Query purpose:
Human trafficking occurs when a person uses force, fraud, or coercion for the purposes of exploitative labor, debt bondage, servitude, or engagement in a commercial sex act (Office on Trafficking in Persons, 2020; Trafficking Victims Protection Act of 2000). If a person is under the age of 18, then any commercial sex act is considered sex trafficking regardless of the presence of force, fraud, or coercion. The purpose of this definition is to assist state, local, tribal, territorial, and federal public health practitioners in detecting and monitoring trends of suspected human trafficking-related visits among emergency departments and ambulatory healthcare settings.
How it was developed:
- Using the CDC Suspected Sex Trafficking v1 Definition and the current best-practices literature, the CDC team created a list of diagnosis codes (International Classification of Diseases, 10th Revision, (ICD-10-CM) and Systematized Nomenclature of Medicine (SNOMED)) and chief complaint terms related to sex trafficking, labor trafficking and unspecified human trafficking.
- The CDC team added any newly identified diagnosis codes or chief complaint terms related to labor trafficking or unspecified human trafficking to the CDC Suspected Sex Trafficking v1 definition. Exclusion terms from the CDC Suspected Sex Trafficking v1 definition were removed if they related to labor or unspecified trafficking.
- Additional negation terms were added based on a careful review of the chief complaint data (e.g., when the term “labor” bought up instances of “labored breathing”).
- Step 3 was repeated, and the definition was refined until the current definition (described in detail below) was finalized in collaboration with participating jurisdictions.
How it works:
Inclusions of ICD-10 and SNOMED codes related to human trafficking. Inclusions of free text related to sex, labor, or unspecified trafficking. Exclusions related to delusions of trafficking, denial of trafficking, vehicular-related traffic accidents, indications of the patient as trafficker, labor referring to breathing, and labor referring to childbirth.
Plain language syntax description:
This definition identifies visits to an emergency room where the patient is known or thought to be a victim of human trafficking. Human trafficking means that someone is being forced to work or do sexual things against their will, through force, fraud or coercion. If the person is under 18 years old, any kind of commercial sex act counts as sex trafficking, even if the act wasn’t forced or coerced. The definition is based on diagnostic medical codes and chief complaint notes about why the patient came in for help. See Table 1 for individual definition components, and Table 2 for ESSENCE syntax.
For consideration:
This definition may still capture potential false positive visits related to delusions of trafficking, mentions of people other than the patient being trafficked, and visits related to traffic accidents.
(,(,^;T7[46]5^,or,^;Z0481^,or,^;713834002;^,or,^Sex traf^,or,^Sexual exploitation^,or,^sex slave^,or,^Forced prostitution^,or,^Forced sex work^,or,^Sexual servitude^,or,^;T746^,or,^;T766^,or,^;Z0482^,or,^labor traf^,or,^labour traf^,or,^forced labor^,or,^forced labour^,or,^;734998001;^,or,^Human Traf^,or,^Traffick^,),),ANDNOT,(,(,^Traffick accident^,or,!Car!,or,^Vehicle^,or,^Drug Traf^,or,^Erratic^,or,^Psychosis^,or,^Psychotic^,or,^Delusion^,or,^Illusion^,or,^Halluci^,or,^Denies being a victim of sex traf^,or,^Denies being a victim of labor traf^,or,^Denies being a victim of human traf^,or,^run into traf^,or,^running in and out of traf^,or,^traffick stop^,or,^running out into traf^,or,^worried about sex traf^,or,^worried about labor traf^,or,^trying to sex traf^,or,^trying to labor traf^,or,^denies sex traf^,or,^denies labor traf^,or,^denies human traf^,or,^hearing voice^,or,^manic^,),or,(,^;Z0482^,AND,^labored breath^,or,^contraction^,or,^delivery^,or,^water broke^,or,^suture^,or,^stitch^,),)