Cost Analysis of Military Eye Injuries in Fiscal Years 1988-1998

Military Medicine, Mar 2005 by Buckingham, Robert S, Whitwell, Kenneth J, Lee, Robyn B

Army, Navy, and Air Force safety center ground eye injuries were evaluated from fiscal year 1988 through fiscal year 1998. The U.S. Army Safety Center data revealed that the average Army military eye injury mishap caused a loss of 6.1 days from work, at a cost averaging $9,724. The U.S. Navy Safety Center data showed that the average Navy military eye injury mishap caused a loss of 5.9 days from work, at a cost averaging $4,222. The Air Force Safety Center data revealed that the average Air Force eye injury mishap caused a loss of 4.7 days from work, at a cost averaging $3,196. Comparing safety center data with Defense Medical Surveillance System data exposed an underreporting of safety center data by at least 250%. To improve accurate meaningful data collection, an automated eye injury collection system should be initiated.

Introduction

Injuries in the workplace have costly effects on both military and civilian workforces. Despite being a small area, the eye is injured quite frequently.1 A study in the 8th Infantry Division in Germany found the annual cost of eye injuries to be $404,800.2 Another study at Fort Campbell estimated that eye injuries cost 89,107 lost person-hours, at a price of $454,446 per year.3 In 1994, safety and health statistics of the Bureau of Labor and Statistics revealed a total of 83,549 eye injuries, with a rate of 10.4 injuries per 10,000 full-time workers.4 Because 90% of eye injuries are preventable, injury prevention should be emphasized.5

The U.S. Army Safety Center (USASC), U.S. Navy Safety Center (NAVSAFECEN), and U.S. Air Force Safety Center (AFSC) collect data on occupational injuries that occur in each military service. The military services receive initial guidance on the collection of this information from Department of Defense (DoD) Instruction (DoDI) 6055.7, Mishap Investigation, Reporting, and Recordkeeping. DoDI 6055.7 provides direction and guidance to the military services on mishap investigation, reporting, and recordkeeping. In addition, DoDI 6055.7 lists the standard cost table used by the military services to compute the cost of eye injuries.

Paragraph E2.1.23 of DoDI 6055.7 establishes the Mishap Severity Classification that the military services follow. Injuries are classified as class A, B, C, or D mishaps (see Table I for definitions).

DoDI 6055.7 is implemented through Army Regulation 385-40, Accident Reporting and Records, Navy Instruction 5100.23E, Navy Occupational Safety and Health Manual, and Air Force Instruction 91-204, Safety, Inspections, and Reports.

In addition to the reporting requirements of DoDI 6055.7, eye injury information is collected through the Defense Medical Surveillance System (DMSS). Through the Standard Inpatient Data Record and Standard Ambulatory Data Record, the DMSS automatically collects Clinical Procedure Codes, Version 4, and International Classification of Diseases, 9th Revision, code data on hospitalizations and ambulatory visits from all DoD medical facilities. This information can be used by the component service's safety centers to compare their injury and hospitalization rates against the information in the DMSS.

Methods

Ground (nonaviation) eye injury data were analyzed from USASC, NAVSAFECEN, and AFSC for fiscal year (FY] 1988 through 1998. Aviation injuries were not considered in this analysis. This analysis included the number of eye injuries, the number of lost workdays, the number of hospitalization days, and the cost of these eye injuries. DMSS data for hospitalizations and ambulatory visits were gathered for comparisons with the safety center data.

Results

Of the military eye injuries in FY 1988 to FY 1998, the Army reported 1,752 individuals injured, with 1,609 being military personnel and 143 being civil service employees. The Navy reported 2,868 individuals injured, with 1,222 being military personnel, 1,645 being civil service employees, and 1 being unidentified. The Air Force safety offices reported 993 military personnel and 484 civilian employees injured (Table II).

The number of injuries per year has been on a downward trend since FY 1988 (Figs. 1, 2, and 3). This number could simply result from decreasing end-strength numbers for the Army, Navy, and Air Force military and civilian personnel. Taking into account the end strength, the rates in each service have also decreased since FY 1988. The large drop in the Navy, between FY 1990 and FY 1992, occurred because in 1991 the reporting threshold for afloat injuries was increased from 1 to 5 lost workdays.

Although the number of eye injuries is on the decline, the cost of eye injuries is still high. The reported estimated cost of class A, B, and C eye injuries from FY 1988 to FY 1998 for Army military personnel was $15,646,043, for Navy military personnel was $5,109,626, and for Air Force military personnel was $3,174,061 (Table III). The reported costs of military eye injury hospitalizations for FY 1988-1998 for the Army was $5,028,978, for the Navy was $3,548,146, and for the Air Force was $1,277,982 (Table IV). The reported costs of military eye injury nonhospitalizations for FY 1988-1998 for the Army was $10,617,065, for the Navy was $1,561,470, and for the Air Force was $1,896,079 (Table V).