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TRAUMATIC INJURIES IN AGRICULTURE David L. Hard John R. Myers Susan G. Gerberich Traumatic Injuries in Agriculture NCASH Report (1989) Traumatic Injuries in Agriculture NCASH Report (1989) Epidemic of traumatic death and injury in American farming Traumatic Injuries in Agriculture

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TRAUMATIC INJURIESIN AGRICULTURE

David L. Hard

John R. Myers

Susan G. Gerberich



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Traumatic Injuries in Agriculture

  • NCASH Report (1989)

    • Epidemic of traumatic death and injury in American farming


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Traumatic Injuries in Agriculture

  • NCASH Report (1989)

    • Epidemic of traumatic death and injury in American farming

    • Traumatic death and injury due in large part to farm machinery—primarily tractors


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Traumatic Injuries in Agriculture

  • NCASH Report (1989)

    • Epidemic of traumatic death and injury in American farming

    • Traumatic death and injury due in large part to farm machinery—primarily tractors

    • Inadequate farm building design and livestock handling


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Traumatic Injuries in Agriculture

  • NCASH Report (1989)

    • Epidemic of traumatic death and injury in American farming

    • Traumatic death and injury due in large part to farm machinery—primarily tractors

    • Inadequate farm building design and livestock handling

    • Affect youth (<16) and elderly (65 and older)


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Traumatic Injuries in Agriculture

  • History of Fatal Occupational Injury

    • National Safety Council (NSC)

      • 1930’s to present


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Traumatic Injuries in Agriculture

  • History of Fatal Occupational Injury

    • National Safety Council (NSC)

      • 1930’s to present

      • Farm Safety Quarterly

      • Accident Facts

      • Injury Facts


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Traumatic Injuries in Agriculture

  • History of Fatal Occupational Injury

    • National Safety Council (NSC)

    • NIOSH--National Traumatic Occupational Fatalities (NTOF)--1980


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Traumatic Injuries in Agriculture

  • History of Fatal Occupational Injury

    • National Safety Council (NSC)

    • NIOSH--National Traumatic Occupational Fatalities (NTOF)--1980

      • Census of work related deaths

      • 16 years of age or older

      • External cause of death


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Traumatic Injuries in Agriculture

  • History of Fatal Occupational Injury

    • National Safety Council (NSC)

    • NIOSH--NTOF

    • BLS--Census of Fatal Occupational Injuries (CFOI)--1992


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Traumatic Injuries in Agriculture

  • History of Fatal Occupational Injury

    • National Safety Council (NSC)

    • NIOSH--NTOF

    • BLS--Census of Fatal Occupational Injuries (CFOI)--1992

      • Multiple records used to determine work-relatedness

      • Details often better than from death certificates

      • No age limit for inclusion


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Traumatic Injuries in Agriculture

  • History of Non-fatal Occupational Injury

    • National Safety Council (NSC)--1970’s-1980’s

      • National survey of agriculture production injuries

      • 3 personal interviews with farm operator—1 year


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Traumatic Injuries in Agriculture

  • History of Non-fatal Occupational Injury

    • National Safety Council (NSC)--1970’s-1980’s

      • National survey of agriculture production injuries

      • 3 personal interviews with farm operator—1 year

      • Standardized instrument—utilized volunteers


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Traumatic Injuries in Agriculture

  • History of Non-fatal Occupational Injury

    • National Safety Council (NSC)--1970’s-1980’s

      • National survey of agriculture production injuries

      • 3 personal interviews with farm operator—1 year

      • Standardized instrument—utilized volunteers

      • 1982—31 states

      • 1985—35 states


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Traumatic Injuries in Agriculture

  • History of Non-fatal Occupational Injury

    • National Safety Council (NSC)--1970’s-1980’s

      • National survey of agriculture production injuries

      • 3 personal interviews with farm operator—1 year

      • Standardized instrument—utilized volunteers

      • 1982—31 states

      • 1985—35 states

      • Not sustainable


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Traumatic Injuries in Agriculture

  • History of Non-fatal Occupational Injury

    • NSC--1970’s-1980’s

    • Olmsted Agricultural Trauma Survey (OATS)--1987


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Traumatic Injuries in Agriculture

  • History of Non-fatal Occupational Injury

    • NSC--1970’s-1980’s

    • Olmsted Agricultural Trauma Survey (OATS)--1987

      • Both fatal and non-fatal

      • Telephone interview-based survey of farm operators

      • 1 year recall


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Traumatic Injuries in Agriculture

  • History of Non-fatal Occupational Injury

    • NSC--1970’s-1980’s

    • Olmsted Agricultural Trauma Survey (OATS)--1987

      • Both fatal and non-fatal

      • Telephone interview-based survey of farm operators

      • 1 year recall

      • Used USDA/NASS list frame of farms

      • Comparison made with medical records at Mayo

      • Results were found to be realistic and effective


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Traumatic Injuries in Agriculture

  • History of Non-fatal Occupational Injury

    • NSC--1970’s-1980’s

    • Olmsted Agricultural Trauma Survey (OATS)

    • Regional Rural Injury Study (RRIS-I)--1990

      • Both fatal and nonfatal

      • 5 states (MN, NE, ND, SD, WI)


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Traumatic Injuries in Agriculture

  • History of Non-fatal Occupational Injury

    • NSC--1970’s-1980’s

    • Olmsted Agricultural Trauma Survey (OATS)

    • Regional Rural Injury Study (RRIS-I)--1990

      • Both fatal and nonfatal

      • 5 states (MN, NE, ND, SD, WI)

      • Sampling frame USDA/NASS

      • Recall period reduced to 6 months


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Traumatic Injuries in Agriculture

  • History of Non-fatal Occupational Injury

    • NSC--1970’s-1980’s

    • Olmsted Agricultural Trauma Survey (OATS)

    • Regional Rural Injury Study-I (RRIS-I)

    • Regional Rural Injury Study-II (RRIS-II)--1998

      • Similar methodology

      • 4,000 farm households; 17,000 persons; 8,600 <20


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Traumatic Injuries in Agriculture

  • History of Non-fatal Occupational Injury

    • NIOSH Traumatic Injury Surveillance of Farmers (TISF)--1993-1995

      • National survey of non-fatal production ag injuries

      • Random sample of farms

      • Sampling frame USDA/NASS

      • Recall period of 1 year


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Traumatic Injuries in Agriculture

  • History of Non-fatal Occupational Injury

    • NIOSH Traumatic Injury Surveillance of Farmers (TISF)--1993-1995

      • National survey of non-fatal production ag injuries

      • Random sample of farms

      • Sampling frame USDA/NASS

      • Recall period of 1 year

      • TISF conducted over 3 years; allowed national estimates and regional/state estimates

      • Total of 36,270 farms participated


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Traumatic Injuries in Agriculture

  • History of Non-fatal Occupational Injury

    • NIOSH Childhood Agricultural Injury Prevention Initiative--1997

      • Develop ag. injury surveillance systems for youth living, working or visiting farms in U.S.


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Traumatic Injuries in Agriculture

  • History of Non-fatal Occupational Injury

    • NIOSH Childhood Agricultural Injury Prevention Initiative--1997

      • Develop ag. injury surveillance systems for youth living, working or visiting farms in U.S.

      • 3 separate surveys conducted:

        -1999 farm operator survey (USDA/NASS)

        -1999 NAWS (USDOL)

        -Case series follow-back (CPSC/NEISS)


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Traumatic Injuries in Agriculture

  • Current Status of Agricultural Injuries

    • Both national and regional data used

    • Limited to production agriculture


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Traumatic Injuries in Agriculture

  • Current Status of Agricultural Injuries

    • CFOI (1992-1998)





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Traumatic Injuries in Agriculture

Production Agriculture Occupational Deaths and Average

Annual Fatality Rate, per 100,000 Workers, 1992-1998, CFOI




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Traumatic Injuries in Agriculture

Production Agriculture Deaths and Average Annual Fatality Rates per 100,000 Workers by Age Group, 1992-1998, CFOI







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Traumatic Injuries in Agriculture

  • TISF--Persons incurring injuries on farms

    • Farm operator or family member (61%)

    • Hired labor (29%)

    • Partners or their family members (6%)


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Traumatic Injuries in Agriculture

  • TISF--Persons incurring injuries on farms

    • Farm operator or family member (61%)

    • Hired labor (29%)

    • Partners or their family members (6%)

  • Majority of injuries temporary (95%)


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Traumatic Injuries in Agriculture

  • TISF--Persons incurring injuries on farms

    • Farm operator or family member (61%)

    • Hired labor (29%)

    • Partners or their family members (6%)

  • Majority of injuries temporary (95%)

  • Most sought medical attention (80%)


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Traumatic Injuries in Agriculture

  • TISF--Most injuries in months

    • August, July, June, and November


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Traumatic Injuries in Agriculture

  • TISF--Most injuries in months

    • August, July, June, and November

  • Type of work activity at time of injury

    • Livestock handling (29%)

    • Farm maintenance (17%)

    • Field work (16%)


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Traumatic Injuries in Agriculture

  • TISF--Leading sources of injury

    • Machinery & Livestock (19% each)

    • Working surfaces and non-powered hand tools (8% each)


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Traumatic Injuries in Agriculture

  • TISF--Leading sources of injury

    • Machinery & Livestock (19% each)

    • Working surfaces and non-powered hand tools (8% each)

  • Most common type of injury events

    • Struck by or against an object (15%)

    • Fall from elevation (13%)

    • Contact with sharp object (11%)


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Traumatic Injuries in Agriculture

  • Most common body part injured

    • Leg, knee or hip (17%)

    • Back (15%)

    • Finger (12%)


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Traumatic Injuries in Agriculture

  • Most common body part injured

    • Leg, knee or hip (17%)

    • Back (15%)

    • Finger (12%)

  • TISF--Leading nature of injuries were

    • Sprain or strain (26%)

    • Fractures (18%)

    • Cuts (17%)


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Traumatic Injuries in Agriculture

  • RRIS-I

    • 3,939 households; 13,144 persons


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Traumatic Injuries in Agriculture

  • RRIS-I

    • 3,939 households; 13,144 persons

    • 1 in 5 farms had farm-related injury;1 in 17 persons

    • 764 farm-related injuries

    • Non-farming injuries reported 1 in 6 farms; one in 17 persons


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Traumatic Injuries in Agriculture

  • RRIS-I Gender issues

    • Males had a rate of farming related injury 3.5 times greater than females (8.7 vs. 2.5/100 persons)


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Traumatic Injuries in Agriculture

  • RRIS-I Gender issues

    • Males had a rate of farming related injury 3.5 times greater than females (8.7 vs. 2.5/100 persons)

    • Males 30-39 had the highest rate (15.8/100 persons)


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Traumatic Injuries in Agriculture

  • RRIS-I Gender issues

    • Males had a rate of farming related injury 3.5 times greater than females (8.7 vs. 2.5/100 persons)

    • Males 30-39 had the highest rate (15.8/100 persons)

    • Females 25-29 had highest rate (5.4/100 persons)


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Traumatic Injuries in Agriculture

  • RRIS-I Gender issues

    • Denominator-- hours worked

    • Male high rates were 5-9 and 10-14 years (11.0 & 8.0/100,000 hours worked)


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Traumatic Injuries in Agriculture

  • RRIS-I Gender issues

    • Denominator-- hours worked

    • Male high rates were 5-9 and 10-14 years (11.0 & 8.0/100,000 hours worked)

    • Female high rates were 10-14 and 25-29 years (7.0 & 8.0/100,000 hours worked)


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Traumatic Injuries in Agriculture

  • RRIS-I Gender issues

    • Denominator-- hours worked

    • Male high rates were 5-9 and 10-14 years (11.0 & 8.0/100,000 hours worked)

    • Female high rates were 10-14 and 25-29 years (7.0 & 8.0/100,000 hours worked)

    • Overall rates equivalent between males and females (5.0/100,000 hours worked)


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Traumatic Injuries in Agriculture

  • RRIS-I Source of injury

    • Livestock (30%)

    • Machinery--other than tractors (20%)

    • Tractors (9%)


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Traumatic Injuries in Agriculture

  • RRIS-I Injury treatment/disposition farm-related injuries

    • 6% hospitalized

    • 80% treated by health care professional

    • 37% restricted for 1 week; 19% month or more

    • 25% resulted in permanent disability


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Traumatic Injuries in Agriculture

  • RRIS-II

  • 4,037 households

  • 16,759 persons (8600 children-51%)


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Traumatic Injuries in Agriculture

  • RRIS-II

  • 4,037 households

  • 16,759 persons (8600 children-51%)

  • Youth: 207 farm operation injuries

    • Animals (36%)


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Traumatic Injuries in Agriculture

  • RRIS-II

  • Youth case/control found increased odds for

    • Horses (2.7 OR, 95% CI=1.88-3.96)

    • Beef cattle (2.2 OR; 95% CI=1.62-3.08)

    • Operating tractors (2.2 OR; 95% CI=1.60-3.02)

    • Riding on tractors (2.2 OR; 95% CI=1.61-3.04)

    • Machinery (2.1 OR; 95% CI=1.50-3.00)

    • Swine (2.0 OR; 95% CI=1.27-1.42)

    • Dairy cattle (1.8 OR; 95% CI=1.20-2.64)


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Conclusions

  • Traumatic injuries still leading cause of death and injury for production agriculture


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Conclusions

  • Traumatic injuries still leading cause of death and injury for production agriculture

  • Main concerns identified in 1989 NCASH continue:

    • Tractors leading cause of farm death; mostly overturns


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Conclusions

  • Traumatic injuries still leading cause of death and injury for production agriculture

  • Main concerns identified in 1989 NCASH continue:

    • Tractors leading cause of farm death; mostly overturns

    • Older farmers at highest risk for death


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Conclusions

  • Traumatic injuries still leading cause of death and injury for production agriculture

  • Main concerns identified in 1989 NCASH continue:

    • Tractors leading cause of farm death; mostly overturns

    • Older farmers at highest risk for death

    • Traumatic injuries still concern for youth


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Conclusions

  • Fatality rates fairly constant in 1990’s


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Conclusions

  • Fatality rates fairly constant in 1990’s

  • Do not have a national non-fatal injury surveillance system in place


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Conclusions

  • Fatality rates fairly constant in 1990’s

  • Do not have a national non-fatal injury surveillance system in place

  • Surveillance is key element for assessing magnitude of the problem, details, and effectiveness of interventions


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Conclusions

  • Fatality rates fairly constant in 1990’s

  • Do not have a national non-fatal injury surveillance system in place

  • Surveillance is key element for assessing magnitude of the problem, details, and effectiveness of interventions

  • Effective interventions imperative to alleviate this public health problem


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