TRAUMATIC INJURIES IN AGRICULTURE David L. Hard John R. Myers Susan G. Gerberich.
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Transcript of TRAUMATIC INJURIES IN AGRICULTURE David L. Hard John R. Myers Susan G. Gerberich.
TRAUMATIC INJURIESTRAUMATIC INJURIESIN IN
AGRICULTUREAGRICULTURE
David L. Hard
John R. Myers
Susan G. Gerberich
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• NCASH Report (1989)
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• NCASH Report (1989)– Epidemic of traumatic death and injury in
American farming
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• 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
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• 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
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• 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)
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• History of Fatal Occupational Injury– National Safety Council (NSC)
• 1930’s to present
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• History of Fatal Occupational Injury– National Safety Council (NSC)
• 1930’s to present• Farm Safety Quarterly• Accident Facts• Injury Facts
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• History of Fatal Occupational Injury– National Safety Council (NSC)– NIOSH--National Traumatic Occupational
Fatalities (NTOF)--1980
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• 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
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• History of Fatal Occupational Injury– National Safety Council (NSC)– NIOSH--NTOF– BLS--Census of Fatal Occupational Injuries
(CFOI)--1992
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• 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
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• 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
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• 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
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• 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
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• 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
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• History of Non-fatal Occupational Injury– NSC--1970’s-1980’s– Olmsted Agricultural Trauma Survey (OATS)--
1987
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• 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
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• 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
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• 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)
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• 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
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• 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
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• 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
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• 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
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• 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.
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• 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)
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• Current Status of Agricultural Injuries
– Both national and regional data used
– Limited to production agriculture
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• Current Status of Agricultural Injuries– CFOI (1992-1998)
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
2,702
1,228
4,082
0500
1,0001,5002,0002,5003,0003,5004,0004,500
Crop Livestock Ag. ProdTotal
Production Agriculture Occupational Injury Deaths, 1992-1998, CFOI
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
407
165
400
214
443
172
364
163
337
157
373
183
378
174
386
175
583
0
100
200
300
400
500
600
1992 1993 1994 1995 1996 1997 1998 Avg.
Crop and Livestock Production Injury Deaths, 1992-1998, CFOI
CropLivestockAg Production
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
0
100
200
300
400
500
600
700
1992 1993 1994 1995 1996 1997 1998
Crop and Livestock Production Injury Deaths, 1992-1998, CFOI
CropLivestockAg Prod.
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
Production Agriculture Occupational Deaths and Average Annual Fatality Rate, per 100,000 Workers, 1992-1998, CFOI
I n d u s t r y
D e a t h s
R a t e
C r o p
2 , 7 0 2
3 7 . 9
L i v e s t o c k
1 , 2 2 8
1 4 . 1
U n k n o w n
1 5 2
A g P r o d u c t i o n
T o t a l
4 , 0 8 2
2 5 . 8
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
5.2 5.2 5.3 5 4.8 4.8 4.6
37.9
14.1
25.8
50
10
20
30
40
50
1992 1993 1994 1995 1996 1997 1998 Total
Production Agriculture and Private Industry Fatality Rates, 1992-1998, CFOI
CropLivestockAg Prod. All Industry
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
104132166
408577578
754
1,363
0200400600800
100012001400
<1515-19
20-24
25-34
35-44
45-54
55-64
65+
Production Agriculture Deaths by Age Group,1992-1998, CFOI
Ag Prod Deaths
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
Production Agriculture Deaths and Average Annual Fatality Rates per 100,000 Workers by Age Group, 1992-1998, CFOI
A g e G r o u p
D e a t h s
R a t e
< 1 5
1 0 4
* * * 1 5 - 1 9
1 3 2
1 0 . 2
2 0 - 2 4
1 6 6
1 4 . 7 2 5 - 3 4
4 0 8
1 4 . 1
3 5 - 4 4
5 7 7
1 7 . 1 4 5 - 5 4
5 7 8
2 1 . 2
5 5 - 6 4
7 5 4
3 1 . 9 6 5 +
1 , 3 6 3
6 5 . 9
T o t a l
4 , 0 8 2
2 5 . 8
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
P r o d u c t i o n A g r i c u l t u r e D e a t h s b y S o u r c e o f I n j u r y , 1 9 9 2 - 1 9 9 8 , C F O I
S o u r c e o f I n j u r y D e a t h s
P e r c e n t
T r a c t o r s
1 , 5 1 0
3 7 T r u c k s
3 9 0
9 . 6
H a r v e s t i n g m a c h i n e s
1 8 0
4 . 4
M o w i n g m a c h i n e s
1 5 0
3 . 7
A n i m a l s
1 4 4
3 . 5 O t h e r a g . m a c h i n e s
1 2 9
3 . 2
G r o u n d
1 2 1
3 . 0 B u l l e t s
1 1 5
2 . 8
L o a d e r s
7 5
1 . 8 T r e e s , l o g s
7 4
1 . 8
A l l o t h e r s o u r c e s
1 , 1 9 4
2 9 . 3
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
P r o d u c t i o n A g r i c u l t u r e D e a t h s b y T y p e o f I n j u r y E v e n t , 1 9 9 2 - 1 9 9 8 , C F O I
T y p e o f I n j u r y E v e n t D e a t h s
P e r c e n t a g e
O v e r t u r n i n g v e h i c l e / m a c h i n e
1 , 0 5 1
2 5 . 8 F a l l f r o m & r u n o v e r b y v e h / m a c h .
2 9 8
7 . 3
C a u g h t i n r u n n i n g e q u i p m e n t
2 7 7
6 . 8 S t r u c k b y f a l l i n g o b j e c t
2 3 4
5 . 7
R u n o v e r ( p e d e s t r i a n )
2 1 1
5 . 2 F a l l t o l o w e r l e v e l
1 7 3
4 . 2
S t r u c k b y r o l l i n g o b j e c t s
1 3 6
3 . 3 A s s a u l t b y a n i m a l
1 2 9
3 . 2
S u i c i d e
8 8
2 . 2 C a u g h t i n c o l l a p s i n g m a t e r i a l
8 0
2 . 0
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
L e a d i n g S o u r c e s o f F a t a l I n j u r y i n P r o d u c t i o n A g r i c u l t u r e a n d t h e P r o p o r t i o n o f D e a t h s t o W o r k e r s 5 5 Y e a r s o f A g e a n d O l d e r , 1 9 9 2 - 1 9 9 8 , C F O I
S o u r c e o f I n j u r y
F a r m i n g D e a t h s A l l W o r k e r s
F a r m i n g D e a t h s 5 5 a n d O l d e r
P e r c e n t o f D e a t h s 5 5 a n d O l d e r
T r a c t o r s
1 , 5 1 0
9 6 9
6 4
T r u c k s
3 9 0
1 6 6
4 3 H a r v e s t i n g M a c h i n e s
1 8 0
7 9
4 4
M o w i n g M a c h i n e
1 5 0
1 0 7
7 1
A n i m a l s
1 4 4
9 2
6 4
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
Nonfatal Injury Frequencies and Rates per 100 Workers for
Agricultural Production Sectors, 1993-1995, TISF
Total
Crop
Employment
3,025,876 Injury
232,546
Rate
7.7 Livestock
Employment
3,855,526 Injury
286,357
Rate
7.4 Ag Prod.
Employment
6,881,403 Injury
518,903
Rate
7.5
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
N o n f a t a l I n j u r i e s i n A g r i c u l t u r a l P r o d u c t i o n b y A g e G r o u p , 1 9 9 3 - 1 9 9 5 , T I S F
A g e G r o u p
A v g . E m p l o y m e n t
A v g . I n j u r y
R a t e *
< 1 5
* * *
4 , 6 0 0
* * *
1 5 - 1 9
1 9 1 , 3 5 9
5 , 8 6 0
3 . 1 2 0 - 2 9
3 4 2 , 3 8 0
2 6 , 5 4 1
7 . 7
3 0 - 3 9
4 9 4 , 2 5 6
3 8 , 9 0 4
7 . 9 4 0 - 4 9
4 4 0 , 4 2 1
3 1 , 3 8 7
7 . 1
5 0 - 5 9
3 6 3 , 4 5 6
2 9 , 5 6 9
8 . 1 6 0 - 6 9
2 9 6 , 1 4 9
2 2 , 7 9 9
7 . 7
7 0 +
1 6 6 , 7 8 1
1 2 , 2 7 9
7 . 4 U n k n o w n
* * *
1 , 0 2 1
* * *
T o t a l
2 , 2 9 3 , 8 0 1
1 7 2 , 9 6 0
7 . 5 * P e r 1 0 0 w o r k e r s
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• TISF--Persons incurring injuries on farms– Farm operator or family member (61%)– Hired labor (29%)– Partners or their family members (6%)
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• 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%)
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• 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%)
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• TISF--Most injuries in months– August, July, June, and November
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• 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%)
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• TISF--Leading sources of injury– Machinery & Livestock (19% each)– Working surfaces and non-powered hand tools
(8% each)
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• 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%)
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• Most common body part injured– Leg, knee or hip (17%)– Back (15%)– Finger (12%)
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• 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%)
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• RRIS-I– 3,939 households; 13,144 persons
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• 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
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• 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)
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• 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)
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• 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)
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• 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)
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• 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)
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• 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)
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• RRIS-I Source of injury– Livestock (30%)
– Machinery--other than tractors (20%)
– Tractors (9%)
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• 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
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• RRIS-II• 4,037 households • 16,759 persons (8600 children-51%)
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• RRIS-II• 4,037 households • 16,759 persons (8600 children-51%)• Youth: 207 farm operation injuries
– Animals (36%)
Traumatic Injuries in Traumatic Injuries in AgricultureAgriculture
• 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)
ConclusionsConclusions• Traumatic injuries still leading cause of
death and injury for production agriculture
ConclusionsConclusions• 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
ConclusionsConclusions• 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
ConclusionsConclusions• 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
ConclusionsConclusions• Fatality rates fairly constant in 1990’s
ConclusionsConclusions• Fatality rates fairly constant in 1990’s• Do not have a national non-fatal injury
surveillance system in place
ConclusionsConclusions• 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
ConclusionsConclusions• 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