An evidence-consultation base for developing child injury prevention priorities for Australian farms

Utilizing the Delphi method to develop parent and child surveys to understand exposure to farming hazards and attitudes toward farm safety

Children on farms are at increased risk of injury. In Australia, children under 15 years consistently represent ~15% of all farm-related fatalities. This study aimed to develop parent and child surveys to gain a greater understanding of children's (5-14 years) exposure to occupational risk on farms by exploring their exposure to farm hazards, risk-taking behavior, their use and attitudes toward safety measures, and experience of farm-related injury. As farming communities are heterogeneous, a modified Delphi method was undertaken to ensure input from a diverse group. Seventeen experts participated in a three round process-the first two rounds required rating of proposed survey questions in an online questionnaire and the final round was an online discussion. Consensus was defined as 75% agreement or higher. This process resulted in 155 parent questions and 124 child questions reaching consensus to include. The modified Delphi method developed surveys that provide insight into the behaviors and attitudes of children (individuals) and their parents on farms (family) and will assist in informing how community, organizations and policy frameworks can improve child safety on farms. It will assist in identifying and understanding common farming exposures/behaviors of children and their parents to inform the development of targeted and culturally appropriate injury prevention strategies. As farming groups are heterogeneous, these survey scan be used on varying farming cohorts to identify their unique farming hazards and challenges. Child farm-related injuries are a problem globally and must be addressed; children are dependent on adults and communities to create safe environments for them.

Disadvantaged by More Than Distance: A Systematic Literature Review of Injury in Rural Australia

Rural populations experience injury-related mortality and morbidity rates 1.5 times greater than metropolitan residents. Motivated by a call for stronger epidemiological evidence around rural injuries to inform prevention, a systematic review of peer-reviewed literature published between January 2010 and March 2021 was undertaken to explore the epidemiology of rural injury and associated risk factors in Australia. A subsequent aim was to explore definitions of rurality used in injury prevention studies. There were 151 papers included in the review, utilizing 23 unique definitions to describe rurality. People living in rural areas were more likely to be injured, for injuries to be more severe, and for injuries to have greater resulting morbidity than people in metropolitan areas. The increase in severity reflects the mechanism of rural injury, with rural injury events more likely to involve a higher energy exchange. Risk-taking behavior and alcohol consumption were significant risk factors for rural injury, along with rural cluster demographics such as age, sex, high socio-economic disadvantage, and health-related comorbidities. As injury in rural populations is multifactorial and nonhomogeneous, a wide variety of evidence-based strategies are needed. This requires funding, political leadership for policy formation and development, and implementation of evidence-based prevention interventions.

Child Farm-Related Injury in Australia: A Review of the Literature

Children on farms have been identified as a population vulnerable to injury. This review seeks to identify child farm-related injury rates in Australia and to determine the key hazards and contributing risk factors. This critical review utilised the PRISMA guidelines for database searching. Research from the year 2000 onward was included as well as earlier seminal texts. Reference lists were searched, and the relevant research material was explored. Our primary focus was on Australian peer-reviewed literature with international and grey literature examples included. Evidence suggests that there is limited Australian research focusing on child farm-related injuries. Child representation in farm-related injuries in Australia has remained consistent over time, and the key hazards causing these injuries have remained the same for over 20 years. The factors contributing to child rates of farm injury described in the literature include child development and exposure to dangerous environments, the risk-taking culture, multi-generational farming families, lack of supervision, child labour and lack of regulation, limited targeted farm safety programs, underuse of safe play areas, financial priorities and poor understanding and operationalisation of the hierarchy of control. It is well known that children experience injury on farms, and the key hazards that cause this have been clearly identified. However, the level of exposure to hazards and the typical attitudes, behaviours and actions of children and their parents around the farm that contribute to chid injury remain unexplored.

Safe play areas on farms in New South Wales

OBJECTIVE

To assess the prevalence and security of fenced house yards on NSW farms and rural properties with a view to providing information to increase the development of safe play areas on farms.

DESIGN

A cross-sectional stratified study using computer-assisted telephone interviewing.

SETTING

Interviews were conducted in the four rural Area Health Services throughout February to December 2008.

PARTICIPANTS

Randomly selected sample of 1117 adults living on a farm or rural property in the study areas.

MAIN OUTCOME MEASURES

Self-reported issues involving fenced house yards or safe play areas for children.

RESULTS

Overall, 79.8% of farm respondents reported that they had a fenced house yard or safe play area. For those respondents with a fenced house yard, 66.6% reported that it was secure enough to prevent /make it difficult for a young child to wander away unsupervised. Based on these figures, it is estimated that only 53.1% of all farms or rural properties have a secure fenced house yard or safe play area. There were statistically significant variations between geographic locations, with the North Coast (37.7%) being lower.

CONCLUSIONS

This study illustrates a need across rural NSW to further promote, install or upgrade secure fenced house yards or safe play areas. While all geographic regions of the state could improve provision to protect children, there may also be some that are in need of more intensive intervention programs to enhance compliance. Such a proposition may also be relevant on a national level.