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(e.g., license issuance and expiry/renewal dates, license class, mechanisms or events (e.g., traffic crash reports). The custo-
violation dates, suspension periods). In some states, informa- dial responsibility for various files within the SWISS is
tion on crash involvements (e.g., occurrence date, crash sever- typically distributed among several agencies and/or offices
ity) is also available. within a State Department of Health.
Driver records are especially useful for examining issues Depending on its component data systems, the SWISS
related to driving history and rates of recidivism (e.g., re- system can provide information that tracks magnitude,
offending for moving violations and traffic-related criminal severity, and types of injuries sustained by persons in motor-
convictions). However, many states purge the driver record vehicle-related crashes. There are standard coding systems
of information on driving history after a certain period of for injuries and injury causal factors that can be gathered
time. Consequently, driver records are incomplete and driv- from the health-related datasets. Although traffic crashes
ers identified as first-time offenders may have had previous cause only a portion of the injuries within any population,
convictions for the same offence. Analysts should also be they often represent one of the more significant causes of in-
aware that a driver history file used for aggregate data analy- juries in terms of frequency and cost to the community. The
sis is certain to be a snapshot of the statewide data at the time SWISS should support integration of the injury data with
the request was made. The data update and purge cycles can police reported traffic crashes and make this information
have a dramatic effect on the information available for analy- available for analysis to support research, public policy and
sis at any given time, so care must be taken to work with the decision-making. In most states, this integration is most
driver file custodians to ensure that the resulting analyses and likely to happen through a CODES probabilistic linkage
conclusions are valid and representative of the driver popu- process.
lation of interest.
National Emergency Medical Services
Vehicle Registration Files Information System (NEMSIS)
Departments of motor vehicles maintain motor vehicle The ability to evaluate and improve Emergency Medical
registration files for use in vehicle licensing and taxation. Services (EMS) systems has long been hampered by the lack of
These files contain information on the vehicle identification consistent and detailed EMS data at either the state or national
number (VIN); plate number; and vehicle weight, model, level. While a state's EMS system is usually coordinated at the
make, and year. Vehicle registration data can be used in state level, with EMS providers trained and certified by the state
developing safety strategies when, for example, information EMS office, the system itself is composed of multiple local
on the number of licensed vehicle by type is needed. Note, providers. Thus, the data required in a sound state (and ulti-
however, that it would be unusual for these files to contain mately national) database must be collected by these local
annual mileage driven, so a measure of "miles of exposure by agencies. Because of both the lack of a universal set of
vehicle type" cannot be developed. Even when the file does "endorsed" data variables and the fact that there is often no
contain annual miles driven, the reliability of the mileage data legal requirement for systematic collection of such data, state
and their utility in analyses are questionable. Analysts are EMS data systems have varied greatly in terms of the composi-
cautioned to be sure they know exactly how the data are col- tion and completeness of their data. Working with the Centers
lected and how the state handles missing, incomplete for Disease Control (CDC) and the Health Resources and
information and odometer readings that are greater than a Services Administration (HRSA), NHTSA is coordinating the
certain threshold (usually 100,000 miles). NEMSIS project which will ultimately lead to a national EMS
database, populated from participating-state databases. The
raw data will continue to be collected by the individual local
Statewide Injury Surveillance System Files
providers, but the data collected will be based on a data
With the growing interest in injury control programs dictionary containing standardized variables and codes. These
within the traffic safety, public health, and enforcement com- data elements were developed by the three sponsoring agencies
munities, there are a number of local, state, and federal in consultation with a number of national EMS associations
initiatives which drive the development of a Statewide Injury ranging from the National Association of State EMS Directors
Surveillance System (SWISS). These systems typically incor- to the National Association of Emergency Medical Techni-
porate pre-hospital (EMS), trauma, emergency department cians. For computer storage, the data will be defined using an
(ED), hospital in-patient/discharge, rehabilitation and mor- XML (extensible markup language) standard which will allow
bidity databases to track injury causes, magnitude, costs, and easy transfer of the data between different local (e.g., private
outcomes. Often, these systems rely upon other components EMS and fire-based EMS), state, and national computer
of the traffic records system to provide information on injury systems. The data dictionary contains a set of core elements
