Fall-related occupational injuries on farms

Falls From Agricultural Machinery: Risk Factors Related to Work Experience, Worked Hours, and Operators' Behavior

Objective We investigated the risk factors for falls when egressing from agricultural tractors, analyzing the role played by worked hours, work experience, operators' behavior, and near misses. Background Many accidents occur within the agricultural sector each year. Among them, falls while dismounting the tractor represent a major source of injuries. Previous studies pointed out frequent hazardous movements and incorrect behaviors adopted by operators to exit the tractor cab. However, less is known about the determinants of such behaviors. In addition, near misses are known to be important predictors of accidents, but they have been under-investigated in the agricultural sector in general and as concerns falls in particular. Method A questionnaire assessing dismounting behaviors, previous accidents and near misses, and participants' relation with work was administered to a sample of Italian tractor operators ( n = 286). Results A mediated model showed that worked hours increase unsafe behaviors, whereas work experience decreases them. Unsafe behaviors in turn show a positive association with accidents, via the mediation of near misses. Conclusions We gave a novel contribution to the knowledge of the chain of events leading to fall accidents in the agricultural sector, which is one of the most hazardous industries. Applications Besides tractor design improvements, preventive training interventions may focus on the redesign of the actual working strategies and the adoption of engaging training methods in the use of machinery to optimize the learning of safety practices and safe behaviors.

Review and Meta-analysis of Emerging Risk Factors for Agricultural Injury

Agricultural injury is a significant public health problem globally. Extensive research has addressed this problem, and a growing number of risk factors have been reported. The authors evaluated the evidence for frequently reported risk factors earlier. The objective in the current study was to identify emerging risk factors for agricultural injury and calculate pooled estimates for factors that were assessed in two or more studies. A total of 441 (PubMed) and 285 (Google Scholar) studies were identified focusing on occupational injuries in agriculture. From these, 39 studies reported point estimates of risk factors for injury; 38 of them passed the Newcastle-Ottawa criteria for quality and were selected for the systematic review and meta-analysis. Several risk factors were significantly associated with injury in the meta-analysis. These included older age (vs. younger), education up to high school or higher (vs. lower), non-Caucasian race (vs. Caucasian), Finnish language (vs. Swedish), residence on-farm (vs. off-farm), sleeping less than 7-7.5 hours (vs. more), high perceived injury risk (vs. low), challenging social conditions (vs. normal), greater farm sales, size, income, and number of employees on the farm (vs. smaller), animal production (vs. other production), unsafe practices conducted (vs. not), computer use (vs. not), dermal exposure to pesticides and/or chemicals (vs. not), high cooperation between farms (vs. not), and machinery condition fair/poor (vs. excellent/good). Eighteen of the 25 risk factors were significant in the meta-analysis. The identified risk factors should be considered when designing interventions and selecting populations at high risk of injury.

Outcomes Following Traumatic Grain Elevator Injuries

OBJECTIVES

The absence of a comprehensive database of grain elevator-associated injuries hinders accurate evaluation of injury prevalence and may lead to discordant information about injury frequencies. The main purpose of this study was to identify the most common mechanisms of injury related to grain elevator events. Comparisons of hospital outcomes between patients who sustained traumatic injuries associated with grain elevators at Occupational Safety and Health Administration (OSHA)-regulated industrial sites versus those on OSHA-exempt farming operations were also made.

METHODS

A retrospective review was conducted of all patients' presenting with grain elevator-related injuries at a level-1 trauma center between January 1, 2003, and December 31, 2013. Data collected included demographics, mechanism of injury, injury severity, hospitalization details, and discharge disposition. Data were summarized, and comparisons were made between the groups.

RESULTS

All patients (N = 18) in the study were male, with a mean age of 37 years. Falls and being caught in equipment each accounted for 27.8% of injuries. Among the 18 patients, there were a total of 37 injuries. The majority of injuries were either lower extremity (29.7%) or chest injuries (21.6%). The average hospital length of stay was 4 ± 4.5 days, and one patient required mechanical ventilation. There were no reported deaths.

CONCLUSION

The literature reports entrapments as the leading cause of grain elevator-related injuries; however, this study found that falls and being caught in equipment were the most common mechanisms of injury. This suggests that a greater emphasis should be placed on fall prevention and equipment safety.

A Pilot Study of Gait Function in Farmworkers in Eastern North Carolina

Farmworkers endure many job-related hazards, including fall-related work injuries. Gait analysis may be useful in identifying potential fallers. The goal of this pilot study was to explore differences in gait between farmworkers and non-farmworkers. The sample included 16 farmworkers and 24 non-farmworkers. Gait variables were collected using the portable GAITRite system, a 16-foot computerized walkway. Generalized linear regression models were used to examine group differences. All models were adjusted for two established confounders, age and body mass index. There were no significant differences in stride length, step length, double support time, and base of support; but farmworkers had greater irregularity of stride length (P = .01) and step length (P = .08). Farmworkers performed significantly worse on gait velocity (P = .003) and cadence (P < .001) relative to non-farmworkers. We found differences in gait function between farmworkers and non-farmworkers. These findings suggest that measuring gait with a portable walkway system is feasible and informative in farmworkers and may possibly be of use in assessing fall risk.

Recruitment and retention of farm owners and workers for a six-month prospective injury study in New Zealand: a feasibility study

Background

Agricultural workers experience high rates of occupational injury. There is a lack of analytic studies which provide detailed occupational exposure information to inform intervention development.

Methods

A feasibility study simulating a six month prospective cohort study was designed and undertaken. The levels of farm and worker participation and retention were analysed to determine the feasibility of the methods for wider deployment.

Results

Recruitment levels were comparable with other studies, with 24% of farms and 36% of non-owner workers participating. Once recruited, retention was high at 85% and 86% respectively.

Conclusions

The main challenges identified were in the recruitment process. Once recruited, farms and workers tended to complete the study, indicating that prospective studies in this the agricultural workforce may be feasible. Issues encountered and potential solutions for future studies are discussed.

Injuries and fatalities to U.S. farmers and farm workers 55 years and older

BACKGROUND

Previous studies have shown that older farmers and farm workers have been identified at high risk for farm fatalities, most notably involving tractor overturns. Older farmers also incur more severe non-fatal injuries.

METHODS

Data from two national surveillance systems are presented to describe fatal and non-fatal injuries occurring to older farmers 55+ years of age. Tractor-related fatality investigations for older farmers are examined for characteristics of the tractors not available in the injury surveillance systems.

RESULTS

Older farmers and farm workers averaged 26,573 lost-time injuries annually in 2001 and 2004, with an injury rate of 4.5 injuries/100 workers/year compared to an overall farming injury rate of 4.8 injuries/100 workers/year. Fatality data show that older farmers accounted for over half of all farming deaths between 1992 and 2004 (3,671 of 7,064 deaths), and had a fatality rate of 45.8 deaths/100,000 workers/year compared to the overall farming fatality rate of 25.4 deaths/100,000 workers/year. Most common mechanisms of fatal injury to older farmers were "tractors" (46%), "trucks" (7%), and "animals" (5%).

CONCLUSIONS

Although older farmers and farm workers are at lower risk of overall injury compared to their younger counterparts, injuries to farmers 55 years and older tend to be much more severe. To effectively minimize the risk faced by older farmers, prevention programs must encourage safe work behaviors and practices and the implementation/installation of appropriate safety devices and equipment.

Slip, trip and fall injuries in potato, sugar beet and open field vegetable production in Finland

STF injuries are common in agriculture. The purposes of this study were to assess the magnitude of STF injuries, to identify contributing factors and to propose preventive actions to reduce injuries in potato, sugar beet and open field vegetable production in Finland. The material consisted of 1648 injury claim records and 22 interviews. The analysis showed 45% (n = 740) of the non-fatal injuries were STFs or jumps. Phrase analysis of injury descriptions provided further insight into the characteristics of STF injuries. The current findings suggest interventions should focus on making access paths (e.g. stairs, ladders, platforms) safer, minimising the need for mounting and dismounting equipment, decreasing manual material handling, improving contamination control and housekeeping in working areas and improving the safety of traffic areas and farmyards.

Measuring determinants of occupational health related behavior in Flemish farmers: an application of the Theory of Planned Behavior

PROBLEM

Preventive interventions to reduce occupational injuries and health problems in farmers require the identification of factors that contribute to unsafe and health damaging behavior. This paper describes the development and validation of a self-report questionnaire, which measures the determinants of occupational health-related behaviors in farmers.

METHOD

A representative sample of 283 Flemish farmers completed a provisional 135 item questionnaire based on the Theory of Planned Behavior, measuring four behaviors related to occupational health (machinery use, animal handling, preventing falls, and pesticide use), as well as the intentions, attitudes, perceived social norms, and self-efficacy for each of these behaviors.

RESULTS

The fit indices of the Confirmatory Factor Analysis turned out not to be sufficient to reproduce the dimensions of the TPB. Therefore exploratory factor analysis was use to determine the underlying dimensions. Principal Component Analyses (PCA) on the behavioral items yielded single component solutions explaining a considerable proportion of the variance for each behavior and for behavioral intentions. Principal component analyses toward an a priori three-component structure reflecting the TPB dimensions did not produce sufficient congruence for the determinants of the four behaviors. Subsequent Varimax rotations and discarding of redundant items resulted in three component solutions explaining 50% to 69% of the variance in the determinants of each behavior, corresponding with the dimensions of the TPB. Internal consistencies ranged from .25 to .89. Scale scores accounted for a significant proportion of the variance in intention and self-reported behavior.

IMPACT

The study demonstrates the validity of the TPB in predicting behavior related to occupational safety and health in farmers, and provides a valid and reliable questionnaire to measure the cognitive concepts featured in this model.

IMPACT ON INDUSTRY

Both authors share the same view on this study's impact on industry. In recent years, efforts have been made to create awareness among farmers about occupational hazards, and to encourage farmers to perform safer and healthier behavior. However, only a limited number of these interventions have proven to be successful. A possible reason for this relative lack of success is that interventions typically focus on risk analysis and raising awareness, whereas the literature on preventive health behavior change indicates that knowledge and awareness with regard to possible health risks are neither necessary nor sufficient to change behavior. To raise the effectiveness of prevention programs, other relevant determinants of behavior need to be addressed as well, such as: attitudes, perceived social norms, self efficacy, and elements of the physical environment that elicit or reinforce behavior. These determinants play a key role in psychological models of health related behavior, such as the Theory of Planned Behavior. Thus far, the use of these models within agricultural settings is fairly limited. This study demonstrates the validity of the Theory of Planned Behavior in predicting behavior related to occupational safety and health in farmers, and provides a valid and reliable questionnaire to measure the cognitive concepts featured in this model.

Understanding the ergonomic risk for musculoskeletal disorders in the United States agricultural sector

INTRODUCTION

Farming is a very large industry in the United States. Understanding the risks for injuries and more specifically musculoskeletal disorders in this industry poses a challenge for health officials.

METHODS

A review was conducted of the existing peer-reviewed publications prior to December 2006 about injuries and musculoskeletal disorders for farmers and farm workers. The aim was to review existing knowledge concerning: (1) the prevalence, types, and causes of farm-related injuries, paying particular attention to musculoskeletal disorders and the special populations within the agricultural sector, and (2) interventions that have been developed to reduce risk factors associated with farm-related injuries.

RESULTS

Farmers and farm workers experience high rates of low back, shoulder, and upper extremity disorders. Musculoskeletal disorders may disproportionately affect farm youth and migrant workers due to the types of farm tasks performed. There is an urgent need for improved and validated interventions to reduce exposures and to improve the health of farmers and farm workers.

DISCUSSION

Future farm-related musculoskeletal disorder research should emphasize: (1) better identification of exposures for special populations, (2) development of interventions for diverse farm populations, and (3) identification of additional exposures for musculoskeletal disorders. Inadequate understanding of musculoskeletal disorders in farming impedes efforts to prevent this common and important type of occupational injuries on farms.

Pediatric Fall Injuries in Agricultural Settings: A New Look at a Common Injury Control Problem

OBJECTIVES

Children on farms experience high risks for fall injuries. This study characterized the causes and consequences of fall injuries in this pediatric population.

METHODS

A retrospective case series was assembled from registries in Canada and the United States. A new matrix was used to classify each fall according to initiating mechanisms and injuries sustained on impact.

RESULTS

Fall injuries accounted for 41% (484/1193) of the case series. Twenty percent of the fall injuries were into the path of a moving hazard (complex falls), and 91% of complex falls were related to farm production. Sixty-one percent of complex falls from heights occurred while children were not working. Fatalities and hospitalized injuries were overrepresented in the complex falls.

CONCLUSIONS

Pediatric fall injuries were common. This analysis provides a novel look at this occupational injury control problem.

Fall-related injuries among agricultural household members: Regional Rural Injury Study II (RRIS-II)

OBJECTIVE

The objective of this study was to identify the magnitude and consequences of and potential risk factors for fall-related injuries among agricultural operation households.

METHODS

Demographic, injury, and exposure data were collected through 1999 from 3765 households in a five-state region. A causal model facilitated survey design, data analyses, and interpretation of results; directed acyclic graphs guided multivariate modeling.

RESULTS

The 16,538 participants experienced 766 fall-related injury events (48.3 per 1000 persons). Consequences included lost agricultural and other work time. Increased risks involved residence in states other than Minnesota, male gender, and injury history. Decreased risks were among those less than 35 years of age and those who worked 40 hours or less per week.

CONCLUSIONS

Fall-related injury is a major problem for the agricultural population. This effort serves as a basis for further in-depth research.

Potential exposure to hazardous work activities: tractor usage among farmwomen

Farmwomen are often an unacknowledged workforce, leading to a lack of targeted safety interventions. This study examined the involvement and work patterns of 665 women in Texas and 657 women in Louisiana who were 18 years old and older and whose family participated in farming operations. Surveys were used to gather specific data regarding tractor work patterns, tractor knowledge, sources of information about tractors, and demographic information in two southern states in which cattle and dairy were the major agricultural commodity. Among the sample of 1,322 women, 577 (43.6%) reported driving tractors at least one day a year. This subset was used to describe characteristics of tractors and tractor-related activities. Findings indicate that women learn to drive tractors in their 20s, use husbands as the primary source of their information about tractors, engage in a wide variety of farm activities including bush-hogging and plowing, and acknowledge knowing an average or less than an average amount about driving tractors. Women most often reported driving between 1 to 12 days/year (n = 321, 55.6%). When examining patterns of ROPS-equipped tractor use, women were 1.47 times more likely to drive a tractor without ROPS or enclosed when driving less than 12 days a year as opposed to 13-103 days/year or greater than 104 days/year. The results of this study support the need for health care professionals and safety specialists to design appropriate interventions that target women to become more knowledgeable regarding the injury risks associated with farm work while driving tractors.

Self-reported symptoms of neurotoxicity and agricultural injuries among Ohio cash-grain farmers

BACKGROUND

In 1993, the Ohio Farm Family Health and Hazard Surveillance Program (OFFHHSP) was initiated to assess the health status of cash-grain farmers and their families. The objective of this study was to examine the postulated relationship between symptoms of neurotoxicity and risk of agriculture-related injury among Ohio cash-grain farmers.

METHODS

A reanalysis of the data from a previously published case-control study of cash-grain farmers [Crawford et al. (1998) Am J Ind Med 34:588-599] was performed. The Principal Operator (PO) of each farm was asked to complete a self-administered questionnaire which included items about injuries experienced during the past year. A section of the questionnaire contained a 24-item instrument ("Q24") that queried symptoms of neurotoxicity experienced during the previous 12 months. Design-based multiple logistic regression analyses were conducted to evaluate associations between neuropsychological subsets ("domains") of the 24-item instrument and injury risk among the white male POs (who accounted for >99% of all POs).

RESULTS

Significantly elevated odds ratios (ORs) were found in 8 of 11 domains. POs answering in the affirmative to the single item "Have you been bothered by lack of coordination or loss of balance?" were 3.12 times more likely to have reported an injury than POs responding negatively (95% CI 1.68-5.81).

CONCLUSIONS

Farmers with higher scores on several Q24 domains, and for particular questionnaire items, appear to be at increased risk of agricultural injury.

Tractor-related injuries: a population-based study of a five-state region in the Midwest

BACKGROUND

Tractor-related injuries are among the most severe of agricultural injuries. This study identifies the incidence, consequences, and potential risk factors for tractor injuries among 3,765 agricultural households in a five-state region.

METHODS

Demographic, injury, and exposure data were collected for two 6-month recall periods in 1999 using computer assisted telephone interviews. A causal model served as a basis for survey design, data analysis, and interpretation of results; associated directed acyclic graphs guided development of multivariate models.

RESULTS

The overall injury rate was 9.6 events per 1,000 persons per year. Increased personal risk was observed for males and prior agricultural injury experience. Compared with ages 35-44, decreased risks were identified for those less than 5, 5-9, 10-14, 15-19, and 20-24.

CONCLUSIONS

Risk of tractor injury among agricultural household members varied by gender, age, and prior injury experience. .

Measuring disease frequency in the Marshfield Epidemiologic Study Area (MESA)

The Marshfield Epidemiologic Study Area (MESA) is a rare resource for population-based health and medical research developed at Marshfield Clinic Research Foundation. Because of high population coverage and health event capture, MESA is particularly useful for determining the frequency of disease in the general population. A substantial proportion of MESA-based publications appearing in the peer reviewed literature have reported incidence or prevalence rates of disease or disease-related factors. This paper reviews the first 10 years of MESA's support of meaningful inquiry into the frequency of disease occurrence, and briefly reports on the data and methods used for such calculations using selected chronic diseases as examples. Limitations of MESA estimates are discussed as are alternate methods. Compared to limited data published for the selected conditions, occurrence rates in MESA based on diagnostic codes and general validation rules only appear somewhat high, although the observed temporal trends and relationships with demographics are consistent. Rich clinical data sources are available to be linked with MESA to improve the specificity of case ascertainment, as is typically done for disease-specific publications from MESA.

Risk factors for falls among Iowa farmers: a case-control study nested in the Agricultural Health Study

BACKGROUND

Farmers are at increased risk for fall-related injury compared with other occupations. Little is known about risk factors for non-fatal falls on the farm. This case-control study, nested within the Agricultural Health Study, aimed to assess risk factors for work-related falls among Iowa farmers.

METHODS

A screener questionnaire sent to 6,999 farmers in 1998 identified 79 farmers who reported a fall-related farm injury that required medical advice or treatment in the previous year. Multivariable logistic regression analysis was used to assess several possible risk factors for injury among these farmers compared with 473 farmers with no injury in the previous year.

RESULTS

There were significant associations between fall-related farm injury and age between 40 and 64 years (OR = 2.21; 95% CI = 1.20-4.07), doctor-diagnosed arthritis/rheumatism (OR = 2.05; 95% CI = 1.11-3.79), difficulty hearing normal conversation (even with a hearing aid, in the case of those who used one) (OR = 1.82; 95% CI = 1.07-3.08), and taking medications regularly (OR = 1.80; 95% CI = 1.02-3.18).

CONCLUSIONS

Aging and health impairments, such as arthritis and hearing difficulties, are risk factors for which accommodations and preventive strategies can be devised to prevent fall-related injuries on the farm.

Farm work practices and farm injuries in Colorado

STUDY OBJECTIVE

s: To describe the farm work patterns and the relationship between hours spent working on specific farm tasks and task specific work related injuries among women and men.

DESIGN

A cross sectional survey of farm operators and their spouses in an eight county area of Colorado was conducted. Personal interviews were conducted between 1993 and 1997. Interviews took between 45 minutes to two hours to complete, depending on the complexity of individuals' personal histories. Farms were selected using stratified random sampling technique.

SETTING

Eight counties in Northeastern Colorado representing 47% of agricultural production in the state.

PARTICIPANTS

A total of 301 women and 459 men who were farm residents and involved in farm work were recruited.

OUTCOME MEASURE

Self reported injuries resulting in medical attention or treatment other than first aid, or inability to do normal work activities, or loss of consciousness, or transfer to another job were assessed in relationship to the specific job task being performed at the time of the injury.

RESULTS

Women were at higher risk for injury than men when involved with other farm chores (rate ratio 8.18). For all other task related injuries, men and women were at similar risk when compared using hours of exposure to the farm tasks.

CONCLUSION

Farm safety training and injury prevention programs need to include women working on farms.

Alcohol consumption patterns and work-related injuries among Colorado farm residents

BACKGROUND

Few studies have assessed the relationship between alcohol consumption patterns among farm populations and work-related injuries. The purpose of this study was to assess the role of alcohol consumption patterns on farmwork-related injuries.

METHODS

Prospective cohort study of Colorado farm residents, 1993 to 1995. Self-reported injuries, alcohol consumption, and demographics were assessed over 3 years. A stratified probability sample of farms was selected to include approximately 2.6% of Colorado farm residences with a farm operator living on the property. A total of 485 farms, including 872 individuals, were recruited in the initial cohort. In the second year, 746 individuals were re-interviewed, and in the third year, 653 of the original group participated.

RESULTS

Injuries during the study period were assessed in relationship to alcohol consumption. During the 3 years, 150 farm residents reported a total of 215 farmwork-related injuries. An increased risk of injury was associated with increased alcohol consumption. Compared to abstainers, farm residents who drank more frequently had higher farmwork injury incidence rates (3.09 and 3.35 injuries per 10,000 person-days of observation versus 1.94 injuries per 10,000). Farm residents who typically drank three or more drinks per day had a farmwork injury rate of 3.62 per 10,000 person-days (95% confidence interval [CI]=2.38-4.85). Farm residents who typically drank one to two drinks per day had a farmwork-related injury rate of 3.02 per 10,000 person-days (95% CI=2.44-3.60). In multivariate models, alcohol consumption frequency and quantity were significantly associated with farmwork-related injuries.

CONCLUSIONS

Alcohol consumption should be considered in studies of agricultural injuries.

Nonfatal injury experiences among women on family farms

Agricultural injury occurrence was determined among 1,096 working farm women in Texas and Louisiana. The 1-year cumulative incidence was 4.8%. Lower extremities were the body parts most frequently injured. The leading external causes were contact with foreign object, followed by falls and overdoing/ lifting. The seasonal pattern of injury was consistent with warm weather. The factors predictive of increased injury risk in multiple logistic regression included large animal farm type, greater time commitment, recurrent or persistent back conditions or weakness during the previous 12 months, hauling goods to market, and driving a tractor more than 52 days per year. Most women consulted a physician as a result of the injury. Resolving the problem of preventable farm-related injuries will require a major and coordinated effort aimed not only at farm women themselves but also at multiple variables that profoundly affect the underlying conditions and behaviors that lead to farm-related injuries.

Incidence and risk of work-related fracture injuries: experience of a state-managed workers' compensation system

Incidence rates of occupational fractures at various anatomic sites and associated risk factors have not been well documented. We identified 3490 work-related fractures from a West Virginia Workers Compensation database that occurred between July 1, 1994, and June 30, 1995. The annual incidence rate was 55 per 10,000 workers, which is substantially higher than the work-related fracture rates reported previously. The incidence rate of fracture was highest in the agricultural sector, followed by the mining, construction, and manufacturing sectors (202.0, 165.2, 116.7, and 88.0 per 10,000 workers, respectively). The age-specific gender distribution comparing fracture and non-fracture injuries showed a bimodal distribution, with greater proportions of female employees at the younger and older age groups. Fracture of the phalanges was the most common, followed by fractures of the foot bone and carpal bone (15.8, 9.5, and 7.9 per 10,000 workers, respectively). In a multiple logistic regression analysis, age, gender, occupation, caught in-between objects, fall, struck by or against object, and vehicle collision were significant independent predictors of fracture (all sites combined). We believe work-related fractures to be a bigger problem than previously reported. The association among gender, age, occupation, and causes of fractures identified in this study will be useful in developing gender- and occupation-specific prevention intervention.

Gender differences in work-related injury/illness: analysis of workers compensation claims

BACKGROUND

Risk of work-related injuries/illnesses among females has not been well documented. This study compares compensable work-related injuries/illnesses between females and males across all major industrial sectors and occupations using a state-managed Workers Compensation database.

METHODS

Incidence rates were calculated by dividing the number of compensable injuries/illnesses among West Virginia Workers Compensation claimants by the total number of female and male workers in each specific industry class (based on SIC codes). Gender-specific denominators for occupations were estimated using 1990 U.S. Census data.

RESULTS

The overall injury/illness rate was significantly lower in females than males (5. 5 vs. 11.5 per 100 employees), a trend that extended to all major industrial classes with the exception of service and agricultural sectors. The distribution of types of injury/illness varied by gender, occupation, and industry with significantly higher risk of carpal tunnel syndrome, burn, sprain, and fracture in females compared to males.

CONCLUSIONS

Female workers have a greater risk of specific injury/illness compared to males in various industries. Further research will be needed to understand the role of differential job-tasks within each occupation in explaining the risk difference.

Agricultural injury

BACKGROUND

Agriculture is one of the most hazardous industries in the US.

METHODS

We reviewed MEDLINE and NIOSHTIC to identify English-language studies addressing occupational injury among agricultural populations, focusing on North America. Additional references were identified from the reference lists of identified studies and from contacts with experts in the field.

RESULTS

U.S. data indicate up to approximately 780 deaths and 140,000 cases of nonfatal disabling injuries in 1998. Risk of agricultural injuries is approximately 5-10/100 persons per year, but is higher in certain risk groups, such as males and cattle workers. Falls, machinery, and animals are among the most common causes. Unique features of the agricultural workplace and exposed population combine to increase risk and hinder accurate measurement. These features include a wide range of activities, hazards, and dispersed work places in agriculture; a seasonal hired work force that often has brief tenure, poor English skills, and a distrust of officialdom; and a history of exemption regarding occupational health and safety regulations.

CONCLUSIONS

Research in agricultural injury should include epidemiologic study of risk factors and evaluation of interventions. Although only limited data are available documenting efficacy of specific preventive approaches, prevention should focus on engineering controls, regulatory approaches, and education.

Farm work related fatalities among adults in Victoria, Australia: the human cost of agriculture

The purpose of this study was to review the patterns of, and trends in, farm work related fatalities among adults in one Australian state for the period 1985-1996. Fatality data was provided by the Victorian Workcover Authority Health and Safety Division. Trends were determined using regression techniques assuming a Poisson error structure for annual fatality rates. Results showed an annual average of eight deaths. Males, and those 60 years and over, were over-represented, compared to persons employed. Tractor incidents were the most common type of fatality (72%), with tractor roll overs accounting for 61% of all tractor incidents. Non tractor fatalities included being hit by a falling object and transport incidents. Statistical trend analyses revealed a non significant decrease in the tractor roll over fatality rate, and significant increases in the all farm (P = 0.004) and non tractor fatality rates (P = 0.036). The 3 year moving average rate for non tractor farm fatalities has increased to the point where it exceeds that for tractor roll over fatalities, and is approaching that for all tractor fatalities. Changes within the agricultural industry, coupled with the ageing of the farm workforce, appear to placing Victorian farmers at increased risk of farm work related death.

Machine-related occupational injuries in farm residents

Farm machinery is an important contributor to the high rates of occupational injury in agriculture. As part of a population-based case-control study, we studied risk factors for machine-related farm injuries. Case patients were farm residents residing in a geographically defined area of central Wisconsin who experienced a farm injury associated with a tractor, farm implement, or other machine which required medical or chiropractic care from May 1990 through April 1992. Controls were selected from an ad hoc census of farm residents in the same area. Telephone interviews regarding demographic characteristics, safety behaviors, and farming practices were completed for 97.8% of 90 case patients and for 82.8% of 221 control subjects. Personal characteristics significantly associated with an increased risk of machine-related injury included the number of hours worked per week and working primarily as a farmer. Dairy farms, farms with nonresident workers, and large farms were associated with an increased risk of injury while farms with registered cows and farms where cows were fed in the barn even in summer experienced fewer injuries. Based on a logistic regression model, the independent risk factors for machine-related farm injury included hours worked per week (2% increased risk/nonresident workers on farm (odds ratio) (OR) = 2.32; 95% confidence interval (CI): 1.07 to 5.06), cows fed in barn in summer (OR = 0.28; 95% CI: 0.12 to 0.64), and registered cows on farm (OR = 0.36; 95% CI: 0.17 to 0.79). Farm safety practices did not appreciably influence the risk of machine-related farm injury.