Magnitude, characteristics, and factors associated with severe occupational injuries among patients presenting to emergency departments in Addis Ababa, Ethiopia

Abstract

BACKGROUND: Occupational injuries account for more than 395 million cases and almost 3 million deaths globally each year, with the highest burden occurring in low- and middle-income countries. In Ethiopia, occupational injuries contribute substantially to emergency department visits, yet evidence on the magnitude, characteristics, and determinants remain limited. This study aimed to describe the magnitude and characteristics of occupational injuries and identify factors associated with severe injuries among patients presenting to emergency departments. METHODS: A prospective hospital-based observational study was conducted at three urban public hospitals in Ethiopia. A total of 868 participants aged 18-60 years who visited emergency departments with occupational injuries were consecutively enrolled. Data was collected from October 3, 2024, to March 14, 2025, using structured interviews and clinical chart reviews. Injury severity was classified based on the World Health Organization injury surveillance guideline. Descriptive statistics summarized patient characteristics, work, and injury patterns. Poisson regression with robust variance estimation was used to identify factors associated with severe injury, and adjusted prevalence ratios with 95% confidence intervals were reported. RESULTS: Among 5,038 injury patients, 918 (18.2%) had occupational injuries. Of these, 868 (94.6%) participated in the study. The median age was 27 years, and most participants were male (89.5%). The majority were employed in manufacturing (43.9%) and construction (24.0%). Craft and related trades (34.9%) and elementary workers (34.2%) were the most affected. Upper extremity injuries were the most common (57.0%), with lacerations (48.2%) as the leading nature of injury, followed by fractures (28.7%). The primary mechanism of injury was contact with sharp, pointed, or rough elements (43.9%), followed by falls or crashes into objects (16.6%). Among the patients, 175 (20.2%) had severe injuries. Low educational level, fall-related mechanisms, no fixed work area, and accidents due to peers and organizational causes were significantly associated with severe injury in a multivariable regression analysis. CONCLUSIONS AND RECOMMENDATIONS: Occupational injuries are a burden on emergency departments, affecting a high proportion of young, male workers in the construction and manufacturing sectors. Severe injuries were related to education, type of work, and injury mechanism. This study underscores the need for targeted workplace safety interventions.