History of agricultural injury among farmers in Alabama and Mississippi: prevalence, characteristics, and associated factors

BACKGROUND: There have been no studies of the prevalence, characteristics, and factors associated with the history of prior farm injury among active farmers. No studies have had adequate numbers of black farmers to evaluate farm owner/farm worker and black/white similarities and differences. METHODS: Our sample is based upon surveys administered to 1,310 active male farmers in nine rural counties in Alabama (5) and Mississippi (4). The farmers are white owner/operators (53.6%), black owner/operators (26.6%), and black workers (19.8%). RESULTS: Overall, 23.4% of the farmers had a prior injury. Prior injury was more frequent among white owner/operators (29.1%), compared with black workers (18.9%), and black owner/operators (15.2%). In multiple logistic regression analyses, post-high school education and tiredness when farming were independently associated with prior injury in black owner/operators. In white owner/operators, age > or = 60 years, post-high school education, full-time farming, tractor use, more pieces of machinery, hurry when farming, and alcohol consumption were associated with prior injury. In black workers, only being very careful was associated with prior injury. CONCLUSIONS: The results suggest that prevention efforts focusing on alcohol consumption, fatigue, and hurry when farming might reduce injuries; however, only a follow-up study of this sample can determine whether these associations reflect causal factors, recall, or selection bias.     

Cancer incidence among Finnish farmers, 1995-2005

OBJECTIVES: The aim of this study was to describe the cancer risk pattern of male and female Finnish farmers and to define the role of the type of farm production as a risk determinant. METHODS: All farmers on 31 December 1978 living on 1 January 1995 were included in the cohort. The data concerning continuation as a farmer and the type of farming was collected from the 31 December 1990 and 1994 farm registries. The observed number of cases in each stratum was divided by the respective expected number based on national incidence rates to calculate the standardized incidence ratio. RESULTS: The overall cancer incidence was smaller than that of the general population. For most of the cancer sites, the standardized incidence ratios were below 1.0. The lowest rates for farmers continuing to farm were determined for mesothelioma and cancers of the liver, larynx, lung, nose, esophagus, and urinary bladder. The only significantly elevated standardized incidence ratio was that for lip cancer. Permanent beef and dairy farmers had the lowest standardized incidence ratios for overall cancer. Dairy farmers of 1978 who had changed their production type to crop farmers had increased their risk for overall cancer from a standardized incidence ratio of 0.82 to 0.92. CONCLUSIONS: The cancer incidence of Finnish farmers was significantly below the national average. The finding that lung cancer risk was low among dairy farmers but increased with a change to another type of farm production gives some support to the hypothesis that endotoxin exposure may decrease cancer risk.     

Childhood deaths and injuries in Finland in 1971-1995

BACKGROUND: This study examined the recent nationwide trends for the absolute number and the age- and sex-specific incidence rates of the fatal and serious non-fatal injuries among 0-14 year old children in Finland in 1971-1995. METHODS: We selected from Official Cause-of-Death Statistics and National Hospital Discharge Register children aged 0-14 years who died or required treatment at a hospital department because of an injury in 1971-1995. The number of Finnish children was 1.1 million in 1971, and 1.0 million in 1995. RESULTS: During the entire study period injuries were the leading cause of death in children aged 1-14 years, but not in infants. However, in these years the incidence (per 100 000 people) of fatal injuries in Finnish children decreased considerably in all age groups and both sexes, in girls from 20.1 in 1971 to 4.6 in 1995, and in boys from 36.7 in 1971 to 9.3 in 1995. In 1995, 41% of all the injurious deaths among 0-14 year old Finnish children were motor vehicle accidents, 12% were drownings, and 24% intentional injuries. The overall number and incidence of serious non-fatal injuries among Finnish children showed no clear trend change in 1971-1995. The mean hospitalization time of injured children shortened between 1971 and 1995, from 7.4 days to 2.7 days. CONCLUSIONS: We conclude that the number and incidence of fatal childhood injuries have decreased dramatically in Finland between 1971 and 1995. The reasons for this positive development are multifactorial, but improved traffic safety and trauma care are probably very important. In children's serious non-fatal injuries the development has not been so encouraging and therefore children's injury prevention should receive continuous intense attention.     

Farm Product Prices and Agricultural Safety: Connections and Consequences

Economic conditions in farming have been a common thread in explanations of agriculture's high rate of occupational injuries and death. If prices were higher or the farm economy were stronger, it is said, farmers could afford to be safer. However, could afford to be safer does not mean that farmers would be safer. This study examines the question of whether higher farm product prices could be expected to reduce agricultural injury rates. The critique includes a statistical model relating prices and acres per worker to non-rollover fatal farm injuries, using national data from 1969 to 1987. Contrary to current arguments, the model shows that higher prices historically are associated with higher fatality rates, suggesting that increased prices serve as an incentive for working harder and that the state of the agricultural economy is not a good explanation for high injury rates.     

Work-Related Injuries and Fatalities on Dairy Farm Operations—A Global Perspective

ABSTRACT

Agriculture is among the most hazardous sectors for workers globally, and dairy farming has been associated with a high risk of injury among workers in several countries. The purpose of this paper is to provide an update on what is known about modern dairy farms and related injuries and fatalities in different regions of the world. As in other sectors of agriculture, fatalities appear to be associated with heavy equipment usage, whereas injuries occur at higher rates with animal production, specifically cattle and milk production. Dairy farming is associated with higher rates of injury as compared with other industrial sectors, but a lack of work-related injury reporting continues to be an issue in several countries. Worker fatality associated with heavy equipment use is not a new observation (e.g., tractors); however, manure-handling systems, livestock handling, and quad bike operation continue to be associated with worker injuries and fatalities on modern farms. Opportunities exist for improvement of safety-related equipment to reduce injury and fatality risk during worker interactions with large animals and farm equipment.     

Increased risk of agricultural injury among African-American farm workers from Alabama and Mississippi

Research on the epidemiology of agriculture-related injuries has largely ignored African-Americans and farm workers. This cohort study is the first to estimate injury rates and to evaluate prospectively risk factors for agriculture-related injuries and compare them among African-American and Caucasian farmers and African-American farm workers. A total of 1,246 subjects (685 Caucasian owners, 321 African-American owners, and 240 African-American workers) from Alabama and Mississippi were selected from Agricultural Statistics Services databases and other sources and were enrolled between January 1994 and June 1996. Baseline data included detailed demographic, farm and farming, and behavioral information. From January 1994 to April 1998, subjects were contacted biannually to ascertain the occurrence of an agriculture-related injury. Injury rates were 2.9 times (95% confidence interval (CI): 2.0, 4.3) higher for African-American farm workers compared with Caucasian and African-American owners. Part-time farming (relative risk (RR) = 2.0, 95% CI: 1.3, 2.5), prior agricultural injury (RR = 1.5, 95% CI: 1.0, 2.1), and farm machinery in fair/poor condition (RR = 1.8, 95% CI: 1.2, 2.7) were also independently associated with injury rates. The results demonstrate the increased frequency of agricultural injury among farm workers and identify a number of possible ways of reducing them.     

Epidemiology of adulthood injuries: a quickly changing injury profile in Finland

Although developed societies have undergone many profound changes during recent decades, including urbanization, increased traffic and aging of the populations, epidemiologic information on secular trends in profiles of injuries is limited. We investigated such trends in Finland by selecting from the National Hospital Discharge Register all Finns aged 15 years or more who required hospital treatment because of an unintentional injury during 1971-1995. The injury incidences were expressed as the number of patients per 100,000 individuals per year. In Finnish men, road traffic accidents and falls, the two leading causes of injury, produced equal numbers of injuries in 1971 (4935 and 4957), but thereafter the role of the traffic accidents gradually decreased (3512 injuries with unadjusted and age-adjusted incidences of 177 and 183 in 1995) and that of falls clearly increased (13,218 injuries with unadjusted and age-adjusted incidences of 664 and 635 in 1995). Changes in the other injury categories of men were less drastic. In Finnish women, falling was the most common cause of injury in 1971 (5051 injuries), after which its role increased sharply, to 17,250 injuries in 1995 (unadjusted and age-adjusted incidences of 804 and 698, respectively). In 1971, road traffic produced 2369 injuries in women, after which this number somewhat decreased (2160 injuries with unadjusted and age-adjusted incidences of 101 and 101 in 1995). The role of all the other injury categories was small in Finnish women during 1971-1995. We conclude that a quick change in the overall profile of injuries occurred in Finland in 1971-1995, a change in which falls replaced road traffic accidents as the major cause of a serious injury. This epidemiologic change will give a new challenge for injury prevention in the new millennium.     

Risk Factors for Machinery-related Injury among Iowa Farmers: A Case-Control Study Nested in the Agricultural Health Study

Abstract

Farm machinery is a major cause of injury morbidity and mortality among farmers. This case-control study assessed risk factors for machinery-related injuries among Iowa farmers. A screener questionnaire sent to 6,999 farmers in 1998 identified 205 farmers who had machinery-related injuries requiring medical advice/treatment in the previous year. Possible risk factors for injury were assessed among these farmers compared with 473 farmers with no injury in the previous year. A multiple logistic regression analysis showed significant associations between machinery-related injury and hours per week spent on farmwork (OR = 2.02; 95% CI 1.38–2.94), fewer years of farming experience (OR = 1.79; 95% CI 1.14–2.79), wearing a hearing aid (OR = 4.37; 95% CI 1.55–12.25), and a high CAGE score suggesting problem drinking (OR = 2.49; 95% CI 1.00–6.19). This is the first study to show associations between machinery-related injury and hearing impairment, problem drinking, and fewer years of farming experience. These findings may be useful for future interventions to decrease injuries related to farm machinery.     

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

Farm machinery is a major cause of injury morbidity and mortality among farmers. This case-control study assessed risk factors for machinery-related injuries among Iowa farmers. A screener questionnaire sent to 6,999 farmers in 1998 identified 205 farmers who had machinery-related injuries requiring medical advice/treatment in the previous year. Possible risk factors for injury were assessed among these farmers compared with 473 farmers with no injury in the previous year. A multiple logistic regression analysis showed significant associations between machinery-related injury and hours per week spent on farmwork (OR = 2.02; 95% CI 1.38-2.94), fewer years of farming experience (OR = 1.79; 95% CI 1.14-2.79), wearing a hearing aid (OR = 4.37; 95% CI 1.55-12.25), and a high CAGE score suggesting problem drinking (OR = 2.49; 95% CI 1.00-6.19). This is the first study to show associations between machinery-related injury and hearing impairment, problem drinking, and fewer years of farming experience. These findings may be useful for future interventions to decrease injuries related to farm machinery.     

Occupational Injury and Disease Incidence and Risk Factors in Finnish Agriculture Based on 5-Year Insurance Records

ABSTRACT

The aim of this retrospective cohort study was to evaluate the incidence of and risk factors for compensated occupational injuries and diseases in agriculture. The study population consisted of 78,679 Finnish farmers, spouses, and salaried family members covered by mandatory workers' compensation insurance. This population had a total of 24,424 occupational injuries and 1684 diseases from 2000 to 2004. In the 5-year period, 20.2% of the population had (one or more) injuries and 2.0% had occupational diseases. Multiple claims were common particularly among livestock producers. Using Poisson regression analyses, we identified several personal and farm-related risk factors, with relative risk estimates ranging from 1.07 to 3.08 for injuries and from 1.45 to 3.01 for diseases. Cattle-intensive geographic regions, occupational health service membership, large farm size, and farming alone were identified as risk factors for both outcomes. Further, male gender, higher number of insurance years, and residing on the farm were among risk factors for injury. These risk factors identified from a large longitudinal data set can be considered for developing and targeting interventions for farmers at highest risk of occupational injury and disease.     

Social and occupational health protection for self-employed farmers in the European Union

Aim The focus of this article deals with the diversity of national social security provisions specific to self-employed farmers in the European Union (EU) and attempts an initial research and categorisation of social protection provisions applying to the European population of self-employed farmers. Methods An extensive internet search was performed to identify national social security provisions for self-employed farmers. A crude categorisation of social security provisions for self-employed farmers is attempted aiming to identify EU Member States (MS) that apply: (1) a general social protection scheme for all the population, (2) a social protection scheme specific for the totality of the self-employed population, and (3) a social protection system specific for self-employed farmers. National provisions for the coverage of self-employed farmers for occupational injuries and diseases are also categorised. Moreover a care study from Finland is presented describing the innovatory Finnish system of substitute farmers’ services that allows self-employed farmers to be substituted in their farms in case of sickness, injury or holidays. Conclusion Persons occupied in agriculture in the EU MS, while facing many of the same occupational risks, are covered to varying degrees by national social security schemes. An initial conclusion that was derived is that countries that apply special social security systems for self-employed farmers are more likely to include in the provisions of their systems the coverage for occupational injuries and diseases as well. The increased diversity of national provions regarding the protection of self-employed farmers should be further researched at the European level and efforts for the coordination of relevant national policies towards a more comprehensive coverage of farmers should be discussed.     

The dangers of dairy farming: the injury experience of 600 workers followed for two years.

In order to better understand the work-related injuries sustained on central New York dairy farms, we undertook a two-year population-based study of 600 farmers and farm workers on 201 dairy farms. During the observation period, 1984-1986, 151 persons had 200 injuries, giving an injury rate of 16.6%/year (166 injuries/1,000 workers/year). Men were injured more often than women (p less than or equal to 0.01). Injured workers were older (p less than or equal to 0.01), worked more hours (p less than or equal to 0.001), and had heavier workloads than noninjured workers (p less than or equal to 0.001). The growing and harvest seasons had the most injuries; winter the fewest. More than 2/3 of the injuries occurred in the afternoon. Owners/operators, often the most experienced, knowledgeable people on the farms, were most often hurt. Those working more than 60 hours/week, with greater than 30 acres under tillage/worker, had a relative risk of 2.76 compared with all other workers. The attributable risk for this group was 51%. There were two fatalities, both involved owner/operators. Our findings suggest that previous studies may have underestimated the risks faced by farmers. Dairy farming in central New York is very dangerous work. Those who own and operate these dairy farms are most often hurt and killed. Analysis of events on individual farms will be reported separately.     

Kentucky AgrAbility

ABSTRACT

For many years, farming has consistently had one of the highest death rates of any industry in America. The National Safety Council has classified agriculture as the most hazardous occupation in America. It is estimated that at least 25 percent of farmers and farm workers suffer disabilities that impede their ability to carry out essential farming tasks. These disabilities include amputations, impaired vision, stroke, head injury, etc. Unlike industrial workers, farmers and farm workers do not have networks of rehabilitation specialists, case managers, or even Workers' Compensation insurance to handle the circumstances of their disabled conditions. They need help, but such help is not usually available. This is where the AgrAbility Project comes into focus.

This paper presents the cases of three Kentucky farmers who sustained farm-related and non-farm-related injuries that resulted in some form of disability. These farmers were on the verge of giving up farming when they came into contact with the Kentucky AgrAbil-ity Project. That contact has made a significant difference in the lives of these farmers. All three are now farming with the aid of assistive technology and modified farm equipment.     

Stable and dynamic differences in injury mortality between the Nordic countries. What do they say about inherent national characteristics with regard to risk?

The aim of this study was to analyse long-term trends and patterns in injury mortality between the Nordic countries and to distinguish differences that are relatively temporary from those that are more durable. Both total injury mortality and special subcategories were examined. Some stable similarities and differences were found. Two kinds of injuries are distinguished: those that largely have a social genesis and those to which environmental causality applies. The general pattern is that there has been an increase in injuries with a social genesis and a decrease in those with an environment-related genesis. Finland has high rates of both types of injuries. Denmark has high rates of injuries with a social genesis, but low rates of those with an environmental genesis. By contrast, Norway has high rates of injuries with an environmental genesis and low rates of those with a social genesis. Sweden has low or medium rates of both types of injuries.     

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.     

Incidence of unintentional injuries in farming based on one year of weekly registration in Danish farms

BACKGROUND: In Denmark, farming ranks as the industry with the highest incidence rate of fatal injuries. For nonfatal injuries, insufficient registration practices prevent valid comparisons between occupations. This study examines the occurrence of farm accidents and injuries, as well as work-specific factors, via weekly registration in a representative sample of 393 farms in one county during 1 year. METHODS: From a random sample of 794 farms, (10% of farms in the county of Ringkoebing, Denmark) 393 farms with 1,597 residents and employees participated in a 1-year self-registration of work-related unintentional incidents. The procedure included a detailed registration of hours spent on all main working tasks. Weekly recording of incident occurrence or nonoccurrence resulted in the completion of 19,782 registration forms. Three months after incident occurrence, a telephone interview was conducted about the related work situation and resulting injuries. RESULTS: During the 12-month period, 479 occupational accidents were reported, of which 389 resulted in an injury. The absolute number of injuries increased with number of work hours, but there was no relative increase of incidence by work hours. Persons below the age of 50 had slightly less than a doubled risk compared with those over 50 years of age. No other marked, reliable age effect was found. There was, however, a seasonal variation, with summer and autumn having a double relative incidence compared with winter and spring. Among farm owners, 35% experienced at least one injury per year, while this was the case for 17% of farm laborers. When adjusting for work hours, the increased frequency of injuries among farm owners was reduced to a factor of 1.5. Animal-related work was the most common injury mechanism. Repair and maintenance work was found to be the most dangerous task relative to the number of task-specific work hours. Subgroups of tasks with a markedly increased injury rate were moving animals within the farm, veterinary procedures, and repair of field machinery and stable equipment. CONCLUSIONS: Farm injuries occur among 32% of full-time farmers and farm laborers each year. A quarter of these require professional treatment. This area calls for preventive action.     

Farm injuries and fatalities in British Columbia, 1990-2000

BACKGROUND: Farming is considered to be one of the most dangerous occupations in Canada and internationally, as it often involves work in a high-risk environment due to exposure to such hazards as machinery, large animals and noxious chemicals. The objective of this study was to describe the incidence and nature of farm-related deaths and injuries on British Columbian farms from 1990-2000, with reference to Canadian averages. METHODS: British Columbian farm fatalities and farm injury hospitalizations data from Canadian Agricultural Injury Surveillance Program for 1990-2000 were analyzed in conjunction with the 1996 and 2001 Canada Census of Agriculture. The incidence and nature of farm injuries were quantified and described for age, gender, cause of injury, primary diagnosis and agent of injury. RESULTS: There were 82 fatal injuries from 1990-2000 and 1,407 hospitalizations from 1991/92 to 1999/2000. No significant overall incidence trends were found during the study period. The rate of machinery-related injuries requiring hospitalization is lower in BC than in Canada as a whole. The net effect of higher than expected hospitalization rates in younger BC adults (age 20-49) and lower than expected hospitalization rates in older BC adults (age 70+) was a much slower increase in hospitalization rates as farmers get older. CONCLUSION: The current data suggest that higher than expected non-machinery-related injuries result in higher hospitalization rates of young adult BC farmers. The potential impact of farm fatalities and injury in youth on loss of productivity and quality of life years emphasizes the need for education and prevention.     

Severe farm injuries among New York farmers.

BACKGROUND: Data from the telephone interview portion of the New York State Farm Family Health and Hazard Surveillance were used to study the incidence and predictors of severe farm injury. METHODS: One thousand seven hundred and six participants completed two telephone interviews in which they reported all injuries over a 12-month period. RESULTS: Nine percent of participants reported at least one severe farm injury. Using logistic regression the significant risk factors for sustaining at least one severe farm injury are younger age, the presence of hearing loss or joint trouble, working more hours per day, being the owner/operator of the farm, and being from a farm with higher gross sales. CONCLUSIONS: There needs to be continuing education of all farmers as to the risks of injury. However, when resources are limited, we recommend that injury education and interventions in this farming population should target younger farmers, those who work longer hours, owner/operators, farmers from higher grossing farms, with special attention to farmers who have physical impairments.     

What Happens to the Farm? Australian Farmers’ Experiences after a Serious Farm Injury

Objectives: To investigate the experiences of farmers on returning to farming following a serious farm-related injury.

Methods: Patients who had sustained major trauma on a farm in Victoria, Australia, were identified using the Victorian State Trauma Registry (VSTR). In depth, semistructured phone interviews were conducted with 31 participants. Interview data were subjected to thematic analysis to identify important recurring themes. Interviews continued until data saturation was achieved.

Results: Interviewees included self-employed full-time farmers, part-time farmers with a supplementary income, and agricultural employees. Analysis of participant responses connected to returning to farming after a serious farm-related injury identified five major interconnected themes: (i) effect on farm work, (ii) farming future, (iii) safety advocacy, (iv) changes to farming practices, and (v) financial ramifications.

Conclusion: Farmers who have sustained a serious farm-related injury are an important resource; their experiences and perspectives could assist in the development of educational and transitional support services from recovery back to working at a preinjury level, while ensuring farming production is sustainable during this period. Furthermore, farm safety programs can be enhanced by the engagement of farmers, such as participants in this study as advocates for improved farm safety practices.     

Injury Rate Comparisons for Nonmechanized and Mechanized Logging Operations,Washington State, 2005-2014

ABSTRACT

Objectives: Current industry classification systems in the United States do not differentiate mechanized and nonmechanized logging operations. The objectives of this article are to quantify injury risk differences between mechanized and nonmechanized logging operations in Washington State and to evaluate for potential injury risk tradeoffs, such as decreasing traumatic injuries while increasing nontraumatic injuries that might occur when mechanized logging operations are substituted for nonmechanized logging operations.

Methods: Using Washington State workers’ compensation insurance risk classes to differentiate mechanized and nonmechanized logging operations, injury and illness claims data and employer reported hours were used to compare claim rates and to characterize injuries by type of logging operation.

Results: From 2005 to 2014, the accepted Washington State worker’s compensation claim rate for nonmechanized logging was 46.4 per 100 full-time equivalent employees compared to 6.7 per 100 full-time equivalent (FTE) for mechanized logging activities. The rate ratio for comparing nonmechanized to mechanized logging claims rates for all accepted claims was 6.9 (95% Confidence Interval 6.4–7.5). Claim rates for traumatic injury and nontraumatic injuries in nonmechanized logging exceeded comparable rates in mechanized logging activities, although the distribution of types of injury differed by type of logging operation. A greater percentage of accepted claims in nonmechanized logging were traumatic injuries than in mechanized logging (92.2% vs. 85.0%, respectively). In addition, nonmechanized logging had higher total claim and medical costs per FTE and had a higher proportion of claims with lost work time than mechanized logging.

Conclusion: Mechanized logging offers a considerable safety advantage over nonmechanized logging operations. Continued efforts to increase the mechanization of logging operations will result in decreased injury rates.