Injury, Musculoskeletal Symptoms, and Stress as a Function of Aging in Agricultural Operators in the Central United States.

BACKGROUND: Studies show conflicting evidence on the association of age and occupational injury in agriculture, and few studies have addressed the effect of age on work-related chronic conditions or preventive practices among farmers. METHODS: We examined the probability of injury, work-related stress, musculoskeletal symptoms (MSS), and preventive practices for MSS as a function of aging using surveillance data of 7,711 farm and ranch operators in the central United States. FINDINGS: Segmented regression analyses of men (85% of sample) indicated that the probability of all four outcomes increased up to a certain age and then decreased; the changepoints in years of age being 59.6 for injury, 55.4 for work-related stress, 59.6 for MSS, and 67.9 for MSS preventive practices. Female operators had an increasing trend for stress up to age 29.7, while they showed no changepoints across their age spectrum in the proportion of injury, MSS, and prevention techniques. CONCLUSION/APPLICATION TO PRACTICE: These findings emphasize the need for preventive efforts particularly among younger and middle-aged farmers and ranchers, and the need to modify work duties to match work abilities at older ages.

Agricultural Injuries: Risk Factors and Severity by Affected Body Part among US (Midwest) Farmers.

OBJECTIVES: Statistics from the United States Bureau of Labor Statistics indicate that agriculture consistently ranks as the most hazardous industry in the US. To identify specific targets for prevention, we investigated injury risk factor profiles separately for each injured body site. We also characterized the severity of agricultural injuries by injured body site using the type of medical care and lost work time due to injury. METHODS: We used the Central States Center for Agricultural Safety and Health (CS-CASH) surveillance data for 2018 to perform descriptive statistics and regression modeling. RESULTS: We found that 12% (513/4351) of the participants experienced one or more injuries in the previous 12 months. Compared to female operators, male operators had 3.53 (95% CI: 1.17-10.68) times higher odds of back injury. Operators in livestock production had 2.77 times (95% CI:1.12-6.82), 2.28 times (95% CI:1.25-4.14), and 1.69 times (95% CI:1.10-2.59) higher odds of injury to the chest/trunk, finger, and leg/knee/hip, respectively, compared to operators in crop or mixed production. After adjusting for age and gender, operators who worked full time (vs. part-time) on the farm/ranch had 2.11 times (95% CI:1.03-4.34) higher odds of back injury. Arm/shoulder and leg/knee/hip injuries were more frequent in older age groups. CONCLUSIONS: Prevention measures should be tailored considering specifically livestock producers with emphasis on trainings on proper livestock handling, such as being gentle, establishing routine, keeping distance, and avoiding sudden and loud noise when handling animals. Applying these techniques avoid startling the animals and reduce the risk of injuries.

Prevalence and Risk Factors for Pulmonary Conditions among Farmers and Ranchers in the Central United States.

This study was conducted to evaluate the prevalence and risk factors for work-related respiratory conditions (asthma, farmer's lung, sinusitis, rhinitis, and environmental allergies, diagnosed by a physician) among farm and ranch operators in the central US. A survey was conducted by the Central States Center for Agricultural Safety and Health (CS-CASH) in 2018, focusing on work-related injuries, illnesses, exposures, and preventive measures in a seven-state region (Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, and South Dakota). Farms and ranches (n = 16,818) with an email address and annual sales exceeding $5,000 were randomly selected for the survey. Agricultural production and weather data were merged with survey responses. The relationship between exposures and respiratory conditions was analyzed using generalized estimating equations. We received responses from 3,268 agricultural operations (19% response rate) containing information on 4,064 individual operators. The life-time prevalence of (any) respiratory conditions among farm/ranch operators was 18%. Risk factors for respiratory conditions included exposures to grain/hay/feed dust (OR 2.41), animal confinement dust (OR 1.57), field/road dust (OR 2.11), manure/silage gasses (OR 1.66), anhydrous ammonia (OR 1.51), fuels/solvents/paints (OR 1.92), older age group >70 vs. <43 (OR 1.40), female gender (OR 1.82), and being primary vs. third operator (OR 1.61). Farmers and ranchers have a high prevalence of respiratory conditions associated with dust and gas exposures at work. More effective protective measures are needed using the hierarchy of controls, including improved use of respiratory protection.

Factors Associated with Musculoskeletal Discomfort in Farmers and Ranchers in the U.S. Central States.

Agricultural work involves ergonomic and psychosocial strain, which contribute to musculoskeletal conditions. The aim of this study was to assess if specific ergonomic, psychosocial, and preventive factors are linked to musculoskeletal pain or discomfort symptoms (MSS) in farmers and ranchers. We analyzed data from the Central States Center for Agricultural Safety and Health survey that was conducted in 2018 in a seven-state region of the central United States. MSS were assessed with questions from the Standardized Nordic Questionnaire. The survey included questions on demographic, ergonomic, psychosocial and preventive factors. Farm production variables were added from the Farm Market iD database. We analyzed the data using Generalized Estimating Equations. The overall prevalence of MSS for all body sites combined was 59% among 4,354 farmers and ranchers who responded (19% response rate). After controlling for age, sex, and operator status, three factors (high stress level, sleep deprivation, and exhaustion/fatigue) showed the strongest associations with MSS in any body site, with adjusted odds ratios (OR) ranging from 4.8 to 5.6. Forceful exertions, repetitive tasks, awkward postures, frequent manual labor, and vibration were also significantly associated with MSS, with adjusted ORs ranging from 1.8 to 3.3. Recommended preventive techniques were not protective for MSS. New effective strategies are needed to reduce the high burden of musculoskeletal outcomes among farmers and agricultural workers.

Work exposures and mental and musculoskeletal symptoms in organic farming.

This study focussed on harmful exposures and mental and musculoskeletal symptoms in organic and conventional farming using interview data of Finnish farmers over the winter of 2014-2015. The data consisted of 2,169 full-time farmers, out of whom 231 (11%) practiced organic farming and 1,938 (89%) conventional farming. Exposure to poisonous and irritating substances was less frequent while exposures to vibration and mould ('smell of root cellar') were more frequent on organic farms. Mental and musculoskeletal symptoms were slightly more common among organic farmers, but the associations were not statistically significant in regression modelling. Risk factors for mental symptoms included animal production, hired labour, female gender, constant hurry, working alone, economic uncertainty, and inadequate recovery from workdays. Risk factors for musculoskeletal symptoms included older age, female gender, constant hurry, economic uncertainty, difficult working postures, heavy lifting and carrying, and inadequate recovery. Workload and recovery, managing the transition period and better follow-up of the occupational well-being were identified as concerns among organic farmers. Practitioner summary: Converting from conventional to organic farming has become increasingly common. Farmer interviews indicated that exposure to poisonous and irritating substances was less frequent while exposures to vibration and mould were more frequent on organic farms. Mental and musculoskeletal symptoms and risk factors were similar in both types of farming.

Occupational stress among farm and ranch operators in the midwestern United States.

BACKGROUND: This study used surveillance data from 2018 and 2020 to test the stability of work-related strain symptoms (high stress, sleep deprivation, exhaustion) with demographic factors, work characteristics, and musculoskeletal symptoms among farm and ranch operators in seven midwestern states of the United States. METHODS: Cross-sectional surveys were conducted among farm and ranch operators in 2018 (n = 4423) and 2020 (n = 3492). Operators were asked whether, in the past 12 months, they experienced extended work periods that resulted in high stress levels, sleep deprivation, exhaustion/fatigue, or other work-related strain symptoms. Covariates included personal and demographic factors, work characteristics, number of injuries, work-related health conditions, and exposures on the operation. Summary statistics were tabulated for explanatory and outcome variables. The classification (decision) tree approach was used to assess what variables would best separate operators with and without reported strain symptoms, based on a set of explanatory variables. Regularized regression was used to generate effect estimates between the work strain variables and explanatory variables. RESULTS: High stress level, sleep deprivation, and exhaustion were reported more frequently in 2018 than 2020. The classification tree reproduced the 2018 model using 2020 data with approximately 80% accuracy. The mean number of reported MSD symptoms increased slightly from 1.23 in 2018 to 1.41 in 2020. Older age, more time spent in farm work, higher gross farm income (GFI), and MSD symptoms in six body regions (ankles/feet, knees, lower back, neck, shoulders, wrists/hands) were associated with all three work strain symptoms. CONCLUSIONS: Musculoskeletal pain and discomfort was a strong predictor for stress, sleep deprivation, and exhaustion among farmers and ranchers. This finding indicates that reducing MSD pain and discomfort is beneficial for both physical and mental health.

Assessing Nonresponse Bias in Farm Injury Surveillance Data.

HIGHLIGHTS: Despite a response rate of about 18%, there was scant evidence of nonresponse bias. Farm and ranch characteristics of operations responding to a mailed survey were similar to those not responding. Responders were significantly more likely to be married but only slightly older and more educated than nonresponders. Earlier survey responders reported more injuries and greater severity when injured compared to later responders. ABSTRACT: Nonresponse bias in a survey can result in misleading estimates of agricultural injuries and can misdirect prevention efforts aimed at reducing the burden of injuries on farmers. Responders (n = 2,977) and nonresponders (n = 13,849) were compared based on demographics and agricultural production characteristics to identify underrepresented subgroups. Injury characteristics were compared between early (n = 1,667) and late (n = 1,309) responders. Methods accounted for correlated data, sample size inflation of p-values, and assessment of meaningful differences. Few differences were identified between responders and nonresponders. Responders differed from nonresponders by state of residence, and responders were more likely to be married. Other characteristics (age, gender, education, farm size, crops grown, animals raised) were similar across groups. Early responders reported more injuries and more often sought medical care for an injury than late responders. The differences identified between responders and nonresponders were minimal and not likely to create bias. Differential reporting of injury and injury severity between early and late responders is worthy of further investigation.

Occupational Injuries among Latino/a Immigrant Cattle Feedyard Workers in the Central States Region of the United States.

Agriculture is a dangerous industry with high rates of occupational injuries. Immigrants comprise the majority of the hired agricultural workforce in the United States, and these workers may be at a higher risk for job-related injuries. This study addressed the frequency, characteristics, and risk factors of occupational injuries among Latino immigrant cattle feedyard workers. Data were collected through structured interviews with Latino immigrant cattle feedyard workers in Kansas and Nebraska (n = 243; 90.9% male). Descriptive statistics and logistic regression were used to identify risk factors for injury. Nearly three-fourths of participants (71.2%) reported having experienced one or more injuries in the past while working on a cattle feedyard. The most frequent types of reported injuries, including those not requiring medical care, were bruises/contusions (40%), cuts/lacerations (21%), and sprains/strains (12%). These injuries were mainly caused by animals/livestock (33%), chemicals (23%), falls (12%), and tools (9%). Significant risk factors for injury included male gender (OR 5.9), being over age 35 (OR 2.6), working on a large or an extra-large feedyard (OR 5.4), having 11 or more employees on the feedyard (OR 3.6), and working more than eight hours a day (OR 4.7). Having received safety training was also associated with greater risk of injury in a univariable model (OR 2.6). Cattle feedyard workers are at high risk for injury and require more effective preventive measures.

Agricultural Injuries among Farmers and Ranchers in the Central United States during 2011-2015.

The high risk of occupational fatalities in agriculture is well documented, but information on non-fatal injuries is lacking due to challenges in injury surveillance. This surveillance study explored the frequency, characteristics, and risk factors for non-fatal injuries among farmers and ranchers in the central United States. The Central States Center for Agricultural Safety and Health (CS-CASH), in collaboration with the USDA National Agricultural Statistics Service (NASS), conducted annual surveys (n = 34,777 sent) during 2011-2015 covering a seven-state region (Iowa, Kansas, Minnesota, Missouri, North Dakota, Nebraska, and South Dakota). The average response rate was 32% in the five consecutive annual surveys. The average injury incidence rate was 7.0 injuries/100 operators per year. Most injuries (89%) occurred during agricultural work. The most frequent sources of injury were livestock (22%), machinery (13%), and hand tools (12%). Risk factors for injury included: male gender, younger age (vs. 65+ years), farming as the primary occupation, greater work time, greater land area, ranch (vs. farm), organic farming, internet access, and production of several types of crops and animals. Most injuries (56%) required a doctor visit, and 12% required hospitalization. The average medical costs were $1,936 out of pocket and $8,043 paid by insurance. The combined average costs for most serious injuries were $7,858. Most injuries (66%) resulted in some lost time from agricultural work, and 13% were serious, resulting in more than 30 days of lost work time. The non-fatal injury rate for self-employed farmers and ranchers was higher than that of hired agricultural workers reported by the Bureau of Labor Statistics. This result reaffirms farming/ranching as a dangerous occupation and emphasizes the need for efforts to prevent agricultural injuries, especially those associated with identified injury sources and risk factors.

Determinants of Good Work Ability among Organic and Conventional Farmers in Finland.

Based on earlier studies, farmers have poorer work ability compared to workers in most other occupations. The aim of this study was to explore if organic production has a positive effect on producers' work ability while controlling for demographic and production characteristics. This study used telephone interview data collected by the Finnish Institute of Occupational Health in 2014-2015. The material consisted of 2,164 farmers: 231 in organic production and 1,933 in conventional production. Work ability was measured with a single question regarding the farmers' current work ability compared with their lifetime best on a scale of 0 to 10, with 0 meaning unable to work. The data were analyzed using multivariable logistic regression. Organic production had a negative effect on work ability, while larger farm size, experiencing economic uncertainty rarely/never/occasionally (vs. often), age under 55 years, having occupational health coverage, and experiencing low amounts of physical strain or mental strain had positive effects in a multivariable model. While this study could not consider potential biases from the farmers' existing health status at the time of switching to organic production and other sources, it is clear that greater attention needs to be paid to improving worker health, safety, and wellness in organic farming.

Comparison of agricultural injuries reported in the media and census of fatal occupational injuries.

The Bureau of Labor Statistics (BLS) publishes annual statistics on occupational injuries and fatalities in the United States. The BLS fatality data include all agricultural workers while the non-fatal injury data only cover hired employees on large farms. In 2012, the Central States Center for Agricultural Safety and Health (CS-CASH) began collecting regional media monitoring data of agricultural injury incidents to augment national statistics. The aims of this report were: a) to compare CS-CASH injury and fatality data collected via print and online sources to data reported in previous studies, and b) to compare fatality data from media monitoring to BLS Census of Fatal Occupational Injuries (CFOI) data. CS-CASH media monitoring data were collected from a news clipping service and an internet detection and notification system. These data covered years 2012-2017 in seven Midwestern states (Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, and South Dakota). CS-CASH occupational fatality data were compared with aggregate CFOI data for the region during 2012-2015. Media monitoring captured 1048 injury cases; 586 (56%) were non-fatal and 462 (44%) were fatal. The numbers of occupational fatality cases from media monitoring and CFOI were nearly identical (280 vs. 282, respectively), and the distributions by type of injury were similar. Findings suggest that media monitoring can capture equal numbers of fatalities compared to CFOI. Non-fatal injuries, not captured by national surveillance systems, can be collected and tracked using print and electronic media. Risk factors, identified in media sources, such as gender, age, time, and source of the incident are consistent with previously reported data. Media monitoring can provide timely access to detailed information on individual cases, which is important for detecting unique and emerging hazards, designing interventions and for setting policy and guiding national strategies.

Gender Division of Farm Work and Occupational Injuries.

Several studies have shown that males are at greater risk of agricultural injuries than females. We investigated if gender division of farm work helps explain this risk difference in the self-employed Finnish farming population. We used insurance claims data and postal survey data charting the relative division of farm work between male and female farmers. Over the five-year study period (2009 to 2013), the average number of farmers was 75,893 (67% males and 33% females). A total of 22,648 occupational injuries (77% males and 23% females) were compensated during that time. Males had significantly higher rates of any, minor, serious, and recurrent injuries compared to females. Altogether, 319 usable responses were received in the postal survey (13% response rate). Both farm work time and occupational injuries differed by gender. Crop production, construction, forestry, and machinery contracting work were male-dominated, whereas females took the main responsibility for domestic and caretaking work. On livestock farms, animal husbandry was divided quite evenly between males and females (56% and 44% contributions, respectively). Animal husbandry-related injuries were distributed similarly (58% males and 42% females), but all other types of injuries occurred mostly to males. These results suggest that the risk of injuries is also nearly equal, given equal work time. Therefore, gender is an indicator of different work exposures in farming, rather than a risk factor for injury. Better understanding of the division of work and the corresponding risk of injuries can help in the design of interventions for males and females in agriculture.

Predictors for occupational injuries and diseases among commercial fishers in Finland 1996-2015.

Fishing is a hazardous occupation worldwide. Commercial fishers in Finland are an aging and diminishing population with a high injury rate. Insurance claims data for self-employed Finnish commercial fishers during the years 1996 through 2015 (n = 1951) were analysed to assess predictors for occupational injuries and diseases. Out of the available variables, fishery location, career length, and participation in the voluntary occupational health service programme were not significant predictors. Male gender (OR 2.02; 95% CI 1.37-2.99), Finnish mother tongue vs. Swedish (OR 1.98, 95% CI 1.53-2.55), and higher income levels from fishing (four income categories, OR range: 1.71-3.53) were associated with higher odds for a compensated occupational injury or disease claim among commercial fishers in the final multivariate model. The identified risk groups could be targeted for interventions, and the content of the occupational health service programme should be developed to gain protective effect.

Occupational injuries and diseases among commercial fishers in Finland 1996-2015.

BACKGROUND: Commercial fishing is recognised as one of the most hazardous professions worldwide. In Finland, commercial fishing has some special characteristics, including fishing on ice during frozen waters, and pluriactivity of the fisher family to gain additional income. The goal of this study was to describe injury characteristics among commercial fishers in Finland during the years 1996-2015. With this information, we wish to promote creation of effective safety campaigns and interventions. MATERIALS AND METHODS: The data for this study was acquired from The Farmers' Social Insurance Institution, who handles the mandatory pension and occupational injury insurance of Finnish commercial fishers. Descriptive statistics was used to categorise and analyse the data that comprised the anonymized insurance history of 1954 insured fishers and reports on 1135 compensated injuries, 11 fatalities, and 53 occupational disease cases. RESULTS: The results show, that the injury rate of Finnish commercial fishers is high. Forty per cent of the fishing-related injuries occur aboard or when entering or leaving the vessel, while 37% happened ashore, and 11% on sea or lake ice. The most common type of incident is preceded by a slip, trip, or sway followed by a fall to lower level. The injuries result in a median disability length of 21 days. An elevated risk for Finnish (vs. Swedish) speaking, as well as for male fishers was found. The occupational diseases of the studied population were for the most part results of manual, repetitive and/or physically straining work due to e.g. hauling in fishing equipment. Due to small numbers and lack of case data, it is not possible to make any further analysis of the 11 fatalities, which were all drownings. CONCLUSIONS: Based on our findings, injury prevention should be targeted, besides preventing fatalities because of drowning, at mitigating the risks for slips, trips, and falls both aboard and ashore.

Occupational Health and Safety of Finnish Dairy Farmers Using Automatic Milking Systems.

INTRODUCTION: Conventional pipeline and parlor milking expose dairy farmers and workers to adverse health outcomes. In recent years, automatic milking systems (AMS) have gained much popularity in Finland, but the changes in working conditions when changing to AMS are not well known. The aim of this study was to investigate the occupational health and safety risks in using AMS, compared to conventional milking systems (CMS). METHODS: An anonymous online survey was sent to each Finnish dairy farm with an AMS in 2014. Only those dairy farmers with prior work experience in CMS were included in the final analysis consisting of frequency distributions and descriptive statistics. RESULTS: We received 228 usable responses (131 male and 97 female; 25.2% response rate). The majority of the participants found that AMS had brought flexibility to the organization of farm work, and it had increased leisure time, quality of life, productivity of dairy work, and the attractiveness of dairy farming among the younger generation. In addition, AMS reduced the perceived physical strain on the musculoskeletal system as well as the risk of occupational injuries and diseases, compared to CMS. However, working in close proximity to the cattle, particularly training of heifers to use the AMS, was regarded as a high-risk work task. In addition, the daily cleaning of the AMS and manual handling of rejected milk were regarded as physically demanding. The majority of the participants stated that mental stress caused by the monotonous, repetitive, paced, and hurried work had declined after changing to AMS. However, many indicated increased mental stress because of the demanding management of the AMS. Nightly alarms caused by the AMS, lack of adequately skilled hired labor or farm relief workers, and the 24/7 standby for the AMS were issues that also caused mental stress. CONCLUSION: Based on this study, AMS may have significant potential in the prevention of adverse health outcomes in milking of dairy cows. In addition, AMS may improve the productivity of dairy work and sustainability of dairy production. However, certain characteristics of the AMS require further attention with regard to occupational health and safety risks.

Characteristics and Costs of Disability Pensions in Finnish Agriculture Based on 5-Year Insurance Records.

The characteristics and costs of disability pensions in Finnish farmers were investigated. The data included a total of 4,088 permanent or temporary disability pensions of the self-employed Finnish farming population over a 5-year period (2008-2012), an annual rate of 1.04 new cases per 100 person-years (males 0.94/100 and females 1.24/100). These cases resulted in the loss of almost 6,800 person-years and 60.2 million Euros in pension costs in the 5-year period. Almost half of the outcomes (44.6%) were primarily related to diseases of the musculoskeletal system (MSDs). Other common outcomes were mental and behavioral disorders (17.5%), injuries (9.8%), diseases of the circulatory system (7.8%), and diseases of the nervous system (6.6%). Relative proportions of these outcomes and their costs were similar with few exceptions. Although farmers have high risk of acute traumatic injuries, they also have a high risk of chronic conditions that affect their work ability. Particularly MSDs were common primary reasons for disability pension among farmers in general and among female farmers in particular. In addition to healthy lifestyle choices, improvements in the working environment and methods to reduce heavy or repetitive manual labor should be emphasized in vocational and extension education of farmers. Modern working conditions with meaningful and varied work tasks could enhance both physical and mental well-being of farmers and thus reinforce and extend their careers.

Pesticide use practices in rural Armenia.

Pesticide use can have adverse effects on both human health and the environment. Inappropriate use of pesticides increases the health risk to those who work with or live around pesticides. Educational programs for agricultural workers on the proper use of pesticides and personal protective equipment coupled with pesticide regulations are important tools to reduce the associated health risks. The authors conducted a survey (N = 2336) on pesticide use practices in the Ararat Valley of Armenia in 2000-2006. This study was a cross-sectional design. A multistage sampling method was implemented in the selection of the study population. The authors developed a questionnaire containing 173 questions to evaluate demographic characteristics, health conditions, and details of pesticides use practices. The intensity of pesticide use was high; 82.8% of respondents used them. More than 150 brand names of pesticides were in use. Unregistered, obsolete, expired, and banned compounds were found in active use. Poor compliance with the basic rules of pesticide safety was found throughout the study population, with 21.3% using gloves and only 11% using respirators. The agricultural workers' knowledge of the toxic properties of these pesticides as well as basic hygienic norms was very low. In some instances, the number of agrichemical applications to crops, particularly cucumbers and melons, reached 40 applications during the growing season. Better protection and training of pesticide users in Armenia is needed.

Modifiable risk factors for depressed mood among farmers.

BACKGROUND: Risk for depression among farmers is not fully understood. DSM-IV considers sadness or depressed mood a critical symptom of depression. The aim of this study was to examine risk factors for depressed mood among farmers using a longitudinal study design. METHODS: Participants were principal farm operators in the Iowa Certified Safe Farm study. We identified risk factors for depressed mood by calculating relative risks (RR) using the generalized estimating equations method. RESULTS: In the multivariate model, pesticide exposure (RR = 1.26; 95% CI: 1.04 to 1.53), having an additional job off the farm (RR = 1.32; 95% CI: 1.08 to 1.62), stress (RR = 3.09; 95% CI: 2.55 to 3.75), and previous injury (RR = 1.41; 95% CI: 1.05 to 1.89) prospectively increased the risk of depressed mood. CONCLUSIONS: Consistent with earlier non-longitudinal studies, the results of this study suggest that reducing pesticide exposure, stress, and injury may reduce the risk of depression in the farm setting.

Distribution and characteristics of occupational injuries and diseases among farmers: a retrospective analysis of workers' compensation claims.

BACKGROUND: Research indicates occupational injuries and diseases are not evenly distributed among workers. We investigated the distribution and characteristics of compensated occupational injuries and diseases requiring medical care in the Finnish farming population. METHODS: The study population consisted of 93,564 Finnish farmers, spouses, and salaried family members who were covered by the mandatory workers' compensation insurance in 2002. This population had a total of 133,207 occupational injuries and 9,148 occupational diseases over a 26-year period (1982-2008). RESULTS: Clustering of claims was observed. Nearly half (47.1%) of the population had no compensated claims while 52.9% had at least one; 50.9% of farmers had one or more injuries and 8.1% had one or more diseases. Ten percent of the population had half of injury cases, and 3% of the population had half of occupational disease cases. Claims frequently involved work tasks related to animal husbandry and repair and maintenance of farm machinery. Injury and disease characteristics (work activity, cause, ICD-10 code) differed between individuals with high and low personal claim rate. Injuries and diseases of the musculoskeletal system had a tendency to reoccur among those with high claim rate. These outcomes were often related to strenuous working motions and postures in labor-intensive animal husbandry. CONCLUSIONS: Analyses of longitudinal insurance data contributes to better understanding of the long-term risk of occupational injury and disease among farmers. We suggest focusing on recurrent health outcomes and their causes among high risk populations could help design more effective interventions in agriculture and other industries.

Farm machinery injuries: the 15-year experience at an urban joint trauma center system in a rural state.

Farm machinery is a major source of injury. The objective of this study is to characterize the incidence, injury characteristics, and outcomes of patients admitted with farm machinery injuries (FMIs) to an urban joint trauma system in a rural state. A retrospective 15-year review of the trauma registries of the two trauma centers that function as a single state-designated Level I joint trauma center system was conducted. There were 65 admissions for FMIs at hospital A and 41 at hospital B; this represents under 0.4% of total trauma admissions. The patients ranged in age from 2 to 87 years. At hospital A, 89% of admitted patients sustained extremity injuries, 16% sustained torso trauma, 92% required surgical intervention, and the mortality rate was 0%. At hospital B, 60% of admitted patients sustained extremity injuries, 36.6% of patients sustained torso trauma, 63% required surgical intervention, and the mortality rate was 14.6%. Tractor-related injuries were responsible for 17% of admissions at hospital A and 69% at hospital B. Of the six fatalities, five were tractor related. The data demonstrate that FMIs affect people in nearly all decades of life. FMIs at the two hospitals had differing injury characteristics and outcomes, in large part secondary to the differing frequency of tractor-related injuries. FMIs frequently required surgical intervention.