black non-Hispanic:

All . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,513 10.2 0.6 107.9 6.6

All, age-adjusted . . . . . . . . . . . . . . . . . . . . . ... ... ... 109.1 6.7

Under 12 years. . . . . . . . . . . . . . . . . . . . . . 579 1.7 0.2 78.8 10.0

12–21 years. . . . . . . . . . . . . . . . . . . . . . . . 613 1.8 0.2 109.7 15.0

22–44 years. . . . . . . . . . . . . . . . . . . . . . . . 1,482 4.3 0.4 128.5 11.1

45–64 years. . . . . . . . . . . . . . . . . . . . . . . . 608 1.8 0.3 110.5 15.4

65 years and over . . . . . . . . . . . . . . . . . . . . 231 0.7 0.1 89.8 19.7

65–79 years . . . . . . . . . . . . . . . . . . . . . . 141 0.4 0.1 69.3 18.3

80 years and over . . . . . . . . . . . . . . . . . . *90 *0.3 0.1 *168.1 54.2

See footnotes at end of table.

Page 16 [ Series 10, No. 202
Table 1. Number, percent distribution, standard error, and annual rate of injury and poisoning episodes by selected demographic

characteristics: United States, 1997—Con.

Selected demographic

characteristic

Number of

episodes in

thousands

Percent

distribution

Standard

error

(percent)

Rate per

1,000

population

Standard

error

(rate)

Hispanic:

All . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,658 7.7 0.5 88.8 5.2

All, age-adjusted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89.3 5.3

Under 12 years. . . . . . . . . . . . . . . . . . . . . . 629 1.8 0.2 82.8 10.4

12–21 years. . . . . . . . . . . . . . . . . . . . . . . . 483 1.4 0.2 93.2 12.0

22–44 years. . . . . . . . . . . . . . . . . . . . . . . . 1,063 3.1 0.3 93.7 8.6

45–64 years. . . . . . . . . . . . . . . . . . . . . . . . 276 0.8 0.1 66.4 9.1

65 years and over . . . . . . . . . . . . . . . . . . . . 207 0.6 0.1 126.1 27.3

65–79 years . . . . . . . . . . . . . . . . . . . . . . 182 0.5 0.1 134.2 30.5

80 years and over . . . . . . . . . . . . . . . . . . *25 0.1 0.0 *87.8 52.1

Geographic region

Northeast . . . . . . . . . . . . . . . . . . . . . . . . . 6,732 19.6 0.9 128.4 5.4

Midwest . . . . . . . . . . . . . . . . . . . . . . . . . . 8,723 25.4 0.9 132.7 5.5

South. . . . . . . . . . . . . . . . . . . . . . . . . . . . 12,214 35.5 1.0 128.3 4.2

West . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,715 19.5 0.9 126.0 6.2

. . . Category not applicable.

* Figure does not meet standard of reliability or precision.

0.0 Quantity more than zero but less than 0.05.

Series 10, No. 202 [ Page 17
rror of leading external causes of injury and poisoning episodes by sex and age: United States, 1997

Fall

Struck by or against

a person or an object Transportation1 Overexertion

Cutting-piercing

instruments Poisoning

Rate

per 1,000

population

Standard

error

Rate

per 1,000

population

Standard

error

Rate

per 1,000

population

Standard

error

Rate

per 1,000

population

Standard

error

Rate

per 1,000

population

Standard

error

Rate

per 1,000

population

Standard

error

42.4 1.5 19.6 1.0 16.7 1.0 13.9 0.9 10.0 0.7 7.3 0.6

43.1 1.5 19.4 1.0 16.5 1.0 13.9 0.8 9.9 0.7 7.2 0.645.7 3.7 17.3 2.2 8.6 1.4 *2.4 1.0 8.0 1.3 13.0 1.8

45.5 4.6 49.1 4.4 23.8 3.0 12.3 2.1 15.4 2.2 5.6 1.430.6 2.0 18.9 1.7 22.9 1.9 20.3 1.8 13.4 1.4 6.7 1.032.1 2.9 11.5 1.5 11.2 1.6 17.6 1.9 5.5 1.1 5.5 1.3

86.2 5.8 4.0 1.2 11.5 2.2 7.8 1.9 4.4 1.3 5.4 1.6

36.9 2.1 27.6 1.7 19.3 1.4 15.1 1.3 13.3 1.2 6.9 0.9

37.6 2.1 26.6 1.6 18.9 1.4 14.9 1.2 12.9 1.1 6.7 0.947.7 5.7 21.9 3.5 13.8 2.5 *3.0 1.7 10.7 2.2 11.3 2.1

49.1 6.1 75.3 7.5 28.2 4.5 17.1 3.5 25.7 4.3 *4.8 1.729.9 3.1 27.0 2.9 26.1 2.7 22.5 2.6 15.7 2.1 7.6 1.625.0 3.4 11.3 2.2 9.8 2.1 17.5 2.7 6.6 1.7 *5.2 1.7

47.2 7.6 *3.4 1.5 12.3 3.4 *4.4 1.9 *4.8 2.0 *2.9 1.8

47.7 2.4 11.9 1.0 14.1 1.2 12.7 1.1 6.9 0.8 7.7 0.8

47.2 2.4 12.1 1.0 14.1 1.2 12.7 1.1 6.8 0.8 7.7 0.843.7 5.0 12.5 2.4 *3.2 1.3 *1.7 1.0 *5.1 1.6 14.7 2.9

41.7 7.3 21.7 4.4 19.2 3.6 *7.4 2.3 *4.6 1.7 *6.4 2.331.3 3.0 11.0 1.7 19.7 2.3 18.1 2.0 11.2 1.8 5.9 1.238.7 4.5 11.6 2.2 12.6 2.2 17.8 2.9 *4.5 1.4 5.8 1.6

114.5 8.8 *4.4 1.6 11.0 2.9 10.2 2.9 *4.2 1.6 *7.2 2.4

cision.

cle traffic;’’ ‘‘Pedal cycle, other;’’ ‘‘Pedestrian, other;’’ and ‘‘Transport, other’’ (appendix II).

he verbatim responses to questions FIJ.050 to FIJ.220 of the questionnaire (appendix I). See appendix II for a list of the ICD–9–CM codes in each cause category.

Page 18 [ Series 10, No. 202
Table 3. Number, percent, and standard error of fall-related episodes by type of fall and sex: United States, 1997

Both sexes Male Female

Number in

thousands

Percent

of all fall

episodes

Standard

error

Number in

thousands

Percent

of all fall

episodes

Standard

error

Number in

thousands

Percent

of all fall

episodes

Standard

error

All fall episodes . . . . . . . . . . . . . . 11,306 100.0 . . . 5,015 100.0 . . . 6,291 100.0 . . .

Type of fall

All types of falls mentioned1

. . . . . . . 12,285 108.7 . . . 5,493 109.5 . . . 6,792 108.0 . . .

Floor/level ground . . . . . . . . . . . . . 4,158 36.8 1.7 1,729 34.5 2.7 2,430 38.6 2.2

Stairs/step. . . . . . . . . . . . . . . . . . 1,296 11.5 1.0 428 8.5 1.4 869 13.8 1.5

Curb/sidewalk . . . . . . . . . . . . . . . 1,162 10.3 1.0 415 8.3 1.4 747 11.9 1.4

Furniture. . . . . . . . . . . . . . . . . . . 807 7.1 0.9 294 5.9 1.3 513 8.2 1.2

Playground equipment . . . . . . . . . . 493 4.4 0.7 246 4.9 1.1 247 3.9 0.8

Ladder/scaffolding . . . . . . . . . . . . . 447 4.0 0.7 327 6.5 1.3 *121 *1.9 0.6

Hole/opening . . . . . . . . . . . . . . . . 382 3.4 0.6 172 3.4 0.9 210 3.3 0.9

Other (specified)2 . . . . . . . . . . . . . 610 5.4 0.8 386 7.7 1.5 224 3.6 0.8

Other. . . . . . . . . . . . . . . . . . . . . 2,793 24.7 1.4 1,439 28.7 2.1 1,354 21.5 1.8

Refused/don’t know ............ *135 *1.2 0.5 *57 *1.1 0.7 *78 *1.2 0.6

. . . Category not applicable.

* Figure does not meet standard of reliability or precision.

1‘‘All types of falls mentioned’’ is greater than the total number of fall episodes because respondents could indicate up to two types of falls. 2‘‘Other (specified)’’ type of fall includes escalator, building, tree, toilet, bathtub, and pool.

NOTES: Only when fall was selected as the cause of the injury were respondents asked how the injured person fell. Therefore, the total number of fall episodes as shown in this table will not match

the total number of fall episodes based on the ICD–9–CM external cause codes. Percents are based on unrounded numbers.

Table 4. Number, percent, and standard error of transportation-related episodes by selected characteristics and sex: United States, 1997

Selected characteristic

Both sexes Male Female

Number

of episodes

in thousands Percent

Standard

error

Number

of episodes

in thousands Percent

Standard

error

Number

of episodes

in thousands Percent

Standard

error

Injured person1

Driver . . . . . . . . . . . . . . . . . . . . 2,530 58.0 2.2 1,414 57.2 3.2 1,116 59.0 3.6

Passenger . . . . . . . . . . . . . . . . . 1,195 27.4 2.2 552 22.3 2.9 643 34.0 3.5

Bicycle. . . . . . . . . . . . . . . . . . . . 439 10.1 1.5 422 17.1 2.6 *17 *0.9 0.7

Pedestrian . . . . . . . . . . . . . . . . . 123 2.8 0.8 *45 *1.8 0.7 *78 *4.1 1.5

Refused/don’t know . . . . . . . . . . . . *76 *1.8 0.7 *39 *1.6 0.9 *37 *2.0 1.0

Type of vehicle2

Passenger car . . . . . . . . . . . . . . . 2,559 68.7 2.9 1,174 59.7 4.1 1,385 78.8 3.3

Light truck. . . . . . . . . . . . . . . . . . 494 13.3 2.2 249 12.7 2.6 245 13.9 3.0

Motorcycle . . . . . . . . . . . . . . . . . 231 6.2 1.5 211 10.7 2.7 20 1.1 0.8

Large truck . . . . . . . . . . . . . . . . . *146 *3.9 1.2 *134 *6.8 2.0 *13 *0.7 0.7

Other (specified)3 . . . . . . . . . . . . . 192 5.2 1.3 130 6.6 1.9 *62 *3.5 1.6

Other. . . . . . . . . . . . . . . . . . . . . *102 *2.8 0.9 *69 *3.5 1.4 *34 *1.9 1.0

Refused/don’t know ............ – ... ... – ... ... – ... ...

Seat belt/child restraint4

Yes . . . . . . . . . . . . . . . . . . . . . . 2,506 78.3 2.7 1,154 74.1 3.9 1,353 82.4 3.4

No . . . . . . . . . . . . . . . . . . . . . . 663 20.7 2.7 387 24.8 3.9 276 16.8 3.3

Refused/don’t know . . . . . . . . . . . . *30 *1.0 0.6 *17 *1.1 0.8 *14 *0.8 0.6

Helmet use5

Yes . . . . . . . . . . . . . . . . . . . . . . 303 40.7 7.1 286 41.2 7.4 *17 *33.4 21.4

No . . . . . . . . . . . . . . . . . . . . . . 432 58.0 7.2 399 57.4 7.5 *33 *66.7 21.4

Refused/don’t know . . . . . . . . . . . . *10 *1.4 1.4 *10 *1.5 1.5 – ... ...

* Figure does not meet standard of reliability or precision.

– Quantity zero.

. . . Category not applicable.

1Only persons providing information about injury episodes caused by a vehicle as transportation were asked if the person involved was injured as a driver, passenger, bicycle rider, or pedestrian. 2Only persons providing information about injury episodes in which a person was injured as a driver or passenger of a vehicle were asked about the type of vehicle involved. 3Other types of vehicle included vehicles such as buses, all terrain vehicles, farm equipment, airplanes, and boats.

4Only persons providing information about injury episodes in which a person was injured as a driver or a passenger in a passenger car, light truck, or large truck were asked if the injured person was

wearing a seat belt or buckled in a safety seat.

5Only persons providing information about injury episodes in which a person was injured while riding a bicycle or motorcycle or all-terrain vehicle or ski/snowmobile were asked if the injured person

was wearing a helmet.

Series 10, No. 202 [ Page 19
Table 5. Number of poisoning episodes, number and percent of poisoning episodes involving a call to a poison control center, and

standard error by sex and age: United States, 1997

Sex and age

Poisonings Poison control center called

Number

of episodes

in thousands

Number

of episodes

in thousands Percent

Standard

error

Both sexes

All ages . . . . . . . . . . . . . . . . . . . . . . . . . . 1,945 877 45.1 4.3

Under 6 years . . . . . . . . . . . . . . . . . . . . . . 551 415 75.5 6.0

6 years and over. . . . . . . . . . . . . . . . . . . . . 1,394 461 33.1 4.9

Male

All ages . . . . . . . . . . . . . . . . . . . . . . . . . . 898 346 38.6 6.7

Under 6 years . . . . . . . . . . . . . . . . . . . . . . 212 155 72.9 9.9

6 years and over. . . . . . . . . . . . . . . . . . . . . 685 *191 *27.9 7.4

Female

All ages . . . . . . . . . . . . . . . . . . . . . . . . . . 1,047 531 50.7 5.5

Under 6 years . . . . . . . . . . . . . . . . . . . . . . 338 261 77.1 7.5

6 years and over. . . . . . . . . . . . . . . . . . . . . 709 270 38.1 6.4

* Figure does not meet standard of reliability or precision.

Page 20 [ Series 10, No. 202
Table 6. Annual rate and standard error of conditions by the nature of the injury and sex and age : United States, 1997

Sex and age

All conditions1 Sprains/strains Open wounds Fractures Contusions

Rate

per 1,000

population

Standard

error

Rate

per 1,000

population

Standard

error

Rate

per 1,000

population

Standard

error

Rate

per 1,000

population

Standard

error

Rate

per 1,000

population

Standard

error

Both sexes

All. . . . . . . . . . . . . . . . . . . . . . . 153.6 3.4 38.6 1.5 29.3 1.3 23.4 1.0 18.7 1.1

All, age adjusted. . . . . . . . . . . . . . 153.7 3.4 38.5 1.5 29.0 1.3 23.7 1.0 19.0 1.2

Under 12 years . . . . . . . . . . . . . . 118.9 6.4 8.7 1.5 41.9 3.5 18.5 2.1 12.3 1.9

12–21 years ................ 197.3 10.7 58.4 4.8 40.5 4.4 31.1 3.3 20.7 3.3

22–44 years ................ 167.5 6.3 52.0 3.0 29.0 2.3 19.7 1.7 17.2 2.0

45–64 years ................ 120.7 7.0 36.7 3.1 14.1 2.0 19.5 2.3 14.6 2.3

65 years and over............. 169.1 9.8 24.0 3.0 24.1 3.2 39.2 4.3 37.2 4.9

Male

All. . . . . . . . . . . . . . . . . . . . . . . 168.5 5.3 39.9 2.2 40.3 2.2 25.1 1.6 16.4 1.5

All, age adjusted. . . . . . . . . . . . . . 167.0 5.4 39.3 2.2 39.2 2.1 25.5 1.7 16.7 1.6

Under 12 years .............. 134.8 9.3 11.1 2.4 54.2 5.1 15.6 2.7 13.7 2.8

12–21 years ................ 260.4 17.0 67.9 7.2 67.9 8.3 43.2 5.5 24.8 5.0

22–44 years ................ 192.8 9.2 53.9 4.3 38.3 3.6 25.3 3.0 15.2 2.3

45–64 years . . . . . . . . . . . . . . . . 115.2 10.4 33.6 4.3 20.3 3.5 17.9 3.6 12.5 3.1

65 years and over. . . . . . . . . . . . . 118.7 14.6 16.1 3.5 21.1 4.4 29.3 5.9 21.4 5.6

Female

All. . . . . . . . . . . . . . . . . . . . . . . 139.3 4.5 37.3 2.1 18.8 1.3 21.8 1.4 20.9 1.7

All, age adjusted. . . . . . . . . . . . . . 138.5 4.5 37.4 2.1 18.6 1.3 21.7 1.4 20.6 1.7

Under 12 years .............. 102.4 8.1 6.1 1.7 29.0 4.4 21.6 3.1 10.8 2.5

12–21 years ................ 131.4 13.9 48.5 6.9 11.9 3.1 18.5 3.8 16.5 3.8

22–44 years ................ 142.8 8.5 50.1 4.2 19.9 2.8 14.2 2.1 19.3 3.0

45–64 years ................ 125.8 9.0 39.5 4.7 8.3 1.8 21.0 3.1 16.5 3.4

65 years and over............. 205.7 14.5 29.7 4.5 26.3 4.3 46.4 6.0 48.8 7.4

* Figure does not meet standard of reliability or precision.

1Poisoning episodes are assumed to have a single condition resulting from the episode.

NOTES: There may be more than one condition per episode. See appendix III for ICD–9–CM diagnosis codes in category.

Series 10, No. 202 [ Page 21
Table 7. Annual rate and standard error of injury conditions by body region injured and sex and age: United States, 1997

Sex and age

Upper extremity Lower extremity Spine/back Face Skull/brain

Rate

per 1,000

population

Standard

error

Rate

per 1,000

population

Standard

error

Rate

per 1,000

population

Standard

error

Rate

per 1,000

population

Standard

error

Rate

per 1,000

population

Standard

error

Both sexes

All. . . . . . . . . . . . . . . . . . . . . . . 43.2 1.6 40.1 1.4 19.8 1.1 15.3 0.8 8.7 0.6

All, age adjusted. . . . . . . . . . . . . . 43.2 1.6 40.3 1.4 19.8 1.1 15.1 0.8 8.6 0.6

Under 12 years . . . . . . . . . . . . . . 27.4 2.6 21.7 2.3 2.8 0.8 30.2 3.0 14.4 1.9

12–21 years . . . . . . . . . . . . . . . . 68.7 5.0 60.9 5.0 17.0 2.5 16.6 2.7 12.9 2.7

22–44 years . . . . . . . . . . . . . . . . 46.7 2.8 40.3 2.3 31.6 2.5 12.0 1.4 6.4 1.0

45–64 years . . . . . . . . . . . . . . . . 30.3 3.0 38.2 3.2 19.7 2.2 5.7 1.1 3.9 0.9

65 years and over. . . . . . . . . . . . . 48.2 4.3 45.4 4.1 14.0 2.5 17.2 2.8 9.7 1.9

Male

All. . . . . . . . . . . . . . . . . . . . . . . 51.2 2.3 38.8 2.2 20.0 1.5 18.9 1.3 10.8 1.0

All, age adjusted. . . . . . . . . . . . . . 51.0 2.3 38.4 2.2 20.0 1.6 18.4 1.3 10.5 1.0

Under 12 years . . . . . . . . . . . . . . 26.9 3.5 25.1 3.9 *4.2 1.4 34.1 4.1 21.4 3.2

12–21 years . . . . . . . . . . . . . . . . 95.9 8.1 73.0 7.9 18.4 3.5 27.9 5.0 16.5 3.3

22–44 years . . . . . . . . . . . . . . . . 58.8 4.2 40.8 3.7 32.7 3.3 15.9 2.4 8.1 1.5

45–64 years . . . . . . . . . . . . . . . . 32.6 4.6 31.8 4.2 17.6 2.8 7.5 2.0 *3.9 1.3

65 years and over. . . . . . . . . . . . . 41.0 6.5 21.1 4.1 *11.9 3.9 *11.1 4.1 *6.3 2.4

Female

All. . . . . . . . . . . . . . . . . . . . . . . 35.6 1.9 41.3 1.9 19.6 1.5 11.8 1.0 6.6 0.9

All, age adjusted. . . . . . . . . . . . . . 35.4 1.9 41.2 1.9 19.5 1.5 11.6 1.0 6.6 0.9

Under 12 years . . . . . . . . . . . . . . 27.8 3.7 18.2 2.8 *1.3 0.8 26.1 4.1 7.1 1.9

12–21 years . . . . . . . . . . . . . . . . 40.3 6.2 48.2 6.0 15.6 3.7 *4.7 1.6 *9.0 4.3

22–44 years . . . . . . . . . . . . . . . . 35.0 3.4 39.7 3.4 30.6 3.2 8.2 1.4 4.7 1.2

45–64 years . . . . . . . . . . . . . . . . 28.3 3.5 44.3 4.3 21.7 3.2 4.1 1.2 *4.0 1.3

65 years and over. . . . . . . . . . . . . 53.5 6.2 63.1 6.6 15.5 3.4 21.6 3.8 12.2 2.7

* Figure does not meet standard of reliability or precision.

NOTES: There may be more than one body part injured per episode. See appendix III for ICD–9–CM diagnosis codes in category.

Page 22 [ Series 10, No. 202
Table 8. Number, percent, and standard error of injury episodes by place of occurrence, activity engaged in, and sex: United States, 1997

Activity and place

Both sexes Male Female

Number

of episodes

in thousands Percent

Standard

error

Number

of episodes

in thousands Percent

Standard

error

Number

of episodes

in thousands Percent

Standard

error

All injury episodes . . . . . . . . . . . . . 32,438 100.0 . . . 17,646 100.0 . . . 14,792 100.0 . . .

Place

All places mentioned1 . . . . . . . . . . 32,900 101.4 . . . 17,911 101.5 . . . 14,989 101.3 . . .

Home (inside) . . . . . . . . . . . . . . . 7,832 24.1 0.9 3,098 17.6 1.1 4,734 32.0 1.5

Home (outside) . . . . . . . . . . . . . . 5,760 17.8 0.7 3,074 17.4 1.0 2,686 18.2 1.2

Street/highway . . . . . . . . . . . . . . . 4,220 13.0 0.7 2,293 13.0 0.9 1,927 13.0 1.0

Sport facility . . . . . . . . . . . . . . . . 2,369 7.3 0.5 1,716 9.7 0.8 653 4.4 0.6

Industrial/construction. . . . . . . . . . . 2,191 6.8 0.5 1,866 10.6 0.8 325 2.2 0.4

School . . . . . . . . . . . . . . . . . . . . 1,991 6.1 0.5 1,315 7.5 0.7 676 4.6 0.6

Trade/service. . . . . . . . . . . . . . . . 1,986 6.1 0.5 1,095 6.2 0.7 892 6.0 0.7

Park/recreation area . . . . . . . . . . . 1,289 4.0 0.4 866 4.9 0.6 423 2.9 0.5

Other public building . . . . . . . . . . . 920 2.8 0.3 447 2.5 0.4 473 3.2 0.5

Other (specified)2 . . . . . . . . . . . . . 2,414 7.4 0.5 999 5.7 0.6 1,415 9.6 1.0

Other. . . . . . . . . . . . . . . . . . . . . 1,603 4.9 0.4 981 5.6 0.6 622 4.2 0.6

Refused/don’t know . . . . . . . . . . . . 324 1.0 0.2 161 0.9 0.3 163 1.1 0.3

Activity

All activities mentioned1 . . . . . . . . . 33,060 101.9 . . . 18,069 102.4 . . . 14,991 101.3 . . .

Leisure. . . . . . . . . . . . . . . . . . . . 7,169 22.1 0.9 3,876 22.0 1.1 3,293 22.3 1.3

Working paid job. . . . . . . . . . . . . . 6,266 19.3 0.8 4,195 23.8 1.1 2,071 14.0 1.1

Sports . . . . . . . . . . . . . . . . . . . . 4,458 13.7 0.7 3,233 18.3 1.1 1,225 8.3 0.9

Working (house/yard). . . . . . . . . . . 3,363 10.4 0.6 1,521 8.6 0.8 1,842 12.5 1.0

Driving . . . . . . . . . . . . . . . . . . . . 2,432 7.5 0.5 1,301 7.4 0.7 1,131 7.7 0.7

Attending school. . . . . . . . . . . . . . 915 2.8 0.3 557 3.2 0.5 358 2.4 0.5

Unpaid work . . . . . . . . . . . . . . . . 960 3.0 0.3 420 2.4 0.4 540 3.7 0.5

Other (specified)3 . . . . . . . . . . . . . 1,611 5.0 0.4 564 3.2 0.5 1,047 7.1 0.7

Other. . . . . . . . . . . . . . . . . . . . . 5,542 17.1 0.8 2,242 12.7 0.9 3,301 22.3 1.3

Refused/don’t know . . . . . . . . . . . . 343 1.1 0.2 160 0.9 0.3 183 1.2 0.3

. . . Category not applicable.

1‘‘All places mentioned’’ and ‘‘All activities mentioned’’ are greater than the total number of injury episodes because respondents could indicate up to two places or activities. 2‘‘Other (specified)’’ place includes child care center or preschool, residential institution, health care facility, parking lot, farm, river, lake, stream, ocean, swimming pool, and mine or quarry. 3‘‘Other (specified)’’ activity includes sleeping, resting, eating, drinking, cooking, and being cared for.

NOTES: Percents are calculated based on the sex-specific total number of injury episodes and are also based on unrounded numbers.

Series 10, No. 202 [ Page 23
Table 9. Number, percent, and standard error of injury and poisoning episodes involving hospitalization by sex and age: United States, 1997

Sex and age

Hospitalized

Number

of episodes

in thousands

Percent

hospitalized

Standard

error

Both sexes

All ages . . . . . . . . . . . . . . . . . . . . . . . . . . 2,466 7.2 0.5

Under 22 years. . . . . . . . . . . . . . . . . . . . . . 506 4.2 0.7

22–64 years. . . . . . . . . . . . . . . . . . . . . . . . 1,335 7.3 0.7

65 years and over . . . . . . . . . . . . . . . . . . . . 625 14.8 2.1

Male

All ages . . . . . . . . . . . . . . . . . . . . . . . . . . 1,395 7.5 0.7

Under 22 years. . . . . . . . . . . . . . . . . . . . . . 350 4.7 0.8

22–64 years. . . . . . . . . . . . . . . . . . . . . . . . 837 8.5 1.1

65 years and over . . . . . . . . . . . . . . . . . . . . 209 17.4 4.1

Female

All ages . . . . . . . . . . . . . . . . . . . . . . . . . . 1,071 6.8 0.8

Under 22 years. . . . . . . . . . . . . . . . . . . . . . 156 3.5 1.0

22–64 years. . . . . . . . . . . . . . . . . . . . . . . . 498 6.0 0.9

65 years and over . . . . . . . . . . . . . . . . . . . . 417 13.8 2.3

Table 10. Number, annual rate, and standard error of injury and poisoning episodes resulting in time lost from work or school:

United States, 1997

Time lost

Number

of episodes

in thousands

Rate

per 1,000

population

Standard

error

Time lost from school1

Any time lost . . . . . . . . . . . . . . . . . . . . . . . 2,777 36.2 2.5

Less than 1 day . . . . . . . . . . . . . . . . . . . . 616 8.0 1.1

1–5 days . . . . . . . . . . . . . . . . . . . . . . . . 1,807 23.6 2.2

6 days or more . . . . . . . . . . . . . . . . . . . . 354 4.6 0.8

Time lost from work2

Any time lost . . . . . . . . . . . . . . . . . . . . . . . 10,054 50.6 1.8

Less than 1 day . . . . . . . . . . . . . . . . . . . . 1,669 8.4 0.7

1–5 days . . . . . . . . . . . . . . . . . . . . . . . . 4,635 23.3 1.2

6 days or more . . . . . . . . . . . . . . . . . . . . 3,750 18.9 1.2

1For persons ages 5–24 years. 2For persons 14–75 years.

Page 24 [ Series 10, No. 202
Table 11. Number, percent, and standard error of injury episodes by whether persons required help with daily routine activities or personal

care and sex and age: United States, 1997

Sex and age

Needs help with daily routine activities1 Needs help with personal care2

Number

of episodes

in thousands Percent

Standard

error

Number

of episodes

in thousands Percent

Standard

error

Both sexes

All injury episodes, ages 5 years and over . . . . . 2,232 7.3 0.5 1,785 5.8 0.5

5–21 years . . . . . . . . . . . . . . . . . . . . . . . . 217 2.3 0.6 361 3.9 0.7

22–64 years. . . . . . . . . . . . . . . . . . . . . . . . 1,158 6.7 0.7 673 3.9 0.5

65 years and over . . . . . . . . . . . . . . . . . . . . 856 21.2 2.3 751 18.5 2.3

Male

All injury episodes, ages 5 years and over. . . . . 780 4.7 0.6 732 4.4 0.6

5–21 years ........................ *136 *2.2 0.7 200 3.3 0.8

22–64 years. . . . . . . . . . . . . . . . . . . . . . . . 397 4.2 0.8 278 3.0 0.6

65 years and over . . . . . . . . . . . . . . . . . . . . 247 21.3 4.8 254 21.9 4.7

Female

All injury episodes, ages 5 years and over . . . . . 1,452 10.4 0.9 1,052 7.5 0.8

5–21 years . . . . . . . . . . . . . . . . . . . . . . . . *81 *2.5 1.0 161 5.0 1.3

22–64 years. . . . . . . . . . . . . . . . . . . . . . . . 761 9.6 1.2 394 5.0 0.9

65 years and over . . . . . . . . . . . . . . . . . . . . 609 21.1 2.6 496 17.2 2.5

* Figure does not meet standard of reliability or precision.

1Daily routine activities includes such things as household chores, doing necessary business, shopping, or getting around for other purposes.

2Personal care needs includes such things as eating, bathing, dressing, or getting around the house.

NOTE: The limitation questions were not asked for persons less than 5 years old.

Series 10, No. 202 [ Page 25
Appendix I

NHIS questionnaire, Family Core: Section II—Injuries

Section II—INJURIES

Injuries are a major health problem. In order to develop new ways to help prevent both accidental and intentional injuries, we

need to know more about them. In this next set of questions, I will ask about injuries that happened in the past 3 months; Note

here that we are only interested in injuries that required medical advice or treatment.

FIJ.010 DURING THE PAST THREE MONTHS, that is since {91 days before today date}, {were/was} {you/anyone in

the family} injured seriously enough that {you/they} got medical advice or treatment?

>FINJ3M< (1) Yes (FIJ.020) (7) Refused (FIJ.300)

(2) No (FIJ.300) (9) DK (FIJ.300)

FIJ.020 Who was this? (Anyone else?)

>PINJ3MR< [] [] []

[] [] []

FIJ.030 How many different times in the past three months {were/was} {you/subject’s name} injured seriously enough to

seek medical advice?

>IJNO3M< Times Injured (01–94):

FIJ.040 [If FIJ.030 equals 1, ask:]

When did {subject’s name} injury happen?

>IJDATE_M< MONTH:

>IJDATE_D< DAY:

>IJDATE_Y< YEAR:

[If FIJ.030 greater than 1, ask:]

Now I’ m going to ask a few question about{subject’s name} most recent injury. When did that injury happen?

>IJDATE_M< MONTH:

>IJDATE_D< DAY:

>IJDATE_Y< YEAR:

[If FIJ.030 equals 2 or more, ask:]

We just talked about {subject’s name} injury on {recent injury date}. When did {subject’s name} injury

BEFORE THAT happen?

>IJDATE_M< MONTH:

>IJDATE_D< DAY:

>IJDATE_Y< YEAR:

[FIJ.051 to FIJ.295 are asked for each injury episode]

FIJ.050 At the time of the injury, what part(s) of {subject’s name} body was hurt? What kind of injury was it? Anything

else?

BODY PART KIND OF INJURY

>IJBODY1< >IJKIND1<

>IJBODY2< >IJKIND2<

>IJBODY3< >IJKIND3<

>IJBODY4< >IJKIND4<

Page 26 [ Series 10, No. 202
FIJ.070 How did {subject’s name} injury(s) happen? Please describe fully the circumstances or events leading to the

injury(s), and any object, substance, or other person involved.

FR: ENTER THE VERBATIM RESPONSE, PROBING FOR AS MUCH DETAIL AS POSSIBLE,

INCLUDING SPECIFICALLY WHAT THE INJURED PERSON WAS DOING AT THE TIME AND ALL

CIRCUMSTANCES SURROUNDING THE EVENT. RECORD ALL VOLUNTEERED INFORMATION.

>IJHOW1<

>IJHOW2<

>IJHOW3<

>IJHOW4<

FIJ.080

FR: ENTER THE FIRST APPROPRIATE BOX WHICH DESCRIBES THE CAUSE OF THE PERSON’S

INJURY FROM THE LIST BELOW.

>CAUS< (1) Vehicle as transportation, including Motor Vehicle/ (5) Fall (FIJ.170)

bicycle/motorcycle/pedestrian/train/boat/airplane(FIJ.090) (6) Other (FIJ.200)

(2) Gun/being shot (FIJ.190) (7) Refused (FIJ.200)

(3) Fire/burn/scald related (FIJ.150) (9) DK (FIJ.200)

(4) Near drowning/water in lungs (FIJ.160)

FR: THE NEXT SET OF QUESTIONS ARE ASKED TO VERIFY DETAILS OF THE CIRCUMSTANCES

SURROUNDING THE INJURY(S). IF YOU ALREADY KNOW THE ANSWER BECAUSE OF THE

VERBATIM RESPONSE FOR HOW THE INJURY(S) OCCURRED, VERIFY THE ANSWER WITH

THE RESPONDENT. OTHERWISE, ASK THE QUESTION.

FIJ.090 {Were/Was} {you/subject’s name} injured as the driver of a vehicle, a passenger in a vehicle, a bicycle rider, or

as a pedestrian?

>MVWHO< (1) Driver of a vehicle (FIJ.100) (4) Pedestrian (FIJ.140)

(2) Passenger of a vehicle (FIJ.100) (7) Refused (FIJ.200)

(3) Bicycle rider (FIJ.130) (9) DK (FIJ.200)

FIJ.100 What type of vehicle {were/was} {you/subject’s name} in?

>MVTYP< (01) Passenger car (FIJ.120) (07) Farm equipment (tractor) (FIJ.200)

(02) Light truck (including pickups, (08) Airplane (FIJ.200)

vans and utility vehicles) (FIJ.120) (09) Boat (FIJ.200)

(03) Bus (FIJ.200) (10) Train (FIJ.200)

(04) Large truck (FIJ.120) (11) Other (FIJ.200)

(05) Motorcycles (including mopeds, (97) Refused (FIJ.200)

minibikes) (FIJ.130) (99) DK (FIJ.200)

(06) All terrain vehicle or ski/snow-mobile

FIJ.120 [If AGE is greater than or equal to 5, ask:]

{Were/Was} {you/subject’s name} wearing a safety belt at the time of the accident?

[Else, ask:]

{Were/Was} {you/subject’s name} buckled in a car safety seat at the time of the accident?

>SBELT< (1) Yes (7) Refused

(2) No (9) DK

(Goto FIJ.200)

(FIJ.130) {Were/Was}{you/subject’s name} wearing a helmet at the time of the accident?

>HELMT< (1) Yes (7) Refused

(2) No (9) DK

(Goto FIJ.200)

Series 10, No. 202 [ Page 27
FIJ.140 What type of vehicle {were/was} {you/subject’s name} struck by?

>MVHIT< (01) Passenger car (07) Farm equipment (tractor)

(02) Light truck (including pickups, (08) Bicycle

vans and utility vehicles) (09) Train

(03) Bus (10) Boat (includes all on)

(04) Large truck water vehicles

(05) Motorcycle (including mopeds (11) Other

and minibikes) (97) Refused

(06) All terrain vehicle or ski or (99) DK

snow-mobile

(Goto FIJ.200)

FIJ.150 What was it that burned/scalded {you/subject’s name}?

FR: IF RESPONSE IS FIRE OR SMOKE ASK:

What caused the fire/smoke?

>BURN< (01) Cigarette, cigar, pipe (07) Other explosive

(02) Cooking unit (08) Water or steam

(03) Heater (09) Food

(04) Wiring (10) Chemicals

(05) Motor vehicle battery caps, (11) Other

radiator caps (97) Refused

(06) Fireworks (99) DK

(Goto FIJ.200)

FIJ.160 What body of water was involved?

>WATER< (1) Bathtub (5) River, creek

(2) Swimming pool (6) Other

(3) Lake, pond (7) Refused

(4) Bay, ocean, sea (9) DK

(Goto FIJ.200)

FIJ.170 How did {you/subject’s name} fall? Anything else?

FR: HAND CARD F4. RECORD UP TO 2 RESPONSES. ENTER ’N’ FOR NO MORE.

On or down or from:

>FALL< (1) Escalator (7) Building or other structure

(2) Stairs or steps (8) Chair, bed, sofa or other furniture

(3) Floor/level ground (9) Tree

(4) Curb, including sidewalk (10) Toilet, commode

(5) Ladder or scaffolding (11) Bathtub, shower

(6) Playground equipment

Into:

(12) Swimming pool (97) Refused

(13) Hole or other opening (99) DK

(14) Other

[] []

FIJ.180 What caused {you/subject’s name} to fall? Was it due to:

>FWHY< (1) Slipping, tripping or stumbling (5) Or something else

(2) Jumping or diving (7) Refused

(3) Collision with/pushing, shoving (9) DK

by another person

(4) Loss of balance/dizziness/becoming faint/seizure

(Goto FIJ.200)

Page 28 [ Series 10, No. 202
FIJ.190 What kind of gun was it?

<GUNTP> (1) Firearm (handgun, shotgun, rifle) (4) Other

(2) BB or pellet gun (7) Refused

(3) Dart gun (9) DK

FIJ.200 What {were/was} {you/subject’s name} doing when the injury(s) happened?

FR: HAND CARD F5. RECORD UP TO 2 RESPONSES. ENTER ’N’ FOR NO MORE.

>WHAT< (1) Driving (7) Leisure activity (excluding sports)

(2) Working at paid job (8) Sleeping, resting, eating, drinking

(3) Working around the house or yard (9) Cooking

(4) Attending school (10) Being cared for (hands on care from

(5) Unpaid work (incl. housework, other person)

shopping, volunteer work) (11) Other

(6) Sports (organized team or individual (97) Refused sport

such as running, biking, skating) (99) DK

[] []

FIJ.220 Where {were/was} {you/subject’s name} when the injury(s) happened?

FR: HAND CARD F6. RECORD UP TO 2 RESPONSES. ENTER ’N’ FOR NO MORE.

>WHER< (1) Home (inside) (11) Farm

(2) Home (outside) (12) Park/recreation area (fields, bike

(3) School (not residential) or jog path),

(4) Child care center or Preschool (13) River/lake/stream/ocean

(5) Residential institution (excl. hosp.) (14) Swimming pool

(6) Health care facility (incl. hospital) (15) Industrial or construction area

(7) Street/highway (16) Mine/quarry

(8) Parking lot (17) Other public building

(9) Sport facility, ath. field or playground (18) Other

(10) Trade and service areas (restaurant, (97) Refused

store, bank, gas station) (99) DK

[] []

(Goto FIJ.250)

FIJ.240 {Were/Was} {you/subject’s name} hospitalized for at least one night as a result of this injury/these injuries?

>IHOSP< (1) Yes (FIJ.250) (7) Refused (FIJ.260)

(2) No (FIJ.260) (9) DK (FIJ.260)

FIJ.250 How many nights {were/was} {you/subject’s name} in the hospital?

FR: IF ‘‘STILL IN HOSPITAL,’’ ASK HOW MANY NIGHTS UP TO TODAY.

>IHNO< (01–94) 1–94 nights (97) Refused

(95) 95+ nights (99) DK

Check item FIJCCI1: If AGE is greater than 13 then go to FIJ.260; Else

If AGE is greater than 4 and less than 14 then go to FIJ.270; Else

If AGE is less than 5 then return to FIJ.040 for next injury event or next person.

If there are no more persons and no more injuries-events, go to FIJ.300.

FIJ.260 As a result of this injury/these injuries, how much work did {you/subject’s name} miss?

FR: HAND CARD F7.

>WKLS< (0) None (6) Not employed at the time of the injury

(1) Less than 1 day (7) Refused

(2) 1 to 5 days (9) DK

(3) Six or more days

Series 10, No. 202 [ Page 29
FIJ.270 As a result of this injury/these injuries, how much school did {you/subject’s name} miss?

FR: HAND CARD F8.

>SCLS< (0) None (6) Not in school at the time of the injury

(1) Less than 1 day (7) Refused

(2) One to five days (9) DK

(3) Six or more days

FIJ.280 As a result of this injury/theses injuries {do/does} {you/subject’s name} now need the help of other persons with

{your/his/her} personal care needs, such as eating, bathing, dressing or getting around this home?

>IJADL< (1) Yes (FIJ.285) (7) Refused (FIJ.290

(2) No (FIJ.290) (9) DK (FIJ.290)

FIJ.285 Do you expect {you/subject’s name} will need this help for a total of 6 months or longer?

>LIMTM< (1) Yes (7) Refused

(2) No (9) DK

FIJ.290 As a result of this injury/these injuries {do/does} {you/subject’s name} now need the help of other persons in

handling routine needs such as everyday household chores, doing necessary business, shopping or getting around

for other purposes?

>IJIAD< (1) Yes (FIJ.295) (7) Refused (FIJ.040/FIJ.300)

(2) No (FIJ.040/FIJ.300) (9) DK (FIJ.040/FIJ.300)

FIJ.295 Do you expect {you/subject’s name} will need this help for a total of 6 months or longer?

>HLIMT< (1) Yes (FIJ.040/FIJ.300) (7) Refused (FIJ.040/FIJ.300

(2) No (FIJ.040/FIJ.300) (9) DK (FIJ.040/FIJ.300)

FIJ.300 The next questions are about POISONING, which includes coming into contact with harmful substances, and

overdose or wrong use of any drug or medication. Do not include any illnesses such as poison ivy or food

poisoning.

FR: HAND CALENDAR CARD.

DURING THE PAST THREE MONTHS, that is since {91 days before today’s date}, did {you/anyone in the

family} have a poisoning that caused someone to seek medical advice or treatment, including calls to a poison

control center?

>FPOIS3M< (1) Yes (FIJ.310 (7) Refused (FAU.010)

(2) No (FAU.010) (9) DK (FAU.010)

FIJ.310 Who was this? (Anyone else?)

>PPOIS3MR< [] [] []

[] [] []

FIJ.320 How many different times in the PAST THREE MONTHS {were/was} {you/subject’s name} poisoned?

(01–94) 1–94 times (97) Refused

(95) 95+ times (99) DK

FIJ.330 [If FIJ.320 equals 1, ask:]

When did {subject’s name} poisoning happen?

>POIDTEM< MONTH:

>POIDTED< DAY:

>POIDTEY< YEAR:

[If FIJ.320 is greater than 1, ask:]

Now I’ m going to ask a few question about {subject’s name} most recent poisoning. When did that happen?

Page 30 [ Series 10, No. 202
>POIDTEM< MONTH:

>POIDTED< DAY:

>POIDTEY< YEAR:

[IF FIJ.320 is greater than or equal to 2, ask:]

We just talked about {subject’s name} poisoning on {recent poisoning}. When did {subject’s name} poisoning

BEFORE THAT happen?

>POIDTEM< MONTH:

>POIDTED< DAY:

>POIDTEY< YEAR:

[FIJ.340 to FIJ.410 are repeated for each poisoning episode.]

FIJ.340 Did {you/subject’s name} poisoning result from:

>POITPR2< (1) a drug or medical substance used mistakenly or in overdose (FIJ.360)

(2) a harmful or toxic solid or liquid substance (FIJ.360)

(3) inhaling gases or vapors (FIJ.360)

(4) eating a poisonous plant or other substance mistaken for food (FIJ.360)

(5) a venomous animal or plant (FIJ.360)

(6) something else (FIJ.350)

(7) Refused (FIJ.360)

(9) DK (FIJ.360)

FIJ.350

FR: ENTER THE VERBATIM RESPONSE.

>PSPEC_1<

>PSPEC_2<

>PSPEC_3<

>PSPEC_4<

FIJ.360 Did you or did someone else call a poison control center for advice in treating {subject’s name} poisoning?

>POICC< (1) Yes (7) Refused

(2) No (9) DK

FIJ.370 {Were/Was} {you/subject’s name} hospitalized for at least one night as a result of this poisoning?

>PHOSP< (1) Yes (FIJ.380) (7) Refused (FIJ.390)

(2) No (FIJ.390) (9) DK (FIJ.390)

FIJ.380 How many nights {were/was} {you/subject’s name} in the hospital?

FR: IF ‘‘STILL IN HOSPITAL,’’ ASK HOW MANY NIGHTS UP TO TODAY.

>PHNO< (01–94) 1–94 nights (97) Refused

(95) 95+ nights (99) DK

Check item FIJCCI2: If AGE greater than 13 then go to FIJ.400; Else

If AGE greater than 4 and less than 14 then go to FIJ.410; Else

If AGE less than 5 then return to FIJ.330 for the next poisoning event or the next person.

If there are no more persons and no more poisoning events, go to FAU.010.

FIJ.400 As a result of this poisoning, how much work did {you/subject’s name} miss?

FR: HAND CARD F7.

>PWKLS< (0) None (6) Not employed at the time of poisoning

(1) Less than 1 day (7) Refused

(2) One to five days (9) DK

(3) Six or more days

Series 10, No. 202 [ Page 31
FIJ.410 As a result of this poisoning, how many days of school did {you/subject’s name} miss?

FR: HAND CARD F8.

>PSCLS< (0) None (6) Not in school at the time of poisoning

(1) Less than 1 day (7) Refused

(2) One to five days (9) DK

(3) Six or more days

(Goto next section—Health Care Access and Utilization)

Page 32 [ Series 10, No. 202
Appendix II

Matrix for External Cause of Injury Mortality and Morbidity Data

Mechanism or cause

Manner or intent

Unintentional

Suicide/

self-inflicted

Homicide/

Assault Undetermined Other

Cut/pierce . . . . . . . . . . . . . . . . . . E920.0–.9 E956 E966 E986 E974

Drowning/submersion ........... E830.0–.9, 832.0–.9, 910.0–.9 E954 E964 E984 . . .

Fall . . . . . . . . . . . . . . . . . . . . . . . E880.0–886.9, 888 E957.0–.9 E968.1 E987.0–.9 . . .

Fire/hot object or substance ....... E890.0–899, 924.0–.9 E958.1,.2,.7 E961, 968.0, .3 E988.1,.2,.7 . . .

Fire/flame . . . . . . . . . . . . . . . . . E890.0–899 E958.1 E968.0 E988.1 . . .

Hot object/scald ............. E924.0–.9 E958.2,.7 E961, 968.3 E988.2,.7 . . .

Firearm . . . . . . . . . . . . . . . . . . . . E922.0–.9 E955.0–.4 E965.0–.4 E985.0–.4 E970

Machinery .................. E919.0–.9 . . . . . . . . . . . .

Motor vehicle traffic ............. E810–819 (.0–.9) E958.5 E968.5 E988.5 . . .

Occupant ................. E810–819 (.0,.1) . . . . . . . . . . . .

Motorcyclist . . . . . . . . . . . . . . . . E810–819 (.2,.3) . . . . . . . . . . . .

Pedal cyclist ................ E810–819 (.6) . . . . . . . . . . . .

Pedestrian ................. E810–819 (.7) . . . . . . . . . . . .

Unspecified . . . . . . . . . . . . . . . . E810–819 (.9) . . . . . . . . . . . .

Pedal cyclist, other ............. E800–807 (.3), E820–825 (.6),

E826 (1,.9), 827–829 (.1)

... ... ... ...

Pedestrian, other .............. E800–807 (.2), 820–825 (.7),

E826–829 (.0)

... ... ... ...

Transport, other ............... E800–807 (.0–.1,.8–.9),

E820–825 (.0–5,.8–9),

E826 (.2–8), 827–829, (.2–.9)

E831.0–9, 833.0–845.9

E958.6 . . . E988.6 . . .

Natural/environmental factors ...... E900.0–909, 928.0–.2 E958.3 . . . E988.3 . . .

Bites and stings . . . . . . . . . . . . . E905.0–.6,.9, 906.0–.4, .5, .9 . . . . . . . . .

Overexertion ................. E927 . . . . . . . . . . . .

Poisoning ................... E850.0–869.9 E950.0–952.9 E962.0–.9 E980.0–982.9 E972

Struck by, against .............. E916–917.9 . . . E960.0, 968.2 . . . E973, 975

Suffocation . . . . . . . . . . . . . . . . . . E911–913.9 E953.0–.9 E963 E983.0–.9 . . .

Other specified and classifiable . . . . . E846–848, 914–915, 918,

E921.0–.9, 923.0–.9,

E925.0–926.9, 929.0–.5

E955.5,.9, 958.0,.4 E960.1, 965.5–.9,

E967.0–.9, 968.4

E985.5, 988.0,.4 E971, 978

E990–994, 996,

E997.0–.2

Other specified, NEC1 ........... E928.8, 929.8 E958.8, 959 E968.8, 969 E988.8, 989 E995, 997.8, 977,

E998–999

Unspecified . . . . . . . . . . . . . . . . . . E887, 928.9, 929.9 E958.9 E968.9 E988.9 E976, 997.9

All injury2 ................... E800–869, 880–929 E950–959 E960–969 E980–989 E970–978

E990–999

1Not elsewhere classifiable. 2Excludes fatal and nonfatal events caused by adverse events (E-codes E870–E879 and E930–E949).

NOTE: E968.5 and E906.5 are the only codes that are singled out that are in ICD–9–CM but not in ICD-9. All of the other codes that are in CM only are folded into larger groupings in the matrix.

Series 10, No. 202 [ Page 33
Appendix III

Injury Morbidity Matrix

Codes for Body Region of Injury

Please note: the following list can be used if ICD is coded to the 4th digit; if only 3-digit codes are available

follow instructions next to **.

1. Skull and Brain: excl. face(1,2) 800–801, 803–804

(incl. scalp) 850–854

873.0–873.1 ** Code 873 under Other

873.8–873.9 ** Code 873 under Other

951

2. Face 802

830

848.0–848.1 ** Code 848 under Other

870–872

873.2–873.7 ** Code 873 under Other

910

918

920–921

925.1 ** Code 925 under Other

940

947.0 ** Code 947 under Other

950

Head (1,2) 800–804

(Skull & Brain & Face) 850–854

870–73

830

848.0–848.1 ** Code 848 under Other

910

918

920–921

925.1 ** Code 925 under Other

940

947.0 ** Code 947 under Other

950–951

3. Neck (2,3,5,8) 807.5–807.6 **Code 807 under Thorax

848.2 **Code 848 under Other

874

900

925.2 **Code 925 under Other

947.1

**Code 947 under Other

4. Thorax (4,5) 807.0–807.4 **Code 807 under Thorax

848.3–848.4 **Code 848 under Other

860–862

875

879.0–879.1 **Code 879 under Other

901

922.0–922.1 **Code 922 under Other

947.2 **Code 947 under Other

5. Abdomen, pelvic contents, genital organs 863–868

878

879.2–879.5 **Code 879 under Other

902

922.2 **Code 922 under Other

922.4 **Code 922 under Other

926.0 **Code 926 under Other

947.3–947.4 **Code 947 under Other

See footnotes at end of table.

Page 34 [ Series 10, No. 202
Please note: the following list can be used if ICD is coded to the 4th digit; if only 3-digit codes are available

follow instructions next to **.

6. Spine and Back (6,7,8) 805

806

876–877

922.3 **Code 922 under Other

839.0–839.5 **Code 839 under Other

847

952–953

7. Upper Extremity 810–818

831–834

840–42

880–887

903

912–915

923

927

943–944

955

959.2–959.5 **Code 959 under Other

8. Lower Extremity and Bony Pelvis(6) 808

821–27

835–838

843–845

846

848.5 **Code 848 under Other

890–897

904

916–917

924

928

945

956

959.6–959.7 **Code 959 under Other

17. (Neck of femur fracture)

(9) 820

9. Other and Ill-Defined Body Region 809

819

828

829

839.6–839.9 ** Code 839 under Other

848.8–848.9 ** Code 848 under Other

869

879.6–879.9 **Code 879 under Other

911

919

922.8–922.9 **Code 922 under Other

926.1 **Code 926 under Other

926.8–926.9 **Code 926 under Other

929

941–42

946

947.8–947.9 **Code 947 under Other

948–949

954

957

959.0–959.1 **Code 959 under Other

959.8–959.9 **Code 959 under Other

10. Foreign Bodies 930–939

11. Poisonings 960–979

See footnotes at end of table.

Series 10, No. 202 [ Page 35
Please note: the following list can be used if ICD is coded to the 4th digit; if only 3-digit codes are available

follow instructions next to **.

12. Toxic Effects 980–989

13. Other and Unspec Effects of External Causes 990–995

Effects of reduced temperature 991

Effects of heat and light 992

Drowning 994.1

Asphyxiation and strangulation 994.7

Electrocution 994.8

All other Effects of External Causes 990, 993, 994.0, 994.2–994.6, 994.9, 995

14. Late Effects 905–909

15. Early Traumatic Complications 958

16. Complications of Surgical and Medical Care 996–999

18. No Injury No diagnosis codes above 799

1Include 804 under Head (instead of Multiple Body Regions) even though it reads: Multiple fractures involving skull or face with other bones: assume that principal fracture is to the skull or face. 2Code all injuries to blood vessels of Head or Neck (900) under Neck; it is not easy to distinguish whether blood vessel is part of head or neck based only on third or fourth digit of ICD 3Injuries to trachea (typically categorized at 4th or 5th digit which is not available for mortality data) is classified under Neck (instead of Thorax) 4Injuries to the trunk unless otherwise specified are coded under Other since these injuries could be to the region of the thorax, abdomen or back 5Fx to larynx and trachea (807.5–807.6) are coded under Neck unless 3rd digit code only, then code under thorax and assume injury (fx) is more likely to be to ribs and /or sternum. 6Injuries to sacrum and coccyx are coded under Spine as they are typically only distinguishable form other injuries to the spine at the 4th or 5th digits. 7Injuries to buttock region (eg. 877) are coded under Spine and Back 8Injuries classified under Neck include only those injuries to the front of the neck or soft tissue; injuries to the neck portion of the spine are classified under Spine and Back 9Neck of femur fractures have been classified separately.

Page 36 [ Series 10, No. 202
Codes for Nature of Injury

1. Fractures(1,2) 800–805; 807–829

2. Dislocations 830–839

3. Sprains and Strains 840–848

4. Crushing Injury 925–929

5. Amputation of Limbs 885–887; 895–897

6. Injury to Internal Organs(2,3,4,5) 860–869

incl. CNS injuries 850–854

952–953

806

7. Nerves(4) 950–951; 954–957

8. Blood Vessels 900–904

9. Open Wounds(3,5) 870–884, 888–894

10. Superficial Injuries 910–919

11. Contusions 920–924

12. Burns 940–949

13. Effects of Foreign Bodies 930–939

14. Other Injury- (other and unspecified) 959

Multiple sites 959.8

All other sites 959.0–959.7

Unspecified sites 959.9

15. Poisonings 960–979

16. Toxic Effects 980–989

17. Other and Unspec. Effects of External Causes 990–995

Effects of reduced temperature 991

Effects of heat and light 992

Drowning 994.1

Asphyxiation and strangulation 994.7

Electrocution 994.8

All other Effects of External Causes 990, 993, 994.0, 994.2–994.6, 994.9, 995

18. Late Effects of Injuries etc. 905–909

19. Early Complications of trauma 958

20. Complications of Surgical and Medical Care 996–999

21. No Injury No diagnosis codes above 799

1Fractures include skull fractures with intracranial injury; HOWEVER, if data are coded to the fourth digit; include the following codes (i.e. intracranial injuries with skull fx) under Injury to Internal

Organs: 800.1– 800.4 801.1–801.4

800.6–800.9 801.6–801.9

803.1–803.4 804.1–804.4

803.6–803.9 804.6–804.9 2Fractures exclude spine fxs with SCI; they are classified under Injuries to Internal Organs; (3) Injuries to Internal Organs include CNS injuries (injuries to the brain and spinal cord); they also

include injuries to larynx, trachea, pharynx and thyroid; they do NOT include injuries to internal structures of the eye, ear, and nose (these are included under Open Wounds); 4Injuries to Nerves exclude injuries to nerve roots to spine and spinal plexus (953)—these are included under Injury to Internal Organs; 5Open Wounds includes injuries to the larynx, trachea, pharynx and thyroid; HOWEVER, if data are only coded to the fourth digit, include codes 874.0–874.5 (i.e. injuries to larynx, trachea, pharynx

and thyroid) under Injury to Internal Organs. 6The United States Multiple Cause of Death does not include 4th digit classification for intracranial injuries with skull fx (800–804) or injuries to larynx, trachea, pharynx and thyroid (874.0–874.5).

Series 10, No. 202 [ Page 37
Appendix IV

Technical Notes

The Methods section of this report

mentioned that tests of significance for

differences between rates or percents

would not be conducted. However, for

individual rates and percents, confidence

intervals and standard errors are

provided to indicate the stability of the

point estimates. The confidence intervals

are displayed in the figures in a way

that graphically portrays the sizes of

differences in the point estimates

relative to their individual stabilities.

Examination of the amount of overlap

between intervals is not equivalent to

standard significance testing for

differences.

If tests of significance for

differences were to be performed, there

would be several technical

considerations. Suppose that it were

desired to test whether two population

percents, say p1 and p2, are different.

The standard error of |p1 – |p2 can be

written as

SE12 = √SE2

1 + SE22 – 2 Cov (|p1 , |p2),

(1)

where SE1 and SE2 are the standard

errors of |p1 and |p2, respectively, ‘‘Cov’’

denotes covariance, and ‘‘hats’’ are used

to label estimates. If an estimate

∧

SE12 of

equation (1) were computed, either via

separate estimation of the components

on the right-hand side of equation (1) or

via another technique, then an

approximate significance test at the 5%

level for whether p1 and p2 are different

could be performed by checking

whether the confidence interval

|p1 – |p2 ± 1.96

∧

SE12 (2)

contains 0.

A nonzero value for Cov (|p1 , |p2) in

equation (1) could occur as a result of

the design of the National Health

Interview Survey. For example, point

estimates for any two groups might be

correlated due to the clustering of

subjects by household or primary

sampling unit. A nonzero covariance

could also occur if the groups being

compared have subjects in common.

This is possible, for example, when

external causes of injury are being

compared because a person could have

more than one episode and each episode

could have a different external cause.

If the covariance between |p1 and |p2

were assumed to be equal to 0, then by

equations (1) and (2), a test of

significance for whether p1 and p2 are

different could be performed by

checking whether the interval

|p1 – |p2 ± 1.96√∧

SE1

2 +

∧

SE2

2

(3)

contains 0.

In addition to the above

considerations, the issue of adjusting for

multiple comparisons arises when more

than one test of significance is to be

carried out.

Page 38 [ Series 10, No. 202
Vital and Health Statistics

series descriptions

SERIES 1. Programs and Collection Procedures—These reports

describe the data collection programs of the National Center

for Health Statistics. They include descriptions of the methods

used to collect and process the data, definitions, and other

material necessary for understanding the data.

SERIES 2. Data Evaluation and Methods Research—These reports are

studies of new statistical methods and include analytical

techniques, objective evaluations of reliability of collected data,

and contributions to statistical theory. These studies also

include experimental tests of new survey methods and

comparisons of U.S. methodology with those of other

countries.

SERIES 3. Analytical and Epidemiological Studies—These reports

present analytical or interpretive studies based on vital and

health statistics. These reports carry the analyses further than

the expository types of reports in the other series.

SERIES 4. Documents and Committee Reports—These are final

reports of major committees concerned with vital and health

statistics and documents such as recommended model vital

registration laws and revised birth and death certificates.

SERIES 5. International Vital and Health Statistics Reports—These

reports are analytical or descriptive reports that compare U.S.

vital and health statistics with those of other countries or

present other international data of relevance to the health

statistics system of the United States.

SERIES 6. Cognition and Survey Measurement—These reports are

from the National Laboratory for Collaborative Research in

Cognition and Survey Measurement. They use methods of

cognitive science to design, evaluate, and test survey

instruments.

SERIES 10. Data From the National Health Interview Survey—These

reports contain statistics on illness; unintentional injuries;

disability; use of hospital, medical, and other health services;

and a wide range of special current health topics covering

many aspects of health behaviors, health status, and health

care utilization. They are based on data collected in a

continuing national household interview survey.

SERIES 11. Data From the National Health Examination Survey, the

National Health and Nutrition Examination Surveys, and

the Hispanic Health and Nutrition Examination Survey—

Data from direct examination, testing, and measurement on

representative samples of the civilian noninstitutionalized

population provide the basis for (1) medically defined total

prevalence of specific diseases or conditions in the United

States and the distributions of the population with respect to

physical, physiological, and psychological characteristics, and

(2) analyses of trends and relationships among various

measurements and between survey periods.

SERIES 12. Data From the Institutionalized Population Surveys—

Discontinued in 1975. Reports from these surveys are

included in Series 13.

SERIES 13. Data From the National Health Care Survey—These reports

contain statistics on health resources and the public’s use of

health care resources including ambulatory, hospital, and longterm care services based on data collected directly from

health care providers and provider records.

SERIES 14. Data on Health Resources: Manpower and Facilities—

Discontinued in 1990. Reports on the numbers, geographic

distribution, and characteristics of health resources are now

included in Series 13.

SERIES 15. Data From Special Surveys—These reports contain statistics

on health and health-related topics collected in special

surveys that are not part of the continuing data systems of the

National Center for Health Statistics.

SERIES 16. Compilations of Advance Data From Vital and Health

Statistics—Advance Data Reports provide early release of

information from the National Center for Health Statistics’

health and demographic surveys. They are compiled in the

order in which they are published. Some of these releases

may be followed by detailed reports in Series 10–13.

SERIES 20. Data on Mortality—These reports contain statistics on

mortality that are not included in regular, annual, or monthly

reports. Special analyses by cause of death, age, other

demographic variables, and geographic and trend analyses

are included.

SERIES 21. Data on Natality, Marriage, and Divorce—These reports

contain statistics on natality, marriage, and divorce that are

not included in regular, annual, or monthly reports. Special

analyses by health and demographic variables and

geographic and trend analyses are included.

SERIES 22. Data From the National Mortality and Natality Surveys—

Discontinued in 1975. Reports from these sample surveys,

based on vital records, are now published in Series 20 or 21.

SERIES 23. Data From the National Survey of Family Growth—These

reports contain statistics on factors that affect birth rates,

including contraception, infertility, cohabitation, marriage,

divorce, and remarriage; adoption; use of medical care for

family planning and infertility; and related maternal and infant

health topics. These statistics are based on national surveys

of women of childbearing age.

SERIES 24. Compilations of Data on Natality, Mortality, Marriage,

Divorce, and Induced Terminations of Pregnancy—

These include advance reports of births, deaths, marriages,

and divorces based on final data from the National Vital

Statistics System that were published as supplements to the

Monthly Vital Statistics Report (MVSR). These reports provide

highlights and summaries of detailed data subsequently

published in Vital Statistics of the United States. Other

supplements to the MVSR published here provide selected

findings based on final data from the National Vital Statistics

System and may be followed by detailed reports in Series 20

or 21.

For answers to questions about this report or for a list of reports published in

these series, contact:

Data Dissemination Branch

National Center for Health Statistics

Centers for Disease Control and Prevention

6525 Belcrest Road, Room 1064

Hyattsville, MD 20782-2003

(301) 458-4636

E-mail: nchsquery@cdc.gov

Internet: www.cdc.gov/nchs/
DEPARTMENT OF

HEALTH & HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

6525 Belcrest Road

Hyattsville, Maryland 20782-2003

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