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National Data Standards

for Injury Surveillance

Version 2.1

Australian Institute of Health and Welfare

National Injury Surveillance Unit

Research Centre for Injury Studies Flinders University of South Australia

(version 2.1c, January 1998)

NDS-IS Version 2.1c (January 1998) ii

Australian Institute of Health and Welfare

National Injury Surveillance Unit

Research Centre for Injury Studies School of Medicine

Flinders University of South Australia

Mark Oliphant Building

Laffer Drive

Bedford Park

SA 5042

Telephone: International: +61 8 8374 0970

National: (08) 8374 0970

Facsimile: International: +61 8 8374 0702

National: (08) 8374 0702

Email: [email protected]

http://www.nisu.flinders.edu.au

mailto:[email protected]

NDS-IS Version 2c (January 1998) iii

Revision history, NDS-IS version 2

Version 2.0

Revision T 18 December 1995: initial release.

Revision U 21 December 1995: correction of Nature of Injury concordance table

Version 2.1

Revision A 30 November 1997: (limited circulation of manuscript of new version)

mapping is now to ICD-9-CM, Australian version, second edition 1996

this version is still mapped to NHDD version 4.0; the next revision will be updated to the

current edition of NHDD version 6.0

New items:

Supplementary items Postcode and Triage score have been added to the dictionary

Tables outlining Coding examples for type of place and type of activity have been added

to Appendix 1

Changes to existing items

Category Struck by or collision with, object or person has been removed and replaced

with two distinct categories for person or object (NDS-IS-Level 1, item 2A; codes [30]

& [31])

General information item, NHDD, item P31 Mode of separation has been modified by

the addition of the category 0= Admitted to hospital

General information item, Employment status, uses the coding recommended for public

and psychiatric hospitals in NHDD, item P14. This coding has also been modified to

distinguish those who are self employed by the addition of two categories, employee [7]

& self-employed [8].

Activity when injured (Level 1, item 4), defaults to other specified activity [8] if Intent

(Level 1, item 2B) = intentional self-harm [2].

Level 1, item 5B, lower back [6] now includes loin

Appropriate ICD-9-CM & ICD-10 codes have been added to Table A2.2A for new

categories [30] & [31]

Formats for new supplementary items have been added to Table A3.1

Format for [6] Nature of injury has been amended to NNN to accommodate 3 digit

nature codes.

Format for [23] Place of injury occurrence-sub-type has been amended to NNN to

accommodate 3 digit place codes.

Format for [26] sub-types has been divided to accommodate different coding for industry

and occupation.

Revision B 4 December 1997: (limited circulation)

Table A3.1: repetition of '26' in first column corrected

Revision C 23 January 1998:

Table A2.2B: corrected numbering of three rows (8 to 7; 9 to 8; 7 to 9); row order altered

accordingly.

Label of Item 5A category 26 revised (to clarify its meaning)

Various minor editorial corrections.

NDS-IS Version 2.1c (January 1998) iv

Contents Acknowledgments ................................................................................................................................ vi

1. Abstract ................................................................................................................................................. 1

2. Introduction and background to National Data Standards for Injury Surveillance

Introduction ...................................................................................................................................... 3

Table 2.1: Three levels of the National Data Standards for Injury Surveillance ....................... 4

2.1 Background................................................................................................................................ 5

2.2 Overview of NDS-IS Level 1 and Level 2 ................................................................................ 6

Table 2.2: Special injury data items .......................................................................................... 7

Table 2.3: General information items ........................................................................................ 8

2.3 Information needed for injury prevention and control ............................................................... 8

3. Guide to NDS-IS Level 1 and NDS-IS Level 2 ................................................................................... 11

3.1 Guide to NDIS Level 1 ............................................................................................................ 11

Table 3.1: NDS-IS Level 1 Injury data items .......................................................................... 11

Table 3.2: NDS-IS Level 1: Recommended general information items. ................................. 11

3.2 Guide to NDIS Level 2 ............................................................................................................ 13

Table 3.3: NDS-IS Level 2 injury data items .......................................................................... 13

Table 3.4: NDS-IS Level 2 Recommended general information items ................................... 13

References ............................................................................................................................................... 17

Appendix 1. National Injury Surveillance Data Dictionary (NISDD) and Guidelines for use ............... 19

A1.1 Use ........................................................................................................................................ 19

A1.2 Case Definition .................................................................................................................... 19

A1.3 Difficult cases ....................................................................................................................... 20

Table A1.1 NDS-IS data items for Level 1 & Level 2 ............................................................ 21

NDS-IS Level 1 Items .................................................................................................................... 23

Level 1, item 1: Narrative description of injury event ............................................................. 23

Level 1, item 2A: External cause – major groups ................................................................... 24

Level 1, item 2B: External cause – intent groups .................................................................... 25

Level 1, item 3: Place of injury occurrence – type .................................................................. 26

Table A1.2 Coding examples for type of place ................................................................ 27

Level 1, item 4: Activity when injured – type ......................................................................... 28

Table A1.3 Coding examples for type of activity ............................................................ 29

Level 1, item 5A: Nature of main injury ................................................................................. 30

Level 1, item 5B: Bodily location of main injury .................................................................... 31

NDS-IS Level 2 Items .................................................................................................................... 32

Level 2, item 1: Narrative description of injury event ............................................................. 32

Level 2, item 2: External cause ............................................................................................... 34

Level 2, item 3A: Place of injury occurrence – sub-type ........................................................ 35

Level 2, item 3B: Place of injury occurrence – part ................................................................ 37

Level 2, item 4: Activity when injured – type ......................................................................... 38

Level 2, item 5: Principle diagnosis – injury or poisoning ...................................................... 42

Level 2, item 6: Major injury factor ........................................................................................ 43

Level 2, item 7: Mechanism of injury – type........................................................................... 48

Level 2, item 8: Date of injury ................................................................................................ 50

Level 2, item 9: Time of injury ............................................................................................... 51

General Information Items.............................................................................................................. 53

Establishment identifier ........................................................................................................... 54

Patient identifier ...................................................................................................................... 55

Sex ........................................................................................................................................... 56

Date of Birth ............................................................................................................................ 57

Area of usual residence ........................................................................................................... 58

Mode of separation .................................................................................................................. 60

Country of birth ....................................................................................................................... 61

NDS-IS Version 2c (January 1998) v

Aboriginality ........................................................................................................................... 62

Employment status .................................................................................................................. 63

Occupation .............................................................................................................................. 64

Preferred language ................................................................................................................... 66

Date of attendance ................................................................................................................... 69

Time of attendance .................................................................................................................. 70

Supplementary data items (new in Version 2.1) ............................................................................. 71

Postcode .................................................................................................................................. 71

Triage score ............................................................................................................................. 72

Appendix 2. Coding concordance tables: ICD and NDS-IS ................................................................... 73

Table A2.2A Main external cause ........................................................................................... 73

Table A2.2B Main external cause- intent ................................................................................ 77

Table A2.3 Type of place ........................................................................................................ 78

Table A2.4 Type of activity..................................................................................................... 79

Table A2.5A Nature of injury ................................................................................................. 81

Table A2.5A/B Nature and Bodily location of injury ............................................................. 83

Appendix 3. Specification for NDS-IS Data interchange ....................................................................... 85

Table A3.1 Data exchange file format ............................................................................................ 86

Appendix 4. Proposed additions to NDS-IS ........................................................................................... 87

Appendix 5. Summary of NDS-IS–Level 1 items and classifications .................................................... 96

Glossary ................................................................................................................................................. 98

Bibliography ............................................................................................................................................ 99

NDS-IS Version 2.1c (January 1998) vi

Acknowledgments

We wish to acknowledge the developers and users of the Injury Surveillance Information System. The

extensive experience gained in conducting injury surveillance based on data collected in hospital emergency

departments using this system has guided the development of the National Data Standards for Injury

Surveillance. Many people engaged in injury surveillance and prevention in Australia have contributed to its

development by submitting comments and suggestions, as well as participating in planning and revision

meetings. NDS-IS version 2 reflects, to a large degree, the input and guidance of people actively engaged in

injury surveillance and prevention.

NISDD Level 1 item

NDS-IS Version 2c (January 1998) 7

1. Abstract The National Data Standards for Injury Surveillance (NDS-IS) describe data items and classifications designed to

support public health surveillance of injury. The data required for injury surveillance depend on the precise

purposes of surveillance, the setting in which data are collected, and the resources available. NDS-IS is designed to

support three levels of data collection. The first level is intended for basic, routine public health surveillance. It is

almost the same as NMDS-IS, version 1.11. The second level builds on the first, with the addition of extended

classifications and additional data items. It is designed to support target-setting, identification and monitoring of

new or unusual injury events, and to assist in identification of hazards. Collection of Level 2 data will generally

require special resources. NDS-IS Level 3 is intended to provide for more detailed collection than Level 2. This

may be required for special studies, or for surveillance focusing on a particular type of injury. Level 3 has yet to be

developed.

The National Data Standards for Injury Surveillance are intended for use in a wide range of settings in which

information necessary for injury surveillance is collected. Special priority is given to collection in hospital

emergency departments. The experience gained in using the Injury Surveillance Information System (ISIS),

developed by the National Injury Surveillance and Prevention Project, in a large number of hospital emergency

departments during several years has been taken into account in designing the NDS-IS.

An important reason for the development of the NDS-IS is to provide a standard for injury surveillance information

to facilitate the comparisons between data collected in different places and at different times.

Principles underlying design of the NDS-IS are:

usefulness for public health injury surveillance

ease of data collection (especially at NDS-IS Level 1)

provision of a hierarchy of levels, providing more detailed classifications and additional data items, for

use in settings where these are required

compatibility with the International Classification of Diseases (ICD-92, ICD-9-CM

3 and ICD-10

4)

compatibility with the Australian National Health Data Dictionary5.

The NDS-IS Version 2.1 comprises:

1. Injury surveillance data items and coding specifications, divided into two levels:

Level 1 consists of five core injury data items, with associated simple classifications that define the

recommended minimum to be collected.

Level 2 provides more detailed classifications and additional data items, and is the level of collection

preferred by injury control personnel for use in emergency departments and other settings where

resources are available for proper collection and use of the data.

2. A recommendation concerning general case information that should be obtained.

3. Tables of concordance between NDS-IS Level 1 and ICD revisions 9-CM3 and 10

4.

4. Specification for NDS-IS data interchange

5. Proposed additions to NDS-IS

Level 1 item Appendix 1

NDS-IS Version 2.1c (January 1998) 8

2. Introduction and background to the

National Data Standards for Injury Surveillance

The National Injury Surveillance Unit, in conjunction with injury surveillance and prevention practitioners in

Australia, has defined data standards for public health injury surveillance. This edition provides for two levels of

surveillance data, and foreshadows a third.

Level 1, minimal level is almost the same as the NMDS–IS, version 1.11 Level 1 is proposed for use in basic,

routine public health surveillance.

Level 2 surveillance data standard builds on the first with more extensive classification of some items and several

additional data items. This data set is suitable for use in emergency departments in hospitals and has been

developed to reflect the need for a standard for use in the emergency departments of hospitals and in other settings

where at least some resources are available for injury surveillance data collection. The standard is based on

extensive experience with injury surveillance using the method developed in the National Injury Surveillance and

Prevention Project (about 700,000 cases recorded at more than 50 hospitals). It is designed to balance the

competing needs for simplicity in data collection, for sufficient information to be useful for public health purposes,

and for compatibility with other relevant data standards (notably, the International Classification of Diseases, and

the National Health Data Dictionary).

Level 3 data standard has been proposed for specialised surveillance or research involving detailed collection of

special data items. Level 3 is in the early stages of development.

The suite of three levels has been named the National Data Standards for Injury Surveillance (NDS-IS). A

summary of the three levels is presented in Table 2.1. This report describes the background and basis for the

development of the Data Standards, and provides documentation for Level 1 and Level 2. Level 3 will be

developed in future. Documentation of Levels 1 and 2 includes a description of the data items comprising each

level (Chapter 3), and a data dictionary including an entry for every data item used in the NDS-IS (Appendix 1).

In addition, the report includes tables detailing:

concordance between NDS-IS Level 1 and the International Classification of Diseases, versions 9-CM and 10

(Appendix 2)

specifications for computer files containing NDS-IS data (Appendix 3)

descriptions of possible additions to future editions of the NDS-IS (Appendix 4)

a summary table of the data items and classifications comprising Level 1 of the NDS-IS (Appendix 5) and

a utility for entry of NDS-IS Level 1 data, written in EpiInfo v6, is available on request.

NISDD Level 1 item


Table 2.1: Three levels of the National Data Standards for Injury Surveillance

Data Items

Level Purpose Injury items General items Intended coverage

1

To provide the

information most

necessary for basic

routine public health

surveillance of injury

levels and patterns:

as a basis for broad

policy development

to inform

communities

to generate

hypotheses

to monitor most

targets

Narrative

Four categorical

items based on

ICD

Ten items (a

subset of

NHDD)

Universal data

collection in settings

for primary care of

injuries (including

EDs) and for

surveillance of

injuries in all

settings

2

To provide information

to:

assist identification of

hazards and solutions

enable target setting

identify and monitor

new/unusual injury

events

As for Level 1

except:

Full ICD

classification

instead of short

code lists

Extended

classifications

for Place and

Activity

Four additional

items

As for Level 1

except:

Three additional

items

Preferred level for

EDs and all settings

where sufficient

resources are

available for

collection and use of

the data.

Aim for

representative or

sentinel coverage in

each state.

3

To investigate particular

classes of injury events at

a fine level of detail to

increase understanding of

risk factors and enable

research and evaluation

To be decided To be decided Where defined need

requires more detail,

and if resources

permit. Cases may

be sampled from

collection at a lower

level.



2.1 Background

An NDS-IS Advisory Group was convened by NISU and met in December 1994. The Advisory Group comprised

people who had been involved in development of the NMDS (Injury Surveillance), version 1.1, and others

interested in the further development of injury surveillance. The groups represented at the meeting were the

Monash University Accident Research Centre, Tasmanian Injury Surveillance and Prevention Project, the

Queensland Injury Surveillance and Prevention Program, Farmsafe Australia and NISU. Others attending the

meeting were Ms Judith Jones of ChildSafe, NSW; Dr P. Cameron, Director of Emergency Medicine at Geelong

Hospital; Dr R. Pitt, Director of Ambulatory Services at Mater Children‟s Hospital; Dr T. Nolan, Director Clinical

Epidemiology and Biostatistics Unit at Royal Children‟s Hospital (Melbourne); Dr Diane Jolly, Centre for Child

and Youth Health Studies; and Dr Ron Somers, South Australian Health Commission Injury Prevention Program.

The following principles have guided development of the NDS-IS. It should:

Provide information seen as being of central importance by injury prevention practitioners;

Be sufficiently small and simple to use (at least in its simplest form; it is hierarchical) to enable its

incorporation as part of the routine operation of important types of data collection site (hospital emergency

departments; possibly also hospital inpatient services, coroners‟ offices, etc);

Have good compatibility with the International Classification of Diseases and with other widely-used data

standards; and

Be capable of providing reliable and valid data.

The main outcome of the meeting in December 1994 was a recommendation to extend the existing single-level

surveillance data standard (the National Minimum Data Set for Injury Surveillance, NMDS-IS) into the three levels

of surveillance outlined in the introduction and in Table 2.1. The extensions beyond NDS-IS Level 1, particularly

for Level 2 surveillance, were designed to provide more complete information than the basic NMDS-IS version 1.1

and were of two types: extended classifications and additional data items. The data items that were proposed for

extended classification at the second level were „Type of Place‟, „Type of Activity‟, and „Occupation‟. Data items

proposed for inclusion in Level 2, and which are not part of Level 1, are injury „Factors‟ (limited to about 100

categories), „Use of protective device, clothing or equipment‟, „Industry‟, „Date and time of injury‟, and an item or

items to be along the lines of the NISPP breakdown and mechanism items, but limited to a small number of

distinctive categories. The data item „Consent for followup‟ was discussed at length, without reaching consensus.

A third level for the injury surveillance standard was envisaged. It would extend NDS-IS Level 2 to meet special

purposes. Such purposes might be to undertake surveillance of a particular type of injury (eg. farm injury, or

burns), or as the basis for a research project into a specific question. It was recognised that Level 3 would not be

fully developed in this edition of the NDS-IS.

Version 2.1 of NDS-IS has minor corrections and coding changes. Refer to the revision history table on page iii for

a summary of changes.

Several groups active in injury surveillance and prevention in Australia are collaborating with NISU and with

directors of emergency departments and software developers, to incorporate the new data standard for injury

surveillance into computerised data collection systems. These systems are being designed to meet the needs of

hospital emergency departments for case management data systems.

The data items and classifications comprising NDS-IS have been published in the National Health Data Dictionary

versions 5 and 6.

NISDD Level 1 item


2.2 Overview of NDS-IS Level 1 and Level 2

Tables 2.2 and 2.3 list the data items and classifications that comprise Level 1 and Level 2 of the NDS-IS.

Table 2.2 describes the „core‟ data items whose inclusion in a data system is largely or solely for the purposes of

injury surveillance. In contrast, the „general information items‟ (listed in Table 2.3) are not specific to injury

surveillance. These, or similar items, are included in many health data systems.

Injury surveillance data items

Certain data items are only necessary for the purposes of injury surveillance, or are of particular interest for this

purpose. Most of these would be meaningless if applied to non-injury cases. Some information relevant to injury

surveillance can be provided by widely used classifications, notably the International Classification of Diseases.

This, however, is insufficient for effective injury surveillance. Work in Australia and elsewhere, particularly in the

past decade, has sought to overcome these deficiencies while ensuring that new methods are practicable. The NDS-

IS „Injury surveillance data items‟ represent the current stage of this development in Australia.

Full specifications for each injury surveillance data item can be found in the data dictionary (NISDD, Appendix 1).

General information items

In order to maximise the compatibility of the NDS-IS with other health data systems, we have not sought to

develop new „general information items‟. Instead, we have looked for suitable existing sources of data items and

classifications. At the time of writing, the National Health Data Dictionary (NHDD, version 6.0) is the most

comprehensive source in Australia and will become the most widely used and recognised. This minor revised

edition of NDS-IS is however, still in accordance with NHDD, version 4.0. Accordingly, wherever a „general

information item‟ has an equivalent in the NHDD, that has been used as the source for its data specifications. The

NHDD does not yet provide all of the necessary „general information items‟. In the main, this reflects the fact that

emergency departments are a primary setting for injury surveillance, and that the NHDD does not yet incorporate a

data set tailored to the needs of emergency departments. Emergency department data sets have been developed in

some States (eg in NSW and Victoria), and developments which may lead to a national standard are in progress.

The NDS-IS recommendations for „general information items‟ are likely to change when a national data standard

for use in emergency departments is available.

Full specifications for the „general information items‟ items can be found in the data dictionary (Appendix 1).



Table 2.2: Special injury data items


Item Level 1 Level 2

1. Narrative description of

injury event

Narrative description of injury

event (short - 100 characters

maximum)

Narrative description of injury

event (unlimited length

structured narrative: injury

event, its location, factors

involved)

2. Main „External Cause‟

External Cause - major groups External Cause

(ICD 9-CM or ICD-10 take

„intent‟ into account)

External Cause – intent groups

(These map to ICD 9-CM &

ICD-10*)

3. Type of Place

Place of injury occurrence –

type

(This maps to ICD 9-CM &

ICD-10)


sub-type


part

4. Type of Activity

Activity when injured – type

(maps to ICD-10)

Activity when injured –

sub-type classifications

5. Trauma

Nature of main injury Principle diagnosis – injury or

poisoning (ICD-9-CM or ICD-

10)

Bodily location of main injury

(These map to ICD 9-CM &

ICD-10*)

6. Major factors not included Major injury factors

7. Major mechanisms of injury not included Mechanisms of injury – types

8. Date of injury not included DDMMYYYY

9. Time of injury not included HHMM

* Mapping is as complete as possible given characteristics of the ICD. Limits are described in Appendix 2

NISDD Level 1 item


Table 2.3: General information items


Item Level 1 Level 2

Establishment identifier NHDD P1 NHDD P1

Patient identifier NHDD P2 NHDD P2

Sex NHDD P4 NHDD P4

Date of birth NHDD P5 NHDD P5

Area of usual residence NHDD P9 NHDD P9

Mode of separation NHDD P31* NHDD P31*

Country of birth NHDD P6 NHDD P6

Aboriginality NHDD P7 NHDD P7

Employment status NHDD P14** NHDD P14**

Occupation NHDD P15 NHDD P15

Preferred language not included NHDD P11

Date of attendance not included DDMMYYYY***

Time of attendance not included HHMM

Notes:

* Mode of separation: This item is based on the NHDD item P31 with the addition of a category for „admitted‟.

Refer to General information item: Mode of Separation in Appendix 1.

** Employment status, uses the coding recommended for public and psychiatric hospitals in NHDD, item P14

with the addition of two categories to distinguish the self-employed.

Refer to General information item: Employment status in Appendix 1.

*** Date of attendance: This is conceptually equivalent to NHDD Date of admission (Item P24).

2.3 Information needed for injury prevention and control

Routine scrutiny of the occurrence of injury is an essential component of effective public health injury control.

Much can be achieved using data which are collected mainly for reasons other than public health injury

surveillance. Coroners‟ records, hospital admission data, and workers‟ compensation records are examples of such

data sources. The special virtue of these sources is that they are already in place, and the cost and difficulty of

establishing a data collection system need not be borne (entirely) by those interested in injury prevention.

Typically, however, the data collected by these systems are of limited value, often because of the selection of data

items, and the ways in which data are classified. Most Australian hospital admission data, and all deaths data, are

classified in a way that enables (most) injury deaths to be identified. The data sets enable analysis of the data by

age, sex, and a few other demographic variables. As for information useful for prevention - particularly on how

injury comes about - relatively little information is provided. A four-digit „external cause‟ code (or „E-code‟;

currently as specified in the 9th revision of the International Classification of Diseases, ICD-9) provides some

insight. E-codes are available for Australian deaths data and for hospital separation data. The E-code classification

distinguishes categories such as „Motor vehicle traffic accident involving collision with another vehicle: injury to

pedal cyclist‟ (E813.6), „Accidental drowning and submersion in bathtub‟ (E910.4), and „Suicide and self-inflicted

injury by other and unspecified means: jumping or lying before moving object‟ (E958.0).

E-codes provide useful information, but have important limitations. For example, E-codes do not (with a few

exceptions) distinguish work-related cases, nor sporting and recreational cases, nor cases occurring in educational

institutions. Yet all of these categories are important, because they define classes of injuries whose prevention falls

into the domain of particular organisations and sectors. A more general concern is that the E-code approach to

classification begins by requiring a decision on the role of human intent in the occurrence of the injury („accident‟,

„suicide‟, „assault and homicide‟, „uncertain intent‟). Intent is more complex than is implied by the E-code

approach, and the intent-based classification tends to obscure features such as the overall role of firearms as a cause

of death.



Another part of ICD-9 provides codes to represent the nature and bodily location of injury. Examples are „Fracture

of neck of femur: trans-cervical fracture, closed‟ (820.0), „Late effect of tendon injury‟ (905.8), and „Poisoning by

sedatives and hypnotics: barbiturates‟ (967.0). This classification (or its more detailed „Clinical Modification‟,

ICD-9-CM ) is used for hospital in-patient classification, but not for Australian deaths data.

One reaction to the limitations of existing data systems has been development of special data systems, designed for

the purpose of injury surveillance. The Injury Surveillance Information System (ISIS) is one such system. ISIS

was designed (largely by Mr Jerry Moller) mainly for use in hospital emergency departments, and was developed

and piloted by the National Injury Surveillance and Prevention Project.(NISPP)6 When ISIS was developed, few

emergency departments had electronic case information systems in place. Hence, ISIS was developed as a „stand-

alone‟ system. A principle of its design was to create a „multi-axial‟ classification, with a separate classification

for each concept of interest.

In contrast, the ICD folds several concepts into a single classification, in a somewhat complex manner. For

example, some E-codes embody each of the following concepts: intent (eg suicide); type of location (eg public

highway); type of road user (eg motorcycle passenger); dynamics of an injury-producing event (eg „re-entrant

collision with another motor vehicle); occupation (eg crew member of a commercial aircraft); context of person

when injured (eg undergoing surgical or medical care); type of substance or object involved in producing injury (eg

methyl alcohol, powered lawn-mower); type of „breakdown event‟ (ie „what went wrong‟ and resulted in injury; eg

fall from slipping, tripping or stumbling); and the mechanism whereby injury was sustained (eg immersion,

poisoning, burning, exposure to electricity).

The ISIS data set and classifications have been implemented in a software application that has been used at several

dozen hospitals for periods of up to 5 years. About 700,000 records have been collected.

The experience of using the ISIS data set has been mixed. Strengths include the relatively great depth of

information, both in the coded items (notably „body part‟, „nature of injury‟, „context‟, „location‟, and „factors‟),

and in the free text fields (notably the „what went wrong‟ field). Limitations include difficulties with some

classifications (particularly „breakdown event‟ and „mechanism‟); the total size of the data set (found to be difficult

to apply with good reliability and completeness of ascertainment); and difficulties in linking or comparing with

data from other sources (in part because of differences in data definition and classification).

An alternative to the creation of a „stand alone‟ injury surveillance data system is to develop a data set and

classifications designed mainly to be taken up into other data systems, such as hospital case information systems.

With this approach in mind, NISU and a number of others interested in the subject proposed a data set for this

purpose, late in 1991. The data set, originally referred to as the minimum data set for „basic routine injury

surveillance‟, was the basis for the NMDS (Injury Surveillance), version 1.1, released in February 1994. The NDS-

IS is the next stage in this area of development.

A first Australian edition of ICD-9-CM was published in 1995, by the National Coding Centre, and has been used

for coding all hospital separations beginning in July 1995. The Australian ICD will be updated annually. This

revision is based on codes of ICD-9-CM, Australian version, second edition, 1996.

NISDD Level 1 item


3. Guide to NDS-IS Level 1 and NDS-IS Level 2

This Chapter describes the two levels of the National Data Standards for Injury Surveillance (NDS-IS) that have

been developed so far.

3.1 NDS-IS Level 1 The lowest level of the NDS-IS was developed to meet the most basic requirements of injury surveillance and

prevention practitioners engaged in routine injury surveillance. It is a minimum data set, intended for widespread,

uniform collection of data at low cost per case. It is particularly suited to injury surveillance with very tight

resource constraints, and in settings in which use of more extensive data sets or classifications is not practicable.

The NDS-IS Level 1 injury surveillance data items and classifications are described in Table 3.1.

For a convenient summary of the items and classifications, see Appendix 5.

In addition to the core injury surveillance data items, a set of general information items is recommended as part of

NDS-IS Level 1. All of the general information items are drawn from the National Health Data Dictionary

(NHDD) version 4. The recommended general information items are listed in Table 3.2.

Table 3.1 NDS-IS Level 1: Injury data items

Data Item Minimum information

1. Description of injury event Short narrative description of injury event

(Text field with capacity for 100 characters)

2. External Cause 2A. External Cause major groups (30 categories)

2B. External Cause intent groups (11 categories)

3. Place of injury occurrence Place of injury occurrence type (13 categories)

4. Activity when injured Activity when injured type (9 categories)

5. Principle diagnosis, injury or poisoning 5A. Nature of main injury (32 categories)

5B. Bodily location of main injury (22 categories)

Table 3.2: NDS-IS Level 1: Recommended general information items.

Item NHDD

item

Comment

Establishment identifier P1 6 digit code

Person identifier P2 Unique establishment code

Sex P4

Date of birth P5

Area of usual residence P9 5 digit geographical location code

Mode of Separation P31 Modified by the addition of a category for Admission to

hospital

Country of birth P6 ASCCSS individual country classification

Aboriginality P7 Will change to a 5 category „Indigenous status‟ classification

in the next version of NDS-IS

Employment status P14 Based on categories for public psychiatric hospitals and

modified for NDS-IS to distinguish the self employed

Occupation P15 ASCO, 2 digit (minor group) classification



The NDS-IS Level 1 can provide information on numbers and rates of injuries in major categories. This

information should be collected widely, as part of relevant routine data collections in the health sector and

elsewhere. The items in Level 1 of the NDS-IS comprise a proposed National Minimum Data Set for Injury

Surveillance. This basic information on injury levels and patterns provides a useful foundation for broad policy

development, for informing communities of their injury experience, and for generating hypotheses for research.

The NDS-IS Level 1 data set consists of two parts: a small set of data items particularly relevant to the

circumstances and nature of injury events, and a set of general information items that are necessary for injury

surveillance, but are equally pertinent to health sector data collection on other topics.

The core of the NDS-IS Level 1 data standard comprises five data items and their classifications. One item is a

narrative text description of the injury event, and the core system contains no classification for this. The remaining

four items are categorical, and each has a recommended simple, minimum classification system. The simple level

classifications represent the minimum level of data that can be regarded as complying with the Level 1 injury

surveillance standard.

All of the four categorical data items are derived from the International Classification of Diseases. Two items -

external cause and principal diagnosis - are aggregations of more extensive classifications which form part of the

ICD. These extensive classifications have proven to be too difficult to implement in some of the settings in which

injury surveillance data collection is undertaken, particularly where coding is done at the time of data recording,

rather than as a separate process at a later stage. The NDS-IS Level 1 equivalents to these items are designed as

relatively short „pick lists‟ of categories, each of which has a well defined relationship to the full ICD

classifications (both ICD-9-CM and ICD-10).

The ICD external cause classification is conceptually untidy. One respect in which it is reasonably consistent is

that it is divided into several sections, according to the assessed role of human intent in the occurrence of the injury

(eg not intentional; intentional self-inflicted; intentional, inflicted by another person). In NDS-IS Level 1, „Intent‟

has been separated as a distinct coding axis (2B), all other „external causes‟ being summarised in a second axis

(2A).

Principal diagnosis has also been divided into two axes in NDS-IS Level 1. Many of the codes in the ICD-9-CM

chapter 17 (vol. 1) („Injury and Poisoning‟), and the equivalent chapter XX in ICD-10 (vol. 1) refer to both the

nature of an injury (eg fracture, burn) and the part of the body affected. Other ICD codes refer only to the nature of

injury, usually where the affected body part is implied by the type of injury (eg concussion) or where the injury can

be seen as affecting the whole person, rather than a particular part (eg drowning). The approach taken for NDS-IS

was to develop a list of Nature of main injury categories, for coding all cases. A second list of Bodily location of

main injury categories was also developed, for use to further specify those injuries for which body part is relevant

(ie those having certain types of Nature).

This approach was modified for coding foreign bodies in various parts of the body. This is because the common

sites for foreign bodies are very specific (eg in the ear canal), and are not well distinguished by the short list of

bodily locations that is suitable for most other types of injury. Accordingly, categories for foreign bodies in each of

several important parts of the body were included in the nature of main injury classification.

The NDS-IS Level 1 place of occurrence classification is based on the ones in ICD-9-CM and ICD-10. Differences

between the ICD-9-CM and ICD-10 versions of the classification are such that a minimum of 13 categories are

needed in the NDS-IS classification if it is to be compatible with both editions of ICD. The relationship between

the ICD place classifications, and the NDS-IS place of injury occurrence classification are shown in Appendix 2

(Table A2.3).

Up to its ninth edition, the ICD lacked categories to identify most injuries which occurred while working or while

engaged in sports. The tenth edition of ICD has a new short classification which identifies these and several other

categories of activity at the time of injury. The NDS-IS Level 1 includes the new ICD-10 activity classification,

extended in NDS-IS by the addition of two additional categories.

NISDD Level 1 item


3.2 NDS-IS Level 2 The information obtained by NDS-IS Level 1 is not sufficient for all aspects of injury surveillance. In particular,

identification and characterisation of risk factors in a manner capable of guiding and supporting injury prevention

interventions requires more detailed case information. A more extensive data set, the National Data Set for Injury

Surveillance–Level 2, has been developed to serve some of these purposes.

The Level 2 data set is an extension of the Level 1 data set, and thus includes all NDS-IS Level 1 items. Level 2

extends beyond Level 1 in two ways:

two recommended Level 1 data items (items 2 and 5) are classified to a greater level of detail than the

minimum specified for the Level 1, and item 3 is extended to enable further specification of place of injury.

some additional injury data items and General information data items are included.

These extensions are summarised in Tables 3.3 and 3.4 and described below.

Table 3.3 NDS-IS Level 2: Injury data items

Data Item Minimum information

1. Narrative description of injury event Narrative description of injury event

(Structured text field of unlimited length)

2. External Cause Full ICD „External Cause‟ code

(ICD-9-CM or ICD-10)

3. Place of injury occurrence 3A. Place of injury occurrence sub-type

3B. Place of injury occurrence part

4. Activity when injured Activity when injured sub-type

5. Principle diagnosis injury or

poisoning

Full ICD injury classification

(ICD-9-CM or ICD-10)

6. Major Injury factors Major injury factors code

7. Mechanism of injury Mechanisms of injury types

8. Date of injury DDMMYYYY

9. Time of injury HHMM

Table 3.4 NDS-IS Level 2: Recommended general information items

Item NHDD item or

other specification

Comment

Establishment identifier P1 6 digit code

Patient identifier P2 Unique establishment code

Sex P4

Date of birth P5

Area of usual residence P9 5 digit geographical location code

Mode of Separation P31 Modified by the addition of a category for Admission to

hospital

Country of birth P6 ASCCSS individual country classification

Aboriginality P7 Will change to a 5 category „Indigenous status‟

classification in the next version of NDS-IS

Employment status P14 Based on categories for public psychiatric hospitals and

modified for NDS-IS to distinguish self employed

Occupation P15 ASCO, 2 digit (minor group) classification

Preferred language P11 2 digit classification

Date of attendance DDMMYYYY The same format as NHDD P24

Time of attendance HHMM 24 hour clock



The items in NDS-IS Level 2 represent a significant data collection task. It is unlikely that collection to a

satisfactory standard of data quality can be achieved without the availability of resources provided specifically for

this purpose. Moreover, the potential value of these data will not be tapped without the availability of competent

injury surveillance and prevention personnel. Implementation of this data set should only be undertaken where

adequate resources for data collection and data use are available. Collection of data on a sample of injury events at

a site, or in a region, may provide adequate information, at lower cost than if information is collected on all cases.

Several items and classifications included in NDS-IS Level 2 which warrant special comment are discussed in this

chapter. This section also lists several items which were suggested for inclusion in NDS-IS Level 2, but which

have not been included in this edition. These proposed items are discussed in Appendix 4.

Level 2 classification: Sub-Type of Place The 13 Type of Place categories specified in the NDS-IS Level 1 are the minimum required to enable reporting

according to both the 10, ICD-9-CM place categories and the slightly different 10, place categories in ICD-10. The

three additional categories also add a small degree of specificity to the classification. For example, hospitals are

placed in a group called „Residential institutions‟ in ICD-9-CM, and in a group called „School, other institution and

public administrative area‟ in ICD-10. The NDS-IS Level 1 classification puts hospitals in their own category.

Often, greater specificity about the place at which an injury occurred is required for injury surveillance and

prevention.

A major aim for injury surveillance is to help agencies and organisations which have responsibility for safety, or

power to improve safety, to do so. A first step in this direction is to enable an organisation to „see‟ the nature and

extent of injury occurring within its sphere of responsibility or influence. Sometimes the sphere of responsibility or

influence extends to a particular type of place. For example, education departments and school authorities have

responsibilities for safety at schools.

The broad place categories in the ICD, and the NDS-IS Level 1, are insufficiently specific to be used in this way

for many of the settings in which injury occurs. Taking again the example of schools, injuries at this type of place

are coded to „Public building‟ under ICD-9-CM and to „School, other institution and public administrative area‟

under ICD-10. Neither of these categories is of much use for learning the nature and extent of injury at schools.

Accordingly, a more detailed classification of sub-types of place has been developed for NDS-IS Level 2. The

principles guiding development were to identify types of place which are relevant to injury control, and to maintain

consistency with ICD-9-CM and ICD-10. Up to nine sub-types of place are specified within each type of place.

See Appendix 1 for a full list of the categories (Level 2, item 3A-Place of injury occurrence-sub-type-).

Consistency with ICD was approached by ensuring that any sub-type category that is referred to in the ICD coding

guidelines as an inclusion for a particular place category has been made a sub-type of that place in the new

classification. Sub-types which are not specifically mentioned in the ICD guidelines have been put into the place

category to which they are most similar.

Level 2 classification: Part of Place The classifications of type and sub-type of place are useful for identifying a whole entity which has distinct

organisational, legal or other characteristics which determine or indicate who can, or should, take responsibility for

injury control in that setting.

„Place‟ can also be seen as referring to more specific and (typically) smaller entities, which constitute parts,

sections, or regions within an entity of the type described in the previous paragraph. This further level of

specification is relevant for much injury surveillance and prevention. For example, sub-type of place can identify

injuries which occur on a farm. While this is useful for overall targeting of a prevention program or for planning

in-depth research, it adds to the usefulness to know, also, at which part of the farm an injury occurred (eg. in a

paddock, a stock yard, a workshop, or on a farm road). Likewise, for an injury which occurred at a home, it is

useful to know whether it occurred in a particular type of room (eg bathroom, kitchen), in the garden, in an under-

house space, or in a workshop or shed.

A new classification titled part of place has been developed to meet the demand for this type of information. Its

categories are shown in its entry in the data dictionary (Appendix 1, Level 2, item 3B). As far as was practicable,

part of place categories have been selected which could be a „part‟ of many of the „sub-types‟ of place

differentiated in that classification. For example, a bathroom or a toilet can form part of a home, a residential

institution, a school, or many other types of places. Likewise, a sealed roadway can be found as part of a farm, a

factory, a hospital or a holiday, as well as comprising nearly all of a freeway. Several specialised part of place

NISDD Level 1 item


categories have been included where warranted by probable frequency or severity of injury, or where public health

interest is particularly strong.

Part of place should be used to supplement the sub-type of place classification. When coding a case, a sub-type of

place category should be selected, then the most appropriate part of place. While all combinations of the two items

are permitted, some are unlikely to occur very often (eg a beach as part of a prison; an escalator or elevator as

part of a camping ground).

A few examples may help to clarify the approach taken to classifying places. A public road - urban is a sub-type

of street or highway. Several part of place categories represent common components of such a road: roadway -

sealed (ie the portion trafficable by motor vehicles); footpath/path (the part restricted to pedestrians); and bicycle

path/cycleway (the part provided for cyclists, if any). Any of these three part of place categories can be paired

with other sub-type of place categories, to identify places such as a roadway - sealed at a factory; a footpath/path

at a home for elderly, frail or sick, or a bicycle path/bikeway at a public park. Sometimes, a thing described by

a part of place category may extend beyond the place of interest. For example, a large body of water (eg a lake)

may extend beyond a place recorded as a holiday resort. Nevertheless, a section of the lake forms part of the

resort. In general, a place is taken to include a building (or associated group of buildings) and associated grounds

(eg. a primary school includes its assembly areas, play grounds and gardens). A farm house (which is taken to

include an adjacent garden, if present) is grouped in the type of place Home, while the rest of the property is coded

to Farm (this is the approach taken in the ICD).

Level 2 item: Activity when injured Injury surveillance data users have requested development of a more detailed level of classification of „Activity

when injured‟ than is provided in NDS-IS Level 1. Several conceptually different bases for such sub-classification

have been suggested. The choice between them was based on an assessment of their value for the major potential

uses of routine injury surveillance data. A key use of the „activity‟ item is to identify cases of injury which fall

within the areas of responsibility and authority of organisations and agencies. The Level 1 „activity‟ classification

does this most successfully for work-related injury and for sport related injury Extension of activity coding of work

activities and sport activities to a more detailed level has been done in a way that identifies classes of injury cases

that are relevant to more specific organisations and agencies.

Sport and Leisure Three considerations influenced the approach taken.

(i) Much of the potential to control sports injuries lies with the organisations which govern and develop particular

games and codes, and the clubs and associations which compete in sporting competitions. The approach to second

level classification most able to identify classes of injury cases relevant to these groups is one that distinguishes

types of sporting codes and games. This is the approach taken in NDS-IS Level 2.

(ii) Two Level 1 „Activity‟ categories both have some relevance to sports: Sports activity and Leisure activity.

The ICD-10 coding guidelines for „Activity‟ do not provide a great deal of assistance in deciding where to allocate

certain common classes of activity. For example, cricket played for a district team or for a school team is readily

coded to Sports activity.

It is not so obvious how to code a less formal activity, such as back-yard cricket, or kicking around a soccer ball at

a family picnic. The approach taken for NDS-IS Level 2 is to limit the use of Sports activity to organised physical

activities undertaken under the auspices of a sports club, association, school or other organisation. This includes

training for the activities. Informal versions of the games should be coded to Leisure activity.

Given this approach, it is convenient to use the same second level classification for „Sports activity‟ and „Leisure

activity.‟

(iii) The third consideration is the large number of sport and leisure activities. For the purposes of NDS-IS Level 2,

a very long list of categories would probably prove to be unworkable. A limit of about 30 categories was suggested

at the December 1994 meeting of the advisory group, on the basis that this is a manageable length for a single-

screen pick list. The meeting also agreed that non-specific categories should be avoided as much as possible, as

these provide less useful information than specific ones. This approach was preferred despite its potential to lead to

a relatively large residual category.

Taking account of these factors, the NDS-IS Level 2 classification for sport and leisure activities was developed in

the following way. The collection of Injury Surveillance Information System data held by NISU on about 700,000

emergency department attendances due to injury was searched for cases with mention of a sport or leisure activity.

Activities were selected which were common among all cases, among cases that resulted in hospital admission, or

among the deaths recorded in this collection. The resulting list was modified slightly to take account of some



categories in a code list proposed by Dr Rob Pitt, trimmed to about 36 categories, circulated for comment to

members of the Advisory Group who had expressed interest in it, and modified further on this basis.

While working for income In the case of work activities, the industry in which the person was working when

injured is a reasonable way to achieve this aim. A standard classification of industry, widely used in Australia for

purposes including occupational health and safety statistics, has been proposed for NDS-IS Level 2 coding of

injuries which occurred while working for income. The occupation of the person at the time of injury while

working for income provides a somewhat different perspective, and this is also to be collected.

Working for income: Industry Information on industry is of great interest to occupational health and safety professionals. It is most relevant

for cases where injury was sustained in the course of work.

This edition of NDS-IS Level 2 makes use of the Australian and New Zealand Standard Industrial

Classification (ANZSIC) at the 2-digit level, which comprises 53 industry „sub-divisions‟. Collection of this

information is limited to cases where the activity at the time of injury was Working for income as these are the

cases for which information about industry is most useful.

Working for income: Occupation

The advisory group recommended that occupation at the time of injury should be coded in the same way that is

used for the NHDD (ie Australian Standard Classification of Occupations, ASCO, at 2-digit level).

Occupation may be coded at a greater level of detail using the 4-digit level of ASCO.

The 2-digit level of ASCO comprises 52 „Minor Groups‟, and the 4-digit level comprises 282 „Unit Groups‟.

The advisory group recognised that coding at the higher level might present difficulties, in terms of

information acquisition and coding. Usual occupation should also be recorded for all cases to ASCO 2-digit

level (refer to General information item P15: Occupation).

Second level classifications have not yet been developed for the other categories in the NDS-IS Level 1 Activity

classification.

Level 2 item: Major Factors Information on the specific objects, substances and other „things‟ which are directly involved in the occurrence of

injury is important for injury prevention and control. The NDS-IS Level 1 „External cause - major groups‟

classification indicates a few fairly specific „factors‟ (eg firearm; electricity), and the full ICD-9-CM or ICD-10

„External cause‟ classification, used for NDS-IS Level 2 item of the same name, identifies some more. However,

these provide no information on factors for many cases, and do not specify many factors that are of interest for

contemporary injury prevention work.

Extensive lists of „factors‟ are available (eg the classification developed for the National Injury Surveillance and

Prevention Project (NISPP), the US NEISS system classification on which it was based, and a classification

forming part of the Nordic NOMESCO injury surveillance system). For the purposes of the NDS-IS Level 2

system, a role was seen for a list of factors that is hierarchical (like the NOMESCO classification), short enough to

enable coding at the time of data collection, and contains categories relevant to the known causes of injury in

Australia, and to issues of interest to current injury prevention efforts in Australia.

The classification of major injury factors developed for NDS-IS Level 2 is presented in Appendix 1 (Level 2, item

6). For the purposes of this surveillance data set, there is no intention to systematically characterise the role of the

factor in the event leading to injury (ie. „breakdown factors‟, „injury factors‟, etc.). The initial version of the

„factors‟ list contains about 140 items, in 13 groups. Each item included is fairly specific (eg. „slide‟ rather than

„playground equipment‟). Selection of items took account of the frequency of factors in the large collection of

emergency department case records held by NISU, public health importance, and comparability with other factor

classifications.

Level 2 item: Major mechanism of injury Several contemporary systems for the classification of injury include an item which records the mechanism by

which trauma came about. Typically, these classifications take account of the model of injury occurrence,

advanced by Haddon, which is framed in terms of the type of energy involved. The December 1994 meeting of the

NDS-IS advisory group recommended that a mechanism item should be included in Level 2 if a suitable

classification was available.

NISDD Level 1 item


A classification of this type is being drafted for consideration be a WHO-sponsored Working Group on Injury

Surveillance Methodology. The NDS-IS mechanism classification is based on a draft of this classification.

Level 2 items: Date and Time of injury occurrence Date and time of injury occurrence do not form part of the NHDD version 4.0. Date of injury appears in a draft

data set for emergency department patients developed by the Australasian College of Emergency Medicine

(ACEM). Neither item is in the current NSW or Victorian emergency department data definitions. The NDS-IS

advisory group argued for the inclusion of these items in the NDS-IS Level 2 data set, and this has been done.

Other items considered by the NDS-IS advisory group Several other items were considered by the advisory group for inclusion in NDS-IS Level 2. Discussion of

proposed additions, including an outline of reasons they have not been included in this edition, can be found in

Appendix 4. The items described are:

Task

Alcohol

Protective devices

Severity

Counterpart (in transport collisions)

Perpetrator of violence

Breakdown event

Consent by injured person

References 1. Australian Institute of Health and Welfare, National Injury Surveillance Unit (1994).

2. World Health Organization (1975)

3. National Coding Centre (1996)

4. World Health Organization (1992)

5. Australian Institute of Health and Welfare (1995)

6. Vimpani G and Hartley P (1991)



Appendix 1. National Injury Surveillance Data Dictionary (NISDD) &

Guidelines for Use

The Injury Surveillance Data Dictionary specifies a set of data items, definitions and classifications to enable the

collection of uniform data about injury and the events leading to injury.

This appendix contains:

Descriptions for:

A1.1 Use

A1.2 Case definition

A1.3 Difficult cases

Table A1.1 listing all NDS-IS items for Level 1 and Level 2

NISDD, a dictionary entry for each of the items listed in Table A1.1.

Level 1 and Level 2 of the National Data Standards for Injury Surveillance (NDSIS), data dictionary (NISDD) each

comprises a set of data items as outlined in Table A1.1. Note that some of the data items in Level 2 (eg. Place of

injury occurrence – sub-type) are extensions of items in Level 1 (Place of injury occurrence – type). Some other

items in Level 2, are in addition to items in Level 1 (eg. Major injury factor). Each item has a separate entry in the

dictionary.

Appendix 5 gives a useful summary of items for coding at Level 1 that are described in the NISDD.

A1.1 Use

It is expected that the NDS-IS (Injury Surveillance) will be used in two main ways within hospital emergency

departments.

Many hospitals are introducing computerised case information systems, and more will do so. It is

recommended that provision be made in these systems for the core NMDS (Injury Surveillance) data items,

particularly in the case of emergency department data systems. These systems may already be capable of

providing recommended general information.

In other hospitals, emergency department data systems specifically designed for injury surveillance may

continue to be used. These should, at least, be capable of providing information consistent with the NDS-IS

Level 1 core items, along with the recommended general information items.

The NDS-IS are not intended only for use in hospital emergency departments. They should be considered for

coroner data systems, trauma registers, hospital inpatient data systems, and systems recording injury experience in

settings such as schools and sporting clubs. The following comments, however, relate most directly to use of the

NDS-IS Level 1 in emergency departments.

A1.2 Case Definition (for emergency department surveillance) The primary aim of this system for injury surveillance is to collect information during the FIRST ATTENDANCE

at any data collection site within the scope of the surveillance system where the attendance is judged to be due to an

EVENT WHICH PRODUCED, OR MIGHT HAVE PRODUCED, INJURY.

Term definitions:

- „first attendance‟: This restriction is to enable estimation of the incidence of injuries. Collection of

information on first attendance and on subsequent attendances due to the same injury (eg for new dressings

or a check on progress) would enable estimation of the total service load due to injury cases. To differentiate,

however, it would be necessary to be able to flag the first attendance due to an injury as opposed to

subsequent attendances.

- „data collection site‟: arrangements and terminology differ between hospitals, some having a single service

for receiving injury cases (eg an Emergency Department); others have two or more services (eg a Priority

Emergency Service and a Casualty Department). Injury cases attending all emergency services at an

institution should normally be included.

NISDD Level 1 item


- „at any data collection site within the scope of the surveillance system‟: This restriction is to avoid double

counting of injuries in surveillance systems collecting data at more than one site. Ideally these would be

collected for first attendance only.

- „event which...might have produced‟: Data collection for injury surveillance typically occurs during clerical

processing and initial assessment of a person soon after arrival at an emergency clinical service, or is based

on records made at this time. At this stage, the fact of injury may be apparent (eg. open wound) or may not be

apparent (eg. crying child, said to have fallen from a horse, without obvious injury). People presenting

should be included if (i) injury is apparent; or (ii) the reason for the attendance is an event which might have

produced injury. A consequence of this approach is that some cases will be collected in which, following

assessment, no injury or trivial injury is found. A Nature of injury code for „no injury detected‟ is provided

for this reason.

- „injury‟ includes trauma, poisoning, and other conditions of rapid onset to which factors and

circumstances external to the person contributed significantly.

-

- Trauma is generally the result of transfer of energy from the immediate environment of a person at a

rate or intensity sufficient to cause damage to tissues. This is most obvious in the case of kinetic

energy (eg person struck by a moving object). By close analogy, excess thermal energy results in

burns.

External factors and circumstances include blows by an object or person, falls, toxic or corrosive

substances, immersion in water or other liquid, sharp objects, crushing, asphyxia by any means, solar

or other radiation, heat, noise or vibration, and extremes of air pressure. By convention, certain

factors which might be seen as internal to the injured person are also included: eg overexertion.

Factors and circumstances include the deficiency or absence of conditions necessary for life (eg

oxygen, heat, water) as well as the presence of excessive amounts.

The role of human intent in the occurrence of an injury has no bearing on its inclusion for purposes of

surveillance. Include cases whether they are thought to be unintentional, or to be deliberate, and

whether self-inflicted or inflicted by another person.

In terms of the International Classification of Diseases (ICD), injury includes any condition which

may properly be classified to a code in Chapter 17, „Injury and Poisoning‟, of the 9th revision (ICD-

9), or its clinical modification (ICD-9-CM), or the equivalent chapter in ICD-10 (Chapter XIX).

In terms of the ICD, contributory factors and circumstances, include any which may properly be

classified to a code in the „Supplementary Classification of Injury and Poisoning‟ (known as „E-

codes‟), which forms part of ICD-9 and ICD9-CM, or to a code in the equivalent part of ICD-10

(Chapter XX). Note that this includes adverse consequences and complications of medical and

surgical care.

A1.3 Difficult cases A minority of cases present definitional difficulties, some of which are discussed here. Consult NISU if necessary.

1. Uncertainty, on presentation, whether injury or disease (eg unconsciousness which might be due to

poisoning, a blow to the head or to a stroke). Assume injury until another diagnosis is made.

2. Exacerbations of chronic conditions. Typical instances are certain types of painful musculo-skeletal

conditions. Sudden recurrences, or acute exacerbations, can be regarded as new events for the purposes of the „first

attendance‟ rule.

3. Iatrogenic injury. Attendances due to effects of medical treatment should be included (eg adverse reaction to a

medication; poisoning due to error in dose; effects of surgery).

4. Delayed presentation. Cases otherwise satisfying the case definition should not be excluded simply because the

person has not presented until long after the injury (eg. A welder presents with long-standing eye irritation. On

investigation, this is found to be due to a fragment of metal in his eye.)



Table A1.1: NDS-IS data items for Level 1 and Level 2 NDS-IS items

NISDD entry Level 1 Level

2

Source

A. Injury surveillance data items

Narrative description of injury event (short) 1 NISU

External cause – major groups 2A NISU/ICD

External cause – intent groups 2B NISU/ICD

Place of injury occurrence – type 3 NISU/ICD

Activity when injured – type 4 NISU/ICD

Nature of main injury 5A NISU/ICD

Bodily location of main injury 5B NISU/ICD

Narrative description of injury event (no limit) 1 NISU

External cause 2 NHDD/ICD

Place of injury occurrence – sub-type 3A NISU/ICD

Place of injury occurrence – part 3B NISU/ICD

Activity when injured – sub-type If ‘sport’ or ‘leisure’: sport/leisure classification

If ‘working for income’: industry

occupation

4

NISU

ANZSIC

ASCO

Principle diagnosis – injury or poisoning 5 NHDD

Major injury factor 6 NISU

Mechanism of injury – type 7 NISU/WHO

Date of injury 8 NISU

Time of injury 9 NISU

B. General information data items

Establishment identifier NHDD (P1)

Patient identifier NHDD (P2)

Sex NHDD (P4)

Date of birth NHDD (P5)

Area of usual residence NHDD (P9)

Mode of separation NHDD (P31)

Country of birth NHDD (P6)

Aboriginality NHDD (P7)

Employment status NHDD P14)

Occupation NHDD (P15)/ASCO

Preferred language NHDD(P11)

Date of attendance NHDD (P24)/NISU

Time of attendance NISU

C. Supplementary data items (new in Version 2.1)

Postcode

Triage score ACEM

Key to sources of data items and classifications

ANZSIC Australian and New Zealand Standard Industry Classification. Collection at „sub-division‟ level.

ASCO Australian Standard Classification of Occupations. Collection at „minor group‟ level for all cases

(NDS-IS Level 1 and Level 2). More detailed collection at „unit group‟ level in NDS-IS Level 2

where Activity = While working for income.

NHDD National Health Data Dictionary item (Version 4.0)

NHDD/ICD National Health Data Dictionary item, taken from ICD-9-CM

NISU Developed by NISU in collaboration with the NDS-IS advisory group

NISU/ICD As above, based on the International Classification of Diseases (9-CM and/or 10)

NISU/WHO As above, based on a draft data item of the WHO Working Group for Injury Surveillance

Methodology

NISDD Level 1 item


NDS-IS Level 1 Items

NDS-IS–level 1, item 1 Narrative description of injury event

Definition: A text description of the injury event.

Classification/coding: None (Text)

Guide for use: Write a brief description, up to 100 characters in length, of how the injury

came about. It should indicate

- what went wrong (the „breakdown event‟)

- the mechanism by which this led to injury

- the object(s) or substance(s) most important in the event

(specify product brand name and model if known)

- the type of place of occurrence

- the activity of the person when injured

- presence or absence of relevant protective equipment

- any other prominent or unusual features

Justification: Narrative is rated of very high importance by injury control workers to

identify features of cases not revealed by coded data.

Used with: NDS-IS level 1, items 2A, 2B, 3, 4, 5A, 5B and General Information data

items.

Source: AIHW National Injury Surveillance Unit and NDS-IS Advisory Group

Comment: In NDS-IS level 1, this item is limited to 100 characters (compare with

NDS-IS level 2, item 1).

Examples of narrative descriptions The following examples state or [imply] key characteristics of injury events:

Examples

[Child] opened

bathroom cabinet at

home and ingested

about 50 ml of [Brand

X] from bottle. Bottle

had child resistant

closure.

Fell 2m from forklift

pallet when fellow

worker suddenly

moved lift. In

warehouse. Safety

boots worn.

Struck on mouth by

shoulder of another

player in school soccer

match. Not wearing a

mouthguard.

Main elements of information in the examples

Specific location Own home, bathroom Warehouse [Soccer pitch]

Specific activity (not specified in this

example)

Working on forklift

pallet

Playing school

competition soccer

What went wrong? [Child gained

unintended access to

substance]

[Unanticipated

movement of forklift]

(not specified in this

example)

Mechanism of injury. [poisoning] Fall from a height [collision]

Specific object(s),

substance(s) or

product(s) involved

Brand X, 50 mls Pallet, forklift Another player

Use of safety

device(s)

Child resistant closure

on bottle

Wearing safety boots Not wearing a

mouthguard.



External Cause (Updated list) Definition: The primary event, circumstances or condition associated with the occurrence of injury, poisoning or violence. The event that caused the injury Functionality: There are thirty codes in this area. (Where two codes appear to be appropriate, use the first listed.)

Code Description Comments

1 Motor vehicle driver Includes on or off road

2 Motor vehicle passenger or unknown occupant Includes fall from moving

vehicle

3 Motorcycle driver Includes burn to rider from bike.

Includes any location

4 Motorcycle passenger Includes burn to passenger from

bike. Includes sidecars

5 Pedal cyclist and pedal cyclist passenger Includes all injuries while riding

a bicycle including falls and

cyclists hit by motor vehicles

6 Pedestrians Person struck by a vehicle or

bicycle. Includes low speed run

overs in driveways

7 Other or unspecified transport related circumstance Includes mine vehicles, trains,

boats, aircraft and also tractors

being driven on a road

8 Horse related All injuries while horse riding

including hitting a tree branch.

Includes bites, kicks and

tramples

9 Fall - low less than 1 meter Fall, stumble or jump on same

level, less than 1 meter or fall

from unknown height

10 Fall – high Fall or jump from height of 1

meter or more

11 Drowning / submersion in a swimming pool Drowning or near drowning.

Includes spas. Code whether in a

public or private pool

12 Drowning / submersion – other than in a swimming

pool

Drowning or near drowning.

Beach, Dam, river, creek,

bucket, bathtub etc

13 Other threat to breathing Strangulation, asphyxiation, FB

in respiratory tract. Excludes

inhalation of smoke (14) or other

poisonous gas

14 Fire, Flames, Smoke Includes smoke inhalation, flame

burns, struck by flaming object,

stepping on or rolling into hot

coals or ash. Includes burns from

fireworks

15 Exposure to hot drinks, food, liquids, steam, gas or

vapour

Applies to all scalds

Excludes chemical burns (28

Other Specified)

16 Exposure to hot object or solid substance Applies to contact burns eg:

Stove /cook top, iron. Excludes

Sunburn (26)

NISDD Level 1 item


17 Poisoning – drug or medicinal substance Includes adverse effect of

medication in normal use, wrong

dose taken / given, intentional

overdose / poisoning, alcohol

poisoning

18 Poisoning – other or unspecified substance Includes spray / splash with non-

corrosive toxic substance (eg:

Organo-Phosphates), ingestion

of toxic plants or mushrooms.

Gaseous poisoning. Excludes

envenomation.

19 Firearm All firearm related injuries

20 Cutting, piercing object Injuries from any object

DESIGNED to cut or pierce eg:

knife, spear, fish hook, needle

stick injuries.

21 Dog related Dog bites also includes knocked

over / pulled over by dog.

Excludes tripping over a dog

22 Animal related Excludes dog and Horse.

Includes insect bites and stings,

marine stingers, fish barbs

23 Discontinued “struck by” code Replaced by 30 and 31

24 Machinery (Including domestic machines) Includes mobile machinery

(forklifts, tractors not on a road),

power tools, welding equipment,

appliances eg: ceiling fans, food

processors, sewing machines.

25 Electricity Includes lightning strike

26 Hot Conditions Natural eg: Sunburn, heat stroke

27 Cold Conditions Natural eg: Exposure, frostbite

28 Other specified Foreign body NEC (eg:

swallowed coin, bead in ear)

Chemical burn, twisted ankle but

did not fall.

29 Unspecified Unspecified external cause

(incl late effects)

30 Struck by or collision with person Includes assaults and contact

sports eg: football tackle

31 Struck by or collision with an object Includes struck by an object

wielded by a person eg: golf club

or baseball bat. Includes hit by

falling item (tree branch) or

projectile eg: a rock thrown



NDS-IS–level 1, item 2A External Cause - major groups SEE UPDATED LIST PREV PAGES

Definition: Event, circumstance or condition associated with the occurrence of injury,

poisoning or violence.

Classification/coding: 1. Motor vehicle - driver

2. Motor vehicle - passenger*

3. Motorcycle - driver

4. Motorcycle - passenger*

5. Pedal cyclist or pedal cycle

passenger*

6. Pedestrian

7. Other or unspec. transport-

related circumstance

8. Horse related (fall from, struck

or bitten by)

9. Fall - low (on same level, or <

1 metre drop or no

information on height)

10. Fall - high (drop of 1 metre or

more)

11. Drowning, submersion - in

swimming pool

12. Drowning, submersion - other

than in swimming pool

13. Other threat to breathing

(including strangulation and

asphyxiation)

14. Fire, flames, smoke

* Includes unspecified occupants

15. Exposure to hot drink, food,

water, other fluid, steam, gas, or

vapour (incl. scalds)

16. Exposure to hot object or solid

substance (incl. contact burns)

17. Poisoning - drug or medicinal

substance

18. Poisoning - other or unspecified

substance

19. Firearm

20. Cutting, piercing object

21. Dog related (incl. bitten, struck

by)

22. Animal-related (excludes horse

[8] or dog [21])

24. Machinery

25. Electricity

26. Hot conditions (natural origin),

sunlight

27. Cold conditions (natural origin)

28. Other specified external cause

29. Unspecified external cause

(incl late effects)

30. Struck by or collision with person

31. Struck by or collision with object

Guide for use: Select the item which best characterises the circumstances of the injury,

on the basis of the information available at the time it is recorded. If two

or more categories are judged to be equally appropriate, select the one

that comes first in the code list.

Must always be accompanied by an intent code (Level 1, item 2B)

Justification: Enables categorisation of injury and poisoning according to factors

important for injury control. Necessary for defining and monitoring injury

control targets, injury costing, and identifying cases for in-depth research.

Used with: NDS-IS Level 1, items 1, 2B, 3, 4, 5A, 5B, and General Information data

items.

Source: AIHW National Injury Surveillance Unit and NDS-IS Advisory Group,

based on ICD-9-CM and ICD-10.

Revision: Category [23.] Struck by or collision with, object or person has been

removed and replaced with category [30.] & [31.]

Comment: This item is related to the more extensive ICD external cause

classification (E-codes in ICD-9-CM, vol. 1 and Item P39 in NHDD). It is

provided for use in settings in which coding to the full external cause

classification is not practicable.

Data coded to the full external cause codes can be aggregated to match

this item, facilitating data comparisons. A table showing the ICD-9-CM

and ICD-10 external cause codes equivalent to each category in this

classification can be found in Table A2.2A in Appendix 2.

NISDD Level 1 item


NDS-IS–level 1, item 2B External Cause - intent groups

Definition: The role of human intent in the occurrence of the injury as assessed by the

treating practitioner.

Classification/coding: 1. Accident; injury was not intended

2. Intentional self-harm*

3. Sexual assault (by bodily force)

4. Maltreatment by parent

5. Maltreatment by spouse or partner

6. Other or unspecified assault

7. Event of undetermined intent

8. Legal intervention (incl. police) or operations of war

9. Adverse effect, or complication of medical or surgical care

10. Other specified intent

11. Intent not specified

Guide for use: Select the item which best characterises the role of human intent in the

occurrence of the injury, as judged by the treating practitioner, on the

basis of the information available at the time it is recorded. If two or more

categories are judged to be equally appropriate, select the one that comes

first in the code list.

Must always be accompanied by an external cause group code (Level

1, item 2A).

* Where the classification [2] Intentional self-harm has been recorded the

default coding for Item 4 (Activity when injured – type) is [8]. Other

specified activity




Used with: NDS-IS level 1 items 1, 2A, 3, 4, 5A, 5B, and General Information data

items.



Revision It is recommended that Activity when injured (level 1, item 4) defaults to

other specified activity [8] if Intent (level 1, item 2B) = intentional self

harm [2]

Comment: This item is related to the more extensive ICD external cause

classification (E-Codes in ICD-9-CM, vol. 1 and Item P39 in NHDD).

Level 1, item 2A is provided for use in settings in which coding to the full

external cause classification is not practicable.

Data coded to the full external cause codes can be aggregated to match

this item, facilitating data comparisons. A table showing the ICD-9-CM

and ICD-10 external cause codes equivalent to each category in this

classification can be found in Table A2.2B in Appendix 2.



NDS-IS–level 1, item 3 Place of injury occurrence – type

Definition: The type of place at which the person was situated when injured.

Classification/coding: 1. Home (includes farm house)

2. Residential institution (excludes hospital [4])

3. School, other institution, or public administrative area (excludes

hospital [4]; includes child day care centre)

4. Hospital or other health service

5. Recreation area (place mainly for informal recreational activity)

6. Sports or athletics area (place mainly for formal sports)

7. Street or highway (public road)

8. Trade or service area

9. Industrial or construction area

10. Mine or quarry

11. Farm (excludes farm house [1])

12. Other specified place (includes forest, beach, abandoned building)

13. Unspecified place

Guide for use: Select the item which best characterises the type of place at which the

person was situated when injury occurred, on the basis of the information

available at the time it is recorded. If two or more categories are judged

to be equally appropriate, select the one that comes first in the code list.

Unless otherwise stated, places include attached grounds, outbuildings,

etc. (eg. „Home‟ includes dwelling and associated garden, garage, shed,

etc. and a school includes its playgrounds and sporting facilities.)

Refer to Table A1.2 on the following page, for coding examples for type

of place.


important for injury control. Necessary for defining and monitoring

injury control targets, injury costing, and identifying cases for in-depth

research.

Used with: NDS-IS level 1, items 1, 2A, 2B, 4, 5A, 5B, and General Information data

items.



Revision Table A1.2: Coding examples for type of place, has been added to assist

the identification of codes for this item.

Comment: Type of place is related to the more extensive ICD place of occurrence

classification.

Table showing the ICD-9-CM and ICD-10 place codes equivalent to each

category in this classification can be found in Appendix 2, Table 2A.3.

The ICD-9-CM place classification has been extended by splitting each of

three categories into two parts. This has two benefits. First, it improves

identification of some important sites of injury. Second, it enables

comparison with data coded to the ICD-10 version of the place

classification.

NISDD Level 1 item


Table A1.2: Coding examples for type of place (Use for classification, NDS-IS Level 1 item 3: Place of injury occurrence-type )

Code Type of Place Includes Excludes

1 Home Farm house, home premises, house,

non-institutional place of residence,

apartment, boarding house, caravan

park (resident), private: driveway to

home, garage, garden/yard to home,

path (walk) to home, swimming pool

in private house,

Institutional place of

residence (2),

abandoned, derelict

house (12), home under

construct but not yet

occupied (9)

2 Residential

institution

Children‟s home, dormitory, home for

the sick, military camp, nursing home,

old people‟s home, orphanage, reform

school, hospice, prison

Hospital (4)

3 School, other

institution, public

administration area

Building, including adj grounds, used

by the general public or by a particular

group of the public such as: assembly

hall, campus, church, cinema,

clubhouse, college, court house, dance

hall, day care centre, gallery/library,

kindergarten, museum, music hall, post

office, university/inst for higher

education, opera house, public hall,

school (public private), theatre, youth

centre.

Hospital (4), building

under construction (9),

sports and athletics areas

(6), recreation areas (5),

trade and service areas

(8).

4 Hospital Hospital, other health service. Hospice, nursing home

(2)

5 Place for recreation Amusement park, public park, aquatic

recreation centre.

Sports, athletics grounds

(6)

6 Sports and athletics

area

Cricket ground, riding school,

basketball court, golf course, stadium,

skating rink

Amusement park, public

park (5)

7 Street or highway Freeway, road, footpath Private driveway (1)

8 Trade or service area Bank, petrol station, supermarket

9 Industrial/construct-ion

area

Any building under construction, dry

dock, industrial yard, workshop

Mine, quarry, tunnel

under construct. (10)

10 Mine/quarry Mine, quarry, tunnel under

construction.

11 Farm Farm buildings and land, ranch. Farm house (1)

12 Other spec place Forest, beach, pond, abandoned or

derelict house.

Park, public or

amusement (5)

13 Unspec. place

Sources: ICD-9-CM (National Coding Centre, 1996) and ICD-10 (World Health Organisation, 1992)



NDS-IS–level 1, item 4 Activity when injured – type

Definition: The type of activity being undertaken by the person when injured.

Classification/coding: 1. Sports activity

2. Leisure activity

3. Working for income (includes travel to and from work)

4. Other type of work (includes unpaid housework)

5. Resting, sleeping, eating, other personal activity

6. Being nursed or cared for

7. Engaged in formal educational activity

(as a student; incl travel to/from)

8. Other specified activity*

9. Unspecified activity

Guide for use: Select the item which best characterises the type of activity being

undertaken by the person when injured, on the basis of the information

available at the time it is recorded. If two or more categories are judged to

be equally appropriate, select the one that comes first in the code list. This

rule means, for example, that an injury sustained by a player in the course

of professional sports activity is coded to sports activity [1], not to

working for income.

Sports activity [1] is limited to organised physical activities undertaken

under the auspices of a sports club or federation, a school, or other

organisation. It includes organised training for these activities. Injuries

during informal activities, such as kicking a football around at a picnic, or

backyard cricket, or play should be coded to Leisure activity [2].

Being nursed or cared for [6] refers to circumstances such as a baby

being carried by an adult, or a frail or disabled person being bathed by a

nurse, or a patient being operated on by a surgeon. In these instances, the

person at risk of injury is directly in the hands of another person. The

category is not intended to refer to the broader and less direct senses of

being „in the care‟ of someone, which are difficult to specify.

*Where Item 2B classification [2.] Intentional self-harm has been

recorded, the default coding for Item 4 is [8.] Other specified activity

Refer to Table A1.3, on the next page for coding examples for type of

activity

Justification: Enables categorisation of injury and poisoning according to factors important for

injury control. Necessary for defining and monitoring injury control targets,

injury costing, and identifying cases for in-depth research. This item is the basis

for identifying work-related and sport-related injuries.

Used with: NDS-IS level 1, items 1, 2A, 2B, 3, 5A, 5B, and General Information data items.

Source: AIHW National Injury Surveillance Unit and NDS-IS Advisory Group, based on

ICD-10.

Revision Table A1.3: Coding examples for type of activity, has been added to assist the

identification of codes for this item.

It is now recommended that Activity when injured (level 1, item 4) defaults to

other specified activity [8] if Intent (level 1, item 2B) = intentional self harm [2]

Comment: This item is based on the similar item included in ICD-10, which has been

extended by splitting each of two categories into two parts. This

extension has the benefit of enabling identification of injury associated

with some types of activity not distinguished in the ICD-10 classification.

A table showing the ICD-10 activity code equivalent to each category in

this classification can be found in Table A2.4 in Appendix 2.

NISDD Level 1 item


Table A1.3: Coding examples for type of activity (Use for classification, NDS-IS Level 1 item 4: Activity when injured-type )

Code

Code Type of activity:

Injured while engaged

in:

Includes Excludes

1 Sports activity Physical exercise with a described

functional element such as: golf,

jogging, riding, school athletics,

skiing, swimming, trekking, water-

skiing.

2 Leisure activity Hobby activities; leisure-time activities

with an entertainment element such

being at a cinema, a dance or a party;

participation in activities of a voluntary

organisation.

Sports activities (1)

Being cared for (6)

3 Working for income Paid work for salary, bonus and other

types of income; transportation (time)

to and from such activities.

4 Other type of work Unpaid domestic duties such as: caring

for children and relatives, cleaning,

gardening, household maintenance or

other duties for which income is not

gained (eg unpaid work in a family

business).

Engaged in educational

activity (7)

5 Resting, sleeping, eating,

other personal

activities

Personal hygiene

6 *Being nursed or cared

for Infant being carried by parent;

patient being lifted by nurse.

7 *Engaged in formal

educational activity (as

student)

Learning activities (eg attending a

school session or lesson); Undergoing

formal education. Includes travel to

and from school or other place

attended for education.

8 Other specified

activity

9 Unspecified activity

* codes 3 & 4 (of the ICD-10 codes) have been extended and split into 2 parts to form NDS-IS codes 6 & 7 (refer

to Table A2.4 in Appendix 2)

Source: ICD-10 Activity code (World Health Organisation, 1992, volume 1: 1017-8)



NDS-IS–level 1, item 5A Nature of main injury

Definition: The nature of the injury chiefly responsible for occasioning the attendance of the

person at the health care facility.

Classification/coding: 1. Superficial (incl. bruise; excl.

eye[13])

2. Open wound (excludes eye [13])

3. Fracture (excludes tooth [21])

4. Dislocation (incl ruptured disc,

cartilage, ligament.)

5. Sprain or strain

6. Injury to nerve (incl. spinal cord;

excludes intracranial injury [20])

7.

Injury to blood vessel

8. Injury to muscle or tendon

9. Crushing injury

10. Traumatic amputation (incl. partial)

11. Injury to internal organ

12. Burn or corrosion (excl. eye [13])

13. Eye injury (excl. foreign body in

external eye [14.1]; includes burn)

14.1 Foreign body in external eye

14.2 Foreign body in ear canal

14.3 Foreign body in nose

14.4 Foreign body in respiratory tract

(excludes f.b. in nose [14.3])

14.5 Foreign body in alimentary tract

14.6 Foreign body in genito-urinary

tract

14.7 Foreign body in soft tissue

14.9 Foreign body, other/unspecified

20. Intracranial injury (includes

concussion)

21. Dental injury (incl. fractured tooth)

22. Drowning or immersion

23. Asphyxia or other threat to

breathing (excl. drowning [22])

24. Electrical injury

25. Poisoning or toxic effect

(excludes venomous bite [26])

26. Effect of venom; any insect bite

27. Other specified nature of injury

28. Injury of unspecified nature

29. Multiple injuries of more than one

„nature‟

30. No injury detected

Guide for use: Select the item which best characterises the nature of the injury chiefly

responsible for the attendance, on the basis of the information available at the

time it is recorded. If two or more categories are judged to be equally

appropriate, select the one that comes first in the code list.

If the nature of injury classification used is 1 to 12, or 26 to 29, then item 5B

should be used to record the bodily location of the injury.

If nature of injury classification 13 to 25 or 30, is used, bodily location is

implicit or meaningless. In this case item 5B, classification 22 may be used as a

filler, to indicate that a specific bodily location code is not applicable.

Justification: Injury diagnosis is necessary for purposes including epidemiological research,

Casemix studies, and planning. Nature of injury, with bodily location, indicates

diagnosis.

Used with: NDS-IS level 1, items 1, 2A, 2B, 3, 4, 5B, and General Information items.

Source: AIHW National Injury Surveillance Unit and NDS-IS Advisory Group, based on

ICD-9-CM and ICD-10.

Comment: This item is related to the more extensive ICD-9-CM (chapter 17) and ICD-10

(chapter XIX) classifications of injury and poisoning (the ICD-9-CM

classification is used for Item P35 in NHDD). It is provided for use in settings in

which coding to the full ICD classification is not practicable. This item is

intended to be used in combination with NDS-IS Level 1, item 5B. Data coded

to the full external cause codes can be aggregated to match this item, facilitating

data comparisons. A table showing the ICD-9-CM external cause codes

equivalent to each category in this classification is in Table A2.5A in Appendix

2.

Code values 15 to 19 are not in use.

NISDD Level 1 item


NDS-IS–level 1, item 5B Bodily location of main injury

Definition: The bodily location of the injury chiefly responsible for occasioning the

attendance of the person at the health care facility.

Classification/coding: 1. Head (excludes face [2]) 12. Wrist

2. Face (excludes eye [22]) 13. Hand (includes fingers)

3. Neck 14. Hip

4. Thorax 15. Thigh

5. Abdomen 16. Knee

6. Lower back (incl. loin) 17. Lower leg

7. Pelvis (incl. perineum, 18. Ankle

anogenital area and buttocks) 19. Foot (includes toes)

8. Shoulder 20. Unspecified bodily location

9. Upper arm 21. Multiple injuries (involving more

10. Elbow than one bodily location)

11. Forearm 22. Body location NOT REQUIRED

Guide for use: If a nature of injury classification numbered 1 to 12, or 26 to 29 has been

selected, then the body region affected by that injury must be specified.

Select the category that best describes the location of the injury. If two or

more categories are judged to be equally appropriate, select the one that

comes first in the code list.

If a nature of injury classification other than 1 to 12, or 26 to 29 has been

selected, then a bodily location classification is not required (code 22 may

be used as a filler, to indicate that a specific body location code is not

applicable).

Justification: The injury diagnosis is necessary for purposes including epidemiological

research, Casemix studies, and planning. Nature of injury, with bodily

location, indicates diagnosis.

Used with: NDS-IS level 1, items 1, 2A, 2B, 3, 4, 5A, and General Information data

items.



Revision Category [6] lower back now includes loin

Comment: This item is related to the ICD injury and poisoning classification

(chapter 17 in ICD-9-CM and chapter XIX in ICD-10).

Coding to the full injury and poisoning classification is not practicable in

most settings in which basic injury surveillance data collection is

undertaken. This item, in combination with level 1, item 5A, is a

practicable alternative. Data coded to the full injury and poisoning codes

can, with some exceptions, be aggregated to match this item, facilitating

data comparisons (refer to Appendix 2 Table A2.5A/B (Nature and Bodily

location table) for further information).

General information item Appendix 1


NDS-IS Level 2 Items

NDS-IS–level 2, item 1 Narrative description of injury event

Definition: Structured text description of the injury event.

Classification/coding: None (Text data, unlimited in length)

Guide for use: Write a brief description of how the injury came about. It should specify:

- what went wrong (the „breakdown event‟)

- the mechanism by which this led to injury

- the object(s) or substance(s) most important in the event

(specify product brand name and model if known)

- the place of occurrence

- the activity of the person when injured

- presence or absence of relevant protective equipment

- any other prominent or unusual features

See examples of narrative descriptions on next page.

Justification: Narrative is rated as of very high importance by injury control workers to

identify features of cases not revealed by the coded data.

Used with: NDS-IS level 2, items 2 to 9, and General Information data items.


Comment: Unlike NDS-IS Level 1, item 1, this Level 2 item is unlimited in text

length

NISDD General information item


Examples of narrative descriptions for Level 2, item 1.

The following examples of narrative descriptions outline the events leading to injury, and other

circumstances relevant to the occurrences:

Examples

A young child who had

recently become adept

at climbing, used a

chair to reach a

bathroom cabinet at

home. She took out

several items including

a half-full 100ml bottle

of [Brand X]. This was

left-over after being

prescribed to her

grandmother during a

recent visit. The bottle

had a „squeeze and

turn‟ child resistant

closure. However, the

lid may have been

replaced loosely (this

was her grandmother‟s

usual practice, due to

arthritis). The child

was found sometime

later with the empty

bottle and told her

mother that she had

drunk grandma‟s

medicine.

A newly hired junior

storeman was standing

on an empty wooden

pallet which was on

the tines of a forklift,

at a height of about

2m above the concrete

floor of a warehouse.

He fell to the floor,

landing heavily on one

foot, after the co-

worker driving the

forklift moved it

unexpectedly. The

injured man was

wearing safety boots.

Playing soccer in an

interschool

competition match.

The grass pitch was

wet. He slipped while

trying to get

possession of the ball

and fell against the

player with the ball,

striking his mouth

against that player‟s

shoulder. He was not

wearing a mouthguard

(they were not

required by his coach).

He was wearing

ordinary soccer boots.

Main elements of information in the examples

Specific location Own home, bathroom Warehouse Soccer pitch

Specific activity (not specified in this

example)

Standing on elevated

forklift pallet

Playing school

competition soccer

What went wrong? Young child gained

unintended access to

substance

Unanticipated

movement of the

forklift.

Slipped on wet grass

during difficult

manoeuvre

Mechanism of injury. Ingestion and possible

poisoning

Fall from about 2m to

a concrete surface.

Struck against another

person

Specific object(s),

substance(s) or

product(s) involved

Brand X, about 50 mls

(not more than 100

mls)

Pallet

Forklift

Another player

Use of safety

device(s)

Bottle had a child

resistant closure. Lid

may have been loose.

Wearing safety boots Not wearing a

mouthguard.



NDS-IS–level 2, item 2 External Cause

Definition: . „External cause is the cause of any condition, where that condition is the result of injury, poisoning or violence‟ (NHDD, 1997: 4-99). The classification includes events, circumstances and conditions associated with the occurrence of injury.

Classification/coding: ICD-9-CM, (4-digit E-code) or ICD-10 (4 character code V01-Y98)

Guide for use: Refer to the external cause code section of the second Australian edition of ICD-9-CM (pp 331 and 370 of Volume 1 (E-codes) and pp 153 to 155 of Volume 4.) or ICD-10 vol. 1 (pp 1011 –1123)

Justification: Enables categorisation of injury and poisoning according to factors important for injury control. Necessary for defining and monitoring injury control targets, injury costing, and identifying cases for in-depth research.

Used with: NDS-IS level 2, items 1, and 3A to 9, and General Information data items.

Source: ICD-9-CM, second Australian edition (National Coding Centre, 1996, vol. 1: E-codes) ICD-10, (World Health Organisation,1992, vol. 1: chapter XX)

Comment: This item is listed as Item P39 in NHDD. When the external cause

classification is used for injury surveillance in other settings (eg.

emergency department attendances), coding should be based on the

information available at the time of recording. External cause recorded at

this stage may sometimes differ from external cause coded at separation,

due to differences in the information available at these different phases of

care.



NDS-IS–level 2, item 3A Place of injury occurrence – sub-type

Definition: The specific type of place at which the person was situated when injured.

Classification/coding: Type of place/sub-type of place

01 Home (includes farm house) .1 Farm-house

.2 Free-standing house

.3 Flat, apartment, terrace house

.4 Boarding house, hostel

.5 Caravan, mobile home

.9 Other or unspecified

02 Residential institution

(excludes hospital [4]) .1 Institutional home

.2 Home for elderly, frail or sick

.3 Prison


03 School, other institution, or

public administrative area .1 Childcare centre

.2 Pre-school, kindergarten

.3 Primary school

.4 Secondary school

.5 Tertiary and adult education

institutions

.6 Public administration place

.7 Place for the arts

.9 Other or unspecified Church

community centre

04 Hospital or other health

service .1 Hospital

.2 Community health centre

.3 Medical surgery or clinic

.4 Dental surgery or clinic


05 Recreation area (place mainly

for informal recreational

activity) .1 Amusement park

.2 Holiday resort

.3 Public park

.5 Other Motel, Hotel etc

.4 Aquatic recreation centre


06 Sports or athletics area (place

mainly for formal sports,

etc.) .1 Oval, field, pitch

.2 Stadium, arena

.3 Race track (horse,

motorcycle, car, etc.)

.4 Other: land-based sport

Skate park / rink

.5 Other: water-based sport

.6 Other: snow or ice based

sport

.7 Indoor sport


07 Street or highway (public

road) .1 Freeway

.2 Urban road

.3 Non-urban road


08 Trade or service area .1 Shop / shopping centre

.2 Commercial eating place

.3 Entertainment/drinking place

.4 Airport

.5 Bus or railway station, ferry .6 Service station

.7 Warehouse

.8 Office building


09 Industrial or construction

area

.1 Construction site

.2 Demolition site

.3 Factory


10 Mine or quarry .1 Underground mine

.2 Open mine or quarry

.3 Oil or gas extraction facility


11 Farm (excl. farm house [1]) .1 Farm

.4 Timber plantation


12 Other specified place .1 Bush, remote or undeveloped

place

.2 Railway (excl. station [8.5])

.3 Camping ground, caravan

park (excl. caravan 1.5)

.4 On board a vehicle / vessel

.9 Other specified place

13 Unspecified place .9 Unspecified place



Guide for use: Select the category that best describes the specific type of place at which

the person was situated when injured. If two or more categories are

judged to be equally appropriate, select the one that comes first in the

code list. Must be accompanied by a part of place code (Level 2, item

3B).

Unless otherwise stated, places include attached grounds, outbuildings,

etc (eg. „Home‟ includes dwelling and associated garden, garage, shed,

etc.) Select a category referring to the whole entity (ie a structure or space

owned or operated as a whole) within which an injury occurred in

preference to a category referring to only a part of such an entity.

For example: code a case which occurred in a primary school playground

to 03.3 (Primary school) rather than to 05.9 (Recreation area: other or

unspecified).




Used with: NDS-IS level 2, items 1, 2, 3B to 9, and General Information data items.


Comment: The 13 main categories are the same as NDS-IS level 1, item 3 (Place of

injury occurrence – type) and are related to the ICD-9-CM & ICD-10

place of occurrence codes (E-codes 849.0 – 849.9 in ICD-9-CM vol. 1

and pp1013 – 1017 in ICD-10 vol. 1)

The ICD-9-CM codes are equivalent to Item P40 in NHDD.

The ICD-9-CM place classification has been extended by splitting each of

three categories into two parts. This has two benefits. First, it improves

identification of some important sites of injury. Second, it enables

comparison with data coded to the ICD-10 version of the place

classification.

Tables showing the ICD-9-CM and ICD-10 place codes equivalent to

each main category (related to Level 1, item 3) in this classification can

be found in Appendix 2, Table A2.3

The 65 sub-types of place enable more precise designation of the types of

place at which injuries occur, facilitating certain injury studies. The

coding guidelines for the place classifications in ICD-9-CM and ICD-10

were the principle basis for deciding the allocation of sub-types to main

categories.



NDS-IS–level 2, item 3B Place of injury occurrence – part

Definition: The part of the specific place at which the person was situated when

injured

Classification/coding:

Room

11 Bathroom

12 Bedroom

13 Classroom

14 Dormitory/workers‟

quarters/ward

15 Hall/foyer

16 Kitchen

17 Laundry

18 Living/dining area

19 Family room/rumpus room

20 Office

21 Toilet

22 Auditorium/spectator area

23 Gymnasium

Structure

31 Garage/carport

32 Workshop

33 Specialised agricultural

building (incl. woolshed,

dairy, piggery, etc.)

34 Stable

35 Shed (any other type)

36 Specialised structure (eg.

silo, tank, pylon)

37 Tunnel, trench

38 Court (tennis, squash, etc.)

Part of building/structure

41 Escalator or elevator

42 Stairs

43 Area beneath a

building or structure

44 Verandah or balcony

45 Roof

46 Dance floor

Part of grounds, site, street

51 Roadway - sealed

52 Roadway - unsealed

53 Car park / Driveway

54 Footpath/path/foot track

55 Median strip/pedestrian

refuge

56 Bicycle path/bikeway

57 Playground - with play

equipment

58 Playground - without play

equipment

59 Garden / Park / National

Park

60 Paddock/Field/ campground

61 Stock yard/other outdoor

animal enclosure

62 Cliff/rock face

Body of water; its shore

80 Beach

81 Dam

82 River/creek/lake/reservoir

83 Sea/surf/bay/ocean

84 Swimming pool

85 Wharf/jetty / boat ramp

Residual categories

90 Other, exterior

91 Other, interior

99 Unspecified part of place

Guide for use: This classification enables further specification of the place at which the

person was when injury occurred. It is designed to be used in conjunction

with NDS-IS level 2, item 3A (Place of injury occurrence - sub-type). It

is not intended for use alone. Code Place of injury occurrence - sub-type,

then code this item. Select the category that best describes the part within

the specific type of place at which the person was situated when injured.


important for injury control. Necessary for defining and monitoring


research.

Used with: NDS-IS level 2, items 1 to 3A, 4 to 9, and General Information data

items.


Comment: While some sub-type of place/part of place combinations are unlikely to

occur, all are permitted.

This item does not correspond to any ICD codes. The place classification



has been extended for use in NDS-IS.

NDS-IS–level 2, item 4 Activity when injured – sub-type

Definition: The specific type of activity being undertaken by the person when injured.

Classification/coding: NDS-IS Level 1 activity

categories

1. Sports activity

2. Leisure activity

3. Working for income (includes

travel to and from work)

4. Other type of work (includes

unpaid housework) 5. Resting, sleeping, eating, other

personal activity 6. Being nursed or cared for 7. Engaged in formal educational

activity (as a student; incl travel to from)

8. Other specified activity 9. Unspecified activity

NDS-IS Level 2 classifications Use Level 1 classification plus Type of sport or leisure activity

categories listed on next page

Industry (ANZSIC sub-divis.) and

Occupation (ASCO unit groups)

-categories listed on pp. 40 & 41. No Level 2 classification (Use Level 1 classification codes)

Guide for use: This item is classified using Level 1 codes in conjunction with the Level 2 code

for eg. Sport and leisure.

Select the NDS-IS Level 1 Activity category which best characterises the type of

activity being undertaken by the person when injured, on the basis of the

information available at the time it is recorded. (See the dictionary entry for

NDS-IS-Level 1, item 4 Activity for further guidelines.)

If the Level 1 Activity category chosen is sports activity or leisure activity, then

use the type of sport or leisure activity classification to further specify it. This

classification is set out on the next page.

If the Level 1 Activity category chosen is working for income, then use the

ANZSIC and ASCO classifications to specify the industry and occupation in

which the person was engaged when injured.

Industry should be coded according to the 53 „sub-divisions‟ of the ANZSIC

classification. These are listed in the table on page 41 (Activity when injured-type

of industry).

Occupation should be coded according to ASCO classification. They may be

coded according to either the 52 „minor groups‟ of ASCO tabulated in the NDS-

IS dictionary entry „Occupation.‟ (table on page 42) or preferably the 282, 4-digit

„minor groups‟ of the ASCO classification. (ABS Cat. No.1222.0, first edition:

27-32).

Level 2 Activity classifications are not available in this edition for other types of

activity. Use Level 1 classifications.

Justification: Enables categorisation of injury and poisoning cases that corresponds

with domains of human activity which relate to responsibilities and

opportunities for injury control. Necessary for defining and monitoring


research.

Used with: NDS-IS level 2, items 1 to 3, 5 to 9, and General Information data items.




Comment Developed for NDS-IS

NDS-IS–level 2, item 4

(continued)

Activity when injured – type of sport or leisure activity in which

person was engaged when injured

NDS-IS Level 2

Classification for use

where NDS-IS Level 1

Activity is:

Sports activity OR

Leisure activity

01 Baseball

02 Basketball

03 Cricket

04 Football - Australian

05 Football - Rugby League

06 Football - Rugby Union

07 Football - soccer

08 Football - not specified

09 Hockey (field)

10 Netball

11 Volleyball

12 Squash

13 Tennis

21 Track and field

22 Weight lifting

31 Gymnastics

32 Trampolining

41 Martial arts/combat sports

51 Karting/gokarting

52 Minibike/trailbike riding

53 Bicycling

54 Roller blading

55 Roller skating

56 Skateboarding

61 Horse riding

71 Ice skating

72 Snow sports

81 Boating

82 Fishing

83 Surfing

84 Swimming (incl. board

diving; excl SCUBA [94])

85 Water skiing

91 Golf

92 Dancing

93 Playing

94 Other sport or leisure

activity (specify in narrative)

Source: Devised for NDS-IS




(continued) Activity when injured –working for income - type of industry

in which person was working when injured

NDS-IS Level 2

Classification for use

where NDS-IS Level 1

Activity is:

[3] Working for income

A. Agriculture, Forestry, Fishing

01 Agriculture

02 Services to agriculture, hunting

and trapping

03 Forestry and logging

04 Commercial fishing

B. Mining

11 Coal mining

12 Oil and gas extraction

13 Metal ore mining

14 Other Mining

15 Services to mining

C. Manufacturing

21 Food, beverage and tobacco

manufacturing / abattoir

22 Textile, clothing, footwear and

leather manufacturing

23 Wood and paper product

manufacturing

24 Printing, publishing and

recorded media

25 Petroleum, coal, chemical and

associated product

manufacturing

26 Non-metallic mineral product

manufacturing

27 Metal product manufacturing

28 Machinery and equipment

manufacturing

29 Other manufacturing

D. Electricity, Gas, Water Supply

36 Electricity and gas supply

37 Water supply, sewerage and

drainage services

E. Construction

41 General construction

42 Construction trade services

F. Wholesale Trade

45 Basic material wholesaling

46 Machinery and motor vehicle

wholesaling

47 Personal and household goods

wholesaling

G. Retail Trade

51 Food retailing

52 Personal and household goods

retailing

53 Motor vehicle retailing and

services

H. Accommodation, Cafes,

Restaurants

57 Accommodation, cafes and

restaurants

I. Transport and Storage

61 Road transport

62 Rail transport

63 Water transport

64 Air and space transport

65 Other transport

66 Services to transport

67 Storage

J. Communication Services

71 Communication services

K. Finance and Insurance

73 Finance

74 Insurance

75 Services to finance and

insurance

L. Property and Business

Services

77 Property services

78 Business services

M. Government Administration

and Defence

81 Government administration

82 Defence / Police

N. Education

84 Education

O. Health and Community

Services

86 Health services

87 Community services

P. Cultural and Recreational

Services

91 Motion picture, radio and

television services

92 Libraries, museums and the

arts

93 Sport and recreation

Q. Personal and Other Services

95 Personal services

96 Other services

97 Private households employing

staff

Source: ANZSIC (ABS Catalogue no. 1292.0, 1993)




(continued)

Activity when injured –working for income – occupation (minor groups) in which person was working when injured

1. Managers and administrators 2. Professionals

11 Legislators and government appointed

officials

12 General managers

13 Specialist managers

14 Farmers and farm managers

15 Managing supervisors (sales and service)

16 Managing supervisors (other business)

21 Natural scientists

22 Building professionals and engineers

23 Health diagnosis and treatment practitioners

24 School teachers

25 Other teachers and instructors

26 Social professionals

27 Business professionals

28 Artist and related professionals

29 Miscellaneous professionals

3. Paraprofessionals 4. Tradespersons

31 Medical and science technical officers and

technicians

32 Engineering and building associates and

technicians

33 Air and sea transport technical workers

34 Registered Nurses

35 Police

36 Miscellaneous paraprofessionals

41 Metal fitting and machining

42 Other metal tradespersons

43 Electrical and electronics tradespersons

44 Building tradespersons

45 Printing tradespersons

46 Vehicle tradespersons

47 Food tradespersons

48 Amenity horticultural tradespersons

49 Miscellaneous tradespersons

5. Clerks 6. Salespersons and personal service workers

51 Stenographers and typists

52 Data processing and business machine

operators

53 Numerical clerks

54 Filing, sorting and copying clerks

55 Material recording and despatching clerks

56 Receptionists, telephonists and messengers

61 Investment, insurance and real estate

salespersons

62 Sales representatives

63 Sales assistants

64 Tellers, cashiers and ticket salespersons

65 Miscellaneous salespersons

66 Personal service workers

7. Plant and machine operators and drivers 8. Labourers and related workers

71 Road and rail transport drivers

72 Mobile plant operators (except transport)

73 Stationary plant operators

74 Machine operators

81 Trades assistants and factory hands

82 Agricultural labourers and related workers

83 Cleaners

84 Construction and mining labourers

89 Miscellaneous workers

Source: NHDD, version 4.0, Table 3.2 (1995:3-36) from ASCO (ABS cat.no.1222.0, first edition)



NDS-IS–level 2, item 5 Principal diagnosis – injury or poisoning

Definition: The diagnosis chiefly responsible for occasioning the attendance of the

person at the health care facility, as assessed at the time of data collection.

Classification/coding: ICD-9-CM, 4 or 5-digit coding (chapter 17) or ICD-10, 4 character coding (S00-T98)

Guide for use: Diagnosis may not have been finalised at the time when injury

surveillance data are recorded. Current provisional diagnosis should be

recorded in this case. Normal ICD-9-CM coding guidelines should be applied. Refer to Item P35 in NHDD, the second edition of ICD-9-CM and ICD-10 Table A2.5A, in Appendix 2, may aid classification.

Justification: The principal diagnosis is valuable for purposes including epidemiological research, Casemix studies, and planning.


Source: ICD-9-CM, second Australian edition (National Coding Centre, 1996 vol. 1: 259- 308) ICD-10, (World Health Organisation,1992, vol. 1: chapter XIX)

Comment: The ICD is typically used to classify cases at the end of episode care, at which time a firm diagnosis is often available. In contrast, ICD-9-CM is being used here to classify current provisional principal diagnosis, as assessed soon after arrival of a patient at a health service, such as an emergency department. Coding of hospital separations is expected to change from ICD-9-CM to ICD-10 Australian Modification from July 1998.

NDS-IS–level 2, item 6 Major injury factors

Definition: Types of objects and substances involved in the occurrence of injury.

Classification/coding: Group name Code Title

01. Infant or child’s product

0101 Baby pram, pusher, etc

0102 Baby walker

0103 High chair

0104 Cot

0105 Change table

0109 Other product intended for

infant/child care

0121 Tree house, play house, play fort

0122 Tricycle (child‟s) or other ride-on toy

(excludes bicycle [0549])

0129 Other toy

0141 Flying fox

0142 Monkey bar or other playground

climbing apparatus

0143 Slide, sliding board

0144 Swing, swing set

0149 Other playground equipment

0199 Other or unspecified infant or

child‟s product



02. Furnishing 0201 Bed (excludes bunk bed [0202],

cot [0104])

0202 Bunk bed

0203 Bedding (Sheets, blankets etc)

0219 Cabinet, rack, room divider, shelf

0229 Chair, stool (excludes step stool

[0711])

0239 Sofa, couch, lounge, divan, etc

0249 Table, desk, bench, etc

0259 Rug, mat, loose carpet

0299 Other or unspecified furnishing

03. Appliance 0301 Electric kettle or jug

0302 Cooking appliance (includes stove,

oven, cook-top, BBQ)

0319 Heating appliance (includes space-

heater, electric radiator, slow-

combustion heater)

0329 Refrigerator, freezer

0339 Iron, other heated clothes pressing

appliance (steam, other)

0349 Washing machine

0359 Television

0399 Other or unspecified appliance

04. Utensil or container 0409 Knife

0419 Cutlery, food preparation utensil

(excludes knife [0409])

0420 Scissors

0421 Drinking glass

0439 Clothesline, clothes drying rack,

clothes horse

0459 Waste container, rubbish basket,

refuse bin

0491 Trolley - grocery, shopping, luggage 0499 Other or unspecified utensil or

0499 Container or utensil other or

unspecified



05. Transport (includes mobile machinery) 0509 Passenger car or station wagon,

people mover

0511 Ag-bike

0519 Motorcycle or sidecar, motor scooter

other or unspecified

0521 Truck or goods van (3 tonnes or more)

0522 Light truck, utility, van (<3 tonnes)

0539 Bus (10 seats or more)

0545 Wheelchair

0548 Non-Motorised scooter

0549 Bicycle

0559 Trailer, horse float or caravan

0569 Train or tram

0571 Tractor

0572 Harvesting machine

0573 Auger

0574 Slasher

0575 Fork lift or lift truck

0576 Lawn mower (power or manual)

0579 Mobile machinery other or

unspecified

0589 Vehicle part, fitting or accessory

0599 Other or unspecified transport

06. Sporting equipment 0601 Ball

0609 Other sporting projectile (eg.

javelin, discus, puck, shuttlecock)

0629 Bat, racquet, hockey stick, etc

0649 Object/structure on or near playing

area (eg goal post, boundary fence)

0699 Other or unspecified sporting

equipment (Trampoline, exercise bike,

skateboard)

07. Tool 0701 Nail, screw, bolt, carpet tack, drawing

pin, etc

0711 Ladder, movable steps (incl.

step stool)

0712 Scaffolding

0721 Hand tool: hammer (includes

sledge, mallet, etc)

0722 Hand tool: chopping (eg hatchet,

axe, cane knife, machete)

0723 Hand tool: cutting (eg. saw,

chisel, plane)

0724 Hand tool: lifting (eg. jack, hoist)

0731 Power tool: nail gun or stud driver

0732 Power tool: grinder, buffer, polisher

0733 Power tool - drill



07. Tool (cont.)

0741 Power tool: chain saw

0742 Power tool: circular saw

0749 Power tool other or unspecified

0751 Shearing plant

0752 Dairy/milking plant

0753 Press (excludes printing press

[0799])

0759 Fixed plant/machinery other or

unspecified

0761 Welding equipment

0764 Hose

0799 Other or unspecified tool – spanner,

pliers

08. Natural object or animal

0801 Tree (includes branch, stick, twig)

0802 Plant (excludes tree [0801])

0811 Climatic factor (eg. wind rain,

snow, sunshine)

0821 Natural surface (includes irregularity,

such as pothole, ditch)

0830 Tick

0831 Bee, wasp

0832 Dog

0833 Horse

0834 Snake

0835 Spider

0836 Cattle

0837 Sheep

0838 Retile – other

0839 Jelly fish / Marine stinger

0840 Fish

0841 Person

0899 Other or unspecified natural

object or animal

09. Food, drink, personal use item

0901 Hot oil or fat / wax

0902 Food; Hot /cold non-alcoholic

beverage

0903 Alcohol (beverage)

0904 Hot beverage (eg tea, coffee, soup)

0921 Footwear (includes sporting or

industrial shoe or boot)

0929 Other clothing

0941 Jewellery

0942 Coin

0943 Pen, pencil

0999 Other or unspecified food, drink,

or personal use item



10. Chemical substance 1001 Moth repellent (includes

naphthalene, camphor)

1002 Petrol, other petroleum distillate

(eg kerosene, diesel, fuel oil,

white spirit)

1003 Dishwasher detergent

1004 Soap, detergent, cleaning

compounds (excludes dishwasher

detergent [1003])

1005 Paint, paint thinner (includes

turpentine), paint stripper

1006 Bleach, caustic (includes ammonia)

1007 Carbon monoxide

1008 Pesticide, insecticide, herbicide

1011 Acid

1049 Other or unspecified. chemical

substance (excludes drug,

medication [1099])

1050 Antihistamine

1051 Aspirin, aspirin compound

1052 Paracetamol, paracetamol

compound

1053 Sedative, tranquilliser, psychotropic

1054 Ointment, topical medicine,

lineament

1055 Preparation containing iron salt

1056 Essential oils includes Tea Tree,

Eucalyptus, Lavender etc

1099 Other or unspecified drug or

medication

11. Structure or fitting 1101 Toilet bowl, cistern, associated

plumbing

1102 Bathtub, shower

1121 Door (includes sill, frame, etc;

excludes glass door [1122])

1122 Glass door

1123 Window (includes sill, frame, etc)

1124 Floor

1125 Wall

1141 Fence, gate

1161 Handrail, railing, banister

1188 Ceiling fan

1189 Electrical fixture (includes

wiring system)

1199 Other or unspecified structure or

fixture includes steps / stairs



Escalators and lifts

12. Material (not part of structure or of uncertain origin) 1209 Rock, stone, gravel, etc.

1219 Brick, concrete, concrete block

1229 Wood: timber, board, splinter, etc

1239 Metal: sheet, part, piece. etc. unspecified origin

1249 Glass: sheet, piece, shard, etc.

1299 Other or unspecified material

13. Miscellaneous 1301 Pin, needle (excludes hypodermic

needle [1302])

1302 Hypodermic needle, syringe

1321 Hot water

1322 Water (excludes hot water [1321])

1331 Rope or string

1332 Chain

1341 Fireworks includes sparklers

1342 Firearm

1399 Other or unspecified factor

Guide for use: Select the code that best describes the main factor which led to the

occurrence of the injury. Give preference to specific factors over general

ones. If two or more categories are judged to be equally appropriate, select

the one that comes first in the code list.

The numbering system for the NDS-IS item 6 codes, is as follows:

- first 2 digits: main group of factors

- third digit: sub-groups of factors

- fourth digit: specific factor; „9‟ is for „other or unspecified‟.

Justification:

Enables categorisation of injury and poisoning according to factors important

for injury control which are not identified in the external cause classification.

Necessary for defining and monitoring injury control targets, injury costing,

and identifying cases for in-depth research



based on NISPP factor codes.

Comment: This item distinguishes factors associated with „what went wrong‟

(breakdown factors) and factors associated with the production of injury

(mechanism factors).

Only some third and fourth digits have been used. Spaces in the series of

codes have been left for a later addition of other factors. The factor

categories included were selected according to the following criteria:

1. All ISIS factor codes which, in the ISIS data held at NISU, had been

applied as breakdown factors to 1000 or more cases, 100 or more

admitted cases, or 10 or more fatal cases; and

2. Any other ISIS factor codes meeting the same criterion when used as

mechanism factors.

3. Certain categories covered by other NDS-IS items (place, activity, etc.)

were omitted.

4. Certain specialised sub-types of factor were grouped together (eg.



types of power saw).

5. Certain common, but uninformative categories, were omitted (eg.

„ground‟)



NDS-IS–level 2, item 7 Mechanism of injury – types

Definition: The way in which injury was sustained.

Classification/coding: Mechanism of injury codes

Fall 01 Fall by stumbling on same level

02 Fall by slipping, tripping on same level

03 Fall on or from stairs

04 Fall/jump from lesser height (less than 1 metre)

05 Fall/jump from greater height (more than 1 metre)

08 Other specified fall

09 Unspecified fall

Struck, hit by contact with other object, person or animal Comprises blunt trauma such as struck,

10 Contact with moving object

11 Contact with static object

12 Contact with person

13 Contact with animal

18 Other specified contact

19 Unspecified contact

Crushing, piercing 20 Pinching, crushing

21 Cutting, tearing

22 Puncture

23 Bite/sting by animal/human/insect

28 Other specified crushing/piercing

29 Unspecified crushing/piercing

Suffocation 40 Strangulation

41 Obstruction of airways

42 Drowning and near-drowning

43 Compression of chest

44 Asphyxia due to smoke, or to oxygen depletion

48 Other specified suffocation

49 Unspecified suffocation

Chemical effect 50 Contact splash spill

51 (Not currently in use)



54 Poisoning by solid substances / oral overdose / ingestion

55 Injection

56 Poisoning by gaseous substances Excludes fire / smoke


58 Other specified chemical effect / battery acid (dry)

59 Unspecified chemical effect

Thermal effect

60 Hot liquids or steam

61 Hot objects

62 Open fire, flames

64 Part of body cooling

65 Whole body cooling

66 Contact cooling

67 Cold, unspecified

68 Other specified thermal effect

69 Unspecified thermal effect



Electric, radiation effect

70 Electric current

71 Welding light

72 Sun light

78 Other specified electric/radiation effect

79 Unspecified electric/radiation effect

Acute over-exertion of body or part of body

81 acute over-exertion of body or part of body (one off)

82 acute over-exertion of body or part of body (recurrent – RSI)

89 Unspecified acute over-exertion of body or part of body

Other and unspecified mechanism of injury 90 Acoustic energy, loud noise

91 Bio-hazard (contact spill / splash)

92 Foreign Body / Ingestion eg swallowed a coin

93 Foreign Body other eg: (Bug in ear)

96 Smoke inhalation

98 Other specified mechanism of injury

99 Unspecified mechanism of injury

Guide for use: Select the category that best describes the main type of mechanism

whereby injury was produced. Where two or more categories are judged

to be equally appropriate, select the one that comes first in the code list.


important for injury control which are not identified in the external cause

classification. Necessary for defining and monitoring injury control

targets, injury costing, and identifying cases for in-depth research

Used with: NDS-IS level 2, items 1 to 6, 8 and 9, and General Information data items.


based on draft version of a classification developed by the WHO Injury

Surveillance Methodology Working Group.

Comment:

NDS-IS–level 2, item 8 Date of injury

Definition: Date on which injury occurred. If injury had gradual onset, then the date

on which it was first noticed.

Classification/coding: DD MM YYYY

Guide for use: If only year, or month and year, is known, record this. Missing day or

month should be coded “99”

Month: January = 01, February = 02 ... December = 12

Justification: In combination with time of injury, and date and time of attendance,

period until attendance can be calculated. Date of injury is important for

prevention (temporal patterns of occurrence), retrieval (assessment of

time to treatment) and health service utilisation (assessment of repeat

visits following a single injury).

Used with: NDS-IS level 2, items 1 to 7, and 9, and General Information data items.

Source: AIHW National Injury Surveillance Unit and NDS-IS Advisory Group.

Comment:



NDS-IS–level 2, item 9 Time of injury

Definition: Time of day when injury occurred or was first noticed.

Classification/coding: HH MM

Guide for use: If only hour is known, then record this and code minute to „99‟

Use the 24 hour (military) clock. Midnight = 00 00; 2:16 pm = 14 16

Justification: The occurrence of many injuries fluctuates with time. Understanding of

the patterns contributes to prevention. In combination with time of injury,

and date and time of attendance, period until attendance can be calculated.

Used with: NDS-IS level 2, items 1 to 8, and General Information data items.


Comment:

General Information Items

All but the last two of the following dictionary entries (Date of attendance; Time of attendance) are

abstracted from the National Health Data Dictionary, version 4.0. The full text of each entry is presented.

Comments on some items have been added to describe issues involved in using them for injury

surveillance. For further information on these items, and for citation details of publications referred to in

them, see the National Health Data Dictionary.

General information items in Version 3.0 of NDS-IS (in development), will be in accordance with

National Health Data Dictionary (NHDD) version 6.0, 1997.

The General information items are used in addition to the core injury surveillance data items at Level 1

and Level 2 in accordance with the recommendations listed in Table A1.1.

NHDD Item P1: Establishment identifier Definition: Identifier for the establishment in which episode or event occurred. Each

separately administered health care establishment to have a unique identifier at the national level.

Classification/coding: Six characters–detailed type derived from hospital/agency number State identifier

1 = New South Wales 2 = Victoria 3 = Queensland 4 = South Australia 5 = Western Australia 6 = Tasmania 7 = Northern Territory 8 = Australian Capital Territory 9 = Other territories (Cocos (Keeling) Islands, Christmas Island and Jervis

Bay Territory) Establishment type–one character For example: 1 = public 2 = private 3 = repatriation



Region–one character Establishment number–three characters

Guide for use: If data is supplied on computer media, this item is only required once in the

header information. If information is supplied from source agency eg. hospital, this item should be manually provided on each form submitted.

Justification: To enable analyses based on geographic location of establishment and/or

establishment type (public or private). Recommended by the National Committee on Health and Vital Statistics (1979).

Effective from: 1989 Effective to: Used with: Source: National Health Data Committee Comment: This data item must be used in a manner compatible with the classification of establishments (E1). A residential establishment is considered to be separately administered if managed as an independent institution for which there are financial, budgetary and activity statistics. For example, if establishment-level data for components of an area health service are not available separately at a central authority, this is not grounds for treating such components as a single establishment unless such data are not available at any level in the health care system.

NHDD Item P2: Patient identifier Definition: Person identifier unique within establishment or agency. Classification/coding: Numeric, alpha or alphanumeric code. Guide for use: Justification: This item could be used for editing at the establishment or collection authority level and, potentially, for episode linkage. There is no intention that this item would be available beyond collection authority level. Effective from: 1989 Effective to: Source: Used with: Comment: To date, there has been little attempt to link data within hospital morbidity collections to provide information on utilisation which is patient–based (and thus may cover a number of admissions). However, it has been done successfully in Western Australia for some years using a state–wide medical record numbering system. More recently, in the Hunter region of New South Wales, patient linkage has been shown to be feasible using unit record number within hospital, and a set of identifiers excluding name, over several hospitals (Hall et al. 1986). The concept of link ability does not require routine record matching, but rather the maintenance of sufficient identifiers to allow records to be matched. In a linkable system, the actual matching of records is a special analysis and only carried out when justified. The linking of records raises the issues of privacy and confidentiality. Methods have been developed to safeguard confidentiality. For example, in a data set in which numbers are used as identifiers, the numbers can be changed systematically so that matching is still accurate but the person to whom the records relate is not identifiable. Linkable records are preferred to routinely linked data on the grounds of preservation of privacy (Hall et al. 1986).



NHDD Item P4: Sex Definition: The sex of the person. Classification/coding: 1 = Male

2 = Female 0 = Indeterminate* 9 = Not stated/inadequately described

Guide for use: *An „indeterminate‟ sex category may be necessary for situations such as the classification of perinatal statistics when it is not possible for the sex to be determined. Justification: Required for analyses of service utilisation and epidemiological studies. Effective from: 1 July 1994 Effective to: Used with: Source: National Health Data Committee Comment: This data item was reviewed by a working party of the National Minimum Data Set Committee looking at the use of the statistical standards published by the Australian Bureau of Statistics in the National Health Data Dictionary. The National Health Data Committee endorsed the recommendation that where possible the ABS standard classification be adopted by the National Health Data Dictionary. This standard is defined in the ABS Directory of Concepts and Standards for Social, Labour and Demographic Statistics, 1993.

NHDD Item P5: Date of birth Definition: The date of birth of the person. Classification/coding: DD MM YYYY Guide for use: If date of birth is not known provision should be made to collect age (in years) and a date of birth derived. Justification: Required to derive age for analysis by age at admission or separation and for use to derive a DRG (as required). Effective from: 1 July 1994 Effective to: Used with: Source: National Health Data Committee Comment: This data item was reviewed by a working party of the National Minimum Data Set Committee looking at the use of the statistical standards published by the Australian Bureau of Statistics in the data dictionary. The ABS standard defines the concept „age‟ as the measure of time elapsed from the date of live birth to the date of collection. It was considered that this ABS standard does not adequately deal with the calculation of age less than one year. It is recommended that further consideration should be given to this matter (ABS 1993). The format for recording the date of birth has been altered to record all four digits of the year of birth to enable the correct calculation of age for patients over 100 years old and to avoid errors after the year 2000.



NHDD Item P9: Area of usual residence

Definition: Geographic location of usual residence as stated by the person.

Classification/coding: The geographical location is recorded using a five digit numerical code. 1: Single digit code to indicate State or Territory

0 = Not applicable (includes resident overseas, at sea, no fixed address) 1 = New South Wales 2 = Victoria 3 = Queensland 4 = South Australia 5 = Western Australia 6 = Tasmania 7 = Northern Territory 8 = Australian Capital Territory 9 = Other territories (Cocos (Keeling) Islands, Christmas Island and

Jervis Bay Territory) 2: Four-digit Statistical Local Area (SLA) to be coded or derived from the

residential address using the Australian Standard Geographical Classification (Australian Bureau of Statistics, edition effective 1 July 1995).

Guide for use: The accurate recording of the State or Territory of residence is essential for all persons.

Where the complete residential address is not collected, then suburb and postcode provide the minimum requirement for derivation of Statistical Local Area (SLA). If collection of both these items is not possible then postcode is the preferred option.

If the person is not resident in Australia, ie. lives in another country or at sea, or has no fixed address, local codes may be used to capture this information. However, for national reporting purposes the item should be coded as follows:

State/Territory coded as, 0 = Not applicable SLA left blank. If the SLA of interstate persons is not recorded or derived by a health

authority, local codes may be used in the SLA field. For national reporting purposes the items should be coded as follows:

State/Territory coded as appropriate, eg. 1 = New South Wales, SLA left blank.

Justification: To define: • catchments and geographical patterns of patient flows, bed planning; • geographical differences in service utilisation; • geographical patterns in treated prevalence of health and related problems; • treatment of Australians outside their State/Territory of usual residence to

satisfy the requirement for inter-state charging agreements. Effective from: 1 July 1995 Effective to: Used with: E2 Source: National Health Data Committee Comment: Both the SLA and State/Territory codes are required as the SLA codes are not unique across the country. The SLA code plus the State/Territory code gives a unique geographic location. Current collection of information in regard to the person‟s usual residence varies from State to State but only New South Wales Department of Health has information on SLAs for all patients irrespective of State of residence. For all health authorities to provide this level of information, establishments will be required to supply as a minimum both suburb and postcode. This would enable mapping at the health authority level and facilitate collection of SLAs at a national level. It is important for data quality that verification of the suburb and postcode and mapping occur as close to the source of the data as possible. These processes could be performed by health authorities but it is preferable that they occur at the establishment level.



To facilitate data verification and mapping to SLA requires a reference file such as the National Localities Index which is produced by the Australian Bureau of Statistics in two parts –the Localities Index and the Streets Sub–Index. The Localities Index is a comprehensive list of over 28,000 localities across Australia together with their postcode and codes from the main structure of the Australian Standard Geographical Classification (ASGC) including SLA. Approximately 5% of all localities cross one or more SLA boundaries and are referred to as split localities. The Streets Sub-Index contains approximately 100,000 records of street data for split localities. Using this index in conjunction with the Localities Index will enable specific SLA coding of split localities where the street name/number is known. It is recognised that to provide SLAs for all persons irrespective of State or Territory of residence will require some States or Territories to make substantial changes to hospital and state information systems involving considerable expense. For this reason the guide for use element provides a hierarchy of preferences. This definition should be reviewed at a later date when the feasibility of making such changes has been assessed in all States and Territories.

NHDD Item P31: Mode of separation (modified P31) Definition: Status at separation of person (discharge/transfer/death) and place to which

person is released (where applicable). Classification/coding: 1 = Admitted*

2 = Discharged ED service event complete 3 = Discharge/transfer to another hospital 4 = Did not wait 5 = Left against medical advice/discharge at own risk 6 = Died in ED 7 = Dead on arrival (No treatment provided in ED 8 = (Not currently in use) 9 = (Not currently in use) 0 = (Not currently in use)

* includes mothercraft hospitals and hostels recognised by the Commonwealth Department of Health, Housing and Community Services, unless this is the usual place of residence

** includes prisons, hostels and group homes providing primarily welfare services

Guide for use: Justification: Required for outcome analyses, analyses of intersectoral patient flows and to assist in the classification of episodes into Diagnosis Related Groups. Source: National Health Data Committee AIHW National Injury Surveillance Unit and NDS-IS Advisory Group Revision: NHDD, Item P31 has been modified by the addition of an extra category 0 = Admitted to hospital Comment: The National Minimum Data Set Review Committee recommended that the modes of separation for acute and private psychiatric hospitals and public psychiatric hospitals and nursing homes, as determined by the various working parties, be rationalised. The terminology of the modes relating to statistical separation have been modified to be consistent with the changes to P21 episode of care, as recommended by the Patient Abstracting and Coding Project, Commonwealth Department of Health, Housing and Community Services.

***The NHDD P31 mode of separation item was designed to be used to summarise a characteristic of

people at the time of discharge from hospital, and their destination after discharge. NDS-IS is

designed to be used in settings including emergency departments. The classification P31 of mode of



separation is not entirely appropriate for use in this setting. Most importantly, it lacks a category for

persons admitted to the hospital from the emergency department.

Pending development of a national data standard for emergency department data collection, an

additional category has been provided: 0 = Admitted to hospital.

NHDD Item P6 Country of Birth

Definition: The country in which the person was born.

Classification/coding: Australian Standard Classification of Countries for Social Statistics (ASCCSS) 4-digit (individual country) level. ABS Catalogue no. 1269.0.

Guide for use: Justification: Ethnicity is an important concept, both in the study of disease patterns and in

the provision of services. Country of birth is the most easily collected and consistently reported of possible ethnicity data items, Uses of this data item included: • investigating the differences in health status between different population groups in Australia and providing a basis for planning, resourcing and service delivery to reduce inequalities cost effectively; • enabling health care authorities and organisations to monitor the health status of migrants; assisting health care workers to provide socio–culturally acceptable and non–discriminatory services to all migrant and ethnic groups.

Effective from: 1 July 1994 Effective to: Used with: Source: National Health Data Committee Comment: This data item was reviewed by a working party of the National Minimum Data Set Committee looking at the use of the statistical standards published by the Australian Bureau of Statistics in The National Health Data Dictionary. The National Health Data Committee endorsed the recommendation that where possible the ABS standard classification be adopted by the National Health Data Dictionary. The current ABS standard is the classification specified above. As of September 1992, two revisions of the ASCCSS (Rev 1.01 and Rev. 1.02) have been issued in response to political change in Europe and the former USSR, as well as a corrigendum. Further revisions may be required and will be made available to purchasers of ABS Catalogue no. 1269.0 who register for updates. In computer systems that do not have the capacity to record the 4-digit code, a 3-digit International Organisation for Standardisation (ISO) code may be used. These 3-digit codes have been assigned to each ASCCSS category, and are published as part of the ASCCSS. It is desirable, when processing systems are reviewed, to standardise on the 4-digit ASCCSS codes (ABS 1990).



NHDD Item P7: Aboriginality Definition: Aboriginality of person according to the following Commonwealth/ Australian

Bureau of Statistics „working definition‟: An Aboriginal or Torres Strait Islander is a person of Aboriginal or Torres Strait Islander descent who identifies as an Aboriginal or Torres Strait Islander and is accepted as such by the community with which he or she is associated (Department of Aboriginal Affairs, Constitutional Section 1981).

Classification/coding: 1 = Aboriginal or Torres Strait Islander 2 = Other Guide for use: Aboriginality shall be determined by patient self-identification. Justification: Given the gross inequalities in health status between Aborigines and non-

Aborigines in Australia, the size of the Aboriginal population and their historical and political context, there is a strong case for ensuring that information on Aboriginality is collected for planning and service delivery purposes and for monitoring Aboriginal health.

Effective from: 1989 Effective to: Used with: Source: NMDS working parties Comment:

All States and Territories except Queensland record Aboriginality for acute hospital inpatients. That State currently collects ethnicity in non-metropolitan public acute hospitals and is moving progressively towards collecting it in other metropolitan acute hospitals.

The Morbidity Working Party noted that the Aboriginality data were relatively unreliable. In many hospitals, Aboriginal status was often coded only by „appearance‟. Several members stated that the Aboriginality question was the „most bitterly resented‟ by admission clerks because they felt the patient could be embarrassed or annoyed at being asked.

The 1984 Taskforce on Aboriginal Health Statistics proposed the following standard for questions on Aboriginal origin in hospital morbidity, maternal and perinatal collections: Are you of Aboriginal No or Torres Strait Islander Yes, Aboriginal origin? Yes, Torres Strait Islander It was recommended that each question should be accompanied by the following explanation: For persons of mixed origin, indicate the one to which they considered themselves to belong.

In relation to the last point, the Morbidity Working Party noted that Queensland and South Australia collect Aboriginality within a more general ethnicity question (see comment to Item P6). The working party endorsed the Commonwealth/Australian Bureau of Statistics definition of Aboriginality but did not go as far as recommending that a standard question be asked explicitly of all patients, leaving it up to each authority to implement the data item in an appropriate and consistent manner. The Nursing Homes Working Party followed the reasoning of the Morbidity Working Party by recommending the inclusion of Aboriginality. However, it too did not go as far as to recommend that a standard question regarding Aboriginality be explicitly asked of all patients, leaving it up to each authority to implement. The NH5 form for nursing home patients contains the following question, which is similar to the one above but does not distinguish Torres Strait Islanders:

Are you of Aboriginal or No Torres Strait Island origin? Yes

This item will change in the next version of NDS-IS to Indigenous Status in accordance with the definition of indigenous identity by the High Court of Australia (in Commonwealth versus Tasmania) in 1983.



NHDD Item P14 Employment status (modified P14) Definition: Self-reported employment status, as defined by the categories given below,

immediately prior to admission. Classification/coding: 1. Child not at school 2. Student 3. Employed – not further specified 4. Unemployed 5. Home duties 6. Other 7. Employee 8. Self-employed Guide for use: The NDS-IS advisory committee recommends use of this classification. It is

based on NHDD Item P14 for public psychiatric hospitals, with the addition of categories [7] and [8].

If known to be employed but unsure whether employee or self-employed, default to [3.] Employed – not further specified

Justification: The Australian Health Ministers‟ Advisory Council Health Targets and Implementation Committee (1988) identified socioeconomic status as the most important factor explaining health differentials in the Australian population. The committee recommended that national health statistics routinely identify the various groups of concern. This requires routine recording in all collections of indicators of socioeconomic status. In order of priority, these would be employment status, income, occupation and education. In practice, this data item and current or last occupation could probably be collected with a single question, as is done in Western Australia. Occupation? For example: • housewife or home duties • pensioner miner • tree feller • retired electrician • unemployed trades assistant • child • student • accountant

However, for National Minimum Data Set purposes it is preferable to distinguish these two data items logically. Source: NMDS working parties AIHW National Injury Surveillance Unit and NDS-IS Advisory Group Revision: Categories for this item are now based on the codes recommended for NHDD,

Item P14 public psychiatric hospitals. These have been modified to distinguish those who are self employed by the addition of two categories employed [7] & self-employed [8].

Comment: Modified version of NHDD item P14.



NHDD Item P15: Occupation

Definition: The current occupation of the person is the current job or duties which the person is principally engaged in.

Classification/coding: Australian Standard Classification of Occupations (ASCO, minor groups) (refer to Table on the following page).

Guide for use: This general item is for the current occupation of the injured person , irrespective of whether the injury occurred while working at this occupation. This is distinct from the occupation recorded for Activity when injured (Level 2, item 4), preferably coded to a greater level of detail, where injury occurred while working for income.

Justification: There is considerable user demand for data on occupation-related injury and illness, including from Worksafe Australia and from industry, where unnecessary production costs are known in some areas and suspected to be related to others in work-related illness, injury and disability. The report Health for All Australians also identifies occupational related ill health as a focus for health promotion and illness prevention activities.

Used with: Source: NMDS working parties Comment: Extensive comments and discussion about this item may be found in the

NHDD, Item P15. These may be referred to, if further clarification is required.



Australian Standard Classification of Occupations: minor groups

1. Managers and administrators 2. Professionals

11 Legislators and government appointed

officials

12 General managers

13 Specialist managers

14 Farmers and farm managers

15 Managing supervisors (sales and service)

16 Managing supervisors (other business)

21 Natural scientists

22 Building professionals and engineers

23 Health diagnosis and treatment practitioners

24 School teachers

25 Other teachers and instructors

26 Social professionals

27 Business professionals

28 Artist and related professionals

29 Miscellaneous professionals

3. Paraprofessionals 4. Tradespersons

31 Medical and science technical officers and

technicians

32 Engineering and building associates and

technicians

33 Air and sea transport technical workers

34 Registered Nurses

35 Police

36 Miscellaneous paraprofessionals

41 Metal fitting and machining

42 Other metal tradespersons

43 Electrical and electronics tradespersons

44 Building tradespersons

45 Printing tradespersons

46 Vehicle tradespersons

47 Food tradespersons

48 Amenity horticultural tradespersons

49 Miscellaneous tradespersons

5. Clerks 6. Salespersons and personal service workers

51 Stenographers and typists

52 Data processing and business machine

operators

53 Numerical clerks

54 Filing, sorting and copying clerks

55 Material recording and despatching clerks

56 Receptionists, telephonists and messengers

61 Investment, insurance and real estate

salespersons

62 Sales representatives

63 Sales assistants

64 Tellers, cashiers and ticket salespersons

65 Miscellaneous salespersons

66 Personal service workers

7. Plant and machine operators and drivers 8. Labourers and related workers

71 Road and rail transport drivers

72 Mobile plant operators (except transport)

73 Stationary plant operators

74 Machine operators

81 Trades assistants and factory hands

82 Agricultural labourers and related workers

83 Cleaners

84 Construction and mining labourers

89 Miscellaneous workers

Source: NHDD, version 4.0, Table 3.2 (1995:3-36) from ASCO (ABS cat.no.1222.0, first edition)



NHDD Item P11: Preferred language Definition: The language (including sign language) most preferred by the person for

communication. This may be a language other than English even where the person can speak fluent English.

Classification/coding: The proposed coding system is that used by the New South Wales Department of Health. It is based on the Australian Bureau of Statistics 2-digit classification of country of birth. Matching codes are used for languages and countries where possible. The major Chinese dialects and Indian languages are separately coded.

Code Language Code Language

01 Australian Aboriginal

language

86 English

02 Afrikaans

03 Albanian

04 Arabic including Lebanese

05 Armenian

06 Bengali

07 Bulgarian

08 Burmese

09 Cantonese

10 Croatian

11 Czech

12 Danish

13 Dutch

14 Estonian

15 Fijian

16 Filipino Languages

17 Finnish

18 French

19 Gaelic

20 German

21 Greek

22 Hindi

23 Hungarian

24 Indonesian

25 Italian

26 Japanese

27 Khmer / Cambodian

28 Korean

29 Lao

30 Latvian

31 Lithuanian

32 Macedonian

33 Maltese

34 Maori Languages

35 Norwegian

36 Polish

37 Portuguese

38 Romanian

39 Romany

40 Russian

41 Serbian

42 Serbo-Croatian

43 Sinhalese / Sri Lankan

50 Thai

51 Tongan

52 Turkish

53 Ukrainian

54 Urdu

55 Vietnamese

56 Welsh

57 Yiddish

58 Yugoslav (not elsewhere defined)

59 African (not elsewhere defined)

60 Asian (not elsewhere defined)

61 European (not elsewhere defined)

62 Oceanic Languages (not elsewhere defined)

63 Other (not elsewhere defined)

64 Unknown / inadequately described

65 Persian

66 Sign Language

67 Mandarin

68 Chinese (not elsewhere defined)

69 Tagalog

70 Chinese (as stated)

71 Pidgin English

72 Bosnian

73 Hmong

74 Indonesian / Malay

75 Malay

76 Samoan

77 Somali

78

79 Kiribati

80 Dari

81 Kirundi (Rundi)

82 Bari

83 Bassa

84 Hazargi

85 Kinyarawanda

86 English only

87

88 Kpelle

89 Madi

90 Mundu

91 Sorani

92 Persian / Farsi

93 Karen

94 Amharic



44 Slovak

45 Slovenian

46 Spanish

47 Swedish

48 Tamil

49 Tetum

95 Tigrinya

96 Krio

97 Filipino

98 Not stated / Inadequately described

99 Not known

Guide for use: ALL sign languages are to be coded 96 • Code = 63 (other language not elsewhere classified) is only to be used where

there is no indication of even the continent in which it is spoken. It should only appear in exceptional circumstances.

• Code = 98 (Not stated / inadequately described) means that the respondent has not been able to communicate the name of the language which he or she prefers.

• Code = 99 (not known) means that information could not be obtained about the preferred language.

Justification: Preferred language is an important indicator of ethnicity, especially for persons from in non-English speaking countries. It is also a surrogate measure for English language proficiency, which is an important determinant of access to health services. The National Better Health Program has a major goal: that is, the reduction in health status differentials among ethnic groups, and has recommended the routine recording of level of facility with English in all statistical collections. Effective from: 1989 Effective to: Used with: Source: NMDS working parties Comment: The Taskforce on National Hospital Statistics (1988) recommended that „need for interpreter services‟ be included in the National Minimum Data Set to assist in health services planning. English language proficiency is also an important determinant of access to health services and of effective communication between health professionals and consumers. It was pointed out that the National Better Health Program has the reduction of health inequalities between ethnic groups in Australia as a major goal (Health Targets and Implementation Committee 1988). The Australian Health Ministers‟ Advisory Council Health Targets and Implementation Committee recommended that national health statistical collections should routinely identify the various groups of concern. This would require the routine recording in all collections of the following ethnicity data items: • birthplace (essential) • race (especially the identification of Aborigines and Torres Strait Islanders) • level of facility with English (highly desirable). Inclusion of all these items in the National Minimum Data Set is highly desirable to allow the Commonwealth and the States and Territories to monitor progress towards the achievement of health goals and targets and the outcomes of specific initiatives under the National Better Health Program. The nursing homes patient database maintained by the Commonwealth Department of Community Services and Health (derived from the NH5 form) contains the following language related data item:

What is your preferred language? (including sign language) ( ) English

( ) Other (please specify). On the other hand, „proficiency in English‟ is the data item recommended for use by the Office of Multicultural Affairs (1988) and the Australian Health Ministers‟ Advisory Council Health Targets and Implementation Committee (1988). The New South Wales hospital morbidity collection contains an item „language used at home‟. New South Wales introduced their language item because in some areas of Sydney up to 70 per cent of patients speak a non-English language at home. Proficiency in English was considered less important



because, although they may speak English well, they may prefer the language used at home in a stressful situation. Acute hospital and private psychiatric hospitals The working party decided that a language-related item should not be included in the National Minimum Data Set, but recommended that the preferred form for language-related data items in hospital morbidity collections should be that of the Australian Bureau of Statistics census questions:

17. Does the person speak a language other than English at home? • No, speaks only English • Yes If yes, please print language spoken.................................................. 18. Answer Question 18 for each person who speaks a language other than English at home. How well does the person speak English? Very well Well Not very well

Not at all. Public psychiatric hospitals The working party agreed to endorse this item as being desirable to collect, as psychiatric patients often regressed to their preferred language. However, it was more of a long-term goal and might take some time to implement. Nursing homes The Nursing Homes Working Party felt that nursing home needs were different from acute hospital needs as migrant long-stay elderly residents may tend to revert to their original language, thus providing an argument for including this item in the data set. In addition, the Commonwealth Department of Community Services and Health has a strong interest in this area and will continue to collect it on the NH5. New South Wales already collects „language spoken at home‟ and „country of birth‟. It considered that „preferred language‟ was an important data item to collect, particularly in relation to access to health care. South Australia also recommended the inclusion of this item in The National Health Data Dictionary for nursing homes.



NDS-IS–level 2 Date of attendance

Definition: Date of the attendance by the person to the place at which NDS-IS data

are being collected.

Classification/coding: DD MM YYYY

Guide for use: If only year, or month and year, is known, record this. Missing day or

month should be coded “99”

Month: January = 01, February = 02 ... December = 12

Justification: In combination with date and time of injury, and time of attendance,

period until attendance can be calculated. Date of injury is important for

prevention (temporal patterns of occurrence), retrieval (assessment of

time to treatment) and health service utilisation (assessment of repeat

visits following a single injury).

Used with:


Comment: This general information items does not have equivalent in the „National

Health Data Dictionary‟. It is conceptually equivalent to the NHDD Item

P24 Admission date



NDS-IS–level 2 Time of attendance

Definition: Time of day of attendance by the person to the place at which NDS-IS

data are being collected.

Classification/coding: HH MM

Guide for use: If only hour is known, then record this and code minute to “99”

Use the 24 hour (military) clock. Midnight = 00 00; 2:16 pm = 14 16

Justification: The occurrence of many injuries fluctuates with time. Understanding of

the patterns contributes to prevention. In combination with date and time

of injury, and date of attendance, period until attendance can be

calculated.

Used with:


Comment: This general information items does not have equivalent in the „National

Health Data Dictionary‟.

Supplementary data item Appendix 1


Supplementary Data Items

Supplementary item 1 Postcode

Definition: Postcodes are allocated by Australia Post for postal areas within Australia

Classification/coding: Four-digit postcode

Guide for use: Allocated Postcodes are published by Telstra Corporation in the White

Pages and elsewhere.

Justification:

Used with: Postcode may be used in conjunction with Item P9.

Revision: Postcode has been added as a supplementary data item for version 2.1

NDS-IS

Source:

Comment: Postcode has been included as an additional item. The current Item P9

(Area of usual residence) remains unchanged and the preference for use

of SLAs is retained. Postcode can be used in conjunction with Item P9

and is available where SLAs are not known or not available.

NISDD Supplementary data item


Supplementary item 2 Triage score

Definition: The urgency of the person‟s need for medical and nursing care.

Classification/coding: 1. Resuscitation (immediate)

2. Emergency (10 minutes)

3. Urgent (30 minutes)

4. Semi urgent (60 minutes)

5. Non urgent (120 minutes)

Guide for use: Normally assessed by a designated ED staff member immediately after

the arrival of the person to ED.

Justification:

Used with:

Revision: Triage score has been added as a supplementary data item for version 2.1

NDS-IS

Source: Australasian College of Emergency Medicine

Comment:

Appendix 2


Appendix 2. Coding concordance tables: ICD and NDS-IS

This appendix contains tables which map the NDS-IS Level 1 injury data item classifications against

related sections of the International Classification of Diseases. Tables are provided for ICD-9-CM and

ICD-10.

Table A2.2A. Main ‘external cause’

NDS-IS

Level 1

Type of ‘external cause’ ICD-9-CM ICD-10

1 Motor vehicle - driver E810-E825/0 V40-V48/0,5 V49/0,4

V50-V58/0,5 V59/0,4

V60-V68/0,5 V69/0,4

V70-V78/0,5 V79/0,4

2 Motor vehicle - passenger

or unspecified occupant

E810-E825/1 V40-V48/1-4,6,7,9 V49/1-3,5-9

V50-V58/1-4,6,7,9 V59/1-3,5-9

V60-V68/1-4,6,7,9 V69/1-3,5-9

V70-V78/1-4,6,7,9 V79/1-3,5-9

3 Motorcycle - driver E810-E825/2 V20-V28/0,4 V29/0,4

V30-V38/0,5 V39/0,4

4 Motorcycle - passenger or

unspecified whether

driver or passenger

E810-E825/3 V20-V28/1-3,5,9 V29/1-3,5-9

V30-V38/1-4,6-9 V39/1-3,5-9

5 Pedal cyclist or cycle

passenger

E800-E807/3

E826-E829/1

E810-E825/6

V10-V19

6 Pedestrian E800-E807/2

E810-E825/7

E826-E829/0

V01-V09

7 Other or unspecified

transport related

circumstance

Includes railways, water

transport, air transport

Includes drowning

associated with watercraft

Excludes machinery

accident in watercraft

E800-E807/0,1,8,9

E810-E829/4,8,9

E958/5,6

E968.5

E988/5,6

E830-E835

E837-E848

V81-V92

V94-V99

X82

Y03

Y32

8 Horse related Includes fall from;

trampled, kicked, or bitten

by; etc.

Excludes injuries to

pedestrians or vehicle

occupants resulting from

collision with a horse [1-6]

See Note 1.

See Note 1.

9 Fall - low Includes falls on same

level, or <1m, or if no

information on height.

Excludes falls in/on/from

transport [5,6,8] and falls

resulting in drowning

[11,12]

See Note 2.

See Note 2.

Appendix 2


10 Fall - high (1m or more) Includes fall, jump, being

pushed from high place

Excludes fall in/on/from

transport [5,6,8] and falls

resulting in drowning

[11,12]

See Note 2.

See Note 2.

11 Drowning, submersion -

in swimming pool

E910/5,6 W67-W68

12 Drowning, submersion -

other than swimming pool

Includes drowning in

unspecified place

Excludes drowning

associated with watercraft

[7]

E910/0-4,7-9

E954

E964

E984

W65-W66

W69-W74

X71

X92

Y21

13 Other threat to breathing

Includes inhalation of food,

suffocation in enclosed

space, strangulation, etc

E911-E913

E953

E963

E983

W75-W84

X70

X91

Y20

14 Fire, flames, smoke

Includes asphyxiation or

poisoning related to fires,

explosion related to

conflagration

Excludes transport related

E890-E899

E958.1

E968.0

E988.1

E990

X00-X09

X76

X97

Y26

15 Exposure to hot drink,

food, water, other fluid,

steam, gas, or vapour

Includes scalds

E924/0,2

E958.2

E968.3

E988.2

X10-X14

16 Exposure to hot object or

solid substance

Includes contact burns, etc

Includes burn if unspecified

whether due to solid, liquid

or gas

E924.8 X15-X19

X77

X98

Y27

17 Poisoning - drug or

medicinal substance

Includes adverse effect of

medication in normal use

E850-E858

E930.0-E950.5

E962.0

E980/0-5

X40-X44

X60-X64

X85

Y10-Y14

Y40-Y59

18 Poisoning - other

substance

Includes poisoning if

unspecified whether

medication or other subst.

Excludes envenomation by

animal [22] or plant [28].

E860-E869

E950.6-E952.9

E962/1-9

E980/6-9 E972 E981

E982 E997.2

X45-X49

X65-X69

X86-X90

Y15-Y19

Y35.2

19 Firearm

Excludes explosive [28]

E922 E955/0-4

E965/0-4 E970

E985/0-4 E991/0-2

W32-W34 X72-X74

X93-X95 Y22-Y24

Y35.0

20 Cutting, piercing object

Excludes machinery, power

tools or appliances [24]

E920/3,4,5,8,9 E956

E966 E974 E986

W25-W27

W45 X78 X99 Y28 Y35.4

21 Dog-related

Incl. bitten, struck by

See Note 1. See Note 1.

22 Other animal-related

Excludes horse[7], dog[21]

See Note 1. See Note 1.

Appendix 2


24 Machinery in operation

Includes power tools,

appliances

Includes machinery in

context of watercraft

Excludes machinery in the

context of other transport

[1-7]

E836

E919

E920/0-2

W24

W28-W31

25 Electricity E925 E958.4 E988.4 W85-W87

26 Hot conditions

(natural origin), sunlight

E900.0 X30 X32

27 Cold conditions

(natural origin)

E901.0

E958.3

X31

28 Other specified external

cause

(including late effects)

E870-E879 E900/1,9

E901/1,8,9

E902-E904 E905.7

E907-E909 E914-

E915 E921 E923

E924/1,9 E926 E927

E928/0-8 E929

E955/5,9 E958/7,8

E959 E960.1 E961

E965/5-9 E967

E968/4,6-8 E969 E971

E975-E978 E985.5

E988/3,7,8 E989

E991/3,9 E992-E999

V93

W23

W35-W44

W49 W60 W64

W88-W99

X28 X33-X39

X50-X58

X75 X83 X96

Y05-Y08

Y25 Y33

Y35.1 Y35/.5-.7

Y89.9

29 Unspecified external

cause

E928.9 E958.9

E968.9 E988.9

X59 X84 Y09 Y34

30 Struck by or collision

with person

E917

E960.0

W50-W52

Y04

31 Struck by or collision

with object

Excludes: pinching or

jamming between objects

[28]; machinery in

operation [24]; firearm

projectile [19]; cutting

object [20]

E916

E918

E958.0

E968.2

E973

E988.0

W20-W22

X79 X81

Y00 Y02 Y29 Y31 Y35.3

Key:

E810-E829/4,8,9 means: „all E-codes in the range E810-E829 where the 4th digit is 4, 8 or 9.‟

E910/0-7,9 means: „E-codes E910.0 to E910.7 and E910.9.‟

E911-E913 means „all valid 3 or 4 digit E-codes from E911.0 to E913.9.‟

Note 1: ICD-9-CM and (to a lesser degree) ICD-10 do not enable good identification of „horse related

injuries‟ or „dog related injuries‟. When data collected according to Level 1, Item 2A are

compared with aggregated ICD data, the three Item 2A „Animal‟ categories [8], [21] & [22],

should be combined. The resulting single „Animal related‟ category is nearly equivalent to the

following ICD codes, which should be used to define a comparison group:

ICD-9-CM: E810-E825/.5; E826-E829/.2,.3; E905/all but .7; E906.

ICD-10: V80, W53-W59, X20-X27, X29

Note 2: ICD-9-CM and ICD-10 do not generally allow the height of a fall to be specified. When data

collected according to Level 1, Item 2A are compared with aggregated ICD data, the two Item

2A „Falls‟ categories [9] & [10] should be combined. The resulting single „Falls‟ category is

Appendix 2


nearly equivalent to the following ICD codes, which should be used to define a comparison

group:

ICD-9-CM: E880-E888; E957, E968.1, and E987

ICD-10: W00-W19, X80, Y01, Y30

Note 3: ICD-9-CM and ICD-10 provide many more categories for coding „accidental‟ external causes

than for other intent groups, and specific codes for non-accidental instances of the types of

event covered by some Item 2A categories are not provided.

The ICD codes shown in the Table A2.2A, include only „accidental‟ instances of the type of

event covered by some Item 2A categories (groups 1 to 7, 11, 16, 21, 22, 24, and 26).

Provision of codes for non-accidental instances is also incomplete for some other groups.

Accordingly, it is advisable to take account of both Item 2A and Item 2B when comparing

data collected according to the NDS-IS Level 1 categories with aggregated ICD data.

Source: NDS-IS Level 1, Item 2A: external cause – major groups

ICD-9-CM (1996, second edition, vol 1: 331-370)

ICD-10 (1992, vol 1: 1026-1123)

Appendix 2


Table A2.2B: Main external cause: intent

NDS-IS

Level 1

Intent ICD-9-CM ICD-10

Accidental harm

1 Accident; injury was not

intended

no obvious human

intention to produce the

injury

E800-E869

E880-E929

V01-X59

Y85

Y86

Intentional self-harm

2 Intentional self harm

evidence is available that

the injured person

intended to produce the

injury

E950-E959 X60-X84

Y87.0

Assault, maltreatment and neglect

3 Sexual assault (by bodily

force)

E960.1

(includes rape only)

Y05

4 Maltreatment by parent E967.0

(of child; incl. neglect)

Y07.1

5 Maltreatment by spouse

or partner

E967.2 Y07.0

6 Other or unspecified

assault

Includes neglect or

abandonment by parent,

spouse or partner

E960.0 E961-E966

E967/1,3-9 E968-E969

X85-Y04 Y06 Y07.2-Y09.9

Y87.1

Undetermined intent

7 Event of undetermined

intent

E980-E989 Y10-Y34 Y87.2

Other or unspecified intent

8 Legal intervention (incl.

police) or operations of

war

E970-E978 E990-E999 Y35-Y36 Y89.0 Y89.1

9 Adverse effect, or

complication of medical

or surgical care

E870-E876 E878-E879

E930-E949

Y40-Y84 Y88

10 Other specified intent No ICD-9-CM

equivalent

No ICD-10 equivalent

11 Intent not specified No ICD-9-CM

equivalent

Y89.9 (sequelae of

unspecified external cause)

Source: NDS-IS Level 1, Item 2B: external cause - intent

ICD-9-CM (1996, second edition, vol 1: 331-370)

ICD-10 (1992, vol 1: 1026-1123)

Appendix 2


Table A2.3: Type of place where injury event occurred

NDS-IS

Level 1

Place ICD-9-CM place

of occurrence

ICD-10 place of

occurrence

1 Home

(includes farm house)

.0 .0

2 Residential institution

(excludes hospital)

.7 .1

3 School, other institution, or public

administrative area

(excl. hospital, incl. child day care centre)

.6 .2

4 Hospital or other health service

.7 .2

5 Recreation area

(place mainly for informal recreational

activity)

.4 .8

6 Sport or athletics area

(place mainly for formal sports)

.4 .3

7 Street or highway

(public road)

.5 .4

8 Trade or service area

(eg. bank, petrol station, supermarket)

.6 .5

9 Industrial or construction area

.3 .6

10 Mine or quarry

.2 .6

11 Farm

(excludes farm house)

.1 .7

12 Other specified place

(includes forest, beach, abandoned building))

.8 .8

13 Unspecified place

.9 .9

The following tables show the aggregations of NDS-IS „Place‟ codes required to map to ICD-9-

CM (vol.1 E-code 849) and ICD-10 (vol. 1: 1013-1017

ICD-9-CM NDS-IS ICD-10 NDS-IS

0 1 0 1

1 11 1 2

2 10 2 3+4

3 9 3 6

4 5+6 4 7

5 7 5 8

6 3+8 6 9+10

7 2+4 7 11

8 12 8 5+12

9 13 9 13

S

Appendix 2


o

u

r

c

e

:

N

D

S

-

I

S

L

e

v

e

l

1

,

I

t

e

m

3

P

l

a

c

e

o

f

i

n

j

u

r

y

o

c

c

u

r

r

e

n

c

e

Appendix 2


–

t

y

p

e

I

C

D

-

9

-

C

M

(

1

9

9

6

,

s

e

c

o

n

d

e

d

i

t

i

o

n

,

v

o

l

.

1

:

3

4

1

-

3

4

2

)

Appendix 2


I

C

D

-

1

0

(

1

9

9

2

,

v

o

l

.

1

:

1

0

1

3

-

1

0

1

7

)

Appendix 2


Table A2.4: Type of activity of person when injured

NDS-IS

Level 1 Activity ICD-10

1 Sports activity

(Organised physical activity under the auspices of a sports club or

federation, a school, or other organisation. Includes training.)

0

2 Leisure activity

(Leisure or recreation activity, alone or with others. Includes

informal sport activities such as „backyard‟ cricket, and

„playing‟.)

1

3 Working for income

(Includes travel to and from work)

2

4 Other type of work

(Includes unpaid housework and related shopping)

3

5 Resting, sleeping, eating, or other personal activities

(eg. personal hygiene)

4

6 Being nursed or cared for

(eg. infant being carried by parent, patient being lifted by nurse)

4

7 Engaged in formal educational activity

(As a student; includes travel to and from)

3

8 Other specified activity

8

9 Unspecified activity

9

Source: NDS-IS, Level 1, item 4: Activity when injured – type

ICD-10 (1992, vol. 1: 1017- 1018)

Appendix 2


5A & 5B Nature and bodily location of injury

Table A2.5A in this section indicates the ICD categories which correspond to each NDS-IS nature of

injury group. A few ICD categories do not refer solely to one of the nature of injury groups.

Allocation of these is described in the notes at the end of the table. A dash indicates a, NDS-IS

category for which there is no ICD equivalent. This table is designed to enable translation of ICD-

coded data to NDS-IS nature of injury groups.

Translation of ICD-coded data to NDS-IS nature of injury AND bodily location groups is more

complex. For many categories, translation is exact. For other categories, however, this is not

possible. In the main, this reflects the lack of consistency from section to section within the ICD

classifications. Further information is available from NISU.

Table A2.5A/B in this section is designed to assist conversion of NDS-IS nature of injury and bodily

location codes to ICD codes. This translation cannot be perfect, due to certain characteristics of the

classifications. The main limitation is that many nature/bodily location categories correspond to

more than one ICD code (see the first table in this section). In the NDS-IS to ICD translation, each

nature/bodily location category must be made to correspond to one ICD category. Translation is

better from NDS-IS to ICD-10 than to ICD-9-CM because ICD-10 has more regular organisation.

This table is for ICD-10.

Appendix 2


Table A2.5A: Nature of injury

‘Nature of injury’ category ICD-9-CM ICD 10

1. Superficial

(includes bruise

excludes eye [13])

910-917

919/0-3,6-9

920

922-924

S00 S10 S20 S30 S40 S50 S60 S70

S80 S90

T00 T09.0 T11.0 T13.0 T14.0

2. Open wound

(excludes eye [13])

872.0-873.61

873.64-873.71

873.74-879

880-884/0,1

890-894/0,1

S01 S11 S21 S31 S41 S51 S61 S71

S81 S91

T01 T09.1 T11.1 T13.1 T14.1

3. Fracture

(excludes tooth [21])

800-801/0,5

802

803-804/0,5

805-829

S02/0-4,6-9

S12 S22 S32 S42 S52 S62 S72 S82

S92

T02 T08 T10 T12 T14.2

4. Dislocation (includes rupture

of disc, cartilage, ligament)

830-839 S03/0,1,3 S13/0-3 S23/0-2 S33/0-4

S43/0-3 S53/0-1 S63/0-4 S73.0

S83/0-3 S93/0-3

5. Sprain or strain 840/0,1,2,8,9

841-848

S03/4,5 S13/4-6 S23/3-5 S33/5-7

S43/4-7 S53/2-4 S63/5-7 S73.1

S83/4-7 S93/4-6

T03 T09.2 T11.2 T13.2 T14.3

6. Injury to nerve (includes

spinal cord; excludes

intracranial [20])

950-957 S04 S14 S24 S34 S44 S54 S64 S74

S84 S94

T06/0-2 T09/3,4 T11.3 T13.3 T14.4

7. Injury to blood vessel 900-904 S09.0 S15 S25 S35 S45 S55 S65 S75

S85 S95

T06.3 T11.4 T13.4 T14.5

8. Injury to muscle or tendon 840/3-6

880-884/2

890-894/2

S09.1 S16 S29.0 S39.0 S46 S56 S66

S76 S86 S96

T06.4 T09.5 T11.5 T13.5 T14.6

9. Crushing injury 925-929 S07 S17 S28.0 S38/0,1 S47 S57 S67

S77 S87 S97

T04 T14.7

10. Traumatic amputation

(includes partial amputation)

885-887

895-897

S08 S18 S28.1 S38/2,3 S48 S58 S68

S78 S88 S98

T05 T09.6 T11.6 T13.6

11. Injury to internal organ 860-869 S26 S27 S36 S37 S39.6

T06.5

12. Burn or corrosion

(excludes eye [13])

941-949 T20-T25

T27-T32

13. Eye injury (excl. f.b. in ext.

eye [14.1]; incl. burn)

870 871

918 921 940

S05

T26

14.1 Foreign body in external eye 930 T15

14.2 Foreign body in ear canal 931 T16

14.3 Foreign body in nose 932 T17/0,1

Appendix 2


14.4 Foreign body in respiratory

tract (excludes foreign body

in nose [14.3])

933

934

T17/2-9

14.5 Foreign body in alimentary

tract

935-938 T18

14.6 Foreign body in genito-

urinary tract

939 T19

14.7 Foreign body in soft tissue - -

14.9 Foreign body, other or

unspecified

- -

20. Intracranial injury

(includes concussion)

800-801/1-4, 6-9

803-804/1-4, 6-9

850-854

S06

21. Dental injury

(includes fractured tooth) 873/62, 63, 72, 73 S02.5

S03.2

22. Drowning or immersion 994.1 T75.1

23. Asphyxia or other threat to

breathing (excl. drowning

[22])

994.7 T71

24. Electrical injury 994.8 T75.4


(excl. venomous bite [26])

960.0-989.4

989/6-9

T36-T62

T64 T65

26. Effects of venom;

all insect bites

919/4,5

989.5

T63

27. Other specified nature of

injury

905-909 958

990-993

994/0,2-6,9

995-999

S09.2, Sx9.8 T06.8 T09.8 T11.8 T13.8

T14.8 T33-T35 T66-T70 T73 T74

T75/0, 2, 3, 8 T78/0-8

T79.0-T98.3

28. Injury of unspecified nature 959 Sx9.9

T07 T09.9 T11.9 T13.9 T14.9 T78.9

29. Multiple injuries of more than

one „nature‟

- Sx9.7

30. No injury detected - -

Notes: 1. T03, T09.2, T11.2, T13.2, T14.3 (unspecified dislocation, sprain or strain of various parts of body) are

allocated to NDS-IS category 5, Sprain or strain.

2. T14.7 (crush injury or traumatic amputation of unspecified body region) is allocated to NDS-IS category

9, Crushing injury.

3. T06.8 (other specified injuries involving multiple body regions) is allocated to NDS-IS category 27,

Other specified nature of injury.

4. 'Sx9.7' refers to the ten codes 'S09.7', 'S19.7', .. ,'S99.7'. Sx9.8' and 'Sx9.9' follow the same pattern.


Table A2.5A/B: ICD-10 Chapter XIX equivalent for each valid combination of NDS-IS Level 1, Item 5A & 5B Nature of Injury and Bodily Location codes

Bodily Location †

Code

NDS-IS

‘Nature of injury ’ category

22 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21

No

t

app

lica

ble

Hea

d

Fac

e

Nec

k

Th

ora

x

Ab

do

men

Lo

wer

bac

k

Pel

vis

Sh

ou

lder

Up

per

arm

Elb

ow

Fo

rear

m

Wri

st

Han

d

Hip

Th

igh

Kn

ee

Lo

wer

leg

An

kle

Fo

ot

Un

spec

ifie

d

Mu

ltip

le

loca

tio

ns

1 Superficial X S00 S00 S10 S20 S30 S30 S30 S40 S40 S50 S50 S60 S60 S70 S70 S80 S80 S90 S90 T14.0 T00

2 Open wound X S01 S01 S11 S21 S31 S31 S31 S41 S41 S51 S51 S61 S61 S71 S71 S81 S81 S91 S91 T14.1 T01

3 Fracture X S02 S02 S12 S22 X S32 S32 S42 S42 X S52 S62 S62 S72 S72 S82 S82 S82 S92 T14.2 T02

4 Dislocation (incl ruptured disc,

cartilage, ligament)

X S03/

0,1,3

S03/

0,1,3

S13/

0-3

S23/

0-2

X S33/

0-4

S33/

0-4

S43/

0-3

X S53/

0-3

X S63.0 S63/

1-4

S73.0 X S83/

0-3

X S93.0 S93/

1-3

T14.3 T03

5 Sprain or strain X S03/

4,5

S03/

4,5

S13/

4-6

S23/

3-5

X S33/

5-7

S33/

5-7

S43/

4-7

X S53.4 X S63.5 S63/

6,7

S73.1 X S83/

4-7

X S93.4 S93/

5-6

T14.3 T03

6 Injury to nerve X S04 S04 S14 S24 S34 S34 S34 S44 S44 S54 S54 S64 S64 S74 S74 S84 S84 S94 S94 T14.4 T06/0-2

7 Injury to blood vessel X S09.0 S09.0 S15 S25 S35 S35 S35 S45 S45 S55 S55 S65 S65 S75 S75 S85 S85 S95 S95 T14.5 T06.3

8 Injury to muscle or tendon X S09.1 S09.1 S16 S29.0 S39.0 S39.0 S39.0 S46 S46 S56 S56 S66 S66 S76 S76 S86 S86 S96 S96 T14.6 T06.4

9 Crushing injury X S07 S07 S17 S28.0 S38 S38 S38 S47 S47 S57 S57 S67 S67 S77 S77 S87 S87 S97 S97 T14.7 T04

10 Traumatic amputation (incl. Partial) X S08 S08 S18 S28.1 S38 S38 S38 S48 S48 S58 S58 S68 S68 S78 S78 S88 S88 S98 S98 T14.7 T05

11 Injury to internal organ X X X X S26,

S27

S36 X S37 X X X X X X X X X X X X X T06.5

12 Burn or corrosion T27

T28

T20 T20 T20 T21 T21 T21 T21 T22 T22 T22 T22 T23 T23 T24 T24 T24 T24 T25 T25 T30 T29

13 Eye injury (incl. Burn; excl. foreign

body [14.1, 14.7])

S05,

T26

X X X X X X X X X X X X X X X X X X X X X

14.1 Foreign body, external eye T15 X X X X X X X X X X X X X X X X X X X X X

14.2 Foreign body, ear canal T16 X X X X X X X X X X X X X X X X X X X X X

14.3 Foreign body, nose T17/0,1 X X X X X X X X X X X X X X X X X X X X X

14.4 Foreign body, respiratory tract T17/2-9 X X X X X X X X X X X X X X X X X X X X X

14.5 Foreign body, alimentary tract T18 X X X X X X X X X X X X X X X X X X X X X

14.6 Foreign body, genito-urinary tract T19 X X X X X X X X X X X X X X X X X X X X X

14.7 Foreign body, soft tissue T14/0,1 X X X X X X X X X X X X X X X X X X X X X

14.8 Foreign body, other or unspecified T14/0,1 X X X X X X X X X X X X X X X X X X X X X

20 Intracranial injury S06 X X X X X X X X X X X X X X X X X X X X X

21 Dental injury S03.2 X X X X X X X X X X X X X X X X X X X X X

22 Drowning or immersion T75.1 X X X X X X X X X X X X X X X X X X X X X

23 Asphyxia or other threat to breathing T71 X X X X X X X X X X X X X X X X X X X X X

24 Electrical injury T75.4 X X X X X X X X X X X X X X X X X X X X X

25 Poisoning or toxic effect (excludes

venomous bite [26])

T36-62;

T64-65

X X X X X X X X X X X X X X X X X X X X X

26 Effect of venom; any insect bite T63 T63 T63 T63 T63 T63 T63 T63 T63 T63 T63 T63 T63 T63 T63 T63 T63 T63 T63 T63 T63 T63

27 Other specified nature of injury * S09.8 S09/

2,8

S19.8 S29.8 S39.8 S39.8 S39.8 S49.8 S49.8 S59.8 S59.8 S69.8 S69.8 S79.8 S79.8 S89.8 S89.8 S99.8 S99.8 T14.8 T06.8

28 Unspecified nature of injury X S09.9 S09.9 S19.9 S29.9 S39.9 S39.9 S39.9 S49.9 S49.9 S59.9 S59.9 S69.9 S69.9 S79.9 S79.9 S89.9 S89.9 S99.9 S99.9 T14.9

**

T07

29 Multiple injuries, more than one nature X S09.7 S09.7 S19.7 S29.7 S39.7 S39.7 S39.7 S49.7 S49.7 S59.7 S59.7 S69.7 S69.7 S79.7 S79.7 S89.7 S89.7 S99.7 S99.7 T07 T06.8

30 No injury detected X X X X X X X X X X X X X X X X X X X X X X

Refer to notes on following page (X; *; **; †)

Appendix 2


Notes relating to Table A2.5A/B

X = Not a permitted combination of Nature and Bodily Location, and has no ICD 10 Chapter XIX code

equivalent

† Refer to NDS-IS Level 1, Item 5B for full specification of the bodily location groups.

* The „nature‟ [27] other specified nature of injury and „bodily location‟ [22] not applicable include the

following ICD-10 codes: T14.8, T66-T70.0; T73-T75/0,2,3,8; T78-T81

** T08-T13 provide categories for coding various types of injury when information about „nature of injury‟

and/or „body location‟ is limited or absent. As such, they do not fit well into this matrix. For completeness,

they may be allocated to „nature‟ and „body location‟ = unspecified

Appendix 3


Appendix 3. Specification for Injury Surveillance Data Exchange

Overview

The purpose of this specification is to provide a standard file format for the exchange of injury

surveillance data which conforms to the NDS-IS. It does not advise on the format for coding

within individual software applications, nor does it provide the means to map coding internal to

particular implementations to that of the standard format. Such issues are the responsibility of

individual users.

Data File Format

To enable compatibility with the many operating systems and applications used for collection of

data, NDS-IS data sets for exchange should consist of items in Delimited ASCII format, in

which each field is enclosed in double quotes (eg. “8109”), fields are separated by a comma (eg.

“8109”,”6”) and each record is separated by a Carriage Return and Line Feed. (ie. ASCII

0DHex

, 0AHex

)

Delimited ASCII has been chosen in preference to fixed format ASCII, mainly because of case

to case variation in the length of the narrative text field.

Data Item Formats and Sequence

Data items should be exported in the format and sequence as specified in Table 3.1. To ensure

commonality between files, fields 1 to 31 must be included regardless of whether or not the item

has been collected.

Null values (ie fields that are empty, because they are not in use, because data have been lost, or

because data were not collected) should be indicated with a single period (ie “.”; ASCII 2EHex.)

Optional Supplementary Items and Classifications

The injury surveillance data set allows for the optional collection of supplementary data items.

To accommodate the various categories and combinations of items which may be collected,

supplementary items should be included as pairs of fields at the end of each record. In each

pair, the first field contains the name of the data item (eg “Type of task”, “Make of vehicle”)

and the second contains data (eg “17”, “VN Commodore”).

Example: An injury surveillance group using NDS-IS might decide to collect data on the injured

person‟s seating position within a vehicle (coded as in the Injury Surveillance Information

System), and the model of that vehicle (recorded as text), in addition to standard NDS-IS items.

These items could be added to the NDS-IS data exchange file as follows:

Example:

Field number Contents

37 “Seating position”

38 “1”

39 “Vehicle model”

40 “VN Commodore sedan”

Appendix 3


Table A3.1 Data Exchange File Format

No.

Field Name

Format

Reference Items

1 Narrative description of injury event (short) ASCII Text Level 1, item 1

2 External cause – major groups NN Level 1, item 2A

3 External cause – intent groups NN Level 1, item 2B

4 Place of injury occurrence – type NN Level 1, item 3

5 Activity when injured – type N Level 1, item 4

6 Nature of main injury NNN † Level 1, item 5A

7 Bodily location of main injury NN Level 1, item 5B

8 Establishment identifier AAAAAA NHDD item P1

9 Patient identifier * NHDD item P2

10 Sex N NHDD item P4

11 Date of birth DDMMYYYY NHDD item P5

12 Area of usual residence NNNNN NHDD item P9

13 Mode of separation N NHDD item P31

14 Country of birth NNNN NHDD item P6

15 Aboriginality N NHDD item P7

16 Employment status N NHDD item P14

17 Occupation NN NHDD item P15

18 Preferred language NN NHDD item P11

19 Date of attendance DDMMYYYY NHDD item P24

20 Time of attendance HHMM

21 Narrative description of injury event (no limit) ASCII Text Level 2, item 1

22 External cause ANNN Level 2, item 2

23 Place of injury occurrence - sub-type NNN † Level 2, item 3A

24 Place of injury occurrence - part NN Level 2, item 3B

25 Activity when injured - sub-type: sport and leisure NN Level 2, item 4

26 Activity when injured -

sub-type: working for

income

Industry (ANZSIC 2-digit) NN †

Level 2, item 4 Occupation (ASCO 4-

digit) NNNN †

27 Activity when injured - other sub-types ** Level 2, item 4

28 Principle diagnosis - injury or poisoning ANNNN Level 2, item 5

29 Major injury factor NNNN Level 2, item 6

30 Mechanism of injury - type NN Level 2, item 7

31 Date of injury DDMMYYYY Level 2, item 9

32 Time of injury HHMM Level 2, item 10

33 Supplementary Item 1: Postcode (item name) Text NHDD item P9

34 Supplementary Item 1: Postcode (code value) NNNN

35 Supplementary Item 2: Triage (item name) Text ECEM

36 Supplementary Item 2: data (code value) N

.. .. ..

.. Supplementary Item n: item name Text

.. Supplementary Item n: data Text

Formats: Text = variable length text

N = numeric code

A = alphanumeric code

* = establishment specific.

**= not yet defined

† = amended for version 2.1 to match data items in NISDD

Appendix 4


Appendix 4. Proposed additions to NDS-IS

This appendix contains descriptions of data items and classifications which have been suggested for addition to the

NDS-IS in future versions. All of the items require further development, and comments and suggestions will be

welcomed. The items described are:

Task

Alcohol

Protective devices

Severity

Counterpart (in transport collisions)

Perpetrator of violence

Breakdown event

Consent by injured person

The proposed items are described in the following pages.

Appendix 4


NDS-IS proposed item Task

Definition: A distinct functional component of an NDS-IS Activity

Background: In the NDS-IS, Activity at the time of injury has been classified in a way

that defines types of activity that relate to areas of social or administrative

action and responsibility (eg sporting codes, industry groups). This is to

enable the group of injuries resulting from each such activity to be

brought to the attention of organisations capable of preventing them.

Activity can be conceived in other ways. For example, the NOMESCO

injury data standard includes a classification of pattern of movement

which has categories for such generic movements as standing and

running.

Lying (conceptually) between the entities defined in the NDS-IS activity

classification, and those defined in the pattern of movement classification

are activities which are components of the former, and aggregations of the

latter. For example, the NDS-IS Level 2 category Cricket is an activity in

which participants run, stand, turn, and so on. They do so in ways that

often are characteristic of a particular role in the game, or a particular

phase of play (eg batting, bowling, running between wickets). Knowledge

of the phase of play in which a person is involved when injury occurs is

likely to offer insights for injury prevention, that information about the

overall activity or about generic movements, cannot.

These relatively distinct components of an activity can be called tasks.

Some tasks are unique to a particular activity, or almost so (eg the launch

in pole-vaulting). Other tasks occur, though with differences, in a number

of activities (eg catching a ball; tackling an opponent). Similarly, tasks

can be identified as parts of occupational activities. For example,

agriculture includes tasks such as ploughing, herding animals, and

machinery maintenance.

Classification: Not yet developed. Suggested task categories for the NDS-IS Level 2

activity agriculture are shown below.

Justification: Interest of injury surveillance and prevention practitioners, particularly

those dealing with farm injury, work-related injury and sports injury.

Comment: A general classification of task has not been developed. The following list

of agricultural tasks is based on categories suggested by MUARC and

Farmsafe. Comments on these, and suggestions for further development

of the „task‟ classification will be welcomed.

mustering or herding

feeding or watering animals

milking

shearing

inspecting animals

slaughtering animals

transporting animals

controlling animal parasites

animal handling, other or unspecified

maintenance of building or structure

maintenance of machinery

maintenance of vehicle

fencing

cleaning

maintenance, etc, other or unspecified

storing crops

cultivating

fertilising crops

applying pesticides

irrigating crops

harvesting crops

loading crops

transporting crops

storing crops

inspecting crops

cropping, other or unspecified

tree felling or clearing

forestry work, other or unspecified

hunting

Appendix 4


NDS-IS proposed item Alcohol

Definitions: Evidence of alcohol involvement as determined by blood alcohol level

Evidence of alcohol involvement as determined by level of intoxication

Self-reported recent consumption of alcohol

Background: Alcohol is well recognised as a factor contributing to the occurrence of

many injuries. Its role is most widely acknowledged for road injury, but

evidence is available for substantial involvement of alcohol in (inter alia)

assault, drowning, and intentional self-inflicted injury.

Most routine injury surveillance conducted in Australia does not collect

any information on alcohol involvement. In much of Australia, however,

the law (3 States) or hospital practice (1 State) requires blood to be

collected from vehicle drivers who attend a hospital after a crash, for the

assessment of alcohol level. Elsewhere, testing is subject to police

discretion. Coverage is incomplete, particularly where collection is at the

discretion of police. The data are sometimes incorporated into hospital

records but they are not included in hospital morbidity data collections

(O‟Connor and Trembath, 1995)

Recent research in the USA suggests that collection of alcohol

information in an emergency department can be practicable and

acceptable to clients.*

The main aim of collecting data on alcohol is to enable assessment of the

patterns of alcohol presence and absence in groups of cases of injury. The

role of alcohol in individual cases cannot normally be assessed. Several

forms of data might be collected:

blood alcohol level

breath analysis for alcohol

self-reported consumption prior to injury

Injuries whose occurrence is partly due to consumption of alcohol may or

may not affect the person who consumed the alcohol. Some road safety

data systems aim to record the alcohol level of all drivers involved in a

crash. In many other settings, it is impracticable to obtain information

concerning anyone other than the injured person.

Classification: Blood alcohol level: no classification (record concentration)

Level of intoxication: use the classification in Y91 of ICD-10

Self-reported consumption: not determined.

Justification: Evidence that alcohol is a major causal factor for injury. Lack of good

Australian data, particularly for injuries other than road injuries.

Comment: The practicability of data collection remains to be determined in

Australia, as do questions concerning any special degree of sensitivity

concerning the confidentiality of data on alcohol. The validity of data on

self-reported recent consumption needs to be studied (Chris Gillam

intends to pilot a question along these lines in ED surveillance in a region

of Western Australia)

O‟Connor, P., Trembath, R., (1995) An investigation of missing values of blood alcohol concentration in

road crash databases. Adelaide: AIHW National Injury Surveillance Unit.

* L Degutis. Personal communication (1995)

Appendix 4


NDS-IS proposed item Protective devices

Definition: Utilisation of selected safety devices and safety precautions

Background: Specific protective devices, clothing and equipment have a role in minimising

harm in a number of hazardous situations. Identification of cases in which

such items were, and were not, in use is potentially of use as a basis for

conducting studies of their protective effect, and for assessments of the

potential population benefits of increasing the prevalence of use.

The Injury Surveillance Information System includes an item Safety Devices

and Safety Precautions Observed which has categories for No safety device,

8 particular types of device (eg bicycle safety helmet, work boots), and for

other safety device. Limitations of this item include the lack of categories

for „no information‟, „present but not used‟ and „present but used incorrectly‟,

and no provision of a way to record information about more than one device

for a case. Due to these factors, it is difficult to interpret data collected.

During development of NDS-IS version 2.0, an attempt was made to revise

and extend the ISIS classification and coding scheme. The draft is shown

below. This draft has not been extended for version 2.1.

Discussion with users revealed differences of opinion concerning the precise

purposes of the items, and about the feasibility of data collection. This item

requires further development before it can be included in NDS-IS.

Classification: 01 Motor vehicle safety belt or approved restraint (incl. approved infant

restraint/carrier; excl. airbag [2])

02 Motor vehicle air bag

03 Helmet - for vehicle use and related activities (incl. helmet for

motorcycling, bicycling, roller blading, horse riding, etc)

04 Child resistant closure (incl. blister packs)

05 Safety glasses, goggles

06 Mouthguard

07 Breathing apparatus

08 Respiratory protection device (excl. breathing apparatus [7])

09 Hard hat

10 Protective gloves

11 Work boots, safety boots

12 Rollover protection device

13 Machinery guard

14 Other specified safety device

For each of the listed safety measures, record that (1) it was in use, (2) it was not in

use, or (3) usage status is not known.

„In use‟ means that the device was in place, installed, worn, or otherwise situated so

that it could exert its protective effect at the time the injury event occurred.

Justification: Records the use or non-use of certain types of protective equipment that are

the subject of public health interest. May be a basis for evaluating

effectiveness and for studies of usage.

Comment: It may be possible to simplify the coding task by having data entry software

use information already entered (eg Main external cause) to limit the list of

devices displayed, by default, to the most relevant one or few, or to sort the

list to place these first (eg if Main external cause is cyclist then helmet

would be displayed or placed first when the user reaches the Protective

devices data item). Comments on this item and classification will be

welcomed.

Appendix 4


NDS-IS proposed item Severity

Definitions: Potential of injury to result in death

Potential of injury to result in adverse health outcome

Background: Measures of injury severity are essential for much research and evaluation

of injury, its prevention, and its management. In this context, severity is

often defined as the level of threat to life. The Abbreviated Injury Scale,

and the related Injury Severity Score (ISS), are measures of threat to life

which are relatively well-validated, at least for kinetic trauma (AAAM

1990). They are more appropriate for injury cases admitted to hospital (or

to the sub-group admitted to a specialised trauma service) than for all

injuries attending an emergency department. This is because these

measures have little power to provide useful discrimination among the

large number of low severity injury cases which attend a hospital but are

not admitted, and because correct severity coding depends on diagnostic

information which may not be available in the early phase of management

that occurs in an emergency department.

More recent work has begun to develop indicators capable of providing

useful discrimination between less severe injuries in terms of their likely

health impact, and which are capable of being applied in emergency

departments. McClure (1994) has proposed and validated a Minor Injury

Scale for this purpose. McClure‟s initial validation was limited to

relatively common types of injury. The scale requires confirmatory

validation, and extension to less common injuries.

Classification: Hospital admission or death: Abbreviated Injury Scale (and ISS)

Emergency department or GP attendance: Minor Injury Scale

Justification:

Comment: Further development of scales such at the one developed by McClure

depends on implementation and testing. It should be considered for

inclusion in the NDS-IS on this basis.

Association for the Advancement of Automotive Medicine (1990) The Abbreviated Injury Scale, 1990 revision.

AAAM: Des Plaines, Il..

McClure, R., (1994) The Public Health Impact of Minor Injury. Doctoral Thesis: Australian National University.

Appendix 4


NDS-IS proposed item Counterpart (in transport collisions)

Definition: The object struck by the injured person, or the vehicle in which s/he

was located, in a transport collision

Background: The nature of the „counterpart‟ is an important factor in determining the

severity of injury sustained in a transport collision.

Draft classification: 1. No counterpart (eg single vehicle rollover crash)

2. Pedestrian

3. Pedal cycle

4. Motor cycle (includes side car)

5. Three-wheeled motor vehicle (mainly for on-road use)

6. Car (4 wheels; designed to carry up to 10 persons)

7. Utility, pick-up truck, or van

8. Heavy transport vehicle (requires heavy vehicle licence)

9. Bus (designed to carry more than 10 persons)

10. Railway train or railway vehicle

11. Tram, trolley or streetcar

12. Special vehicle, industrial (includes forklift)

13. Special vehicle, agricultural (includes tractors)

14. Special vehicle, construction (includes earthmoving equipment)

15. Special vehicle, all terrain (includes snowmobile)

16. Watercraft

17. Aircraft

18. Other or unspecified transport counterpart

19. Non-transport counterpart (eg lamp post, rock, building)

20. Other or unspecified counterpart.

Justification: Transport collisions account for a large proportion of severe injury.

Comment: The draft classification is based on the categories listed in the ICD-10

Definitions related to transport accidents (ICD-10 Vol 1, pp 1018-23).

Refer to this for further specification of categories. ICD-10 has been used

as the basis for the draft classification to maximise comparability with

other items in NDS-IS. Other classifications, including those used in

certain road safety data collection systems, can be considered as

alternatives. Comments will be welcomed.

Appendix 4


NDS-IS proposed item Perpetrator of violence

Definition: Perpetrator of violence, as alleged by informant.

Background: Information about the perpetrator of violence is essential for researching

and preventing injury resulting from interpersonal violence. Commonly,

injury surveillance systems record information about the victim of assault,

but not about the perpetrator.

Draft classification: Unknown person

Known person:

Present spouse/partner

Former spouse/partner

Child/grandchild

Parent/grandparent

Other relative

Friend

Acquaintance

Person in dependence

Other specified known person

Unspecified

Source: NOMESCO Classification of external causes of injuries

Justification:

Comment: Legal and other factors add special sensitivity to this information. The

proposal is designed to record the perpetrator as alleged by the person

providing the information on injury circumstances (usually the injured

person, or an accompanying adult in the case of a child). The item, as

proposed in this draft, does not seek an assessment by hospital staff or

injury surveillance personnel in the absence of an allegation by the

informant, or which contradicts an allegation.

Is the NOMESCO classification suitable? Should categories be added?

Instances occur in which hospital personnel may suspect assault in the

absence of an allegation of assault, or in the face of denial of assault.

Consideration may be given to inclusion of a separate data item to enable

such cases to be flagged.

Consideration may also be given to inclusion of items on other features of

violent acts. For example, the NOMESCO Classification of external

causes of injuries includes the following items: number of perpetrators;

sex of perpetrator; age of perpetrator; and violence situation (the latter

records, for violence in a home or residence, whether it was the residence

of the victim, the perpetrator, or of another person).

Appendix 4


NDS-IS proposed item Breakdown event

Definition: The event, generally rapid in onset, after which the subsequent injury was

largely unavoidable.

Background: This concept, or similar ones, are common in contemporary models of

injury occurrence. A few attempts have been made to collect and classify

such information in surveillance systems, including the Injury

Surveillance Information System.

The complexity of the information that would be required to use this

classification is beyond the capabilities of the types of data collection for

which NDS-IS Level 2 is intended. The item has thus not been included in

this version.

Draft classification: No suitable classification is available


important for injury control.

Comment: The item was not included in this version of NDS-IS Level 2 because a

satisfactory classification is not available. The ISIS classification includes

some categories which are imprecise, and lacks categories for some types

of breakdown event and a coherent classification of the types. NISU

developed the following draft classification as a possible alternative. The

intention was to encompass a wide range of types of „breakdown‟, and to

order them beginning with the most specific and concrete. A difficulty is

that many of the types of „breakdown‟ referred to in injury control

literature are quite abstract, or their identification would depend on

information that is not likely to be available for routine surveillance data

collection. The draft classification is included here to prompt comment.

Natural catastrophe

11 Bushfire

12 Storm, cyclone, etc

13 Earthquake, landslip, etc

19 Other natural catastrophe

Technical failure or malfunction 31 Mechanical or structural failure 32 Information system failure

39 Other technical failure or malfunction

Task/person mismatch

51 Lack of knowledge - injured person

52 Lack of knowledge - another person

53 Lack of skill or competence - injured person

54 Lack of skill or competence - another person

55 Diminished skill or competence - injured person

56 Diminished skill or competence - another person

59 Other task/person mismatch

Risk taking

71 Initiated by the injured person

72 Initiated by another person

79 Other risk-taking

Intentionally initiated breakdown event 81 Initiated by the injured person

82 Initiated by another person

89 Other intentionally initiated

Other or unspecified type of breakdown event

98 Other specified type of breakdown event

99 Unspecified breakdown event

Appendix 4


NDS-IS proposed item Consent by injured person

Definition: Informed consent of injured person to provide information for injury

surveillance purposes.

Background: NISPP data collection forms included an item inviting the patient (or

accompanying adult) to indicate willingness to be contacted later for more

information about the injury or its circumstances. Some participants in

the advisory group meeting advocated inclusion of a similar item in this

data set. In support of this proposal, they argued that the item tends to

simplify the process of obtaining the consent of institutional ethics

committees to follow up groups of injury patients. Counter-arguments

were heard. One was that this type of approach to obtaining consent to

follow-up may no longer carry sufficient weight, given current

circumstances of heightened concern about patient privacy, and the

prospect that the record of consent might be no more than a data item

„ticked‟ or „crossed‟ or left blank by the hospital staff member recording

case information. The second argument was that the presence of the item

tends to lead ethics committees to make very restrictive decisions

concerning follow-up of cases where the consent item has not been

recorded as „yes‟.

This item, therefore, should not be included in the data set until the legal

status of unsigned consent was determined and the above issues are

resolved.

Appendix 5


Appendix 5. Summary of NDS-IS Level 1 items and classifications

National Data Standards for Injury Surveillance, Level 1

Minimum classifications for core injury data items

Version 2.1

1. Text Description of Injury Event

Brief description (up to 100 characters) of how injury came about. It should indicate what went wrong (the

„breakdown event‟), the mechanism by which this led to injury, and the object(s) or substance(s) most important in

the event („factors‟). The type of place at which the event occurred, and the activity of the person when injured should

also be indicated, as should use (or presence) or non-use (or absence) of relevant protective devices.

Examples:

1. [Child] opened bathroom cabinet at home and ingested about 50 ml of [Brand X] from bottle. Bottle had

child resistant closure.

2. Fell 2m from forklift pallet when fellow worker suddenly moved lift. In warehouse. Safety boots worn.

3. Struck on mouth by shoulder of another player in school soccer match. Not wearing mouthguard.

2A. Main ‘external cause’ of injury 1. Motor vehicle - driver

2. Motor vehicle - passenger*

3. Motorcycle - driver

4. Motorcycle - passenger*

5. Pedal cyclist or pedal cycle passenger*

6. Pedestrian

7. Other/unspec transport-related circumstance

8. Horse related (fall from, struck or bitten by)

9. Fall - low (on same level, < 1 m, or ? height)

10. Fall - high (drop of 1 metre or more)

11. Drowning, submersion - in swimming pool

12. Drowning, submersion - not in swimming pool

13. Other threat to breathing

14. Fire, flames, smoke

15. Exposure to hot drink, food, water, other fluid,

steam, gas, or vapour (incl. scald)

16. Exposure to hot object or solid substance (incl.

contact burn)

17. Poisoning - drug or medicinal substance

18. Poisoning - other or unspecified substance

19. Firearm

20. Cutting, piercing object

21. Dog related (incl. bitten, struck by)

22. Animal-related (excludes horse [8] or dog [21])

24. Machinery

25. Electricity

26. Hot conditions (natural origin), sunlight

27. Cold conditions (natural origin)

28. Other specified external cause (incl. late effect)

29. Unspecified external cause

30. Struck by or collision with person

31. Struck by or collision with object

* Includes unspecified occupants

2B. Most likely role of human intent

1. Accident; injury was not intended

2. Intentional self-harm*

3. Sexual assault (by bodily force)

4. Maltreatment by parent

5. Maltreatment by spouse or partner

6. Other or unspecified assault

7. Event of undetermined intent

8. Legal intervention (incl. police); war

9. Adverse effect or complication of medical or

surgical care

10. Other specified intent

11. Intent not specified

* Where the classification [2] has been recorded the default

coding for Item 4 (Activity when injured – type) is [8]

3. Type of place where injury event occurred

1. Home (incl. farm house)

2. Residential institution (excl. hospital [4])

3. School, other institution, or public

administrative area (excludes hospital [4]; incl.

child day care)

4. Hospital or other health service

5. Recreation area (place mainly for informal

recreational activity)

6. Sports or athletics area (place mainly for formal

sports)

7. Street or highway (public road)

8. Trade or service area

9. Industrial or construction area

10. Mine or quarry

11. Farm (excl. farm house [1])

12. Other specified place (incl. forest, beach,

abandoned building)

13. Unspecified place

Appendix 5


4. Type of activity of the person when injured

1. Sports activity

2. Leisure activity

3. Working for income (incl. travel to/from work)

4. Other type of work (incl. unpaid housework)

5. Resting, sleeping, eating, other personal activity

6. Being nursed or cared for

7. Engaged in formal educational activity (as a

student; incl. travel to/from)

8. Other specified activity

9. Unspecified activity

5A. Nature of main injury

*1. Superficial (incl. bruises; excl. eye [13])

*2. Open wound (excl. eye [13])

*3. Fracture (excl. tooth [21])

*4. Dislocation (incl ruptured disc, cartilage,

ligament

*5. Sprain or strain

*6. Injury to nerve (incl. spinal cord; excl.

intracranial injury [20])

* 7. Injury to blood vessel

* 8. Injury to muscle or tendon

* 9. Crushing injury

*10. Traumatic amputation (incl. partial)

*11. Injury to internal organ

*12. Burn or corrosion (excl. eye [13])

13. Eye injury

(excl. f.b. in external eye[14.1]; incl. burn)

14.1 Foreign body in external eye

14.2 Foreign body in ear canal

14.3 Foreign body in nose

14.4 Foreign body in respiratory tract

(excl. f.b. in nose [14.3])

14.5 Foreign body in alimentary tract

14.6 Foreign body in genito-urinary tract

14.7 Foreign body in soft tissue

14.9 Foreign body, other/unspecified

20. Intracranial injury (incl. concussion)

21. Dental injury (incl. fractured tooth)

22. Drowning or immersion

23. Asphyxia or other threat to breathing

(excl. drowning [22])

24. Electrical injury


(excl. venomous bite [26])

26. Effect of venom; any insect bite

*27. Other specified nature of injury

*28. Injury of unspecified nature

*29. Multiple injuries of more than one „nature‟

30. No injury detected

5B. Bodily location of main injury

1. Head (excl. face [2])

2. Face (excl. eye [22])

3. Neck

4. Thorax

5. Abdomen

6. Lower back (incl. loin)

7. Pelvis (incl. perineum, anogenital area, buttock)

8. Shoulder

9. Upper arm

10. Elbow

11. Forearm

12. Wrist

13. Hand (incl. fingers)

14. Hip

15. Thigh

16. Knee

17. Lower leg

18. Ankle

19. Foot (incl. toes)

20. Unspecified bodily location

21. Multiple injuries (involving more than one

bodily location)

22. Body location NOT REQUIRED

* Requires a „bodily location‟ code.


GLOSSARY

ABS Australian Bureau of Statistics

ACEM Australasian College of Emergency Medicine

AIHW Australian Institute of Health and Welfare

ANZSIC Australian and New Zealand Standard Industry Classification.

ASCO Australian Standard Classification of Occupations.

ASCCSS Australian Standard Classification of Countries for Social Statistics

ED Emergency Department

ICD International Classification of Diseases

ICD – 9 International Classification of Diseases, Version 9

ICD – 9 – CM International Classification of Diseases, Version 9, - Clinical Modification

ICD-10 International Statistical Classification of Diseases and Related Health Problems: 10th

revision

IOS International Organisation for Standardisation

ISS Injury Severity Score

ISIS Injury Surveillance Information System

NDS-IS National Data Standards for Injury Surveillance

NEISS National Electronic Injury Surveillance System

NISPP National Injury Surveillance and Prevention Project

NHDD National Health Data Dictionary

NISU National Injury Surveillance Unit

RCIS Research Centre for Injury Studies, Flinders University of South Australia

NMDS National Minimum Dataset for Injury Surveillance

NOMESCO Nordic Medico Statistical Committee

MUARC Monash University Accident Research Centre

WHO World Health Organization


BIBLIOGRAPHY

Association for the Advancement of Automotive Medicine (1990) The Abbreviated Injury Scale,

1990 revision. AAAM: Des Plaines, Il..

Australian Bureau of Statistics (1993) Australian and New Zealand Standard Industry Classification

(ANZSIC) Canberra: ABS Catalogue no. 1292.0

Australian Bureau of Statistics (1986) Australian Standard Classification of Occupations (ASCO),

Statistical classification, first edition. Canberra, ABS Catalogue 1222.0.

Australian Bureau of Statistics, (1993) Directory of Concepts and Standards for Social, Labour and

Demographic Statistics, Canberra, ABS.

Australian Bureau of Statistics.(1990) Australian Standard Classification of Countries for Social

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