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Introduction Injuries and fatalities due to large truck and other vehicle crashes have decreased over the last decade, but motor vehicle injuries remain a leading cause of death for both the working and general populations. The present study was undertaken to determine semi truck driver and sleeper berth passenger injury risk in a moving semi truck collision using a matched-pair cohort study. Method Study data were obtained from the Kentucky Collision Report Analysis for Safer Highways (CRASH) electronic files for 2000–2010. A matched-pair cohort study was used to compare the odds of injury of both drivers and sleeper berth passengers within the same semi truck controlling for variables specific to the crash or the semi truck. The crude odds ratio of injury was estimated and a statistical model for a correlated outcome using generalized estimating equations was utilized. Results In a moving semi truck collision, the odds for an injury were increased by 2.25 times for both semi truck drivers and sleeper berth passengers who did not use occupant safety restraints compared to semi truck drivers and sleeper berth passengers who used occupant safety restraints at the time of the collision. The driver seat or sleeper berth position in the vehicle was not a significant factor (p-value = 0.31) associated with a moving semi truck collision injury. Conclusion Nonuse of occupant safety restraints by either drivers or sleeper berth passengers significantly increased the odds of an injury in a moving semi truck collision; semi truck seating position (driver's seat or sleeper berth) did not increase the odds for an injury in moving collisions. Impact on Industry Trucking companies should include the mandatory use of occupant safety restraints by both semi truck drivers and sleeper berth passengers in their company safety policies.

BackgroundAccording to the National Center for Health Statistics, Kentucky had the third highest drug overdose fatality rate in the nation in 2015 at 29.9 drug overdose fatalities per 100 000 population.ObjectiveThe elevated drug overdose fatality rate necessitated the development and implementation of a comprehensive multisource drug overdose fatality surveillance system (DOFSS).MethodsDOFSS stakeholder work group members and data sources were identified, and memorandums of understanding were established. The following data sources were used to establish DOFSS: (1) death certificates; (2) autopsy reports; (3) toxicology result reports; (4) coroner reports; and (5) Kentucky All Schedule Prescription Electronic Reporting (KASPER) (prescription drug monitoring programme) data. Drug overdose poisonings were defined using Injury Surveillance Workgroup 7 definitions. Analyses were performed to investigate possible drug overdose-related health disparities for disabled drug overdose decedents and to characterise gabapentin in drug overdose deaths.ResultsDOFSS identified 2106 drug overdose poisoning fatalities in Kentucky for 2013–2014. Identification of specific drugs involved in drug overdose deaths increased from 75.8% using a single data source to 97.5% using multiple data sources. Disabled drug overdose decedents were significantly more likely to have an active prescription for drugs identified in their system compared with the non-disabled drug overdose decedents. Toxicology data showed increased gabapentin involvement in drug overdose deaths from 2.9% in 2013 to 17% in 2014. Alprazolam was found most often in combination with gabapentin (41%), along with various other benzodiazepines and prescription opioids.ConclusionsA comprehensive multisource DOFSS improved drug overdose fatality surveillance by increasing completeness of data and data quality. DOFSS is a model that can be considered by other states to enhance their efforts in tracking drug overdose fatalities, identifying new and emerging trends, and informing policies and best practices, to address and reduce drug overdoses.

OBJECTIVES The healthcare industry continues to have a high number of reported injuries. The purpose of this study was to characterize healthcare industry injuries by patient contact status, identify the occupations associated with healthcare injuries by patient contact status, and determine healthcare injury rates by occupation to gain a better understanding of healthcare industry-compensated injuries and better target safety practices and programs in the healthcare industry. METHODS Kentucky healthcare industry workers' compensation first reports of injuries from calendar years 2012-2014 were categorized into injuries involved in direct patient contact versus injuries without direct patient contact using narrative text analysis. Injury numbers and rates were calculated for a number of data variables. RESULTS Healthcare injuries without direct patient contact (55% of all first reports of injuries) occurred more frequently among older workers (45 years old and older [51%]), in "other" occupations such as housekeeping and maintenance (28%), and as a result of falls/slips/trips (39%) and sprains/tears (38%). In contrast, a higher percentage of healthcare injuries involving direct patient contact occurred among workers younger than 35 years (48%), in healthcare support occupations (50%), and resulting from sprains/tears (66%) and lifting/handling (52%), compared with those without direct patient contact. CONCLUSIONS Findings from this study can better target the need for new and/or additional specific workplace safety training, especially in the healthcare support and nursing occupations with and without patient contact.

A retrospective population-based case-control study was performed to determine the association between vehicle fires, and vehicle, collision, and driver factors on highways with a posted speed limit of at least 55mph. Data were obtained from the Kentucky Collision Report Analysis for Safer Highways (CRASH) electronic files for 2000-2009 from the Kentucky State Police Records Sections. The results from the final multiple logistic regression show that large trucks were at a higher risk for a collision involving a fire than passenger vehicles and pickup trucks. When controlling for all other variables in the model, vehicles 6 years old and older, driving straight down the highway, and single vehicle collisions were also identified as factors that increase the risk of motor vehicle collision fires on roadways with a posted speed limit of ≥55mph. Of the 2096 vehicles that caught fire, there were 632 (30%) non-fatally injured drivers and 224 (11%) fatally injured drivers. The results of this study have the potential to inform public health messages directed to the transportation industry, particularly semi truck drivers, in regard to fire risk.

Solid waste collection is among the occupations with the highest risk for injuries and illnesses. Solid waste collector injuries were characterized in terms of injury risk and employment industry sector (public versus private) using Kentucky workers' compensation first reports of injury and claims data. When compared to 35–44-year-old workers, solid waste collectors who were under 35 years of age were less likely to have a workers' compensation first report of injury or claim that resulted in awarded benefits. The probability that a workers' compensation first report of injury or claim would result in an awarded benefit was higher if the worker was employed as a solid waste collector in the private sector compared to the public sector, or was injured due to a motor vehicle-related injury or a push-or-pull type of injury. A better understanding of the differences in the contributing factors for an injury that results in a first report of injury or claim with awarded benefits (e.g. job activities, new and refresher worker safety training, type of equipment used, differences in collection vehicle automation, and differential reporting of injuries on the job) between the public and private sectors is necessary to target injury prevention strategies in this high-risk occupation.

A retrospective population-based case control study was conducted to determine whether semi truck driver age and gender and the presence of passengers affect the likelihood that a semi truck driver will be at fault in a semi truck collision (STC) with another vehicle.Cases were identified as semi truck drivers in at-fault STCs with other vehicles and controls were semi truck drivers in not-at-fault STCs with other vehicles, using the Kentucky Collision Report Analysis for Safer Highways (CRASH) electronic database from 2000-2006. Multiple logistic regression was performed.The results from the final multiple logistic regression show that solo semi truck drivers, aged 65 and over, were the age group at highest risk for at-fault STCs with other vehicles. However, the presence of passengers in the semi truck had a protective effect for semi truck drivers aged 65 and older. When controlling for all other variables in the model, female semi truck drivers were at higher risk than male drivers, and curvy and graded/hillcrest roads increased the odds that the semi truck driver would be at fault in an STC with another vehicle. Daytime driving and driving on roads with low posted speed limits (35 mph and less) were associated with a higher probability of being at fault in an STC with another vehicle.The results of this study have the potential to inform public policy in regard to the presence of passengers and their positive protective effect on older (aged 65 and older) semi truck drivers, particularly in long-distance driving performed by solo semi truck drivers vs. team semi truck drivers.

OBJECTIVES This study examined associations between prenatal drug exposures and congenital organ system malformation diagnoses in newborns (at birth) and infants (hospitalizations after birth up to 30 days of age) in Kentucky. METHODS Data were obtained from Kentucky inpatient hospitalization records for newborns and for infants from 2009 to 2013. Prenatal drug exposures and congenital anomalies were identified using International Classification of Diseases, Ninth Revision, Clinical Modification codes for prenatal drug exposures (760.70-760.79; 304; 779.5) and congenital anomalies (740-759). Descriptive analyses and logistic regression were performed. RESULTS Neonatal abstinence syndrome was the most frequent prenatal drug exposure-related diagnosis in newborns (1%). Cardiac and circulatory malformation diagnoses were significantly elevated in newborns prenatally exposed to drugs compared with cardiac and circulatory malformation diagnoses in newborns with no prenatal drug exposures (P < 0.0001); genital and urinary anomalies also were significantly elevated among newborns with prenatal drug exposures (P < 0.05). Newborns and infants diagnosed as having congenital malformations who were prenatally exposed to drugs had significantly extended hospitalization stays and higher total hospitalization charges compared with newborns and infants diagnosed as having congenital malformations who were not prenatally exposed to drugs (P < 0.0001). CONCLUSIONS Further research is needed to identify specific risk factors (eg, drug classes, tobacco) and toxicities (eg, intake amount, frequency of intake, drug metabolism) associated with congenital malformation diagnoses following prenatal exposure to drugs.

Purpose The purpose of this exploratory study was to investigate the effectiveness of vision screenings performed during school entrance physical examinations compared with comprehensive vision examinations in the state of Kentucky, which mandates comprehensive eye examinations for children, ages 3 to 6, who are entering the public school system. Methods and subjects In this exploratory study, 1,386 children had forms submitted from 36 optometrists and 1 ophthalmologist reporting on their vision and eye problems. Vision and eye problems were defined as the presence of strabismus, amblyopia, or a refractive error requiring an optical correction, as determined by the optometrists or ophthalmologist using cycloplegic refraction. Among these 1,386 children, there were 300 diagnosed with vision problems. Results Sixty-six children were diagnosed with a vision problem who had not previously been to an eye doctor and had received a vision screening at their school entrance physical examination. In 56 of these 66 children, the vision problem was not detected by the vision screening, according to the parents. Conclusion The exploratory study suggests that comprehensive vision examinations may identify some vision problems that were not found in children’s preschool physical examinations that included vision screenings. A larger randomized study is needed to determine the most appropriate method of timely diagnosis of vision problems in children that can be corrected with early intervention in order to ensure the vision health and well-being of children entering the public school system.

This paper considers a non-parametric method for identifying intervals on the line where the relative risk of cases to controls exceeds a pre-specified level. The method is based on the kth nearest neighbor (kNN) approach for density estimation. An asymptotic result is presented that yields an explicit formula for constructing a confidence interval for the relative risk at a given point. Numerical simulations are used to compare this approach with a kernel density estimation procedure. An application is made to a case-control study in which the relative risk of motor vehicle crashes caused by female drivers is compared to male drivers in the state of Kentucky as a function of age and then by time of day.

This paper considers the use of additional questions for decreasing survey non-response rates and an approach for estimating a probability based on the results obtained. In a survey, the respondents are asked to answer an original question and follow-up questions, where the answers for the follow-up questions are grouped answers for the original question. For example, respondents are asked to provide an exact number of incidents, but in cases of 'Do not know' or 'Refuse' responses, they are subsequently asked to pick an answer from a less specific categorical scale. The new estimator obtains smaller variance asymptotically and does not depend on a distribution family. This method is applied to income questions in a survey regarding injury prevention and behaviours. Another application is survey data on intimate partner violence, where some amendments were applied for incorporating post-stratification weights and for using non-random grouping. For additional illustration, an example of parameter estimation on artificially generated data is presented.

In 2008, the work-related injury fatality rate was 3.8 per 100,000 workers in the United States but was 5.2 per 100,000 workers for the southeast region. Work-related fatalities in the southeast were examined for the period 2008 to 2011. Median work-related injury fatality rates are reported for the southeast region, each of the 12 states, and the United States. The percentages of employees in high fatality industries and work-related fatalities by cause were calculated. Finally, the Occupational Safety and Health Administration’s database was searched for fatality reports. States with the highest rates (per 100,000 workers) included Arkansas (7.2), Louisiana (6.8), and West Virginia (6.6). Arkansas, Louisiana, Mississippi, and West Virginia each had more than 20% of their employees in high fatality industries. Forty percent of work-related injury fatalities were from transportation incidents in the southeast and the United States. Future analyses should include work-related injury fatality rates by industry and compare rates with other U.S. regions.

Mortality rates associated with total pneumoconiosis, including coal worker's pneumoconiosis (CWP), have remained elevated.2003-2013 pneumoconiosis mortality data obtained from National Center for Health Statistics and 2011-2013 Kentucky death certificates were analyzed.Total pneumoconiosis mortality rates showed significant linear decreases in West Virginia, Pennsylvania, Kentucky, and the U.S. from 2003 to 2013; Pennsylvania and Kentucky had comparable rates in 2003 but while Pennsylvania rates significantly decreased ∼3.0 deaths/million annually, Kentucky rates decreased only 0.5/million annually. Kentucky and Pennsylvania CWP fatality rates were also comparable in 2003 but while Pennsylvania rates decreased 82% over the study period, Kentucky rates decreased only 26%. Kentucky pneumoconiosis deaths primarily occurred in white Appalachian males in-hospital. Diseases leading to pneumoconiosis death were largely respiratory and cardiovascular, with autopsies rarely performed.Coal worker environmental exposure protection should be enhanced and pneumoconiosis surveillance improvements, including enhanced management of comorbid conditions like COPD, should be considered.

BACKGROUND: Identification and characterization of occupational injury fatalities in self-employed workers typically relies on a single data source and thus may miss some cases. METHODS: Kentucky self-employed worker injury fatalities were identified using Fatality Assessment and Control Evaluation (FACE) program data (1995-2004) and compared to non self-employed worker data. Occupations and industries listed on death certificates were compared to those in which the decedent was actually engaged. RESULTS: Of 1,281 Kentucky worker injury deaths, 28% were self-employed. Death certificates failed to identify 31% of these deaths as work-related; industry and occupation were incorrectly identified in 27% and 16%, respectively. Fifty-seven percent of the deaths were in agriculture, primarily tractor-related. For Kentucky, the self-employed crude death rate was higher (27.6/100,000) than the non self-employed worker (5.4/100,000) rate or the US (11.5/100,000) self-employed rate. CONCLUSIONS: Multiple information sources improve identification of self-employed status in work-related injury fatalities. Effective prevention requires accurate surveillance and examination of contributing factors. Self-employed worker injuries in high-risk industries should be more fully examined for development of effective injury prevention programs. Language: en

A retrospective population-based case-control study was conducted to determine whether driver sleepiness/fatigue and inattention/distraction increase the likelihood that a commercial motor vehicle collision (CVC) will be fatal. Cases were identified as CVC drivers who died (fatal) and controls were drivers who survived (nonfatal) an injury collision using the Kentucky Collision Report Analysis for Safer Highways (CRASH) electronic database from 1998-2002. Cases and controls were matched on unit type and roadway type. Conditional logistic regression was performed. Driver sleepiness/fatigue, distraction/inattention, age of 51 years of age and older, and nonuse of safety belts increase the odds that a CVC will be fatal. Primary safety belt law enactment and enforcement for all states, commercial vehicle driver education addressing fatigue and distraction and other approaches including decreased hours-of-service, rest breaks and policy changes, etc. may decrease the probability that a CVC will be fatal.

Purpose: Adequate levels of physical activity are essential for health, but participation in sports and recreational physical activities is associated with an increased risk of injury. The present study quantifies the impact of sports- and recreation-related injuries (SRIs) for middle and high schooleaged Kentucky children. Methods: The study describes unintentional injuries in 2010e2012 Kentucky emergency department (ED) administrative records for patients age 10e18 years. SRIs were identified based on external codes of injuries, according to the International Classification of Diseases, Ninth Revision, Clinical Modification. Results: A total of 163,252 ED visits by 10- to 18-year olds occurred during the study period, of which 31,898 (20%) were related to participation in physical activity. Males accounted for 70% of the SRIs. The primary mechanisms for SRIs were strikings (55%), falls (26%), and overexertion (13%). Superficial contusions (25%), sprains/strains (33%), and fractures (18%) were the primary diagnoses. The total charges billed for SRIs exceeded $40 million, or 19% of the total charges billed for all unintentional injury-related ED visits in this age group. Conclusions: The present study revealed one fifth of all Kentucky ED visits, and ED charges billed for unintentional injury among youth aged 10e18 years were related to sport and recreation. In the absence of a dedicated SRI surveillance system, ED administrative records provide meaningful utility for conducting statewide assessments of adolescent SRIs.

Background Kentucky (Ky) had the 2 nd highest DOF rate in the U.S. in 2012 (25/100,000) mainly due to prescription drug (PD) overdose (PDO). In response, Ky enacted comprehensive PDO prevention laws. The law evaluation required death certificates (DCs) with accurate drug overdose data. Methods In KY, DCs are completed by elected county coroners. In 2011, 30% of the Ky DCs did not list any drugs contributing to DOFs, underestimating the burden of PDO deaths. DOF reporting based on a DC data alone didn’t allow monitoring of PDO by specific drugs and identifying sources of diversion. Results To improve the completeness of DOF data Ky enacted a law in 2013 (KRS72.026) requiring the coroners to test for controlled substances postmortem if a cause of death was not clearly established; the toxicology testing is performed by an accredited national laboratory, and is paid by the Kentucky Medical Examiner Office (MEO). KY’s Chief Medical Examiner reviews all of the test results, and follows up with a review of DCs, and consultation with coroners on a case-by-case basis. Two years after law implementation, there is a significant increase in completeness of DOF data. To further improve the quality of DOF data, the MEO expanded coroners’ education and supplemented autopsy reports with DC cause of death completion suggestions. The OME and Ky Injury Prevention and Research Centre expanded the KyDOF surveillance, incorporating DC, death investigation, autopsy, toxicology, and prescription drug monitoring data. New epi tools were introduced to analyse the comprehensive KyDOF data. Data showed the PDO prevention laws contributed to better prescribing and decreased diversion of historically abused medications (e.g., oxycodone, alprazolam); and identified heroin and fentanyl (mostly illicitly manufactured) as emerging drugs of abuse. Conclusions Quality DOF data are critical to inform targeted policy interventions and evaluate effectiveness.

Background Information transfer is critical in the primary care to specialist referral process and has been examined extensively in the US and other countries, yet there has been little attention to the patient's perspective of the information transfer process. This cross-sectional study examined the quality of the information received by patients with a chronic condition from the referring and specialist physician in the specialist referral process and the relationship of the quality of information received to trust in the physicians. Methods Structured telephone interviews were conducted with a random sample of 250 patients who had experienced a referral to a specialist for the first visit for a chronic condition within the prior six months. The sample was selected from the patients who visited specialist physicians at any of the 500 hospitals from the National Research Corporation client base. Results Most patients (85%) received a good explanation about the reason for the specialist visit from the referring physician yet 26% felt unprepared about what to expect. Trust in the referring physician was highly associated with the preparatory information patients received. Specialists gave good explanations about diagnosis and treatment, but 26% of patients got no information about follow-up. Trust in the specialist correlated highly with good explanations of diagnosis, treatment, and self-management. Conclusion Preparatory information from referring physicians influences the quality of the referral process, the subsequent coordination of care, and trust in the physician. Changes in the health care system can improve the information transfer process and improve coordination of care for patients.

To measure the relationship between procedural volume and quality by examining the association between hospital procedural volume and mortality in coronary artery bypass graft (CABG) and percutaneous transluminal coronary angioplasty (PTCA).A retrospective quantitative analysis was conducted of Kentucky hospital discharge database for patients who underwent CABG and PTCA from 2000 through 2005. Hospitals were classified into three categories based on annual number of procedures--low (12-249), medium (250-499), and high-volume (or = 500) CABG and PTCA facilities. This study employed a multiple logistic regression model to compare the odds for fatal outcome for patients treated in high, medium, and low-volume facilities, while controlling for patient age, gender, admission urgency, hospital length-of-stay, case severity, and pre-existing clinical conditions.From 2000 through 2005, 24 facilities performed 47,972 CABGs, while 30 facilities performed 75,869 PTCAs across the state of Kentucky. In non-emergent CABG and PTCA patients between the ages of 18 to 65 years, there was no statistically significant difference in the odds for fatal outcomes between low-, medium-, and high-volume hospitals. However, older (or = 65 years old) emergent CABG and PTCA patients were more likely to die at high-volume and low-volume hospitals than medium-volume hospitals (odds ratio for CABG surgery--1.260 [1.004-1.580], 1.753 [1.266-2.4261, and odds ratio for PTCA--1.106 [1.207-2.163], 1.616 [1.207-2.163]).This study indicates that in hospital procedural volume Kentucky, is an imprecise predictor of quality as measured by CABG and PTCA outcomes, and should not be used by purchasers and policy makers as the only index of hospital quality.

In recent decades, coalitions have been established to address many public health problems, including injury prevention. A partnership among the Kentucky Injury Prevention and Research Center and four injury prevention coalitions has documented the developmental stages of successful coalitions. This developmental process was constructed through the analysis of participating coalition documents, such as each coalition's mission statement, bylaws or rules of operation, the use of committees within the organization, frequency of meetings, and additional historical documents. Themes from this analysis guided researchers in designing a critical pathway model that describes milestones in coalition formation. Critical components in coalition formation include a clear definition of the coalition structure, coalition enhancement, funding, community support, leadership, education and outreach to the community, membership, partnerships, data and evaluation, and publicity. These findings are applicable to public health professionals who work with community-based coalitions and citizens who participate in local coalitions.

In 2005, the Kentucky Poison Control Center (PCC) recorded 46,625 poisoning calls; 27% received hospital treatment. Probabilistic data linkage of accidental poisoning inpatient hospital (IPH) discharge data and PCC data (years 2000-2004) was performed. This study compared IPH with/without preexisting medical conditions and IPH with/without PCC consultation, examining total length of stay and total hospitalization charges. When compared to the IPH reference group with no preexisting medical conditions and who did not consult the PCC (mean charges = $8748, mean length of stay = 3.2 d), PCC consultation without a preexisting medical condition was significantly associated with decreased total hospitalization charges and decreased length of stay (mean charges = $4999, mean length of stay = 1.9 d). When the patient had a preexisting medical condition, PCC consultation was still associated with decreased total hospitalization charges and length of stay (mean charges = $8145, mean length of stay = 2.4 d) compared to those patients with a preexisting medical condition who did not consult the PCC (mean charges = $10,607, mean length of stay = 3.6 d). These results suggest that after accounting for a patient's age and gender, consultation with the PCC is significantly associated with reduced total hospitalization charges and reduced length of stay for IPH, and this association holds for patients with and without a preexisting medical condition.

The identification of industry, occupation, and associated injury costs for worker falls in Kentucky have not been fully examined. The purpose of this study was to determine the associations between industry and occupation and 1) hospitalization length of stay; 2) hospitalization charges; and 3) workers' claims costs in workers suffering falls, using linked inpatient hospitalization discharge and workers' claims data sets.Hospitalization cases were selected with ICD-9-CM external cause of injury codes for falls and payer code of workers' claims for years 2000-2004. Selection criteria for workers'claims cases were International Association of Industrial Accident Boards and Commissions Electronic Data Interchange Nature (IAIABCEDIN) injuries coded as falls and/or slips. Common data variables between the two data sets such as date of birth, gender, date of injury, and hospital admission date were used to perform probabilistic data linkage using LinkSolv software. Statistical analysis was performed with non-parametric tests.Construction falls were the most prevalent for male workers and incurred the highest hospitalization and workers' compensation costs, whereas most female worker falls occurred in the services industry. The largest percentage of male worker falls was from one level to another, while the largest percentage of females experienced a fall, slip, or trip (not otherwise classified). When male construction worker falls were further analyzed, laborers and helpers had longer hospital stays as well as higher total charges when the worker fell from one level to another.Data linkage of hospitalization and workers' claims falls data provides additional information on industry, occupation, and costs that are not available when examining either data set alone.

Narrative information in fatality investigation reports contains data elements not routinely analyzed with coded occupational injury surveillance data. A narrative text analysis of 69 Kentucky Fatality Assessment and Control Evaluation (FACE) agricultural tractor fatality reports from 1994 to 2004 was performed. The FACE reports were developed using the National Institute for Occupational Safety and Health, Division of Safety Research-recommended FACE report format that incorporates Haddon's matrix. Haddon's matrix separates the fatal incident into three event phases and is used to develop points of intervention based on human, organizational, and environmental factors. A multivariate logistic regression analysis for association between identified exposure variables and the outcomes of interest was undertaken. The operation of a tractor with an attached bucket, muddy terrain, and being thrown from the tractor were independent risk factors for being declared "dead at the scene". A tractor rollover and operation of a tractor on a slope were independent risk factors for being "crushed" by a tractor. Narrative text analysis of FACE fatality investigation reports is a valuable tool for the identification of additional factors contributing to tractor fatalities that can inform farm safety training, identify new areas for agricultural interventions, and support the development of new agricultural engineering strategies.

Background Kentucky has the 6th highest drug overdose rate, 5th highest medical use rate of opioid pain relievers, and 11th highest opioid pain reliever sales rate in the USA (CDC, 2011). Aims/Objectives/Purpose The present study was undertaken to identify the presence of drugs (illicit and prescription) and crash characteristics among drivers who were injured in a motor vehicle crash using linked emergency department (ED), inpatient hospitalisation (IH), and crash data. Methods Kentucky CRASH data was probabilistically linked to emergency department datasets for years 2008–2009 and to inpatient hospitalisation datasets for years 2000–2009. Descriptive analyses were performed. Results/Outcome Of the 47 089 linked crash/ED-treated cases, there were: (1) 408 drivers diagnosed with non-dependent abuse of drugs (NDAD) in the ED; (2) 697 drivers cited for drugs in CRASH data (only 102 overlapped and were cited for drugs in both CRASH data and coded as NDAD in IH); (3) 42 drivers diagnosed with multiple drugs; and (4) 98 drivers in very severe crashes. Of the 19 466 total linked crash/IH cases, there were: (1) 1045 drivers diagnosed with NDAD in the IH; (2) 656 drivers cited for drugs in CRASH data (186 overlapped); (3) 250 drivers diagnosed with multiple drugs; and (4) 484 drivers in very severe crashes. Significance/Contribution to the Field Community and workplace strategies focusing on comprehensive drug policies (eg, increased drug recognition training of police officers and increased traffic fines) and interventions (eg, improved prescription drug monitoring programmes, designated drivers) are necessary to reduce driving while under the influence of drugs.