Self-Reported Head Injuries Before and After Age 13 in Pedophilic and Nonpedophilic Men Referred for Clinical Assessment

Previous research has found that pedophilic men referred for clinical assessment of their sexual behavior are more likely to report that they suffered head injuries before their 13th birthday than are nonpedophilic men referred for the same purpose. This study investigated whether pedophilic patients are also more likely to report head injuries after their 13th birthday. The 685 participants represented all patients with usable data from a consecutive series of men referred to a clinical laboratory specializing in phallometric assessment of erotic preferences. In addition to phallometric testing, participants were administered a brief neuropsychological test battery and a companion interview, which included questions on head injury, drug abuse, and childhood diagnosis of attention-deficit/hyperactivity disorder. The results showed that the pedophilic patients reported more head injuries before age 13 than did the nonpedophilic patients, but they did not report more head injuries after age 13. The association between pedophilia and childhood head injuries could mean either that subtle brain damage after birth increases a boy's risk of pedophilia, or that neurodevelopmental problems before birth increase a boy's accident-proneness along with his risk of pedophilia. Additional analyses showed that self-reported head injuries before age 13 were associated with attentional problems and with left-handedness; in contrast, head injuries after age 13 were associated with drug abuse and promiscuity. These analyses suggest that, among patients with primary presenting complaints of sexual rather than cognitive problems, childhood head injuries cluster with neuropsychological phenomena, whereas later head injuries cluster with lifestyle variables.     

Single-vehicle and Multi-vehicle Accidents Involving Motorcycles in a Small City in China: Characteristics and Injury Patterns

IntroductionThere is a gap that involves examining differences between patients in single-vehicle (SV) versus multi-vehicle (MV) accidents involving motorcycles in Shantou, China, regarding the injury patterns and mortality the patients sustained. This study aims to address this gap and provide a basis and reference for motorcycle injury prevention.MethodMedical record data was collected between October 2002 and June 2012 on all motorcycle injury patients admitted to a hospital in the city of Shantou of the east Guangdong province in China. Comparative analysis was conducted between patients in SV accidents and patients in MV accidents regarding demographic and clinic characteristics, mortality, and injury patterns.ResultsApproximately 48% (n = 1977) of patients were involved in SV accidents and 52% (n = 2119) were involved in MV accidents. The average age was 34 years. Collision of a motorcycle with a heavy vehicle/bus (4%) was associated with a 34 times greater risk of death (RR: 34.32; 95% CI: 17.43–67.57). Compared to patients involved in MV accidents, those involved in SV accidents were more likely to sustain a skull fracture (RR: 1.47; 95% CI: 1.22–1.77), an open head wound (RR: 1.46; 95% CI: 1.23–1.74), an intracranial injury (RR: 1.39; 95% CI: 1.26–1.53), a superficial head injury (RR: 1.37; 95% CI: 1.01–1.86), an injury to an organ (RR: 2.01; 95% CI: 1.24–3.26), and a crushing injury (RR: 1.98; 95% CI: 1.06–3.70) to the thorax or abdomen. However, they were less likely to sustain a spinal fracture (RR: 0.58; 95% CI: 0.39–0.85), a pelvic fracture (RR: 0.22; 95% CI: 0.11–0.46), an upper extremity fracture (RR: 0.75; 95% CI: 0.59–0.96), or injuries to their lower extremities, except for a dislocation, sprain, or injury to a joint or ligament (RR: 0.82; 95% CI: 0.49–1.36).ConclusionThe relative risk of death is higher for patients involved in multi-vehicle accidents than patients in single-vehicle accidents, especially when a collision involves mass vehicle(s). Injury to the head dominated motorcycle injuries. Single-vehicle accidents have a higher correlation with head injury or internal injuries to the thorax or abdomen. Multi-vehicle accidents are more correlated with extremity injuries, especially to the lower extremities or external trauma to the thorax or abdomen.     

Paediatric head injury admissions over a 10-year period in a regional neurosurgical unit

Traumatic brain injury is a leading cause of death and disability in childhood. A retrospective study of all paediatric head injuries admitted to the neurosurgical unit for the West of Scotland over a 10-year period was performed to assess the impact of the National Institute for Health and Clinical Excellence head injury guidelines on the admission rate and to determine the associated risk factors, causes, severity and outcomes of these injuries. There were 564 admissions between 1998 and 2007. The median age at presentation was nine years and two months. There was no change in the admission rate, injury mechanism or severity of head injury admitted over the period studied. A relationship was observed between the Scottish Index of Multiple Deprivation Score and the incidence of head injury (P = 0.05). Alcohol was reported as a causative factor in only a small number of cases, and moderate to severe head injuries were more commonly identified as a result of road traffic accidents.     

Accidental injuries are more common in children with attention deficit hyperactivity disorder compared with their non-affected siblings

Background Accidental injuries are a leading cause of paediatric morbidity and mortality. We hypothesized that attention deficit hyperactivity disorder (ADHD), a common childhood disorder characterized by behaviours such as hyperactivity and impulsivity, is a risk factor for accidental injuries. Previous retrospective studies suggested that children with ADHD have an increased injury rate, but controlled prospective studies are lacking. Methods We conducted a prospective case–control study of 29 school‐aged children with ADHD and their same‐sex, similarly aged, non‐ADHD‐affected siblings. All diagnoses were made by a paediatric neurologist according to DSM‐IV criteria and the children and their parents underwent a structured psychiatric interview and a battery of complementary assessments including: Child Behavior Checklist (CBCL), ADHD Rating scale and Developmental Coordination Disorder Questionnaire (DCDQ). The parents were contacted by telephone every 3 months during a 9‐month follow‐up period and all injuries requiring medical attention were recorded. Incidence of injuries was compared between the pairs of siblings. Results During the follow‐up period, a total of 13 injuries in 13 children with ADHD were reported, compared with six injuries in six children from the control group (Z=?2.11, P < 0.05). ADHD severity and subtype, CBCL, DCDQ and IQ scores were not predictive of injury risk. Conclusions School‐aged children with ADHD are at higher risk of accidental injuries than their non‐ADHD siblings, regardless of ADHD subtype, co‐morbid psychiatric conditions, developmental co‐ordination problems and environmental/familial conditions. Awareness and adequate education of parents and caregivers of children with ADHD concerning the increased injury risks are thus warranted.     

Neurodevelopmental Differences,Pedohebephilia, and Sexual Offending: Findings from Two Online Surveys

The neurodevelopmental theory of pedohebephilia states that sexual interests in children arise from early neurodevelopmental perturbations, as, for example, evidenced by increased non-right-handedness, more childhood head injuries, and reduced intelligence and height. As corroborating evidence largely rests on samples of convicted men, we conducted online surveys among German-speaking (Study 1, N?=?199) and English-speaking men (Study 2, N?=?632), specifically targeting community members with pedohebephilic or teleiophilic interests. Although we detected theoretically meaningful sexual interest patterns in an embedded viewing time task, we could not detect expected neurodevelopmental differences between teleiophilic and pedohebephilic men in either of the two studies. Strikingly, pedohebephilic men who reported convictions for sexual offenses emerged as shorter and less intelligent than pedohebephilic men without convictions in Study 2. While elucidating possible third variable confounds, results have to be interpreted cautiously because of the methodological problems inherent to non-matched case control designs.

     

Les accidents en France : évolution et facteurs associés

BackgroundWhatever the type of injury considered, prevention requires an improvement in health services’ awareness of risk factors. The Health Barometer is a general population survey conducted in France since 1992 to contribute to surveillance in this field. The survey's statistical power and the numerous health topics included in the questionnaire provide accurate information for healthcare professionals and decision-makers.MethodsThe Health Barometer 2010 was a nationwide telephone survey of 9110 persons representative of the 15–85-year-old population. One part of the questionnaire detailed injuries which had occurred during the past year. The numerous variables recorded enabled application of logistic regression models to explore risk factors related to different types of injury by age group. The findings were compared with the Health Barometer 2005 data to search for temporal trends of injury prevalence.ResultsThe data analysis showed that 10.3 % of the 15–85-year-olds reported an injury during the past year. This rate was higher than recorded in 2005; the increase was mainly due to domestic accidents and injuries occurring during recreational activities. Both type of injury and risk factors exhibited age-related variability. Domestic accidents and injuries occurring during recreational activities predominated in the older population and were associated with physical or mental health problems (chronic disease, diability, sleep disorders). For younger people, injuries were related to cannabis use, drunkedness, and insufficient sleep. Risk factors were also depended on type of injury: occupational accident-related injuries were linked with social disadvantage (manual worker population) whereas sports injuries were more common in the socially advantaged population.ConclusionThis survey confirms established knowledge and highlights, at different stages of life, new risk factors that contribute to injuries in France. These findings should be helpful for the development of adapted injury prevention programs, by providing a better understanding of the characteristic features of this major public health issue.     

昆明市60岁及以上老年人伤害住院特征及未治愈影响因素分析

目的分析昆明市老年人伤害住院的流行特征及影响未治愈的因素,为伤害的预防控制提供科学依据。方法整群抽取昆明市6所医院2003—2007年间因伤害首诊住院的≥60岁老年人,收集住院病案资料,采用描述性流行病学方法分析病例人口学特征、伤害住院类型、伤害外因、意外事故原因等,并采用logistic逐步回归法对未治愈的影响因素进行多因素分析。结果 5年间因伤害住院老年人共6 966例;男女分别为5 743和1 223例。住院天数中位数为16 d。伤害住院类型首位为损伤,60~69、70~79、≥80岁3个年龄组损伤者分别占各年龄组伤害总病例的85.4%（2 616/3 064）,86.1%（2 333/2 711）和91.2%（1 086/1 191）;各年龄组损伤部位的构成有差异,60~69岁损伤部位以＂头部＂为主（34.5%）,而70~79岁和≥80岁以＂腿部＂为主,分别为38.6%和46.4%。伤害外因以意外事故为主（95.8%）,各年龄组的意外事故原因的构成首位均是跌落,3个年龄组分别为44.1%、60.6%和70.4%。伤害转归中治愈占56.8%,未完全治愈占43.2%,其中3.9%死亡。Logistic逐步回归分析结果显示伤害住院时间越长者的未治愈风险越小（OR=0.992 2）;年龄越大者、有手术患者的未治愈的风险越大（OR=1.027 2、2.072 7）;入院情况一般者比入院情况危重患者、跌落患者较交通伤害的未治愈的风险小（OR=0.837 3、0.843 5）;颈部损伤患者较头部的未治愈风险大（OR=3.412 0）（P〈0.05或P〈0.01）。结论昆明市受调查的老年伤害住院患者以损伤为主,损伤部位多为头部和腿部,原因以意外事故为主。年龄、住院天数、手术、入院情况、损伤部位和事故原因等可能是伤害住院患者未治愈的影响因素。     

意外损伤住院的6岁以下儿童相关因素分析

目的：研究6岁以下儿童意外损伤的危险因素，为制定有效的预防措施提供依据。方法：分析我院1994年1月1日-2004年12月31日收治的儿童意外损伤中6岁以下儿童病例的损伤类别、年龄、性别、住院时间及费用等特点。结果：741例6岁以下儿童意外损伤占同期儿童意外损伤总住院人数的55％。意外损伤的前4位原因是烧、烫伤、意外跌落、交通事故和意外中毒。男女比为1．65：1。烧、烫伤随年龄增长明显减少，而交通事故伤随年龄增长逐渐增多。住院费用最高及住院时间最长的是交通事故伤。结论：6岁以下儿童是意外损伤的高危人群，在年龄、性别及意外损伤类别上有其特点。社会、学校及家庭应密切配合，研究儿童意外损伤的各种危险因素，制定有效的预防措施。     

Head injury and amyotrophic lateral sclerosis

Recent data showed that soccer players in Italy had an unusually high risk of amyotrophic lateral sclerosis (ALS) and that repeated head trauma might have contributed to this increase. The authors examined whether head injury was related to ALS risk in a case-control study of 109 New England ALS cases diagnosed in 1993-1996 and 255 matched controls. They also conducted a meta-analysis of the published literature. Overall, ever having experienced a head injury was nonsignificantly associated with a higher ALS risk. When compared with persons without a head injury, a statistically significant ALS risk elevation was found for participants with more than one head injury (odds ratio (OR) = 3.1, 95 percent confidence interval (CI): 1.2, 8.1) and patients who had had a head injury during the past 10 years (OR = 3.2, 95 percent CI: 1.0, 10.2). For participants who had had multiple head injuries with the latest occurring in the past 10 years, risk was elevated more than 11-fold. The meta-analysis also indicated a moderately elevated risk of ALS among persons with previous head injuries (OR = 1.7, 95 percent CI: 1.3, 2.2). In this study population, physical injuries to other body parts, including the trunk, arms, or legs, were not related to ALS risk. These data support the notion that head injury may increase the risk of ALS.     

Epidemiology of accidents among users of two-wheeled motor vehicles. A surveillance study in two Italian cities

BACKGROUND: This paper describes a study on the epidemiology of accidents among users of two-wheeled motor vehicles in two Italian cities, Rome and Naples. METHODS: A surveillance study was conducted, recruiting the victims of accidents among users of two-wheeled motor vehicles, visiting the emergency departments of two Italian hospitals. The registration form includes personal data of the involved person, circumstances of the accident, means of arrival at the hospital, type of vehicles involved, helmet use, and eventually third parties involved, and data on the specific injury diagnosis. RESULTS: 736 injured drivers of two-wheeled motor vehicles were investigated for the study (65.1% males, 34.9% females). The mean age of the victims was 22.92 years; 42.9% of the injuries were the result of a single accident. In 35.5% of the injuries cars were involved and in 8.6% of the cases there was a passenger included. Only 12% of the injured people were wearing a helmet. Most of the lesions concerns the knee or lower leg (27.5%), followed by the head (17.5%), elbow and forearm (8.8%), wrist and hand (8.6%), shoulder and upper arm (8.4%) and ankle and foot (6.9%). Helmet use has a protective effect (OR = 0.23), whereas accidents in Naples and during dark hours are associated with an increased risk of head injury (respectively OR = 1.93, and OR = 1.46). CONCLUSION: In this study the lower injury risk due to the use of the helmet on the frequency and severity of head trauma was confirmed. Moreover, the results confirm that Emergency Departments can provide essential epidemiological information, and they have already provided clear arguments in favour of extending the compulsory use of helmets to people above 18 years in Italy.     

Trends in head injury mortality among 0-14 year olds in Scotland (1986-95)

STUDY OBJECTIVE: To examine the trends in childhood head injury mortality in Scotland between 1986 and 1995. DESIGN: Analysis of routine mortality data from the registrar general for Scotland. SETTING: Scotland, UK. SUBJECTS: Children aged 0-14 years. MAIN RESULTS: A total of 290 children in Scotland died as a result of a head injury between 1986 and 1995. While there was a significant decline in the head injury mortality rate, head injury as a proportion of all injury fatalities remained relatively stable. Boys, and children residing in relatively less affluent areas had the highest head injury mortality rates. Although both these groups experienced a significant decline over the study period, the mortality differences between children in deprivation categories 1-2 and 6-7 persisted among 0-9 year olds, and increased in the 10-14 years age group. Pedestrian accidents were the leading cause of mortality. CONCLUSIONS: Children residing in less affluent areas seem to be at relatively greater risk of sustaining a fatal head injury than their more affluent counterparts. While the differences between the most and least affluent have decreased overall, they have widened among 10-14 year olds. The decline in head injury mortality as a result of pedestrian accidents may be partly attributable to injury prevention measures.     

A prospective population based study of childhood injuries: the Velestino town study

BACKGROUND: Unintentional injuries in childhood constitute a significant public health problem. Our purpose is to estimate the incidence of identifiable unintentional childhood injuries of any type and severity, and to document risk factors of non-transient nature. METHODS: We have undertaken a prospective population-based investigation in a Greek town with a population of 748 children (0-14 years old). All identifiable injuries have been monitored during a twelve-month period through information provided by the health care outlets or educational institutions as well as the police station and the regional hospital. RESULTS: The overall incidence was 28.2 per 100 person-years (95% confidence interval from 24.4 to 32.0), whereas the incidence of injuries with Hopkins Injury Severity Score equal to or higher than four was 6.3 with 95% confidence interval 4.5 to 8.1. The incidence of total injuries was higher among boys than among girls (p<0.01) and the gender difference was particularly evident among older children. Almost half of the injuries were due to falls and more than 20% were due to cutting. Children of younger and less educated parents have higher risk for injury and children from families with more injuries were more likely to be injured themselves. There was no evidence that somatometric characteristics were associated with injury risk. CONCLUSION: The incidence of unintentional childhood injuries is high and represents a considerable health burden. Family related variables are important risk factors for childhood injuries, whereas somatometric characteristics play a minimal role. Key points: Incidence and risk factors of all injuries in a population-based study among children. About 28 per 100 children got injured over a period of one year. There is evidence that younger paternal age and lower education may be associated with increased injury risk. Family related variables seem to be important risk factors for childhood injuries, whereas somatometric characteristics play minimal role.     

Does sexual abuse in childhood cause pedophilia: An exploratory study

The reliability of the notion that pedophilia is caused by sexual abuse in childhood was explored by examining retrospective self-reports of 344 males. Included in the study were 77 heterosexual pedophiles, 54 homosexual pedophiles, 51 nonpedophilic sex offenders against children, 36 sex offenders against physically mature females, 75 heterosexual paid volunteers who erotically preferred mature females, and 51 homosexual clients who preferred mature males. For each sex offender the differential diagnosis of an erotic preference for minors vs. a preference for physically mature partners was made by means of the phallometric test of erotic gender and age preferences. The analysis of self-reports confirmed that the proportion of pedophiles who report having been sexually abused in childhood by mature persons is larger than that of men who were not charged for or accused of a sex offense against a child though the difference is relatively small (28.6 vs. 13.9 and 10.7% for the heterosexual pedophiles and the two groups of gynephiles, respectively, and 25.9 vs. 11.8% for the homosexual pedophiles and androphiles, respectively). Further analysis demonstrated, however, that pedophiles who admitted having an erotic interest in children significantly more often claimed that they had been sexually abused as children than pedophiles who did not admit having such feelings. This interdependence renders the reliability of these self-reports questionable.This research was supported in part by grant MA-9134 from the Medical Research Council of Canada.Forensic Division Clarke Institute of Psychiatry     

The association between head trauma and Alzheimer's disease

The relation between head trauma and Alzheimer's disease was one of four major risk factors explored in a case-control study of 130 matched pairs; cases were clinically diagnosed between January 1980 and June 1985 at two geriatric psychiatric clinics in Seattle, Washington, and controls were friends or nonblood relatives of the cases. Subjects were matched by age, sex, and relationship between the case and his or her surrogate respondent. Head injuries which resulted in a loss of consciousness or which caused the subject to seek medical care were documented by means of interviews with surrogate respondents. A history of head injury was recorded for 24% of the cases and 8.5% of the controls, yielding an odds ratio of 3.5 (95% confidence interval 1.5-8.3) in conditional logistic regression analysis adjusted for age at onset of disease symptoms and family history of Alzheimer's disease. The estimated risk of Alzheimer's disease increased as the time between the last head trauma event and the onset of disease symptoms diminished (p = 0.002). This trend remained statistically significant (p = 0.006) when head injuries which occurred within 5 years of onset of the disease were excluded from the analysis. There was some difference between cases and controls for the average duration of unconsciousness in events accompanied by such a loss, but this was not statistically significant. The two groups were also similar in the circumstances surrounding the injuries and in the frequency of alcohol problems. This is the third case-control study to find a statistically significant association between head trauma and Alzheimer's disease.     

A population-based study of nonfatal childhood injuries

A random-digit-dialing telephone survey was used to assess the frequency and associated characteristics of childhood poisoning, burns, and head injuries in 1,213 San Diego County households having at least one child 14 years of age or younger at the time of the telephone interview in 1980. The survey population was representative of the general San Diego County population with regard to socioeconomic status and geographic distribution. The frequency of injuries judged to be serious enough to require medical care and the median ages for each injury were head injury, 4.2% and 5.5 years; burns 4.0% and 2 years; and poisonings, 3.4% and 2 years. Forty-four percent of all poisonings were related to drugs, of which aspirin was the single most common medication. Hot liquids or hot surfaces were responsible for 52% of burns. The majority of head injuries (65%) were caused by falls, usually outside the home. Education was positively associated with poisonings, and income was negatively associated with burns. Children of caretakers working outside the home did not have higher injury rates than those whose caretakers were not so employed. Differences in caretaker attitudes were few, and may reflect the experience of having an injury, rather than factors preceding it. The advantages and limitations of this method of assessing childhood injury in populations are discussed.     

深圳市0～6岁儿童伤害影响因素及干预研究

【目的】探讨儿童伤害的影响因素，制定一套适合深圳地区儿童伤害的预防与控制措施。【方法】采用整群随机抽样的方法．以深圳6大区的12个社区为研究社区，对2001年全年内发生非致命性伤害的122名儿童进行1：1配对的病例对照研究。选择伤害发生率比较高的龙岗区横岗镇作为伤害监测点，开始伤害控制的全面监测工作。【结果】儿童伤害的危险因素有；散居儿童、危险的物理环境得分多、家庭子女数多、父亲职业为个体及商业工作者、儿童外向型性格、家中药品位置与热源放置不当；其保护因素有：家庭经济收入高、家中地板防滑情况好、父亲职业为公务员、儿童接受过老师的安全教育等。根据以上提供的儿童伤害及危险因素的基本数据，选择监测点，开始了伤害干预研究。【结论】应针对儿童伤害的影响因素，及早开展伤害的干预控制，以期减少儿童伤害发生率，达到促进儿童的健康和提高生命质量。     

Prevalence and prevention of needlestick injuries among health care workers in a German university hospital

Objective Health care workers (HCWs) are exposed to bloodborne pathogens, especially hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV) through job-related risk factors like needlestick, stab, scratch, cut, or other bloody injuries. Needlestick injuries can be prevented by safer devices. Methods The purpose of this study was to investigate the frequency and causes of needlestick injuries in a German university hospital. Data were obtained by an anonymous, self-reporting questionnaire. We calculated the share of reported needlestick injuries, which could have been prevented by using safety devices. Results 31.4% (n = 226) of participant HCWs had sustained at least one needlestick injury in the last 12 months. A wide variation in the number of reported needlestick injuries was evident across disciplines, ranging from 46.9% (n = 91/194) among medical staff in surgery and 18.7% (n = 53/283) among HCWs in pediatrics. Of all occupational groups, physicians have the highest risk to experience needlestick injuries (55.1%—n = 129/234). Evaluating the kind of activity under which the needlestick injury occurred, on average 34% (n = 191/561) of all needlestick injuries could have been avoided by the use of safety devices. Taking all medical disciplines and procedures into consideration, safety devices are available for 35.1% (n = 197/561) of needlestick injuries sustained. However, there was a significant difference across various medical disciplines in the share of needlestick injuries which might have been avoidable: Pediatrics (83.7%), gynecology (83.7%), anesthesia (59.3%), dermatology (33.3%), and surgery (11.9%). In our study, only 13.2% (n = 74/561) of needlestick injuries could have been prevented by organizational measures. Conclusion There is a high rate of needlestick injuries in the daily routine of a hospital. The rate of such injuries depends on the medical discipline. Implementation of safety devices will lead to an improvement in medical staff’s health and safety.     

老年人口伤害特点及防范措施研究

目的分析大连市老龄人口伤害发生的分布特点及流行规律,为制定干预性措施提供依据。方法运用描述流行病学方法,将2006年1—12月在大连市3所3级甲等医院急诊室、其他门急诊及临床科室就诊后诊断为伤害的全部首诊病例作为监测对象并进行分析。结果全年3所医院共报告60岁以上老年伤害病例911例,男性390人,女性521人,男：女为0．75：1。前5位发生原因依次为跌倒／坠落（42．59％）、机动车车祸（24．04％）、钝器伤（13．28％）、刀／锐器伤（10．21％）、非机动车车祸（1．32％）;发生地点主要是家中（38．86％）、公路／街道（23．93％）、贸易和服务场所（24．82％）,公共居住场所（13．06％）、工业和建筑场所（2．41％）;伤害部位主要是头部（27．22％）、下肢（22．50％）、上肢（22．％％）、躯干（14．82％）;大多数伤害属于非故意伤害（86．39％）;57．19％的患者是轻度患者,治疗后可回家（69．59％）,死亡仅占0．22％。结论由于身体功能的衰退,老年人是各种伤害的高发人群,但所处环境相对较固定,活动范围较局限,因此伤害原因较集中,主要以跌倒／坠落和交通伤害为主,应强化针对性的防范措施。     

Prevention of farm injuries in Denmark

OBJECTIVES: This study examined the effects of a 4-year randomized intervention program that combined a safety audit with safety behavior training in the prevention of farm injuries. METHODS: From a random sample of farms in the county of Ringkoebing, Denmark, 393 farms with 1597 residents and employees participated in a weekly self-registration of work-related accidents and injuries during 1 year. Worktasks and time at risk were recorded. A questionnaire including items on safety behavior was also mailed to each farm. Thereafter, the farms were randomly assigned to an intervention or control group. Two hundred and one farms with 990 persons at risk participated in the intervention study. The main outcome measures were the number and severity of accidents, safety behavior, and farmsite safety audits. RESULTS: Pre- and postmeasurements showed a substantial reduction in injury rates in the intervention group in comparison with a slight reduction in the control group. In a multivariate regression analysis the intervention effect was estimated to be a 30% injury-rate reduction of all injuries, while there was a 42% reduction for medically treated injuries only. Although none of these effects are statistically significant with the present sample size, their magnitude and direction support an intervention effect. The measures of safety behavior revealed significant improvements, and this finding supports the conclusion that the intervention effect was positive, since they concern some of the mediating factors on the pathway from intervention to improved injury rates. CONCLUSIONS: This intervention, which focused on safety behavior and was performed as a randomized controlled trial, was followed by a substantial reduction in the number of farm injuries. The reduction was particularly marked for the more severe injuries demanding medical treatment.