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Reducing the Burden of Injury: Advancing Prevention and Treatment
independent evaluation of the expanded system should be conducted annually or biennially, to determine its utility to the field and its ultimate future.
In addition to NEISS, there exist several other sources of national data specific to a particular injury mechanism or intent. Examples include the Fatality Analysis Reporting System (FARS) and the National Automotive Sampling System (NASS) for motor vehicle-related injuries; the National Traumatic Occupational Fatality Surveillance System (NTOF), the Census of Fatal Occupational Injuries (CFOI), and the Survey of Occupational Injuries and Illnesses (SOII) for occupational injuries; the National Crime Victimization Survey (NCVS) and the Uniform Crime Reporting (UCR) System for intentional injuries associated with criminal conduct. These data systems are particularly useful for monitoring trends in injury rates specific to certain mechanisms and for identifying risk factors associated with their occurrence. This information, in turn, has been useful in setting national priorities for research and program implementation and in developing and evaluating national policies. For example, data from FARS was able to document the benefits of legislation that raised the minimum purchase age for alcoholic beverages (Chapter 5).
The committee considered the merits and feasibility of establishing a comprehensive fatal injury surveillance system that would collect detailed data on all fatal injuries not currently included in existing fatality surveillance systems and that would be coordinated with existing systems. However, the magnitude of that task would be enormous, given the approximately 140,000 injury deaths each year, of which approximately 42,000 are entered into the FARS database (NHTSA, 1998b) and approximately 6,200 are occupational fatalities (BLS, 1996). Therefore, the committee considered ways to accomplish that goal incrementally by identifying a subset of deaths (e.g., homicides and suicides).
The committee noted that an ongoing federally sponsored system of surveillance for all intentional injuries (homicides and suicides) is conspicuously absent from the array of data systems available on a national level. While the UCR System, maintained by the FBI, does provide some information on homicides, detailed information about the type of weapon involved is missing. Since the UCR is a voluntary reporting system, it tends to underestimate the actual incidence of homicide (as compared with the record of vital statistics). Moreover, suicides (which outnumber homicides) and unintentional firearm injury deaths are not included in the database.
Given the success of FARS, in monitoring motor vehicle fatalities, and the utility of occupational surveillance systems (e.g., CFOI), it seems reasonable to consider a system for recording detailed data on injury deaths that are ordinarily the subject of police investigations, such as suspected homicides and suicides. However, suicide is not a crime in all jurisdictions, and police do not necessarily investigate deaths that are clearly self-inflicted. Therefore, a system depending on police reports for case identification could miss a large proportion of the 31,000 suicides annually.