industries with the most deaths were agriculture (110), construction (59), and services (56). Nearly half of the death certificates for 16-and 17-year-olds did not contain information on industry or occupation, however, so these numbers should be interpreted with caution.

This surveillance system has a number of other limitations. Studies have found that, on average, death certificates capture only 81 percent of work-related deaths (Stout and Bell, 1991). Certain types of deaths are more likely to be undercounted by NTOF, including work-related homicides and motor-vehicle-related deaths—important causes of occupational fatalities among children and adolescents. Furthermore, only a 60–76 percent agreement exists between the "usual occupation" and "usual industry" entries on death certificates and the victim's actual employment at the time of death (Bell et al., 1990). For adolescents, the agreement may be even worse. Castillo et al. (1994) found the "usual occupation" of a high percentage of young people was listed as "student,'' even though other information on the death certificate indicated that the fatality was work-related.

The NTOF surveillance system predates the CFOI by 10 years. The National Institute for Occupational Safety and Health and the Bureau of Labor Statistics are working to merge the two systems.

Fatality Assessment and Control Evaluation Program

The Fatality Assessment and Control Evaluation (FACE) program was developed by NIOSH to obtain more detailed information about the interactions of the worker, work environment, and work processes in work-related fatalities, details that are necessary to devise prevention strategies. This program provides an important follow-up component to the occupational fatality surveillance system. It involves in-depth, research-oriented investigations of targeted occupational fatalities, including fatal falls and machinery-related deaths. Confined-space deaths and electrocutions have been targeted in the past. NIOSH staff investigate deaths due to targeted causes in West Virginia and five surrounding states. With the assistance of NIOSH, 14 states enumerate all work-related fatalities occurring within their borders and conduct investigations of targeted deaths. For each investigation, a FACE report is prepared; it includes recommended measures to prevent similar deaths in the fu-



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