Pediatric Exposure to Agricultrual Machinery:

The agricultural population has been underserved and difficult to reach in terms of injury control interventions, particularly regarding children at the farm worksite. Risk factors for pediatric agricultural injuries have been hypothesized but not well documented. In order to plan appropriate interventions, it is necessary to characterize possible risk factors. To address this need, a survey of a random sample of 208 Iowa farm families with 470 children under age 19 conducted. It was found that 91% of boys and 44% of girls ages 15-18, 59% of boys and 16% of girls ages 10-14, 21% of boys and 3% of girls ages 5-9, and 3% of four-year-old boys operate tractors, with 67% of boys and 16% of girls in the oldest group doing so unsupervised. Thirty-nine percent of children under five rode with an adult on tractors without cabs and 76% in cab tractors; 37% were allowed on cab tractors only. Preschool children who mothers work full-time off-farm were least involved in machinery-related activities. Nineteen percent of mothers employed full-time off-farm work, compared to 63% of mothers employed part-time off-farm and 57% of mothers not employed off-farm. These data indicate a need for primary prevention measures including guidance in age-appropriate tasks; innovative engineering controls for tractors and acceptable child care options for farm families.     

Ethnic and gender differences in farm tasks and safety practices among rural California farm youth

Agricultural work is hazardous and is common among rural youth, especially those living on farms or ranches. Previous work has shown differences in farm work and injury patterns between boys and girls, but little data exist addressing ethnic differences. This study examined ethnic and gender differences in farm tasks, safety attitudes, and use of protective measures among rural California youth working on farms or ranches. The University of California, Davis Youth Agricultural Injury Study is a longitudinal study focusing on agricultural work experience among youth enrolled in an agricultural sciences curriculum in 10 public high schools in California's Central Valley during the 2001-2005 school years. Using cross-sectional data from the initial entrance survey, we studied 946 participants who reported farm work in the previous year. Median annual hours of farm work varied significantly between boys and girls (p < 0.001) and between ethnic groups (p < 0.05) (Hispanic boys: 624 hr; Hispanic girls: 189 hr; White/Other boys: 832 hr; White/Other girls: 468 hr). Girls and Hispanic students were less likely than boys and White/Other students, respectively, to perform hazardous tasks involving tractors, machinery, and chemicals. Median age for initiating work on selected hazardous tasks was up to 3 years later for Hispanic students. Use of task-appropriate safety measures was low in all groups for most hazardous tasks. Boys were more likely than girls to use task-appropriate safety measures, with the exception of seatbelt use when in a car or truck. Hispanic students were more likely than White/Other students to employ safety measures. Girls and Hispanic youth worked fewer farm hours and had reduced exposure to selected hazardous tasks. Use of task-appropriate safety measures was low for all groups but increased for Hispanic students. Further study should explore reasons for low use of safety measures and develop educational efforts to bring about social norm changes promoting their use.     

Farm Work is Dangerous for Teens: Agricultural Hazards and Injuries Among North Carolina Teens

Children who work in agriculture suffer more than 23,000 injuries and 300 fatalities on American farms every year. Using survey data collected from a random sample of working teens (ages 14 to 17) in North Carolina, the authors analyze the farm-based hazard exposure and injury experiences of teens who work on farms. The group of farmworking teens (N = 141) is 72 percent male, has a mean age of 16.6 years, and is, on average, in the 10th grade. The data show that teens working on farms in North Carolina are exposed to significant safety hazards throughout their farmworking careers. A majority of the respondents in this group of farmworkers reported exposure to tractors, large animals, all-terrain vehicles, farm trucks, and rotary mowers, and more than one-third reported exposure to pesticides and tobacco harvesters. Common reported injuries include insect stings, cuts, burns, and falls. The researchers find that gender, age, and farmwork experiences are related to variations in types of hazards to which teens are exposed and in the types of injuries they suffer. These variables also are related to the overall complexity of the teens' farmwork experiences and the burden of injury endured by teens.     

Work Exposures,Injuries, and Musculoskeletal Discomfort Among Children and Adolescents in Dairy Farming

ABSTRACT

Little research is available about the specifics of child or adolescent work on dairy farm operations. The objective of this study was to investigate work performed by children and adolescents on these operations. The authors administered mail questionnaires to a community-based, age- and operation size-stratified sample of individuals aged 6 to 18 (n = 240) who worked on dairy operations in Wisconsin. Data were collected in 1999. The 197 children and adolescents reported averaging 567 hours of dairy farm work in the last year (10.9 hours/week) and completed over 1/3 of all calf feeding, 1/5 of the milking, 1/5 of cow feeding, and 1/10 of tractor operation hours on their farm during the weeks they worked. Some of these young workers reported accomplishing duties also judged by some experts as hazardous work, including nearly half of the 9- to 11-year-olds driving tractors. Six nonfatal injuries were reported that required stopping work (14.6 per 100 full time equivalents per year), including those that required medical attention. Musculoskeletal discomfort and disability reports were unremarkable compared to existing studies of general and working populations. Wisconsin dairy farm youth appeared to be working no more hours per week than their peers in other studies of agricultural populations. Adolescents and some children largely performed the same range of tasks and often the same scope of work as adults, including some performing hazardous work. There is a need for further investigations with larger samples of dairy youth to confirm these findings. The exposures of very young workers to hazardous tractor driving and tower silo tasks suggest that there is an urgent need for improved and validated interventions to reduce these exposures.     

Assessing noise exposures in farm youths

OBJECTIVE: This exploratory study evaluated the feasibility of field exposure assessment methods to characterize the noise sources and levels that farm youths experience during a typical workday. METHODS: Detailed exposure assessments were performed with a sample of 10 farm youths working on Vermont dairy farms to characterize potential noise hazards typical in the farm setting. Personal and area noise measurements were taken using noise dosimeters. Information concerning work- and non-work-related noise exposure histories was collected via questionnaire. RESULTS: The average age was 15.5 years (SD 2.5, range 10-18). Youths started working at an average age of 8.4 years (SD 2.3, range 6-12) and during the summer months worked an average of 41.3 hours per week (SD 32.3, range 2-68). Two youths exceeded the OSHA action level, having eight-hour time-weighted averages of 95 dBA and 92 dBA, or alternatively, doses of 206% and 127%. (The OSHA action level for the hearing conservation amendment is an eight-hour time-weighted average of 85 dBA or a dose of 50%.) Participants exceeding the action level reported working with tractors, skid steers (Bobcats), and all-terrain vehicles and doing general barn work. Additional sources of noise exposure included a mechanical silo elevator, chain saw, and wood splitter. CONCLUSION: Two of the monitored subjects were overexposed to noise in their farm work. Youths may be exposed to noise levels that exceed adult OSHA hearing conservation amendment action level as part of their daily farm activities.     

Children''s Agricultural Health: Traumatic Injuries and Hazardous Inorganic Exposures

CONTEXT: Farming is one of the most hazardous occupational industries in the USA, and farms pose numerous health risks for youth visiting, living in, or working in the farm environment. PURPOSE: This review discusses both potential traumatic injuries and hazardous inorganic exposures that are common in agricultural settings. FINDINGS: An estimated 2 million youth under the age of 20 currently live or work on US farms. Approximately 103 farm fatalities occur in this age group each year; over 32,000 nonfatal youth injuries occurred on farms in 1998. Children working in US agriculture make up only 8% of the population of working minors overall, yet they account for 40% of work-related fatalities among minors. Farm children and youth are also exposed to potentially harmful chemicals, such as pesticides and solvents, and many of these exposures go undetected. The long-term health effects of exposure to pesticides or solvents are not known, but the developmental vulnerabilities of children and youth are of particular concern. CONCLUSIONS: Clinical and epidemiologic research in pediatric populations is needed to expand the empirical data, particularly for inorganic and organic exposures, musculoskeletal trauma, skin disorders, occupation-induced hearing loss, and psychosocial stress. Rural health professionals can work to reduce these risks to farm youth by becoming more aware of the problem, by conducting clinical and epidemiologic research, and by engaging in advocacy at state and local levels.     

Personal Protective Equipment Use and Safety Behaviors Among Farm Adolescents: Gender Differences and Predictors of Work Practices

CONTEXT: Children on farms perform work that places them at risk for acute and chronic negative health outcomes. Despite strategies for preventing and reducing the risk of disease and injury, children's use of personal protective equipment and safely equipped farm machinery has generally remained unreported. PURPOSE: This paper reports the use of personal protective equipment, self-protective work behaviors, and selected risk exposures of children aged 14-19, who perform farm work. METHODS: Survey results of adolescent high school students (n = 593) enrolled in agriculture class in Kentucky, Iowa, and Mississippi. Students were part of the sample that participated in the Agricultural Disability Awareness and Risk Education Project. Findings: Boys were at a significantly higher risk of exposure compared to girls, and boys engaged more frequently in risky behavior. Hearing and respiratory protection was used minimally and sporadically. Physical symptoms influenced use of hearing and respirator use, as did physician recommendation to use such protection. Of students who operated farm tractors, only half most frequently operated tractors with safety bars and seat belts. Sixty percent of the students reported using equipment with damaged or missing safety shields. CONCLUSIONS: In addition to the usual risks of farm work, adolescents may be at even greater risk by not using personal protective equipment or not having access to machinery that is properly equipped for maximum protection. Health care providers should incorporate advice to adolescents and their parents on risk reduction, particularly on the use of personal protective equipment.     

Involving Fathers in Teaching Youth About Farm Tractor Seatbelt Safety—A Randomized Control Study

PurposeFarm youth continue to experience high rates of injury and deaths as a result of agricultural activities. Farm machinery, especially tractors, is the most common cause of casualties to youth. A Roll-Over Protection Structure (ROPS) along with a fastened seatbelt can prevent almost all injuries and fatalities from tractor overturns. Despite this knowledge, the use of seatbelts by farmers on ROPS tractors remains low. This study treats farm safety as a family issue and builds on the central role of parents as teachers and role models of farm safety for youth.MethodsThis research study used a longitudinal, repeated-measures, randomized-control design in which youth 10–19 years of age were randomly assigned to either of two intervention groups (parent-led group and staff-led group) or the control group.ResultsFathers in the parent-led group were less likely to operate ROPS tractors without a seatbelt compared with other groups. They were more likely to have communicated with youth about the importance of wearing seatbelts on ROPS tractors. Consequently, youth in the parent-led group were less likely to operate a ROPS tractor without a seatbelt than the control group at post-test.ConclusionsThis randomized control trial supports the effectiveness of a home-based, father-led farm safety intervention as a promising strategy for reducing youth as well as father-unsafe behaviors (related to tractor seatbelts) on the farm. This intervention appealed to fathers' strong motivation to practice tractor safety for the sake of their youth. Involving fathers helped change both father as well as youth unsafe tractor-seatbelt behaviors.     

Chronic Disease and Injury in an Agricultural County: The Keokuk County Rural Health Cohort Study

The Keokuk County Rural Health Study (KCRHS) was designed as a 20-year, prospective cohort study focusing on chronic disease and injury in an agricultural southeastern Iowa county. The goals of the KCRHS are to prospectively describe, measure, and analyze prevalent rural and agriculturally related adverse health outcomes and their respective risk factors and to provide the basis for future community-based intervention programs to reduce disease and injury incidence. Methods of data collection included in-person interviews, medical screenings, and environmental assessments of homes and farms. All households studied were rural; comparisons were made among farm, rural nonfarm, and town households, between men and women, and between smokers and nonsmokers. The present paper reports selected adult baseline data from Round 1 of this study. Residents of farm households were somewhat younger and better educated than residents of rural nonfarm and town households; smoked less; were more likely to have ridden an all-terrain vehicle; and were more likely to report firearms in the home. Eighty-nine percent of the men and 66% of the women engaged in farming or did so in the past. Men more often reported hearing loss, were more often overweight and obese, more often reported an injury, less often reported asthma, and less often saw a medical practitioner. Women reported poorer emotional health and higher rates of depression symptoms. The KCRHS has identified several modifiable health outcomes and risk factors as candidates for further analysis and targets for community-based prevention and intervention programs.     

Incidence and cost of nonfatal farm youth injury, United States, 2001-2006

The objective of this study was to estimate the annual incidence and cost of nonfatal farm youth injury in the United States for the period 2001-2006. The authors used 2001-2006 Childhood Agricultural Injury Survey data to estimate the annual incidence of farm youth nonfatal injury. To estimate the costs for injuries suffered by youth working/living on the farm, the number of injuries was multiplied by published unit costs by body part, nature of injury, and age group. The annual number of nonfatal injuries to youth (ages 0-19) on farms in 2001-2006 was 26,570. The annual cost of nonfatal farm youth injuries was $1 billion (in 2005 dollars), with 26% of costs related to working on the farm and 47% on beef cattle farms. Around 9.3% of the cost was medical costs, 37.2% work and household productivity loss, and 53.5% quality of life loss.     

Children's safety on American Indian farms: information and recommendations

It is estimated that 1.2 million youth younger than age 20 live on farms; American Indian children constitute an important but understudied subset of this at-risk group. Despite documented risks of injuries and death among children who live and work on farms and a descending trend in the overall reported fatalities among youth who live and/or work on farms, very little is known about the agriculture-related injury and fatality experience of American Indian youth. Limited data indicate that drowning, motor vehicles, and poisonings are leading causes of unintentional mortality and morbidity for this group, although the attribution to agricultural exposure is not evident. The scant available data indicate a need to look more closely at agricultural work, bystander exposures, and other farm events that put American Indian youth at risk of illness, injury, or death compared to factors more fully reported for majority youth in the agriculture population, in order to guide intervention and prevention programs that are appropriate and acceptable to this vulnerable population.     

Incidence and Cost of Nonfatal Farm Youth Injury,United States, 2001–2006

ABSTRACT

The objective of this study was to estimate the annual incidence and cost of nonfatal farm youth injury in the United States for the period 2001–2006. The authors used 2001–2006 Childhood Agricultural Injury Survey data to estimate the annual incidence of farm youth nonfatal injury. To estimate the costs for injuries suffered by youth working/living on the farm, the number of injuries was multiplied by published unit costs by body part, nature of injury, and age group. The annual number of nonfatal injuries to youth (ages 0–19) on farms in 2001–2006 was 26,570. The annual cost of nonfatal farm youth injuries was $1 billion (in 2005 dollars), with 26% of costs related to working on the farm and 47% on beef cattle farms. Around 9.3% of the cost was medical costs, 37.2% work and household productivity loss, and 53.5% quality of life loss.     

Adolescent work patterns and work-related injury incidence in rural Minnesota

BACKGROUND: Although there have been many studies on working youth in the United States, we have noted none which have provided a broad picture of adolescent work practices in a rural community. METHODS: Six high schools in rural Minnesota were evaluated for adolescent work practices. Schools ranged in size from 173 to 525 students in grades 9 through 12. A 20 page self-administered survey examining work practices was administered to students. RESULTS: A total of 2,250 students completed the survey, representing 92% of the student body. Twenty-eight percent of students lived on a farm. Approximately 45% of the male students and slightly more than 21% of the females were involved in farm work. Only 2.6% of students were injured during this 8-month time period in farm-related activities, and 5.1% were injured doing non-farm work. Many students reported working long hours. CONCLUSIONS: Work represents a serious problem for rural youth. These data are significant in the context of national policy discussion concerning the failure of the Fair Labor Standards Act to regulate the agricultural environment.     

The Keokuk County Rural Health Study

ABSTRACT

The Keokuk County Rural Health Study is a unique, population-based, prospective study of an agricultural community. The study is expected to continue for twenty years. The research includes systematic assessment of respiratory disease, injury, and other health outcomes in relation to agricultural, occupational, and environmental exposures. The aims of the environmental surveys are: (1) to conduct a systematic assessment of rural households in order to characterize the environmental exposures associated with the resi-dences and properties of the study subjects comparing farm, rural non-farm, and town households; and (2) to characterize occupational exposures associated with activities of the study subjects, particular-ly those related to farming and the rural environment. The environ-mental surveys consist of a combination of personal interviews, walk-through observations, and measurement of a selected number of environmental parameters. The focus of these assessments is on the environment and operations of the household and farm. Four instruments are used to record data: a Home Environmental Ques-tionnaire; a Home/Grounds Environmental Checklist; a Farm Envi-ronmental Questionnaire; and a Farm Environmental Checklist. Pre-liminary results from the first 106 environmental assessments are described, including the first 26 farms. More than half of residences were built before 1950, and they are primarily heated with liquid propane gas, natural gas, or wood. Dangerously high levels of car-bon monoxide were measured in several homes during winter 1995/96. Only 77 of 148 smoke detectors functioned. Farms ranged from 7 to 1,600 acres, with a mean of 324 acres. Eleven raised swine in enclosed systems. The average age of tractors in use was 26 years. Twenty-eight percent of all tractors had cabs, 25% had ROPS, and 39% had PTO shields.     

Compliance with the North American Guidelines for Children's Agricultural Tasks (NAGCAT) work practice recommendations for youth working with large animals

The North American Guidelines for Children's Agricultural Tasks (NAGCAT) were developed to reduce the risk of childhood agricultural injury. The purpose of this study was to evaluate compliance with NAGCAT-recommended work practices (WPs) when youth work with large animals. On a daily basis, over a period of 10 weeks, youth self-reported the number of minutes they worked with a large animal and whether they followed the associated NAGCAT WP guidelines. Statistical analyses were conducted to compare boys to girls and to consider the effect of factors such as youth age, farm residence status, and selected parental characteristics. A high proportion of youth exhibited relatively low compliance for most of the five WPs evaluated. Respirators were rarely worn, but checking for people and obstacles in the area while working with large animals was commonly reported. In general, boys, especially the older boys, exhibited higher compliance than did girls. The results of our study demonstrate, in general, that youth are not following recommended NAGCAT WPs when working with large animals, identifying an area in agricultural safety and health requiring focused attention.     

Non-Fatal Agricultural Injuries and Risk Factors Among Colorado Female Farmers

ABSTRACT

Non-fatal agricultural injuries and associated risk factors among female farmers in Colorado were assessed on 485 farms between 1993 and 1995. Risk factors assessed include age, number of years in farming, primary cash crop and annual cash value on farm, depressive symptoms, organophosphates use on farm, having children under 6 years of age, having children worked on farm. On those farms, there were 872 principal operators and spouses interviewed in 1993, 402 were female farmers. Three hundred fifty-nine of those 402 female farmers were re-interviewed in 1994 and 316 of the second year participants were followed up in 1995. A total of 49 (12.1%) of the female farmers reported agricultural work-related injuries between January 1992 and June 1995. Of these, 29 (59.2%) were injured one time, 14 (28.2%) were injured two times, 5 (10.2%) were injured three times, and 1 (2.04%) was injured four times. Injury rates per 200,000 working hours for animal handling, farmstead material handling, crop production, farm maintenance, transport of farm equipments or produce, and other activities were 8.3, 11.4, 5.0, 8.2, 5.4, and 14.5, respectively. Significantly associated with agricultural work-related injuries were depressive symptoms (odds ratio 4.91, 95% confidence interval 1.93, 12.53), more than 30 years experience in agricultural work (odds ratio 4.90, 95% confidence interval 2.06, 11.66), age between 30 and 39 (odds ratio 3.14, 95% confidence interval 1.10, 9.01).