No. 41831 (Amendment): Rule R386-703. Injury Reporting Rule

(Amendment)

DAR File No.: 41831
Filed: 06/15/2017 08:10:13 AM

RULE ANALYSIS

Purpose of the rule or reason for the change:

The rule has been amended by adding the definition for laboratory and lowering the case definition of an elevated blood lead level from greater than or equal to10 micrograms per deciliter to greater than or equal to 5 micrograms per deciliter. In 2012, the Centers for Disease Control and Prevention (CDC) lowered their level of concern for blood lead levels in children to greater than or equal to 5 micrograms per deciliter. This amendment will align Utah with CDC's guidelines to provide assistance and educate parents of children having a blood lead level lower than Utah's current guidelines. The amendment will help to alleviate any disparities between Utah's state and local health departments and the health care providers when assessing a child's exposure to lead in relation to Utah's Injury Reporting Rule and CDC's guidelines.

Summary of the rule or change:

The proposed amendment defines the types of laboratories for reporting injuries and the lowering of the case definition from greater than or equal to 10 micrograms per deciliter to greater than or equal to 5 micrograms per deciliter at which intervention is determined for a child exposed to lead.

Statutory or constitutional authorization for this rule:

• Section 26-6-3
• Section 26-1-30

Anticipated cost or savings to:

the state budget:

There are no anticipated costs or savings at the state level. Any costs will come out of existing budgets.

local governments:

There will be anticipated costs to local government by adding this language to the rule. The lowering of the case definition will increase the number of cases being identified by the local health districts to provide case management. The anticipated cost throughout Utah's health districts is estimated to be $25,841 per year.

small businesses:

There will be no anticipated costs or savings to small businesses by adding this language to the rule.

persons other than small businesses, businesses, or local governmental entities:

As stated above, local government will have anticipated costs by adding this language to the rule. The lowering of the case definition will increase the number of cases being identified for the local health districts to provide case management. The anticipated cost throughout Utah's health districts is estimated to be $25,841 per year.

Compliance costs for affected persons:

There will be anticipated costs to the local health districts adding this language to this rule. The anticipated cost throughout Utah's health districts is estimated to be $25,841 per year. In addition, the Utah Department of Health will need to change their reporting criteria in their reporting system to the local health districts.

Comments by the department head on the fiscal impact the rule may have on businesses:

After conducting a thorough analysis, it was determined that this proposed rule will not result in a fiscal impact to businesses. No negative fiscal impacts are expected to result in this amendment.

Joseph Miner, MD, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Office of Administrative Rules, or at:

Health
Disease Control and Prevention, Epidemiology
CANNON HEALTH BLDG
288 N 1460 W
SALT LAKE CITY, UT 84116-3231

Direct questions regarding this rule to:

• Sam LeFevre at the above address, by phone at 801-538-6191, by FAX at 801-538-6564, or by Internet E-mail at [e-mail]

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

07/31/2017

This rule may become effective on:

08/07/2017

Authorized by:

Joseph Miner, Executive Director

RULE TEXT

R386. Health, Disease Control and Prevention, Epidemiology.

R386-703. Injury Reporting Rule.

R386-703-1. Purpose Statement.

(1) The Injury Reporting Rule is adopted under authority of Sections 26-1-30 and 26-6-3.

(2) The Injury Reporting Rule establishes an injury surveillance and reporting system for major injuries occurring in Utah. Injuries constitute a leading cause of death and disability in Utah and, therefore, pose an important risk to public health.

(3) Rule R386-703 is adopted with the intent of identifying causes of major injury which can be reduced or eliminated, thereby reducing morbidity and mortality.

 

R386-703-2. [Injury ]Definitions .

(1) "Injury " is defined as bodily damage resulting from exposure to physical agents such as mechanical energy, thermal energy, ionizing radiation, or chemicals, or resulting from the deprivation of basic environmental requirements such as oxygen or heat. Mechanical energy injuries include acceleration and deceleration injuries, blunt trauma, and penetrating wound injuries.

(2) "Laboratory" is defined as any clinical laboratory, physician office, hospital, health clinic, reference laboratory or any facility that performs blood lead analysis.

R386-703-3. Reportable Injuries.

([1]3) The Utah Department of Health declares the following injuries to be of concern to the public's health. Each case shall be reported to the Utah Department of Health as described in R386-703-4.

(a) Acute traumatic brain injury. Reportable acute traumatic brain injuries include head injuries of sufficient severity to cause death or to require admission to a hospital. Acute traumatic brain injuries may be associated with transient or persistent neurological dysfunction, and may be diagnosed as brain concussions, brain contusions, or traumatic intracranial hemorrhages.

(b) Acute spinal cord injury. Reportable acute spinal cord injuries include traumatic injuries to the contents of the spinal canal, spinal cord or cauda equina, which result in death or which result in transient or persistent neurological dysfunction of sufficient severity to require hospital admission.

(c) Blunt force injury. Reportable injuries include all blunt force injuries which result in death or which are of sufficient severity to require hospital admission.

(d) Drowning and near drowning. Reportable drownings and near drownings include all water immersion injuries resulting in death and other water immersion injuries of sufficient severity to require hospital admission.

(e) Asphyxiation. Reportable asphyxiations include injuries which arise from atmospheric oxygen deprivation or from traumatic respiratory obstruction which result in death or which are of sufficient severity to require hospital admission.

(f) Burns. Reportable burn injuries include injuries resulting from acute thermal exposure or exposure to fire which result in death or which are of sufficient severity to require hospital admission.

(g) Electrocution. Reportable electrocution injuries include injuries arising from exposure to electricity which result in death or which are of sufficient severity to require hospital admission.

(h) Blood Lead. All blood lead test results are reportable. Cases of elevated blood lead levels include all persons with [whole ]blood lead concentrations equal to or greater than [10]5 micrograms per deciliter. All cases shall be confirmed by either a venous or capillary blood sample, if the first sample was a capillary blood sample.

(i) Chemical Poisoning. Reportable cases of chemical poisoning include all persons with acute exposure to toxic chemical substances which result in death or which require hospital admission or hospital emergency department evaluation. Unintentional adverse health effects resulting from the use of pharmacological agents as prescribed by physicians do not require reporting under this rule.

(j) Intentional Injuries. Reportable intentional injuries include all cases of suicide or attempted suicide resulting in hospital admission and all cases of homicide, attempted homicide, or battery resulting in hospitalization.

(k) Injuries Related to Substance Abuse. Reportable injuries include all cases of injury resulting in death or hospitalization and associated with alcohol or drug intoxication of any person involved in the injury occurrence.

(l) Traumatic Amputations. Reportable amputations include traumatic amputations of a limb or part of a limb which result in death or which require hospital admission or hospital emergency department treatment. Only amputations resulting in bone loss shall be reported.

 

R386-703-4. Report Requirements.

(1) Reporting blood lead testing results.

([1]a) Non-Case Report Contents. Unless otherwise specified, each blood lead result shall provide at minimum the following: name, date of birth or age if date of birth is unknown, sex, zip code, and the individual or agency submitting the report.

([2]b) Case Report Contents. Unless otherwise specified, each injury report shall provide the following information pertaining to the injured person: name, date of birth or age if date of birth is unknown, sex, address of residence, date of injury, type of injury, external cause of injury, locale of injury, intentionality, relation of injury to occupation, disposition of the injured person, and the individual or agency submitting the report. A standard report format has been adopted and shall be supplied to reporting sources by the Department of Health upon request.

([3]2) Agencies or Individuals Required to Report Injuries. A reportable injury evaluated or treated at a hospital shall be reported by that hospital. Reportable injuries not evaluated at a hospital shall be reported by the involved physician, nurse, other health care practitioner, medical examiner, head start health coordinator or laboratory administrator.

([4]3) Time Requirements. Persons required to report shall submit their reports to the local health department or the Utah Department of Health within 60 days of the time of diagnosis or recognition of injury. In the event of an unusual or excessive occurrence of injuries which may arise from a continuing or immediate threat to the public's health, persons required to report shall immediately report by telephone to the local health officer or to the Utah Department of Health.

([5]4) Case Report Destinations. Each case of injury shall be reported to the Utah Department of Health or to the local health department responsible for the geographic area where the injury occurred.

(a) The local health officer shall forward all original reports to the Utah Department of Health. Local health departments may maintain copies of these reports.

(b) Except as noted in R386-703-4 (4)(c), (d) and (e), case reports shall be sent to the Bureau of Epidemiology of the Utah Department of Health.

(c) In fatal cases, submission of completed death certificates to the Bureau of Vital Records fulfills reporting requirements.

(d) In cases evaluated in hospital emergency departments, submission of properly completed hospital emergency department logs to the Bureau of Emergency Medical Services will fulfill reporting requirements, provided that the records are submitted through an electronic medium in a computer database format acceptable to the Bureau of Emergency Medical Services.

(e) In cases where reportable injuries listed in R386-703-3 are reported under the requirements of the Utah Health Data Authority Act, 26-33a, the data supplier may notify the Utah Department of Health in writing that information relating to individuals with a reportable injury will be supplied to the Bureau of Epidemiology before the identifying information is removed from the data file. Any data provided in this manner fulfills reporting requirements. If permission is not granted by the data supplier, duplicate reporting is required.

 

R386-703-5. Special Investigations of Injury.

(1) The Utah Department of Health and local health departments may conduct epidemiologic investigations of injury occurrence. The Utah Department of Health and local health departments may collect additional information pertaining to risk factors, medical condition, and circumstances of injury. Hospitals and other health care providers shall, upon request, provide authorized health personnel the occasion to inspect medical records of reportable injuries. The Utah Department of Transportation, Utah Industrial Commission, Utah Department of Public Safety, and local public safety agencies shall make available to authorized health personnel information on reportable injuries.

 

R386-703-6. Confidentiality of Reports.

(1) All reports herein required are confidential and are not open to public inspection. The confidentiality of personal information obtained under this rule shall be maintained according to the provisions of Sections 26-6-27 through 26-6-30. Nothing in this rule, however, precludes the discussion of case information with the attending physician or public health workers.

 

R386-703-7. Penalties.

(1) Enforcement provisions and penalties for the violation or for the enforcement of public health rules, including this Injury Reporting Rule, are prescribed under Sections 26-23-3 through 26-23-6.

 

KEY: rules and procedures, injur[y]ies

Date of Enactment or Last Substantive Amendment: [May 15, 2015]2017

Notice of Continuation: September 23, 2015

Authorizing, and Implemented or Interpreted Law: 26-1-30

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