Upload
others
View
0
Download
0
Embed Size (px)
Citation preview
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
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
NDS-IS Version 2c (January 1998) 9
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.
Level 1 item Appendix 1
NDS-IS Version 2.1c (January 1998) 10
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
NDS-IS Version 2c (January 1998) 11
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).
Level 1 item Appendix 1
NDS-IS Version 2.1c (January 1998) 12
Table 2.2: Special injury data items
National Data Standards for Injury Surveillance
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)
Place of injury occurrence –
sub-type
Place of injury occurrence –
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
NDS-IS Version 2c (January 1998) 13
Table 2.3: General information items
National Data Standards for Injury Surveillance
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.
Level 1 item Appendix 1
NDS-IS Version 2.1c (January 1998) 14
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
NDS-IS Version 2c (January 1998) 15
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
Level 1 item Appendix 1
NDS-IS Version 2.1c (January 1998) 16
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
NDS-IS Version 2c (January 1998) 17
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
Level 1 item Appendix 1
NDS-IS Version 2.1c (January 1998) 18
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
NDS-IS Version 2c (January 1998) 19
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
Level 1 item Appendix 1
NDS-IS Version 2.1c (January 1998) 20
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
NDS-IS Version 2c (January 1998) 21
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)
Level 1 item Appendix 1
NDS-IS Version 2.1c (January 1998) 22
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
NDS-IS Version 2c (January 1998) 23
- „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.)
Level 1 item Appendix 1
NDS-IS Version 2.1c (January 1998) 24
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 Version 2c (January 1998) 25
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.
Level 1 item Appendix 1
NDS-IS Version 2.1c (January 1998) 26
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
NDS-IS Version 2c (January 1998) 27
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
Level 1 item Appendix 1
NDS-IS Version 2.1c (January 1998) 28
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 Version 2c (January 1998) 29
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
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, 2A, 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 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.
Level 1 item Appendix 1
NDS-IS Version 2.1c (January 1998) 30
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.
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, 2A, 2B, 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 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
NDS-IS Version 2c (January 1998) 31
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)
Level 1 item Appendix 1
NDS-IS Version 2.1c (January 1998) 32
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
NDS-IS Version 2c (January 1998) 33
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)
Level 1 item Appendix 1
NDS-IS Version 2.1c (January 1998) 34
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 Version 2c (January 1998) 35
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.
Source: AIHW National Injury Surveillance Unit and NDS-IS Advisory Group,
based on ICD-9-CM and ICD-10.
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 Version 2.1c (January 1998) 36
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.
Source: AIHW National Injury Surveillance Unit and NDS-IS Advisory Group
Comment: Unlike NDS-IS Level 1, item 1, this Level 2 item is unlimited in text
length
NISDD General information item
NDS-IS Version 2c (January 1998) 37
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.
General information item Appendix 1
NDS-IS Version 2.1c (January 1998) 38
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.
NISDD General information item
NDS-IS Version 2c (January 1998) 39
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
.9 Other or unspecified
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
.9 Other or unspecified
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
.9 Other or unspecified
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
.9 Other or unspecified
07 Street or highway (public
road) .1 Freeway
.2 Urban road
.3 Non-urban road
.9 Other or unspecified
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
.9 Other or unspecified
09 Industrial or construction
area
.1 Construction site
.2 Demolition site
.3 Factory
.9 Other or unspecified
10 Mine or quarry .1 Underground mine
.2 Open mine or quarry
.3 Oil or gas extraction facility
.9 Other or unspecified
11 Farm (excl. farm house [1]) .1 Farm
.4 Timber plantation
.9 Other or unspecified
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
General information item Appendix 1
NDS-IS Version 2.1c (January 1998) 40
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).
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, 2, 3B to 9, and General Information data items.
Source: AIHW National Injury Surveillance Unit and NDS-IS Advisory Group
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.
NISDD General information item
NDS-IS Version 2c (January 1998) 41
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.
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 to 3A, 4 to 9, and General Information data
items.
Source: AIHW National Injury Surveillance Unit and NDS-IS Advisory Group
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
General information item Appendix 1
NDS-IS Version 2.1c (January 1998) 42
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
injury control targets, injury costing, and identifying cases for in-depth
research.
Used with: NDS-IS level 2, items 1 to 3, 5 to 9, and General Information data items.
Source: AIHW National Injury Surveillance Unit and NDS-IS Advisory Group
NISDD General information item
NDS-IS Version 2c (January 1998) 43
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
General information item Appendix 1
NDS-IS Version 2.1c (January 1998) 44
NDS-IS–level 2, item 4
(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)
NISDD General information item
NDS-IS Version 2c (January 1998) 45
NDS-IS–level 2, item 4
(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)
General information item Appendix 1
NDS-IS Version 2.1c (January 1998) 46
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.
Used with: NDS-IS level 2, items 1 to 4, 6 to 9, and General Information data items.
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
NISDD General information item
NDS-IS Version 2c (January 1998) 47
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
General information item Appendix 1
NDS-IS Version 2.1c (January 1998) 48
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
NISDD General information item
NDS-IS Version 2c (January 1998) 49
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
General information item Appendix 1
NDS-IS Version 2.1c (January 1998) 50
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
NISDD General information item
NDS-IS Version 2c (January 1998) 51
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
Used with: NDS-IS level 2, items 1 to 5, 7 to 9, and General Information data items.
Source: AIHW National Injury Surveillance Unit and NDS-IS Advisory Group,
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.
General information item Appendix 1
NDS-IS Version 2.1c (January 1998) 52
types of power saw).
5. Certain common, but uninformative categories, were omitted (eg.
„ground‟)
NISDD General information item
NDS-IS Version 2c (January 1998) 53
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)
52 (Not currently in use)
53 (Not currently in use)
54 Poisoning by solid substances / oral overdose / ingestion
55 Injection
56 Poisoning by gaseous substances Excludes fire / smoke
57 (Not currently in use)
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
General information item Appendix 1
NDS-IS Version 2.1c (January 1998) 54
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.
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
Used with: NDS-IS level 2, items 1 to 6, 8 and 9, and General Information data items.
Source: AIHW National Injury Surveillance Unit and NDS-IS Advisory Group,
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:
NISDD General information item
NDS-IS Version 2c (January 1998) 55
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.
Source: AIHW National Injury Surveillance Unit and NDS-IS Advisory Group.
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
General information item Appendix 1
NDS-IS Version 2.1c (January 1998) 56
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).
NISDD General information item
NDS-IS Version 2c (January 1998) 57
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.
General information item Appendix 1
NDS-IS Version 2.1c (January 1998) 58
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.
NISDD General information item
NDS-IS Version 2c (January 1998) 59
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
General information item Appendix 1
NDS-IS Version 2.1c (January 1998) 60
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).
NISDD General information item
NDS-IS Version 2c (January 1998) 61
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.
General information item Appendix 1
NDS-IS Version 2.1c (January 1998) 62
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.
NISDD General information item
NDS-IS Version 2c (January 1998) 63
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.
General information item Appendix 1
NDS-IS Version 2.1c (January 1998) 64
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)
NISDD General information item
NDS-IS Version 2c (January 1998) 65
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
General information item Appendix 1
NDS-IS Version 2.1c (January 1998) 66
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
NISDD General information item
NDS-IS Version 2c (January 1998) 67
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.
General information item Appendix 1
NDS-IS Version 2.1c (January 1998) 68
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:
Source: AIHW National Injury Surveillance Unit and NDS-IS Advisory Group.
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
NISDD General information item
NDS-IS Version 2c (January 1998) 69
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:
Source: AIHW National Injury Surveillance Unit and NDS-IS Advisory Group.
Comment: This general information items does not have equivalent in the „National
Health Data Dictionary‟.
Supplementary data item Appendix 1
NDS-IS Version 2.1c (January 1998) 70
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
NDS-IS Version 2c (January 1998) 71
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
NDS-IS Version 2.1c (January 1998) 72
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
NDS-IS Version 2c (January 1998) 73
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
NDS-IS Version 2.1c (January 1998) 74
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
NDS-IS Version 2c (January 1998) 75
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
NDS-IS Version 2.1c (January 1998) 76
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
NDS-IS Version 2c (January 1998) 77
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
NDS-IS Version 2.1c (January 1998) 78
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
NDS-IS Version 2c (January 1998) 79
–
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
NDS-IS Version 2.1c (January 1998) 80
I
C
D
-
1
0
(
1
9
9
2
,
v
o
l
.
1
:
1
0
1
3
-
1
0
1
7
)
Appendix 2
NDS-IS Version 2c (January 1998) 81
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
NDS-IS Version 2.1c (January 1998) 82
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
NDS-IS Version 2c (January 1998) 83
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
NDS-IS Version 2.1c (January 1998) 84
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
25. Poisoning or toxic effect
(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.
NDS-IS Version 2c (January 1998) 85
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
NDS-IS Version 2.1c (January 1998) 86
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
NDS-IS Version 2.1c (January 1998) 87
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
NDS-IS Version 2.1c (January 1998) 88
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
NDS-IS Version 2.1c (January 1998) 89
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 Version 2.1c (January 1998) 90
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 Version 2.1c (January 1998) 91
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 Version 2.1c (January 1998) 92
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 Version 2.1c (January 1998) 93
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 Version 2.1c (January 1998) 94
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 Version 2.1c (January 1998) 95
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 Version 2.1c (January 1998) 96
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
Justification: Enables categorisation of injury and poisoning according to factors
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 Version 2.1c (January 1998) 97
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
NDS-IS Version 2.1c (January 1998) 98
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
NDS-IS Version 2.1c (January 1998) 99
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
25. Poisoning or toxic effect
(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.
NDS-IS Version 2.1c (January 1998) 100
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
NDS-IS Version 2.1c (January 1998) 101
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
Statistics (ASCCSS) ABS Catalogue no. 1269.0, Canberra, ABS
Australian Institute of Health and Welfare National Injury Surveillance Unit, (1994) National
Minimum Dataset for Injury Surveillance, version 1.1. Adelaide: AIHW National Injury Surveillance
Unit.
Australian Institute of Health and Welfare, (1995) National Health Data Dictionary: version 4.0.
Canberra: Australian Institute of Health and Welfare.
Australian Institute of Health and Welfare, (1996) National Health Data Dictionary: version 5.0.
Canberra: Australian Institute of Health and Welfare.
Australian Institute of Health and Welfare, (1997) National Health Data Dictionary: version 6.0.
Canberra: Australian Institute of Health and Welfare.
Hall, J., Masters, G., Tarlo, K., Andrews, G., (1986) Report to the National Committee on health and
vital statistics on outcome data in health. Australian Institute of Health, Canberra: AGPS.
McClure, R., (1994) The Public Health Impact of Minor Injury. Doctoral Thesis: Australian National
University.
Moller, J (1994). Coronial information systems: needs and feasibility study. Adelaide: Australian
Institute of Health and Welfare, National Injury Surveillance Unit.
National Coding Centre, (1996) Australian Version of the International Classification of Diseases,
9th revision, Clinical Modification (ICD-9-CM), second edition, vol. 1,2 & 4,. Sydney: National
Coding Centre, University of Sydney.
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.
Vimpani G, Hartley P., (1991) National injury surveillance and prevention project: final report
(NISPP),. Canberra: Australian Government Publishing Service.
World Health Organization, (1975) International Classification of Diseases, 9th revision(ICD-9).
Geneva: World Health Organization.
World Health Organization (1992) International statistical classification of diseases and related
health problems - 10th revision (ICD-10), vol. 1 (vol. 3, 1994), Geneva: World Health Organization.