Toxicology testing in fatally injured workers: A review of five years of Iowa FACE cases

Marizen Ramirez, Ronald Bedford, Ryan Sullivan, T. Renee Anthony, John Kraemer, Brett Faine, Corinne Peek-Asa

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Toxicology testing of fatally injured workers is not routinely conducted. We completed a case-series study of 2005-2009 occupational fatalities captured by Iowa's Fatality Assessment and Control Evaluation (FACE) Program. The goals of our research were to: (1) measure the proportion of FACE cases that undergo toxicology testing, and describe the factors associated with being tested, and (2) measure the rate of positive toxicology tests, the substances identified and the demographics and occupations of victims who tested positive. Case documents and toxicology laboratory reports were reviewed. There were 427 occupational deaths from 2005 to 2009. Only 69% underwent toxicology testing. Younger workers had greater odds of being tested. Among occupational groups, workers in farming, fishing and forestry had half the odds of being tested compared to other occupational groups. Of the 280 cases with toxicology tests completed, 22% (n = 61) were found to have positive toxicology testing. Commonly identified drug classes included cannabinoids and alcohols. Based on the small number of positive tests, older victims (65+ years) tested positive more frequently than younger workers. Management, business, science, arts, service and sales/office workers had proportionately more positive toxicology tests (almost 30%) compared with other workers (18-22%). These results identify an area in need of further research efforts and a potential target for injury prevention strategies.

Original languageEnglish (US)
Pages (from-to)6154-6168
Number of pages15
JournalInternational journal of environmental research and public health
Issue number11
StatePublished - Nov 14 2013


  • Alcohol
  • Drugs
  • Fatality
  • Injury
  • Occupational

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