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Assessments of the impact of occupational amputations with outcomes of pain, disfigurement, and often an inability to return to the same job, are limited. The present study examines and quantifies the rates, risk factors, and costs of occupational amputations in the workplace in the State of Kentucky.Worker's compensation data from 1994 through 2003 from Kentucky was used to investigate job-related amputations (n = 2,297). The US Department of Labor's Current Population Survey (CPS) was used to estimate injury rates.The average amputation claim rate for all Kentucky workers was 1.37 per 10,000, with an average per-claim indemnity cost of $8,822. A declining trend was found in the rate over the last 7 years studied. Accidents resulting in amputations occurred at twice the rate on weekends than on weekdays. Amputations affecting the hand constituted 94.6% of all injuries. Workers in the mining industry had the highest estimated claim rate of 5.92 (95% CI 5.23-6.66), and machine operators and assemblers had the highest rate of all occupations with 3.35 (95% CI 3.23-3.47).Workplace amputations remain a significant workplace concern and represent a particular hazard for those in the mining and manufacturing industries. Future research should examine causes of the weekend effect to develop human resource and safety interventions for risk reduction. Am. J. Ind. Med. 49:1031-1038, 2006. © 2006 Wiley-Liss, Inc.