Each day an estimated 16 workers are killed and 36,000 workers are injured in the United States. The economic and medical costs associated with these injuries are as much as cancer and heart disease combined. Although limited, existing data indicate that serious work-related traumatic injury, including trauma is a major yet largely undefined problem both nationally and within Minnesota. NIOSH has specifically requested proposals for the development and/or evaluation of methods to characterize workplace hazards, exposures, and risk factors to promote the early recognition and prevention of workplace illness or injury. The lack of available data point to the need to establish a surveillance system with a set of uniform definitions for serious work-related traumatic injury as well as establish surveillance systems to facilitate understanding the magnitude, distribution, etiology, outcome, and trends of serious work-related trauma. Accordingly, the specific aims of this proposal are to: (1) Develop, test, and refine a definition for serious work-related trauma; (2) Determine the feasibility of establishing a surveillance system for serious work-related trauma by linking existing sources of information, such as workers' compensation data, the existing Minnesota Department of Health (MDH) Trauma Registry, and hospital discharge records; (3) Determine the reporting biases found in data compiled from different reporting sources; and (4) Determine the magnitude, distribution, etiology, and outcome of serious work-related trauma. These aims will be accomplished by establishing a multi-source surveillance system. The core of this system will consist of the MDH Trauma Registry and the Minnesota Department of Labor and Industry. The MDH Trauma Registry compiles case reports on traumatic injury hospitalized within the region's trauma treatment centers. A definition for serious trauma will be developed in conjunction with an expert working group consisting of physicians and trauma center representatives. Data completeness and referral patterns will be evaluated by comparing MDH Trauma Registry and Department of Labor case reports with those received from a sample of regional hospitals. Data analysis will consist of three parts: (1) Descriptive statistics; (2) Timeliness; and (3) Computation of incidence rates by industry.