Nonfatal injuries to household youth on racial minority-operated farms in the U.S., 2000

The National Institute for Occupational Safety and Health (NIOSH) estimated that 32,808 nonfatal injuries occurred to youth less than 20 years of age on U.S. farms during 1998. These data, however, do not allow for the identification of minority farm operators. The Minority Farm Operator Childhood Agricultural Injury Survey (M-CAIS) was conducted to provide an overview of the number of youth on minority-operated farms and their associated farm-related injuries during 2000. M-CAIS was conducted by the USDA for NIOSH through a telephone survey of 49,270 minority-operated farms identified in the 1997 Census of Agriculture. These minority-operated farms included four racial categories (black, Asian, Native American, and other) and operators of Hispanic ethnicity. This study included only racial minority-operated farms for analysis, white Hispanic farms were excluded. In 2000, there were an estimated 28,577 youth living on U.S. farms operated by racial minorities. In that year, these youth sustained an estimated 348 nonfatal injuries. Males accounted for 245 (70%) of the injuries to household youth. The majority of all injuries to household youth (247, 71%) occurred on livestock operations. Native American household youth accounted for both the largest number of injuries (177) and the highest rate of injury (24.0/1,000 household youth) on these farms. M-CAIS data indicated significant variation in injury rates among specific racial categories. Results of the M-CAIS suggest the need for prevention strategies to address issues found within these specific sub-populations of the agricultural community.     

Farm safety issues in Old Order Anabaptist communities: unique aspects and innovative intervention strategies

The Amish and other Old Order Anabaptists have been inseparably linked with agriculture since coming to America. However few efforts have been identified which analyze the issues involved with Old Order Anabaptist farm injuries or present best practices for addressing these problems. As part of an effort to develop culturally appropriate and effective injury prevention strategies for use within the Old Order Anabaptist community, this article identifies important cultural issues that should be considered in understanding and attempting to reduce farm injures in this population, summarizes statistics concerning farm-related fatalities among Old Order Anabaptists, and discusses methods which have been effectively used to address farm injuries within these communities. In the statistical analysis, 92 cases were identified that were classified as being work-related or occurring in a farm work-related setting during the period 1980 to 2000. Approximately 64% of the identified cases were children 15 years and under; and approximately 77% were male. Run-over incidents were the most frequent primary cause of the fatal injuries, while animal-related behavior was the most frequent secondary cause, reflecting agricultural practices that remain highly dependent upon the use of horses and mules. The authors believe evidence suggests that certain Old Order Anabaptist choices concerning farm safety issues may be directly related to their socio-religious beliefs, and that effective intervention strategies must also be sensitive to socio-religious beliefs.     

Fatal injuries in Finnish agriculture, 1988-2000

Agriculture is one of the most hazardous industries in Finland. The aim of this study was to describe and analyze fatal farm injuries in Finland in 1988 to 2000. The information regarding farm-related fatalities was collected by the Kuopio Regional Institute of Occupational Health. The material of this study consisted of all fatal injuries that occurred on a farm or away from a farm in the course of agricultural work. A total of 217 farm-related fatalities occurred in Finland between 1988 and 2000. Of these, 120 were tractor-related, and 97 were other fatal farm injuries. Most of the injuries involved middle-aged or older male farmers. The most typical fatalities with tractors were tractor overturns during driving on a road or working in a field. Other fatal farm incidents occurred mainly in construction work, animal husbandry, or forest work. Elderly farmers and children proved to be risk groups for fatal injuries.     

Occupational all-terrain vehicle deaths among workers 18 years and older in the United States, 1992-2007

The objective of this study was to summarize basic information on the characteristics of work-related A TV deaths among civilian persons 18 years of age or older in the U.S. from 1992 through 2007. Work-related ATV death data were obtained through the Bureau of Labor Statistics' annual Census of Fatal Occupational Injuries. From 1992 to 2007, 297 work-related ATV deaths occurred among persons over 17 in the U.S. Ninety-two percent were male, 93% were white, 23% were ages 18 to 34, 51% were ages 35 to 64, and 26% were ages > or = 65. Half of the fatal incidents involved overturns resulting in head and chest injuries. Sixty percent of crashes occurred on farms and 20% occurred on highways. The fatality rate among agricultural production workers was significantly higher than the rates in all other industries. While more in-depth analysis of incident and exposure data for this growing problem will more clearly define personal risk and causal factors in the long term, in the short term, stronger emphasis must be placed on the development of prevention strategies, particularly focused on older workers in the agriculture production industry.     

Traumatic injuries in agriculture

The National Coalition for Agricultural Safety and Health (NCASH) in 1988 addressed issues in agriculture and noted "a sense of urgency... arose from the recognition of the unabating epidemic of traumatic death and injury in American farming . . ." This article provides an update to the NCASH conference on traumatic injuries in agriculture, a history on how the facts and figures were arrived at for the NCASH conference, and a current report on the status of traumatic injuries in agriculture in the U.S. Fatal and nonfatal injuries are addressed along with national and regional surveillance systems. The Census of Fatal Occupational Injuries (CFOI) was used for reporting national agricultural production fatal injuries from 1992-1998 (25.8 deaths per 100,000 workers), the Traumatic Injury Surveillance of Farmers (TISF) 1993-1995 was used to report nonfatal injuries occurring nationally (7.5/100 workers), and Regional Rural Injury Studies I and II (RRIS-I and RRIS-II) were used to illustrate a regional approach along with in-depth, specific analyses. Fatality rates, which showed some decline in the 1980s, were fairly constant during the 1990s. Changes in nonfatal injury rates for this sector could not be assessed due to a lack of benchmark data. The main concerns identified in the 1989 NCASH report continue today: tractors are the leading cause of farm-related death due mostly to overturns; older farmers continue to be at the highest risk for farm fatalities; and traumatic injuries continue to be a major concern for youth living or working on U.S. farms. Fatal and nonfatal traumatic injuries associated with agricultural production are a major public health problem that needs to be addressed through comprehensive approaches that include further delineation of the problem, particularly in children and older adults, and identification of specific risk factors through analytic efforts. Continued development of relevant surveillance systems and implementation of appropriate interventions are the primary challenges for the current decade.     

Compliance with NAGCAT work practices recommendations for youth cleaning service alleys in stall barns

Unintentional injury is the leading cause of death in the U.S. among persons 1 to 44 years of age. Over one million children and adolescents in the U.S. live, work, and/or play on farms, where injury risk is relatively high compared to other settings. In an attempt to reduce the number of childhood agricultural injuries occurring on farms, the North American Guidelines for Children's Agricultural Tasks (NAGCAT) was developed to assist parents or other caregivers in assigning developmentally appropriate chores to youth exposed to agricultural hazards. The results presented here are from a longitudinal study in which we obtained (self-reported) daily chore, injury, and safety behavior data from children and adolescents. We focused on one NAGCAT chore, cleaning a service alley in a stall barn, in order to estimate the extent of compliance with specific work practice recommendations contained in the NAGCAT. Our results indicated that among the four NAGCAT-recommended safety practices for cleaning service alleys in stall barns (wearing nonskid shoes, leather gloves, a respirator, and eye protection), wearing non-skid shoes was the only safety practice reported with any degree of regularity. Overall, boys were more likely to wear non-skid shoes compared to girls. In addition, older youth were generally more likely to report higher work practice compliance compared to younger youth.     

Assessing farm tractor incidents and awareness levels of operators for tractor safety issues in the Hatay province of Turkey

Studies and statistical data on safety issues related to farm tractors and machinery are very limited in developing countries, including Turkey. This study was carried out to investigate tractor-related incidents in the Hatay province, located in the mid-south of Turkey. A questionnaire was conducted with 107 tractor operators using face-to-face interviews. Data were evaluated according to the incident type, machinery involved, and mechanism of injury or fatality. A total of 101 incidents were reported by 77 of the 107 respondents. Most of the incidents were due to tractor rollovers (65.4%), 14.8% of the incidents were due to entanglement of body parts in moving machinery, and 12.9% involved crashing into other vehicles or obstacles. The leading cause of the incidents was personal mistakes (60.4%). Fatalities resulted from 25.7% of the incidents, while 45.5% of the incidents caused non-fatal injuries. Only 5.6% of the tractors had a ROPS-enclosed cab. The percentage of ROPS-equipped tractors was 19.6%, while 41.3% of the tractors had a shade cover and 33.6% had no protective structure. Only one of the respondents used a seatbelt, although 44.9% of them stated that seatbelts should be used. It was also found that only 13.5% of the operators had training in work safety, while 95.1% stated that incidents might be reduced if people were trained. Development of appropriate policies and training programs are needed for safer operation of agricultural machinery to reduce injuries and fatalities due to farm accidents.     

Injury surveillance for youth on farms in the U.S., 2006

In order to provide injury surveillance for youth on farms in the U.S., the National Institute for Occupational Safety and Health (NIOSH), in partnership with the USDA, developed the Childhood Agricultural Injury Survey (CAIS). CAIS data for all youth less than 20 years of age on farms have been collected for the calendar years of 1998, 2001, 2004, and 2006. CAIS data from 2006 indicated that an estimated 30.7 million youth lived on, worked on, or visited U.S. farms. These youth experienced almost 23,000 injuries while on the farm. The majority of these injuries occurred to males (15,223) and youth between the ages of 10 and 15 years (10,158). Approximately 25% (5,773) of the injuries were related to work being done on the farm. Youth living on the farm incurred 51% (11,654) of the injuries, hired youth sustained 6% (1,363), and 40% were to visiting youth (9,729). Although youth injuries on farms have declined by 30% since 1998, the numbers are still unacceptably high. Further indepth evaluation of subsets of the youth population may serve to better direct safety intervention programs and research.     

Agricultural injuries among operation household members: RRIS-II 1999

The purpose of this study was to determine the magnitude and consequences of agricultural injuries, and to reveal potential risk factors among agricultural household members. The Regional Rural Injury Study (RRIS-II) collected injury and exposure data on agricultural households of 16,538 people in Minnesota, Wisconsin, North Dakota, South Dakota, and Nebraska for each six-month period of 1999. Adjusted injury rates, consequences, and potential risk factors were identified through analyses. Selection of variables for multivariate analyses was based on a causal model. Injuries reported here occurred while the individuals were involved in activities associated with their own farm or ranch, unless otherwise stated. Estimates of injury rates and the effects of various exposures were derived by Poisson and logistic regression. These models accounted for correlation within both subject and household, and were adjusted for non-response. The rate of agricultural injury to household members on their own operation was 74.5 injuries per 1,000 persons per year. Differences in rates due to age and gender diminished when rates were calculated according to hours worked. Although only 5% of injured persons required in-patient hospitalization, 28% required emergency department treatment, and 84% required some type of professional health care. Moreover, 47% of all injuries required time off from agricultural work, and 7% required time off from non-agricultural work. In multivariate analyses, decreased risks were associated with Minnesota, and increased risks were identified for those with prior injuries and for males.This study provides a basis for further research on agricultural injuries and their prevention.     

Summary of fatal entrapments in on-farm grain storage bins, 1966-1998

For over 30 years, Purdue University has maintained a national database of agriculture-related entrapment cases that have occurred in loose agricultural material. At present, 391 documented fatal and non-fatal entrapments from the U.S. and Canada make up the Purdue University Agricultural Entrapment Database. In order to specifically study fatal cases of entrapments in grain bins located on farms, the database was reviewed, 181 cases were identified using specific criteria, and the results were summarized. Approximately five cases per year were identified between 1966 and 1998, representing 18 states and one Canadian province. Entrapments were generally reported more often in the top corn-producing states and during the months of November, December, January, March, and June. In 24% of the cases in which the victim's age was known, the victims were younger than 16. Children and adolescents younger than 16 were more often fatally entrapped in June than in any other month. For cases in which the product was known, corn was the agent of injury in 53% of the cases and was frequently found to be out-of-condition. At the time of entrapment, victims were involved with bin unloading activities in 76% of the cases in which the activity was identified. These findings are being used to design new injury prevention strategies, including educational materials and recommendations for engineering controls that focus on primary causative factors.     

Agricultural injuries in Central India: nature,magnitude, and economic impact

A study was carried out in Madhya Pradesh (Central India) to collect data on injury-causing agricultural incidents during the period 1995-1999. The overall incidence rate was 1.25/1000 workers/year. About 9.2% of the incidents were fatal, and most of the fatal incidents were due to tractors and snakebites (42.9% each). About 77.6% of all incidents were due to farm machinery, 11.8% were due to hand tools, and the remaining 10.6% were due to other sources like snakes, wells, etc. Data on 1,911 incidents reported in 10 leading newspapers published during the five-year period (1995-1999) from different regions of the state were also collected and analyzed, which indicated that only major or roadside agricultural incidents were reported in newspapers. Based on the survey data, it was estimated that in the year 2000 there would have been about 17,480 agricultural incidents in Madhya Pradesh, causing death to about 2,050 workers and injuries to about 16,770 workers, including amputations of limbs, burns, cuts, etc. Total monetary loss due to agricultural injuries in the state of Madhya Pradesh has been estimated as US $27 million/year.     

Evaluation of the Farm and Agricultural Injury Classification Code and follow-up questionnaire

The Farm and Agricultural Injury Classification (FAIC) code was developed specifically to identify and classify all agricultural injuries of interest to agricultural safety and health professionals. The FAIC code overcomes fundamental problems of classifying agricultural-related injuries by grouping incidents into categories describing actual exposures encountered on farms and in agricultural work. The successful application of the FAIC code depends largely on a researcher's ability to obtain appropriate information to correctly use the code. The purpose of this research project was to: (1) compare data obtained through a newly developed FAIC follow-up questionnaire (FQ) with data from the Penn State Agricultural Injury Database (AID); and (2) test FAIC Code utility, reliability, and construct validity with agricultural safety and health professionals. The FQ improved classification of 57% of cases in the Penn State AID. A majority of agricultural health and safety professionals understood and used the FAIC coding system, without training, to code an average of 75% of the test cases the same as the researcher. A large majority of the professionals that participated in this study judged the FAIC code and the accompanying materials to be very useful.     

An insight into the grain auger injury problem in Queensland, Australia

Grain auger-related injuries were studied by examining the injury data obtained from the Queensland worker's compensation database. Close to 60% of 52 claimants were male employees in the 20 to 34 age group. Fingers, hands, and arms were affected in 65% of all cases, and the auger flighting was involved in 60% of claims. The severity of auger-related injuries is reflected in the high average cost of claims and number of working days lost, which were more than double the all-industries values. Injuries involving the auger flighting are three times more costly (in time and money) than the all-industries values. More claims were made during winter and towards the end of summer, with the majority of injuries occurring in the animal industries. Most incidents occurred in the early or middle periods of a working shift. In addition, two focus group meetings were held to gain a broader perspective of the grain auger injury picture in Queensland, Australia. Focus group participants suggested that the operator's state of mind and attitude to safety are important, while the auger's age, type, and shielding were cited as important risk factors. They suggested that older augers are less likely to be adequately shielded, and mobile augers are most likely to be involved in injury events. The information gained from this study is being used to develop strategies to help farmers minimize injuries associated with the use of grain augers.     

Risk factors for agricultural injury: a case-control analysis of Iowa farmers in the Agricultural Health Study

The purpose of this case-control study nested in the Agricultural Health Study was to assess risk factors for agricultural injury among a large group of Iowa farmers. A questionnaire sent to 6,999 farmers identified 431 cases who had a farm work-related injury requiring medical advice/treatment in the previous year and 473 controls who had no injury in the previous year. We assessed several potential risk factors for injury. A multiple logistic regression analysis showed significant associations between farm work-related injury and weekly farming work hours (> or = 50 hours/week) (OR = 1.65; 95% CI = 1.23-2.21), the presence of large livestock (OR = 1.77; 95% CI = 1.24-2.51), education beyond high school (OR = 1.61; 95% CI = 1.21-2.12), regular medication use (OR = 1.44; 95% CI = 1.04-1.96), wearing a hearing aid (OR = 2.36; 95% CI = 1.07-5.20), and younger age. These results confirm the importance of risk factors identified in previous analytic studies and suggest directions for future research in preventive intervention strategies to reduce farm work-related injuries.     

A summary of state laws regulating youth operating farm tractors on highways

Driving farm tractors on highways is hazardous for youth due to the large speed differential between motor vehicles and agricultural vehicles, as well as recent increases in traffic volume on many rural roads. In 1994, the state of Wisconsin enacted legislation requiring youth who operate farm tractors on highways to complete a tractor and machinery certification course. We were interested in finding out whether other states have similar requirements. The purpose of this project was to collect and summarize state laws regulating youth who operate farm tractors on highways in the U.S. A systematic method was used that included an initial Lexis-Nexis database search followed by internet searches in combination with follow-up email and telephone communications when missing or unclear results were obtained. The findings show that 14 states have legislation addressing youth who operate farm tractors on highways. The content of these statutes varies, but includes driver's license or educational requirements, as well as regulations concerning the ages, locations, and/or times of day when youth may drive farm machinery on highways. This compilation of state laws will be useful information for agricultural safety professionals in designing effective outreach programs. A synthesis of the findings may also lead to the development of model legislation or inform future research efforts aimed at preventing youth farm tractor crashes on highways.     

Protecting young workers in agriculture: participation in tractor certification training

Tractor-related injuries among youth are an important public health problem. The major objectives of this study were to (1) provide a rigorous estimate of the number of youth operating tractors in Ohio and (2) assess the extent to which these youth are participating in federally mandated tractor safety training. A self-administered questionnaire was completed by approximately 4,000 students ages 14 or 15 years who were enrolled in a stratified cluster sample of 99 Ohio schools. Almost one-third of the youth (30%) reported having operated tractors, with 19% having operated a tractor on a farm not owned by a parent or guardian. More than half of the youth (52%) reported having operated a tractor and/or other hazardous machinery, with 25% having operated the machinery on a farm not owned or operated by a parent or guardian. Extrapolating from 4-H records and Ohio census data, fewer than 1% of the youth who are operating tractors or other hazardous machinery have participated in tractor certification training. Increasing participation in mandated training may be an important step in protecting the health of our nation's young agricultural workers.     

Expected injury cost indices on Finnish farms

Annually, more than 6000 work-related injuries occur on Finnish farms. One-fourth of these injuries are classified as severe, resulting in considerable economic losses to agricultural enterprises and the national economy. The injury rate among farmers is more than twice that among all employees on average. This study aimed to identify the risk factors that should be considered when targeting interventions, thus improving their cost-effectiveness. The expected injury cost (EIC) risk index method, which combines the probability of injuries with their severity and costs, was implemented. The potential risk factors included the type of agricultural operation, worker characteristics (gender, age), agricultural work tasks performed, and the geographical location of the farm enterprise. Crop production emerged as the type of agricultural operation with the highest risk index (1.12). The lowest risk index was in sheep and goat husbandry operations (0.35). The risk index was higher for men compared to women (1.11 vs. 0.77). The highest risk age group was farmers from 55 to 59 years of age (1.36). Farmers under 40 (0.17 to 0.89) and over 65 years old (0.70) had the lowest injury risks. No evidence was found that dangerous regions are concentrated in certain geographical parts of the country. The most common agricultural work tasks in which injuries occurred were the repair and maintenance of machinery and equipment, the transportation and relocation of animals, and milking. These accounted for more than one-third of all compensated work injuries in 2005. The identified risk factors could be considered when setting priorities in injury prevention and resource allocation.     

Safety assessments of agricultural machinery in Iran

Serious agriculture-related accidents are increasing in Iran, and this has come to the attention of authorities and planners. Due to the lack of data for this region of the world, research was conducted in different states of Iran to assess the most common causes of agriculture-related injuries. The relevant factors were divided into the three groups: personal, mechanical, and environmental. The major personal factors were education level, age, experience, injured limb, hospitalization period, gender, injury level, training, working hours, and insurance. The mechanical factors were machine type, machine part, mechanism of injury, machine's effective life, work activity at the time of injury, safety equipment, and insurance. The environmental factors were time of incident, geographical conditions of the accident location, and the time lapse between the accident and arrival at the hospital. The interactions between the various factors were also analyzed. All data were collected directly from farmers or their relatives. Data collection efforts were led by an official from the nearest health center or the local government agricultural office. The results indicated that 53% of injuries were related to personal factors, and 40% were related to the combination of personal and mechanical factors. The results confirmed that tractors and rotating parts were associated with the highest percentage of injuries in machine-related accidents. Lack of safety equipment and working beyond effective machine life was also observed in most cases. Personal factors need to be carefully considered in this region; insufficient levels of education and training were the main personal factors related to agricultural accidents. The results suggest that experience without training does not prevent injury, as more than 80% of injuries occurred to individuals with no training. Statistical analysis confirmed a significant effect of safety equipment and training on injuries. This study showed that agricultural injuries were severe in 60% of cases.     

Childhood cancer in Texas counties with moderate to intense agricultural activity

With few established risk factors, cancer remains the second leading cause of death for children in the U.S. Agricultural pesticide use is one of many suspected factors that may contribute to the etiology of childhood cancer. This study tests the hypothesis that birth in Texas counties with moderate to intense agricultural activity increases childhood cancer risk. This case-control study analyzed 6974 cases and controls ages 0 to 14, identified through the Texas Cancer Registry and Texas birth records, respectively. Exposure data were obtained from the Census of Agriculture. Percent cropland in the county of birth and total county-specific pesticide exposure incorporating the EPA's carcinogenicity classification served as surrogates for pesticide exposure. Cancer sites examined include: all cancers, leukemia, lymphoma, CNS tumors, and several specific subsites. Elevated, although not statistically significant, ORs for the association between birth in counties with > or =50% cropland were produced for all CNS tumors (OR = 1.3, 95% CI = 0.9-1.8), astrocytoma (OR = 1.4, 95% CI = 0.8-2.2), and PNET (OR = 1.3, 95% CI = 0.7-2.5). A similar pattern was not observed using the index of total county-specific pesticide exposure. Although imprecise, these exposure assessment methods represent novel applications of agricultural census data. Although a pattern of increased risk was observed between percent cropland and CNS tumors, this study's results do not support an association between birth in Texas counties with moderate to intense agricultural activity and childhood cancer. Due to study limitations, such an association should not be ruled out. Future research should incorporate individual-level data from various sources to increase precision and decrease misclassification in the exposure assessment.