expertise can therefore be used outside the traditional setting of fatal incident investigations—for example, in investigations of nonfatal traumatic occupational injury incidents. As in a criminal investigation, all available evidence must be identified, preserved, and collected from the start of an occupational accident investigation. No evidence should be ignored or overlooked. What might not seem relevant initially, including injury interpretation, may become highly relevant as the investigation progresses. Examining the information and circumstances associated with the accident—to the exclusion of any medical or pathological information about traumatic injuries—would be a disservice to the injured worker and his or her family, coworkers, and employer. Occupational accident investigators must identify and examine all possible evidence, including the forensic evaluation of injuries and any pathophysiology associated with the seriously or fatally injured worker, to achieve the best possible outcome. Injury results from an exchange of physical force, whether from the rapid deceleration of a fall to the forward deceleration of an automobile collision or the impact on the body from a moving object (Sheridan & Nash, 2007). Kinetic energy—the type of force involved in explosions, crashes, falls, and blunt or penetrating trauma— is the most common cause of injury (Lim & Rehmar, 1997). Injury caused by the impact of an object is related to several factors, including the shape and size of the object, the energy delivered by that object at impact, and the properties of the impacted area (Kieser, Taylor & Carr, 2013). Identifying injury causation requires a thorough understanding of the multiple characteristics of blunt and sharp force injuries and wounds and the ability to predict the types of mechanical forces that might have caused them, including the wounding object or instrument. Injury characteristics may provide information such as the exact site of contact, the direction of the impact force, whether it is a pattern injury, and the nature and shape of the injury object. The forensic evaluation of injuries also requires the use of internationally accepted definitions in describing and documenting injuries. However, incorrect terminology is commonly found in the medical documentation of injuries. In clinical practice, health professionals often misuse common forensic terms and confuse such injuries as lacerations and cuts (Sheridan & Nash, 2007). Original Article 194 www.journalforensicnursing.com Volume 9 • Number 4 • October–December 2013 Copyright © 2013 International Association of Forensic Nurses. Unauthorized reproduction of this article is prohibited. Trauma physicians in emergency departments are frequently involved in the assessment and treatment of patients injured in occupational accidents. Any patient admitted to the hospital with liability-related injuries must be considered as a clinical forensic patient (Lynch, 2011a). However, unless they have received forensic training, most physicians and nurses, even in the emergency department setting, lack the knowledge and ability to both distinguish the forensic characteristics of injuries and successfully document them properly from a legal perspective (Dougherty, 2011). Medical records often include numerous entries about an injury and the required treatment but fail to specify injury characteristics that may be of great forensic importance, such as size, appearance, and location on the body (Besant-Matthews, 2011). A physician’s early subjective statements have often been proven to be incorrect during subsequent investigations and/or court testimony (Sharma, 2006). Carmona and Prince (1989) reported that most of the cases they reviewed from level one trauma centers showed significant forensic medical deficiencies, primarily in the areas of documentation and/or handling or securing evidence. Given their lack of forensic training, therefore, hospital physicians cannot necessarily be relied upon to provide occupational accident investigators with accurate injury analysis or forensic evaluation of trauma. If the occupational accident investigator depends on the average healthcare professional to provide this crucial information, his or her ability to determine causation is severely limited. Errors in interpreting injuries may result not only from inadequate or incorrect injury description but also from erroneous medical knowledge or by trying to fit the findings to the injury history and bias. Although an error in interpreting injuries may be insignificant in the context of therapeutic treatment, in the medico-legal setting, such an error can have considerable ramifications. In a criminal investigation, injury misinterpretation could lead to the wrong weapon being identified and inadmissibility of evidence. In an occupational accident investigation, injury misinterpretation could result in wasted investigative resources as officers proceed down an incorrect investigative pathway. Occupational Accident Analysis Accidents are processes that culminate in an injury or illness. An accident may be the result of various simultaneous factors—interconnected or cross-linked events that have interacted in some dynamic way. An effective accident investigation will involve three levels of cause analysis. Injury analysis focuses on trying to determine how the energy transfer caused the