National Electronic Injury Surveillance System All Injury Program, 2016

Beginning in July 2000, the National Center for Injury Prevention and Control (NCIPC), Centers for Disease Control and Prevention (CDC) in collaboration with the United States Consumer Product Safety Commission (CPSC) expanded the National Electronic Injury Surveillance System (NEISS) to collect data on all types and causes of injuries treated in a representative sample of United States hospitals with emergency departments (EDs). This system is called the NEISS-All Injury Program (NEISS-AIP). The NEISS-AIP is designed to provide national incidence estimates of all types and external causes of nonfatal injuries and poisonings treated in U.S. hospital EDs. Data on injury-related visits are being obtained from a national sample of U.S. NEISS hospitals, which were selected as a stratified probability sample of hospitals in the United States and its territories with a minimum of six beds and a 24-hour ED. The sample includes separate strata for very large, large, medium, and small hospitals, defined by the number of annual ED visits per hospital, and children's hospitals. The scope of reporting goes beyond routine reporting of injuries associated with consumer-related products in CPSC's jurisdiction to include all injuries and poisonings. The data can be used to (1) measure the magnitude and distribution of nonfatal injuries in the United States; (2) monitor unintentional and violence-related nonfatal injuries over time; (3) identify emerging injury problems; (4) identify specific cases for follow-up investigations of particular injury-related problems; and (5) set national priorities. A fundamental principle of this expansion effort is that preliminary surveillance data will be made available in a timely manner to a number of different federal agencies with unique and overlapping public health responsibilities and concerns. Also, annually, the final edited data will be released as public use data files for use by other public health professionals and researchers. NEISS-AIP data on nonfatal injuries were collected from January through December each year except the year 2000 when data were collected from July through December (ICPSR 3582). NEISS AIP is providing data on approximately over 500,000 cases annually. Data obtained on each case include age, race/ethnicity, gender, principal diagnosis, primary body part affected, consumer products involved, disposition at ED discharge (i.e., hospitalized, transferred, treated and released, observation, died), locale where the injury occurred, work-relatedness, and a narrative description of the injury circumstances. Also, major categories of external cause of injury (e.g., motor vehicle, falls, cut/pierce, poisoning, fire/burn) and of intent of injury (e.g., unintentional, assault, intentional self-harm, legal intervention) are being coded for each case in a manner consistent with the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) coding rules and guidelines. NEISS has been managed and operated by the United States Consumer Product Safety Commission since 1972 and is used by the Commission for identifying and monitoring consumer product-related injuries and for assessing risk to all United States residents. These product-related injury data are used for educating consumers about hazardous products and for identifying injury-related cases used in detailed studies of specific products and associated hazard patterns. These studies set the stage for developing both voluntary and mandatory safety standards. Since the early 1980s, CPSC has assisted other federal agencies by using NEISS to collect injury- related data of special interest to them. In 1990, an interagency agreement was established between NCIPC and CPSC to (1) collect NEISS data on nonfatal firearm-related injuries for the CDC Firearm Injury Surveillance Study; (2) publish NEISS data on a variety of injury-related topics, such as in-line skating, firearms, BB and pellet guns, bicycles, boat propellers, personal water craft, and playground injuries; and (3) to address common concerns. CPSC also uses NEISS to collect data on work-related injuries for the National Institute of Occupational Safety and Health (NIOSH), CDC. In 1997, the interagency agreement was modified to conduct the three-month NEISS All Injury Pilot Study at 21 NEISS hospitals (see 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 Emerg. Med. 1999;34:637-643.) This study demonstrated the feasibility of expanding NEISS to collect data on all injuries. National estimates based on this study indicated product-related injuries that fall into CPSC's jurisdiction accounted for approximately 50 percent of injuries treated in U.S. hospital EDs. The study also indicated that NEISS is a cost-effective system for capturing data on all injuries treated in U.S. hospital EDs. The NEISS-AIP provides an excellent data source for monitoring national estimates of nonfatal injuries over time. Analysis and dissemination of these surveillance data through the ICPSR, and Internet publications will help support NCIPC's mission of reducing all types and causes of injuries in the United States, as well as assist other federal agencies with responsibilities for injury prevention and control.

2000年7月起，美国疾病控制与预防中心（Centers for Disease Control and Prevention, CDC）下属的国家伤害预防与控制中心（National Center for Injury Prevention and Control, NCIPC）与美国消费品安全委员会（United States Consumer Product Safety Commission, CPSC）合作，扩展了国家电子伤害监测系统（National Electronic Injury Surveillance System, NEISS），以收集美国带急诊科（emergency departments, EDs）医院代表性样本中所有类型及原因伤害的治疗数据。该系统被称为NEISS-全伤害项目（NEISS-All Injury Program, NEISS-AIP）。NEISS-AIP旨在提供美国医院急诊科接诊的所有类型非致命伤害及中毒事件的全国发生率估算数据，涵盖其外部原因。伤害相关就诊数据来自美国NEISS医院的全国样本——这些医院是按分层概率抽样选取的美国本土及领地内至少拥有6张床位且提供24小时急诊服务的机构，样本包含按年急诊就诊量划分的超大、大、中、小型医院及儿童医院等独立分层。报告范围超越了CPSC管辖范围内消费品相关伤害的常规报告，涵盖所有伤害与中毒事件。该数据可用于：（1）衡量美国非致命伤害的规模与分布；（2）长期监测非故意及暴力相关非致命伤害；（3）识别新发伤害问题；（4）筛选特定伤害相关问题的后续调查案例；（5）制定国家优先事项。此次扩展的核心原则是，初步监测数据将及时向多个负有独特且重叠公共卫生职责的联邦机构开放。此外，每年最终编辑的数据将作为公共使用数据集发布，供其他公共卫生专业人员及研究者使用。NEISS-AIP的非致命伤害数据每年从1月收集至12月，但2000年数据为7月至12月（ICPSR 3582）。NEISS-AIP每年提供约50万例以上的案例数据。每个案例的数据包括年龄、种族/族裔、性别、主要诊断、受影响的主要身体部位、涉及的消费品、急诊出院处置（如住院、转诊、治疗后出院、观察、死亡）、伤害发生地点、是否与工作相关，以及伤害情景的叙述性描述。此外，每个案例的伤害外部原因主要类别（如机动车、跌倒、切割/穿刺、中毒、火灾/烧伤）及伤害意图类别（如非故意、袭击、故意自伤、法律干预）均按照《国际疾病分类第九版临床修订本》（International Classification of Diseases, Ninth Revision, Clinical Modification, ICD-9-CM）编码规则与指南进行编码。NEISS自1972年起由美国消费品安全委员会管理运营，用于识别和监测消费品相关伤害，并评估美国所有居民的风险。这些产品相关伤害数据用于向消费者宣传危险产品，以及筛选特定产品及相关危险模式详细研究中的伤害案例。此类研究为制定自愿性和强制性安全标准奠定基础。自20世纪80年代初以来，CPSC通过NEISS协助其他联邦机构收集其关注的特定伤害相关数据。1990年，NCIPC与CPSC签订跨机构协议，旨在：（1）为CDC枪支伤害监测研究收集NEISS非致命枪支相关伤害数据；（2）发布NEISS在多种伤害相关主题的数据（如直排轮滑、枪支、BB枪与 pellet枪、自行车、船用螺旋桨、个人水上交通工具及 playground伤害）；（3）解决共同关切问题。CPSC还利用NEISS为CDC下属的国家职业安全与健康研究所（National Institute of Occupational Safety and Health, NIOSH）收集工作相关伤害数据。1997年，跨机构协议修订，在21家NEISS医院开展为期3个月的NEISS全伤害试点研究（参见Quinlan KP、Thompson MP、Annest JL等人的《扩展国家电子伤害监测系统以监测美国医院急诊科接诊的所有非致命伤害》，《急诊医学年鉴》1999年；34卷：637-643页）。该研究证明扩展NEISS以收集所有伤害数据的可行性。基于此研究的全国估算显示，CPSC管辖范围内的产品相关伤害约占美国医院急诊科接诊伤害的50%。研究还表明NEISS是捕获美国医院急诊科所有伤害数据的具成本效益的系统。NEISS-AIP为长期监测非致命伤害全国估算提供了优质数据源。通过ICPSR及互联网出版物对这些监测数据进行分析与传播，将助力NCIPC减少美国所有类型及原因伤害的使命，同时协助其他负有伤害预防与控制职责的联邦机构开展工作。