ANSI Z16.4 PDF
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The ILO does not take responsibility for content presented on this web portal that is presented in any language other than English, which is the language used for the initial production and peer-review of original content. Systems of workplace injury and illness asni constitute a critical resource for management and reduction of occupational injuries and illnesses.
They provide essential data which can be used to identify workplace problems, develop corrective strategies and thus prevent future injuries and illnesses. To accomplish these goals effectively, surveillance systems must be constructed which capture the characteristics of workplace injuries in considerable detail.
To be of maximum value, such a system should be able to provide answers to such questions as which workplaces are the most hazardous, which injuries produce ansj most time lost from work and even what part of the body is injured most frequently.
The system was developed to meet the needs of a variety of constituencies: For a number of years, the BLS has collected three basic types of information concerning an occupational injury or illness:. The previous classification system, though useful, was somewhat limited and did not fully meet the needs described above. In it was decided that a revision of the existing system was in order that would best suit the needs of the varied users. This team worked in consultation with safety and health specialists from the public and private sectors, with the goal of developing andi revamped and expanded classification system.
Several criteria were established governing the individual code structures.
Module 2 – Accident Investigation and Analysis
The system must have a hierarchical arrangement to allow maximum flexibility for varied users of occupational injury and illness data. The system should meet the needs of other government agencies involved in the safety and health arena. Finally, the system must be responsive to the differing traits of nonfatal and fatal cases. Drafts of the case characteristic classification structures z166.4 produced and released for comment in and again in The system included nature of ansu or illness, part qnsi body affected, source of injury or illness, event or exposure structures and secondary source.
Comments were received and incorporated from bureau staff, state agencies, Occupational Safety and Health Administration, Employment Standards Administration and NIOSH, after which the system was ready for an onsite test. Pilot testing of the structures for compiling data for nonfatal injuries and illnesses, as well as the operational application in the Census of Fatal Occupational Anai, was conducted in four states. Test results were analysed and revisions completed by z1.64 fall of The final version of the classification system consists of five case characteristic code structures, an occupational code structure and an industry code structure.
Besides numerical codes that represent specific conditions or circumstances, each code structure includes aids to assist in identification and selection of the proper code. The rules of selection offer guidance to choose the appropriate code uniformly when two or more code selections are possible.
The descriptive paragraphs provide additional information about the codes such as what is included or excluded in a particular code. For instance, the code for eye includes the eyeball, the lens, the retina and the eyelashes.
The alphabetical listings can be used to quickly find the numerical code for a specific characteristic, such as medical terminology or specialized machinery. Finally, edit criteria are quality-assurance tools that can be used to determine which code combinations are incorrect prior to final selection. This code serves as the basis for all other case classifications.
Once the nature of injury or illness has been identified, the remaining four classifications represent the circumstances associated with that particular outcome. The classification structure for nature of injury of illness contains seven divisions:. Before finalizing this structure, two similar classifications systems were evaluated for possible adoption or emulation.
The ICDCM, designed for classifying morbidity and mortality information qnsi used by a large portion of the medical community, provides the required detailed codes for illnesses. However, technical knowledge and training requirements for users and compilers of these statistics made this system prohibitive.
ANSI Z16.1 PDF DOWNLOAD
The final structure arrived at is a hybrid which combines the application method and rules of selection from the ANSI Z The first division in the Z164. nature of injury or illness structure classifies traumatic injuries and disorders, effects of external agents and poisoning, and corresponds to Chapter 17 of the ICDCM. Outcomes in this division are generally the result of a single incident, event or exposure, and include conditions such as fractures, bruises, cuts and burns. In the occupational environment, this division accounts for the great majority of reported cases.
Several situations required careful consideration when establishing rules to select codes in this division. Review of fatality cases revealed difficulties in coding certain types of fatal injuries.
For example, fatal fractures usually involve z166.4 or indirect mortal damage to a vital organ, such as the brain or spinal column. Specific coding categories and instructions asni required to note the mortal damage associated with wnsi types of injuries. Gunshot wounds constitute a separate category with special instructions for those instances in which such wounds also resulted in amputations or paralysis. In keeping with an overall philosophy of coding the most serious injury, paralysis and amputations take precedence over less serious damage from a gunshot wound.
Responses to questions on employer reporting forms concerning what happened to the injured or ill worker do not always adequately describe the injury or illness. Finally, this division has a section of codes to classify the most frequently occurring combinations of conditions that result from the nasi incident.
For example, a worker may suffer both scratches znsi bruises from a single incident. Five of the remaining divisions of this classification structure were devoted to identification of occupational diseases and disorders.
These sections present codes for specific conditions that are of paramount interest to the safety and health community. In recent years, a growing number of diseases and disorders have been linked to the work environment but were seldom represented in the existing classification structures. The part of body affected classification structure specifies the part of the body which was directly affected by the injury or illness. When linked with the nature of injury or illness code, it provides a more complete picture of the damage incurred: This structure consists of eight divisions:.
Three issues surfaced during evaluation of redesign options for this theoretically simple and straightforward piece of anei classification system. The first was the merit of coding external location arm, trunk, leg of the injury or illness versus the affected internal site heart, lungs, brain. Test results indicated that coding the internal part of body affected was appropriate for diseases and disorders, but extremely confusing when applied to many traumatic injuries such as cuts or bruises.
The BLS developed a policy of coding the external location for most traumatic injuries and coding internal locations, where appropriate, for diseases. The second issue was how to handle diseases that affect more than one body system simultaneously. For instance, hypothermia, a condition of low body temperature due to exposure to the cold, can affect the nervous and endocrine systems. Because it is difficult for nonmedical personnel to determine which is the appropriate choice, this could lead to a tremendous amount of research time with no clear resolution.
Therefore, the BLS system was designed with a single entry, body systems, that categorizes one or more body systems. Adding detail to identify typical combinations of parts in the upper extremities and the lower extremities was the third major enhancement to this code structure. These combinations, such as hand and wrist, proved to be supportable by the source documents. The event or exposure code structure describes the manner in which the injury or illness was inflicted or produced.
The following eight divisions were created to identify the primary method of injury or exposure to a harmful substance or situation:. Injury-producing incidents are frequently composed of a series of events. To illustrate, consider what occurs in a traffic accident: A car hits a guard-rail, crosses the median strip and collides with a truck.
The driver has several injuries from striking parts of the car and being struck by broken glass. If the micro-events—such as hitting the windshield or being struck by flying glass—were coded, the overall fact that the person was in a traffic accident could be missed.
In these multiple event instances, the BLS designated several occurrences to be considered primary events and to take precedence over other micro-events associated with them.
These primary events included:.
An order of precedence was established within these groups as well because they frequently overlap—for example, a highway accident can involve a fire. This order of precedence is the order which they appear in the above list. Assaults anssi violent acts were assigned first precedence.
Codes within this division generally describe the type of violence, while the weapon is addressed in the source code. Transportation accidents are next in precedence, followed by fires and explosions. These last two events, fires and explosions, are combined in a single division. Because the two often occur simultaneously, an order of precedence between the two had to be established. Selection z16. codes for inclusion in this structure was influenced by the emergence of non-contact disorders that are associated with the activities and ergonomics of the job.
Carpal tunnel syndrome is now widely recognized to be tied to repetitive actions such as key entry, typing, cutting actions and even operating a cash register. The division bodily reaction and exertion identifies these non-contact, or non-impact, incidents. A separate category to identify the transmission of an infectious agent through a needle stick was developed.
Also included in this 1z6.4 are other non-impact nasi in which the worker was harmed by electric power or by environmental conditions, such as extreme cold. Contact with objects and equipment and falls are the divisions that will capture most impact events that injure workers. The source of injury or illness classification code identifies the object, substance, bodily motion or exposure which directly produced or inflicted the injury or illness.
If a worker is cut on the head by a falling brick, the brick is the source of injury. There is a direct relationship between the source and the nature of the injury or illness. If a worker slips on oil and falls to the floor, breaking an elbow, the fracture is produced by hitting the floor, so the floor is source of injury.
This code system contains ten divisions:. However, the task of developing a more complete and hierarchical code listing was initially daunting, since virtually any item or substance in the world can qualify as a source of injury or illness. Not only can everything in the world qualify as source, so can pieces or parts of everything in the world. To add to the difficulty, all candidates for inclusion in the qnsi codes had to be grouped into only ten divisional categories.
Examination of historical data on work injuries and illness identified areas where the previous code structure was inadequate or out of date. The machinery and tools sections needed expansion and updating. There was no code for computers.
Newer technology had made the list of power tools obsolete, and many items listed as nonpowered tools were now almost always powered: There was a demand from users to expand and update the list of chemicals in the new structure.
The US Occupational Safety and Health Administration requested expanded detail for a variety of items, including several types of scaffolds, forklifts and construction and logging machines. The most difficult aspect of developing the source structure was organizing the items required for inclusion into distinct divisions and groups within the division.
To add to the difficulty, the source code categories had to be mutually exclusive.