A Descriptive Study of Farm-Related Injuries Presenting to Emergency Departments in North Carolina: 2008-2012.

Farming is among the most dangerous industries for fatal and nonfatal injuries. A comprehensive agricultural injury surveillance system is absent in North Carolina (NC), and data sets traditionally used to provide estimates of nonfatal farm injuries surveillance in the United States are relatively incomplete. In the absence of a comprehensive farm injury surveillance system, individual local administrative data sources can provide a useful profile of the epidemiology of injuries in a population. The objective of this study was to use emergency department data to help describe the burden of farm-related injuries in NC and explore its usefulness in conducting work-related injury surveillance. Emergency department data from the North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT) was utilized to identify farm injury cases. The study sample included all farm injury cases for the period of 2008-2012 that contained International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) E code 919.0 (agricultural machinery) or 849.1 (place of occurrence = farm; this E code excludes farm house and home premises of farm). Results indicated that an average of 459 cases of farm injury occurred annually from 2008 to 2012, with no significant change between years. Among the patients, 79.7% were male, 74.7% were between 18 and 64 years old, and 28.1% had no form of insurance coverage. Injuries were more heavily concentrated in the Piedmont and Coastal Plains regions (41.3% and 42.2%, respectively). Of farm-coded incidents, 73.2% were given injury- or poisoning-related primary diagnosis codes, and of these, the most frequent specific codes were related to open wounds of upper limbs (16.2%), contusions (12.0%), and sprains and strains (9.3%). Some significant relationships between diagnoses and sex, region, and age are also identified. Injuries occurring on a farm have been well documented and constitute a significant public health problem. Exploring emergency department data provides an opportunity to better characterize nonfatal farm-related injuries in NC for prevention purposes. The data provided by this study may serve to direct prevention programs, whereas the methods used offer a potential farm-related injury surveillance tool.

Sun protection behaviors among Latino migrant farmworkers in eastern North Carolina.

OBJECTIVE: Farmworkers are at an increased risk of skin cancer from exposure to excessive amounts of ultraviolet radiation from the sun. The primary objective of this study was to evaluate sun protection behaviors. METHODS: A cross-sectional study of Latino farmworkers in eastern North Carolina was conducted using personal interviews followed by a full-body examination for skin cancers (N = 157). RESULTS: Participants were predominately, young, males from Mexico who spent 9 or more hours each work day in the sun. Most reported wearing long sleeved shirts (85.7%) and long pants (98.0%). Few workers rarely used sunscreen (90.8%) or wore sunglasses (87.4%). Skin cancers were not identified among workers. CONCLUSIONS: In general, farmworkers lack sufficient information and knowledge about the risks of skin cancer from the sun. Interventions for reducing excessive ultraviolet radiation exposures are warranted.

A cross-sectional study of stressors among farmers in Eastern North Carolina.

BACKGROUND: Agriculture is a hazardous, stressful occupation that can adversely affect farmers' health. Identifying stressors among farmers may help health professionals improve health outcomes by developing targeted intervention strategies and services. METHODS: Over a 4-month period, we conducted a cross-sectional study of 128 farmers in an economically disadvantaged, 29-county region of Eastern North Carolina. We used a modified version of the Farm Ranch Stress Inventory to measure farmers' self-reported reactions to potential stressors. RESULTS: The majority of farmers surveyed were aged 40-59 years, had farmed for more than 20 years, and worked more than 40 hours per week on the farm. Large proportions of respondents identified the following factors as 'very stressful': concern about the weather (60.2%), concern over the future of the farm (29.7%), outsiders not understanding the nature of farming (25.2%), problems with machinery (23.4%), market prices for crops/livestock (45.3%), taxes (38.3%), health care costs (32.5%), and not having enough time to spend with family in recreation (13.3%). Experiencing 8 or more factors as "very stressful" was found to be positively associated with working more than 40 hours per week on the farm (P = .008) and with being a farm manager or a farm worker who does not operate equipment (P = .001). CONCLUSIONS: Information about perceived stressors among farmers may help health professionals develop targeted interventions for reducing stress. More research is needed to better evaluate health outcomes, to reduce farm-related injuries, and to improve psychosocial well-being.