A Detailed Analysis of Workplace Foot and Ankle Injuries
Authors: Hoch Caroline P. , Caughman Alexander , Griffith Adam , Hoch Caroline P. , Rex James C. , Scott Daniel J. , Gross Christopher E. 
Published: January 2022

Category: Trauma; Ankle; Hindfoot; Midfoot/Forefoot Introduction/Purpose: In 2018 over 96,000 foot and ankle injuries resulted in lost workdays. The average 2017-2018 workers compensation claim for ankle injuries was $17,210 for medical costs with an additional $13,276 of indemnity. Workplace foot injuries were similarly expensive, averaging $15,762 in medical costs and $11,866 in indemnity. These costs highlight the burden workplace foot and ankle injuries place on both workers and employers. This study analyzes the incidence, rate, and days lost from work due to foot and ankle injuries across different industries, age groups, and genders and compares these findings to other musculoskeletal injuries. These findings will help us better understand which industries are greater impacted by foot and ankle injuries and what factors may influence the occurrence and severity of these injuries. Methods: Workplace injury data was obtained using a special query from the Bureau of Labor Statistics Workplace Injuries and Illnesses Nonfatal Cases Involving Days Away From Work: Selected Characteristics database. Data included injury incidence, incidence rate per 10,000 workers, and median days missed from work due to injury. The data was grouped by injury location (all injuries, ankle injuries, and foot injuries), type of injury (fracture, sprain, amputation), and industry. Spearman correlation, one-way ANOVA, and independent samples t-test were used to identify the industries, sex, and ages associated with the highest rates and median days missed from work for each of these groups. Regression analysis was used to analyze changes in incidence rate over time. Incidence rate data was obtained for a seventeen-year period (2003-2019) and days lost from work data was obtained for a nine-year period (2011-2019). Data analysis was performed using SPSS statistics software, version 25.0. Results: The mining (44.85 foot,17.09 ankle), transportation/warehousing (16.82,16.29), and utilities (24.41,26.69) industries had three of the five highest average median days missed from work for both foot and ankle injuries. Of these, only transportation/warehousing (11.06,13.80) was among the five industries with the highest rates of foot and ankle injuries. There was a strong negative correlation (P<0.001) between age and rate of both foot and ankle injuries and a strong positive correlation (P<0.001) between age and median days missed from work. Males had significantly higher rates of foot injuries (5.31) than females (3.80; P<.0001). Males also had higher rates of ankle injuries (4.96) than females (4.88; P=.453). Regression analysis showed the incidence rate of ankle sprains, ankle fractures, foot sprains, and foot fractures decreased from 2003-2019. Conclusion: This study demonstrates that the incidence rate and severity of workplace foot and ankle injuries are influenced by workers' age, gender, and the industry they work in. It shows that industries with higher days missed often did not have higher rates of injuries. Our results have the potential to be used to identify industries in need of additional safeguards to protect workers from injury and provide companies with information about the industry norm for rates of employee injuries and days missed from work for these injuries.