Agricultural tractor overturn deaths: Assessment of trends and risk factors

Medicolegal Implications of Deaths due to Agricultural Accidents

ABSTRACT

Agriculture encompasses a variety of activities that carry with them a variety of different risks. The unsafe use of vehicles, machinery, and tools as well as animal husbandry, working at heights, and exposure to chemical, biological, and weather events may result in the deaths of agricultural workers. Inexperienced operators and/or their inappropriate conduct may lead to avoidable fatalities. Forensic pathologists operating with the support of agricultural engineers or other professionals must evaluate the death scene, the case background and circumstances, the autopsy findings, and the toxicological data to establish the factors and dynamics responsible for such accidents and deaths.The aim of this review is to focus on the diagnostic approach required, by means of an interdisciplinary approach, to identify the cause of some typical agricultural fatalities, to confirm that death was accidental, and to help exclude the possibility of homicide or suicide.

Agricultural Injury Surveillance in the United States and Canada: A Systematic Literature Review

INTRODUCTION

Agricultural injuries remain a major concern in North America, with a fatal injury rate of 19.5 deaths per 100,000 workers in the United States. Numerous research efforts have sought to compile and analyze records of agricultural-related injuries and fatalities at a national level, utilizing resources, ranging from newspaper clippings and hospital records to Emergency Medical System (EMS) data, death certifications, surveys, and other multiple sources. Despite these extensive efforts, a comprehensive understanding of injury trends over extended time periods and across diverse types of data sources remains elusive, primarily due to the duration of data collection and the focus on specific subsets.

METHODS

This systematic review, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, consolidates and analyzes agricultural injury surveillance data from 48 eligible papers published between 1985 and 2022 to offer a holistic understanding of trends and challenges.

RESULTS

These papers, reporting an average of 25,000 injuries each, were analyzed by database source type, injury severity, nature of injury, body part, source of injury, event/exposure, and age. One key finding is that the top source of injury or event/exposure depends on the chosen surveillance system and injury severity, underscoring the need of diverse data sources for a nuanced understanding of agricultural injuries.

CONCLUSION

This study provides policymakers, researchers, and practitioners with crucial insights to bolster the development and analysis of surveillance systems in agricultural safety. The overarching aim is to address the pressing issue of agricultural injuries, contributing to a safer work environment and ultimately enhancing the overall well-being of individuals engaged in agriculture.

Farm Machinery Injuries: A Retrospective Analysis of Admissions at a Level I Trauma Center in North Dakota

OBJECTIVES

The purpose of the present study was to characterize the incidence, injury characteristics, and outcomes of patients presented to a Level I adult trauma center in Fargo, North Dakota, with farm machinery injuries (FMI).

METHODS

We performed a retrospective review of the trauma registry of Sanford Medical Center Fargo (SMCF) between January 2010 and December 2020. We compared admission characteristics of FMI admissions to non-FMI admissions, identified the types of machinery that are most commonly associated with FMI, and described the nature of these injuries by severity, anatomical site, type, age, sex, and length of stay (LoS). Injury severity was evaluated using Injury Severity Score (ISS).

RESULTS

Findings indicated that FMI admissions had a higher mean ISS, longer ICU LoS, and a higher mortality rate than non-FMI admissions. The leading cause of fatal and non-fatal FMI in this region are tractors. Males experience 91.2% of tractor injuries, and individuals 65 and over account for nearly 53% of all tractor injuries (n = 18). Males accounted for all deaths, tractor and otherwise. The "other machinery" category was the second most common category and accounted for 50% of female patients. Additionally, 24.5% of all FMI are related to machine maintenance.

CONCLUSION

The findings from this study indicate that FMI injuries represent a significant problem in the upper Midwest. Older, male farm workers experience a higher incidence of tractor-related injuries, and all tractor-related deaths occurred in individuals 65 years of age and older. These results underscore the need for further investigation into aging-related farm safety issues.

Towards a Better Understanding of Farm Fatalities: Identification and Estimation of Farming Fatality Rates

OBJECTIVE

Occupational fatality rates are useful in communicating key safety challenges associated with different industries or affecting different populations within those industries. Though seemingly intuitive, the calculation and use of fatality rates associated with farming needs to be carefully considered. This paper highlights difficulties and variability in Farm Fatality Rate (FFR) measures, proposes a series of rates appropriate for assessments of farm safety, and demonstrates their usage through an analysis of farm workplace deaths in Ireland between 2008 and 2016.

METHODS

Six FFRs are calculated including: the Farm Household Rate (FHR); Farm Operator Rate (FOR); Family Worker Rate (FWR), Worker Rate (WR), Seasonal Fatality Rate (SFR) and, Enterprise Fatality Rate (EFR). To assess trends over time we calculate the rate using appropriate numerators and denominators in three sub-periods.

RESULTS

FFRs vary considerably depending on which numerator and denominator are deployed. Over the period, the FHR, FOR, and FWR increased due to growth in the number of fatalities and a slight decrease in the denominator populations. The WR has declined substantially over the full period. The QFR increased substantially for Q2-Q4 whilst the EFR highlights workers on dairy or beef enterprises being particularly at risk.

CONCLUSION

The characteristics of farm workforces present many challenges to the calculation of occupational fatality rates. We propose six alternatives that provide insights into the risks faced by farm households, farm operators, farm workers, seasonally and by type of farm enterprise. We recommend that, regardless of the rate used, the limitations associated with all fatality rates are clearly explained, particularly when engaging with media and occupational health and safety stakeholders.

Trends in Work-Related Fatal Farm Injuries, Saskatchewan, Canada: 2005-2019

OBJECTIVES

This study was conducted to estimate farm fatality rates and to describe patterns of fatal agricultural injuries on Saskatchewan farms from 2005-2019.

METHODS

Data on work-related farm fatalities was collected from January 2005 to December 2019 in the Province of Saskatchewan as a part of the injury and mortality surveillance for the Canadian Agricultural Injury Reporting (CAIR) program. Data were abstracted from records made available by the Provincial Coroner's Office.

RESULTS

There were 166 farm work-related fatalities recorded between 2005 and 2019 in Saskatchewan. The majority (93.4%) of work-related fatalities were in males. The overall work-related fatality rate was 10.5 (95% CI: 8.9-12.1) per 100,000 farm population. The overall age-adjusted work-related fatality rate was 18.1 (95% CI: 15.2-20.9) per 100,000 farm population among males and 1.4 (95% CI: 0.6- 2.3) per 100,000 farm population among females. Age-adjusted rate decreased from 91.2 (95% CI: 69.4 - 117.66) per 100,000 farm population in 2005-2009 to 89.7 (95% CI: 64.9 - 120.2) per 100,000 farm population in 2015-2019 in males. Trend analysis of the work-related fatality rate in all cases showed a non-significant average annual decline of 2.6% (p=0.156). Rollover injuries contributed to a high proportion of fatalities in children (30.0%) and the elderly population (14.9%). The most common causative agent was a tractor, and the most common location of injury was the farmyard or field.

CONCLUSION

The burden of mortality in this industry is still substantial. There was a non-significant decreasing trend in the injury rate over the 15 years period. Elderly farmers continue to be at high risk for fatality while the rates for children have declined. Application of the hierarchy of control to this workplace could reduce the risk of fatal injury, and in particular the high proportion of rollover injuries in children and the elderly population.

Machinery Safety and Ergonomics: A Case Study Research to Augment Agricultural Tracklaying Tractors' Safety and Usability

Occupational Health and Safety (OHS) in agricultural activities is an issue of major concern worldwide notwithstanding the ever stricter regulations issued in this sector. In particular, most accidents are related to the use of tractors and the main causes of this phenomenon are due to the lack of rollover protective structures (ROPSs). This happens especially when tractors are used in particular in-field operations that are characterized by limited clearances between tractor and crop rows so that farmers usually use tractors without ROPS (e.g., dismounting it). To solve such a problem, foldable protective structures (FROPSs) have been proposed, which should augment the operator's protection. However, FROPS's conventional solutions underestimate the operators' risk-taking behavior and the widespread misuse of FROPS due to the efforts needed to operate it. The current study aims at contributing to the improvement of the latter issue proposing the development of a novel approach for the implementation of partial assistance systems (PASs) that can reduce the physical effort of the operator when raising/lowering the FROPS. The proposed methodology, which is based on a reverse engineering approach, was verified by means of a practical case study on a tracklaying tractor. Results achieved can contribute to expanding knowledge on technical solutions aimed at improving the human-machinery interaction in the agricultural sector.

Agricultural Tractor Roll-Over Related Fatalities in Italy: Results from a 12 Years Analysis

In Italy, about 160 fatal accidents per year have occurred recently in agriculture, most of them involving agricultural machinery. The most frequent cause of fatal events is the tractor overturning. One of the opportunities to monitor the trend of agricultural tractors fatal overturning is a meticulous search for information on the numerous web portals, at national and local level. In fact, in their information purposes are also included the recording, practically in real time, of significant details about each fatal event, such as the place of the accident, the year, the month and the day of the week of occurring, the victim’s age, gender and nationality, etc. This article is describing the results of the monitoring of fatal tractor overturning accidents in the period of 2008–2019 in Italy. In the 12 years of the survey, 1414 fatal accidents were recorded, most of them occurring in the spring and summer months. The region with the highest cumulative number of fatal events was Tuscany (143). The majority (58.8%) of the victims were over 60, while 71.4% of accidents occurred during field work. Most (57.6%) of the tractors involved in the fatal events did not have rollover protective structures (ROPS), while 19.4% were equipped with a two-post foldable front roll-bar, which, however, was in the lowered position at the time of the accident. In most cases, the tractors involved were obsolete and in poor maintenance conditions, and did not comply with general and specific laws on work safety. To improve the situation, the introduction of the tractor training certificate for the drivers and the periodical inspection for tractors, as well as the issuing of significant financial supports to encourage the replacement of the old models with modern more safe models, are the most effective actions to be put into practice.

Fatal Agricultural Accidents in Kansas: A Thirty-Nine-Year Follow-Up Study with an Emphasis on Vehicular Fatalities

The purpose of this study was to evaluate trends in agricultural mortality before and after implementation of safety initiatives. Retrospective review of Kansas mortality data from agriculture-related injuries from 1979 to 2018. The 39-year period was stratified into four periods to compare mechanisms of injury and fatality rates between study periods. There were 780 agricultural-related deaths. Mean age significantly increased between study Period I to Period IV from 46.4 to 55.3 years (P = 0.013). Tractors remain the primary cause of farm-vehicle mortality overall; however, tractor-related deaths significantly decreased during the study periods from 75.6% to 44.3% (P < 0.001). Tractor rollover mortality also decreased from 50.8% to 25.6% (P = 0.036). ATV-related deaths significantly increased from study Period II to III (5.1% to 23.9%, P < 0.001), but decreased from Period III to IV (23.9% to 17.0%). Tractor-related fatalities are decreasing, but tractors still remain the most dangerous piece of farm equipment. ATV-related fatalities are a continued concern. Continued rural education and emphasis on the use of rollover protection structures is a critical focus in the effort to prevent fatal farming injuries.

Risk for Depressive Symptoms and Suicide Among U.S. Primary Farmers and Family Members: A Systematic Literature Review

Background: About 84% of the agriculture, fishing, and forestry occupational sector is comprised of farmers. This sector is at high risk for suicide in the United States. Recent disasters and trade upheavals may make farmers and their families more vulnerable to depression and suicide. This review focused on the risk for depression and suicide among United States’ primary farm operators and their families. Methods: A systematic search of the literature published between January 2000 and June 2019, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology was conducted. Results: A total of 30 articles met full inclusion criteria. Seventeen reports emanated from the midwest. Twenty studies used a cross-sectional design, primarily assessing a convenience sample or random stratified sample from a limited geographic area. We discovered only one intervention evaluation study. Depressive symptoms were assessed as part of the studies, but it was not the major focus. A variety of instruments measured depressive symptoms, with the Centers for Disease Control Epidemiologic Studies—Depression (CES-D) Scale used more frequently than other scales. Thirteen studies focused on the relationship between pesticide/chemical exposure and depression or suicide risk. Increased stress, poor physical health, compromised financial position, and previous injury were among the leading indicators of depression. Conclusion/Application to Practice: The limited number of studies that was discovered identified the need for more robust science where the risk for depression and suicide is the primary focus of the study and for intervention studies grounded in science. Occupational health providers should be vigilant about farm exposure and be aware of factors that may influence depressive symptoms of workers who operate farm establishments.

Estimating the Number of Agricultural Fatal Injuries Prevented by Agricultural Engineering Developments in the United States

Agriculture has been consistently marked as one of the deadliest industries by the United States Bureau of Labor Statistics (BLS). While this statistic is widely used in promoting agricultural safety and health, it does not paint a complete picture on the current status of agricultural safety and the advances that have been made in the last century. For example, even with a stagnant rate of injury, the BLS has reported that fatal incidents decreased from a high of 855 incidents in 1993 to a low of 500 incidents in 2013. The purpose of this study was to analyze the impact that agricultural engineering developments had on reducing fatal injuries. Agricultural engineering developments are defined as any agricultural improvement that results in a direct reduction in the amount of labor needed. This study uses existing federal agricultural statistical, injury and demographic data to calculate the impact that engineering, in contrast to yield improvements and safety enhancements, contributed to a reduction in the number of fatal incidents. The study found that engineering developments could have contributed to the reduction in the number of fatal injuries by about 170 incidents from 1992 to 2015. This represents 63% of the total reduction in the number of fatal injuries. In conclusion, agricultural engineering developments play a substantial role in reducing the number of fatal incidents by removing and reducing labor exposure to hazardous environments.

Summary of Indiana Farm Fatalities Involving Individuals 55 Years and Older—1988–2017

Agriculture has historically been one of the most hazardous of all occupations, with a variety of potential safety risks to workers and even higher risks documented for older agricultural workers. This study was undertaken to document and summarize Indiana farm work-related fatalities involving persons 55 years and older over the 30 year period from 1988 to 2017. Data were mined from the Purdue University Agricultural Safety and Health Program’s Fatality Database that dates back to the 1960s. A total of 388 fatalities involving persons 55 years and older was documented. The average age of the victims was 69.3 years old, and an overwhelming majority of the cases involved males (96.1%). The average number of deaths per year has remained fairly consistent, though it has occasionally been erratic, with an unanticipated increase in the number of documented fatalities over the period 2012–2017. There appeared to be a direct positive correlation between the level or intensity of agricultural production in a county and the frequency of fatalities. The type of fatal injury most commonly reported was crush/run-over, with 229 cases (59%). The most common agent or source of injury involved was tractors, with 157 cases (40.5%). Another noted contributing factor was the high frequency of incidents in which the victim was reported to be working alone at the time of death. Findings will be used to develop evidence-based injury prevention strategies, including the development of agricultural safety training materials and methods more relevant to older farmers. A special emphasis should be placed on reducing the risk of tractor and farm machinery overturns, especially when older, non-roll over protection structure (ROPS) equipped tractors are being operated.

Incidence, patterns and associated factors for occupational injuries among agricultural workers in a developing country

Background: Injuries are common among agricultural workers, and a large section of the population is employed in agriculture worldwide. We aimed to determine the incidence, patterns and associated risk factors of occupational injuries among the agricultural workers in a developing country.

Methods: A cross-sectional study in Hyderabad, Pakistan was conducted from December 2012 to February 2013. Information was collected about incidence, pattern and associated risk factors of occupational injuries from 472 agricultural workers. Injury incidence and patterns for place, severity, type, agent, parts of body affected and work activity were calculated. Analysis was performed using SPSS version 19.0. Multivariate logistic regression was performed to calculate the adjusted odds ratio (OR) with 95% confidence interval, to identify the putative risk factors for occupational injuries.

Results: Incidence of occupational injuries was 35.0 per 100 per year (95% CI: 28.9 - 42.7). Cuts (70%) and hand tools (71%) were the most common type and agent for injury, respectively. Majority of injuries occurred during harvesting (55%). Increasing age [AOR 1.03 (95% CI: 1.01 - 1.05)], income <6000PKR/month [AOR 2.27 (95% CI: 1.08 - 4.76)] and driving tractor [AOR 2.58 (95% CI: 1.25 -5.33)] increase the risk for injuries.

Conclusion: There was a high burden of injuries among the agricultural workers in Pakistan. Large-scale studies are required to further characterize the risk of injuries and develop preventive strategies to protect agricultural workers.

Rollover Protective Structures, Worker Safety, and Cost-Effectiveness: New York, 2011-2017

OBJECTIVES

To measure cost-effectiveness of an intervention to increase retrofitting of rollover protective structures (ROPS) on tractors.

METHODS

Tractor overturns are the leading cause of farm fatalities. ROPS prevent these deaths. This study updates a 2011 cost-effectiveness assessment of a New York State intervention to increase use of ROPS. We subtracted intervention cost from the cost of injuries averted, then divided this figure by the number of averted injuries. We used related probabilities and costs of fatalities and injuries from published literature to calculate the program's cost-effectiveness.

RESULTS

The total cost of the injuries averted from 2007 to 2017 was $6 018 742 versus a total program cost of $1 776 608. The one-time retrofit costs will continue to prevent injuries as long as the tractors are used, generating additional (projected) future savings of $12 136 512, $15 781 027, and $18 924 818 if retrofitted tractors remain in operation 15, 20, or 25 years after their retrofit.

CONCLUSIONS

Social marketing was cost-effective for reducing injuries from tractor overturns. Public Health Implications. These results indicate that the intervention model is effective from both a public health and economic standpoint and should be expanded into other states.

Fatal Agricultural Accidents in Kansas: A Thirty-One-Year Study

Agricultural work results in numerous injuries and deaths. Efficacy of farm equipment safety interventions remains unclear. This study evaluated agricultural mortality pre- and post-implementation of safety initiatives. A 31-year retrospective review of mortality data from agriculture-related injuries was conducted. Demographics and injury patterns were evaluated by mechanism of injury. There were 660 deaths (mean age 48.6 years). Female deaths increased from 5.2 to 11.7 per cent ( P = 0.032). Mortality associated with tractors decreased (75.6% vs 53.9%; P < 0.001) and with all-terrain vehicles increased (3.5% vs 22.0%; P < 0.001) from Period I to III. However, tractors remain the primary cause of mortality. For mechanical equipment–associated mortality, there was a decrease (83.3% vs 50.0%) in “caught in equipment,” and an increase (6.7% vs 38.9%) in those killed by “crush injury” from Period I to III. Application of safety devices to enclose and stabilize machinery has led to an overall decrease in mortality associated with tractors and “caught in equipment.” Expanded rural education, as well as further development and use of safety devices, is warranted to curtail farm-related injuries and deaths.

Morbidity and mortality from farm tractor-related injuries in Arkansas

This study applied a text string search algorithm to ascertain suspect farm tractor or agricultural machinery-related injuries in data sources available for 2000-2014 in the state of Arkansas. The occurrences of tractor or other agricultural machinery-related injuries were compared with data available from the Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS) and the Bureau of Labor Statistics' Census of Fatal Occupational Injuries (CFOI). For death certificates that assigned an external cause of death, the authors first collected all those that were coded as related to agricultural machinery, based on search strings for occupation and industry and a description of how the injury occurred. They then inspected each case individually and removed those that were likely unrelated to agricultural machinery. This approach significantly increased (by 7.8 times) the number of suspect agricultural machinery-related fatalities compared to the number reported to CFOI, but there was only a 17% (not statistically significant) increase compared to NCHS. All hospital records with any discharge diagnosis coded as related to agricultural machinery were selected. Descriptive analysis of the fatalities and hospital records showed a significantly increased risk among men above retirement age, peaks during the summer, and an increased risk in the Mississippi delta region. About one-third of the agricultural machinery-related fatalities were due to overturns. The use of the algorithm can improve ascertainment of fatal agricultural machinery-related injuries in Arkansas. The death records were found to be rich in data on the circumstances of the injuries, which can be used to screen for tractor-related fatalities and, if confirmed, translated into action to improve the safety of Arkansas farmers.

It does not occur by chance: a mediation model of the influence of workers' characteristics, work environment factors, and near misses on agricultural machinery-related accidents

Agriculture is among the most hazardous productive sectors, and farm machinery is a major source of injury. In the present study, a mediated model was used to test the role played by workers' characteristics, work environment factors, and near misses in predicting agricultural machinery-related accidents in a sample of Italian users (n = 290). Hours worked per week (via the mediation of an adverse work environment) showed a positive association and years of work experience (via the mediation of risk perception) showed a negative association with the probability of being involved in a near miss, which in turn showed a positive association with the probability of being involved in a machinery-related accident. Implications for tailored preventive interventions are discussed.

Analysis of Tractor-Associated Fatalities

INTRODUCTION AND OBJECTIVE

Tractor is regarded as a key equipment in agriculture, and it is also used for transportation and transfer purposes in addition to its agricultural use. Accidents resulting in death in farmlands are frequently encountered. Tractor-related fatalities are the most common ones among the deaths after farm accidents. This study aimed to evaluate the characteristics of tractor-related deaths and to discuss the measures that could be taken to prevent these deaths.

METHODS

In this study, 42 cases who underwent postmortem examination and/or autopsy because of tractor fatalities in the province of Elazig between January 2005 and December 2016 were examined retrospectively with such variables as sex, age, month and season of incident, cause of incident, location of incident, position of case, and injured region.

RESULTS

Of the cases, 36 (85.7%) were male, and 6 (14.3%) were female. The youngest case was 2 years old, and the oldest case was 83 years old; the mean age was 43.3 ± 25.0 years. Examining the deaths regarding the cause of incident showed that tractor rollover was the most common cause (42.9%). This was followed by being run over by the tractor (19.0%). Of the cases, 24 (57.1%) were drivers, 10 (23.8%) were passengers, and 8 (19.0%) were pedestrians.

CONCLUSIONS

Tractor-related fatalities due to tractor rollover are most often seen. To reduce the deaths caused by this reason, drivers should have special training and technical support, use helmets and seatbelts in the tractor, and have a health check at certain intervals (especially the drivers at advanced age).

Medicolegal Investigations Into Deaths Due to Crush Asphyxia After Tractor Side Rollovers

Farm tractors are large, heavy, powerful vehicles with a high center of gravity. When driven carelessly on sloping, irregular, or slippery ground, tractors can overturn sideways and cause the death by crush asphyxia of the driver or passengers, especially if appropriate safety equipment is not fitted or used. The aim of this review is to focus on the diagnostic difficulties with which coroners and forensic pathologists have to cope when a confirmation of crush asphyxia after tractor side rollover is required by judicial authorities. Forensic investigations in such cases must involve the meticulous analysis of the death scene and the mechanical characteristics of the vehicle together with accurate postmortem and toxicological examination.

Review and Meta-analysis of Emerging Risk Factors for Agricultural Injury

Agricultural injury is a significant public health problem globally. Extensive research has addressed this problem, and a growing number of risk factors have been reported. The authors evaluated the evidence for frequently reported risk factors earlier. The objective in the current study was to identify emerging risk factors for agricultural injury and calculate pooled estimates for factors that were assessed in two or more studies. A total of 441 (PubMed) and 285 (Google Scholar) studies were identified focusing on occupational injuries in agriculture. From these, 39 studies reported point estimates of risk factors for injury; 38 of them passed the Newcastle-Ottawa criteria for quality and were selected for the systematic review and meta-analysis. Several risk factors were significantly associated with injury in the meta-analysis. These included older age (vs. younger), education up to high school or higher (vs. lower), non-Caucasian race (vs. Caucasian), Finnish language (vs. Swedish), residence on-farm (vs. off-farm), sleeping less than 7-7.5 hours (vs. more), high perceived injury risk (vs. low), challenging social conditions (vs. normal), greater farm sales, size, income, and number of employees on the farm (vs. smaller), animal production (vs. other production), unsafe practices conducted (vs. not), computer use (vs. not), dermal exposure to pesticides and/or chemicals (vs. not), high cooperation between farms (vs. not), and machinery condition fair/poor (vs. excellent/good). Eighteen of the 25 risk factors were significant in the meta-analysis. The identified risk factors should be considered when designing interventions and selecting populations at high risk of injury.

Development and Evaluation of a Computer-Based ROPS Design Program

Tractor overturn is the leading cause of agricultural fatalities in the U.S. Most of these fatalities can be eliminated using a rollover protective structure (ROPS) and a seatbelt. Unfortunately, not all agricultural tractors designed to support ROPS have ROPS designs. A computer-based ROPS design program (CRDP) was developed and successfully tested to provide quick and simple two-post, rear axle-mounted ROPS designs based on SAE Standard J2194. The program uses the tractor dimensions and mass to calculate the dimensions needed for ROPS components. Excel was used as the framework to provide the input, calculation, and ROPS drawing worksheets. Three ROPS (for Massey Ferguson 265, Long 460, and Allis Chalmers 5040 tractors) were designed and constructed using the CRDP. Static rear, side, and vertical tests were conducted based on SAE J2194 on two of the ROPS. All ROPS performance deflection (RPD) tests were less than the ROPS allowable deflection (RAD), indicating that the ROPS passed the static tests. The third ROPS was successfully mounted on the tractor axle housing within one hour, demonstrating the ease of installation using a bolted corner bracket design. Although the CRDP provided quick and simple ROPS designs, this program does not eliminate the requirement to conduct and pass the performance tests for ROPS designs specified in OSHA and SAE standards.

Characteristics of Fatal Agricultural Injuries by Production Type

Although agriculture is recognized as a hazardous industry, it is unclear how fatal agricultural injuries differ by production type. The purpose of this study was to characterize fatal occupational injuries in agriculture, comparing crop and animal production, and determine which risk factors are specifically associated with each production type. A cross-sectional study was conducted among crop and animal pro ducers using data from the Census of Fatal Occupational Injuries in the Midwest region from 2005 to 2012. Rates offatal injury by production type were estimated. The frequency of fatal injury in each production type was also reported by demographic and injury characteristics. Finally, a logistic regression was performed to determine whether age, gender, injury timing, or injury event/exposure type were associated with crop or animal production. A total of 1,858 fatal agriculture-related injuries were identified, with 1,341 in crop production and 517 in animal production. The estimated rate of fatal injury was higher in crop production than in animal production (15.9 vs. 10.8 per 100,000 workers). Fatal injuries among young and elderly agricultural workers were significantly associated with crop production compared to animal production. Animal assaults, falls, and exposure to harmful substances or environments were significantly associated with animal production. Fatal agricultural injury is more common in crop production. However, the characteristics and risk factors of fatal injuries differ by production type. Intervention strategies may be guided by considering the production-specflc risk factors.

Trends in non-fatal agricultural injuries requiring trauma care

Background

Efforts to control agricultural injuries have been underway for years. Yet, very little is known about their trends over time. We examined trends in non-fatal agricultural injuries through analyzing injuries reported in a state trauma registry.

Methods

Using Iowa Trauma Registry data collected by the Iowa Department of Public Health, we examined trends in non-fatal agricultural injuries reported by acute care hospitals accredited as Level I, II, and III Trauma Care Facilities from 2005 to 2013. Rate ratios and corresponding 95 % confidence intervals were used to examine the burden of non-fatal agricultural injuries across this period. Negative binomial regression was used to calculate the average annual change in agricultural injury rates over time. Joinpoint regression analysis was used to examine the average annual change in the number of injuries over time.

Results

Between 2005 and 2013, a total of 1238 agricultural injuries were reported to the trauma registry by Level I, II and III trauma facilities. From 2005 to 2013, the rate of agricultural injuries per 100,000 hired workers, ranchers, and farm operators increased by 11 % for every unit increase in year and had nearly tripled over this time period. From 2005 to 2008 there was a significant annual increase of 31.74 % in the number of agricultural injuries whereas from 2008 to 2013 there was a non-significant annual increase of 3.70 %. The number of moderate and severe/critical injuries increased steadily and significantly over the study period, with annual percent increases of 13 and 20 %, respectively.

Conclusion

Non-fatal agricultural injuries are rising, although the documented increases could be influenced in some part by treatment patterns in the trauma system, reporting bias or increases in farm work exposure. However, these issues do not likely account for all of the increase found, and this calls for an increase in priority of agricultural safety programs. Since the majority of research involves fatal injuries, information about non-fatal injuries may help inform new intervention approaches.

Trends of occupational fatalities involving machines, United States, 1992-2010

BACKGROUND

This paper describes trends of occupational machine-related fatalities from 1992-2010. We examine temporal patterns by worker demographics, machine types (e.g., stationary, mobile), and industries.

METHODS

We analyzed fatalities from Census of Fatal Occupational Injuries data provided by the Bureau of Labor Statistics to the National Institute for Occupational Safety and Health. We used injury source to identify machine-related incidents and Poisson regression to assess trends over the 19-year period.

RESULTS

There was an average annual decrease of 2.8% in overall machine-related fatality rates from 1992 through 2010. Mobile machine-related fatality rates decreased an average of 2.6% annually and stationary machine-related rates decreased an average of 3.5% annually. Groups that continued to be at high risk included older workers; self-employed; and workers in agriculture/forestry/fishing, construction, and mining.

CONCLUSION

Addressing dangers posed by tractors, excavators, and other mobile machines needs to continue. High-risk worker groups should receive targeted information on machine safety.

Nonfatal tractor-related injuries presenting to a state trauma system

PURPOSE

To identify tractor-related injuries using data from a statewide trauma system, to characterize the mechanisms of nonfatal tractor-related injury, and to determine which injuries are associated with higher severity injury.

METHODS

A retrospective observational study was conducted using the Iowa State Trauma Registry to identify cases of nonfatal tractor-related injuries over an 11-year period from 2002 to 2012. Frequency of injury was reported by age, sex, severity, and nature. Injuries were classified by mechanism and a polytomous regression model was used to predict injury severity adjusting for sex and age.

RESULTS

Five-hundred thirteen nonfatal tractor-related injuries were identified with 18% classified as severe. Injuries were most frequent among males and among those ≥45years of age. Rollovers were the most frequent mechanism of both total (25%) and severe injury (38%), although the frequency of injury mechanism varied by age. Falls were the next most frequent mechanism of injury (20%) but resulted in fewer high-severity injuries. Collision (adjOR=1.89, 95% CI=1.01-3.51), rollover (adjOR=2.03, 95% CI=1.21-3.40), and run over/rolled on (adjOR=2.06, 95% CI=1.17-3.62) injuries were significantly associated with higher injury severity. Advanced age was also a significant predictor of higher severity injury (adjOR=1.82, 95% CI=1.06-3.12).

SUMMARY

Mechanisms of nonfatal tractor-related injuries are heterogeneous, differ by age, and are associated with varying level of severity.

PRACTICAL APPLICATIONS

This work shows the burden of nonfatal tractor injuries on a rural state trauma system. These findings also demonstrate the heterogeneous nature of nonfatal tractor injuries and underscore the need for a multi-level approaches to injury prevention.

Multiple jobholder mortality patterns in Kentucky: an examination of occupational fatalities

BACKGROUND

The percentage of multiple jobholders was elevated in Kentucky compared to the US from 2002 to 2010.

METHODS

Kentucky Fatality Assessment and Control Evaluation (FACE) multiple jobholder fatality data were analyzed to identify contributing injury factors from 2002 to 2010.

RESULTS

Kentucky's total occupational fatality rates were higher than US rates for all years (2002-2010). Kentucky multiple jobholder fatalities averaged 8.4 deaths per 100,000 employees compared to the total average occupational fatality rate of 6.5. Almost half of multiple jobholder fatalities (47%) occurred in the agricultural industry and management occupation as the primary industry and occupation; 67% were tractor-related. The most prevalent secondary industry and occupation were the construction industry and management occupation.

CONCLUSIONS

Increased surveillance of multiple jobholder injuries is needed to improve safety and health on the job. Future investigations should include the relationship between multiple jobholding and agricultural employment as farm owners.

Occupational health outcomes for workers in the agriculture, forestry and fishing sector: implications for immigrant workers in the southeastern US

BACKGROUND

Workers in the Agriculture, Forestry, and Fisheries (AgFF) sector experience exposures directly related to the work itself, as well as the physical environment in which the work occurs. Health outcomes vary from immediate to delayed, and from acute to chronic.

METHODS

We reviewed existing literature on the health outcomes of work in the AgFF sector and identified areas where further research is needed to understand the impact of these exposures on immigrant Latino workers in the southeastern US.

RESULTS

Outcomes related to specific body systems (e.g., musculoskeletal, respiratory) as well as particular exposure sources (e.g., pesticides, noise) were reviewed. The most extensive evidence exists for agriculture, with a particular focus on chemical exposures. Little research in the southeastern US has examined health outcomes of exposures of immigrant workers in forestry or fisheries.

CONCLUSION

As the AgFF labor force includes a growing number of Latino immigrants, more research is needed to characterize a broad range of exposures and health outcomes experienced by this population, particularly in forestry and fisheries.

Action Learning: a new method to increase tractor rollover protective structure (ROPS) adoption

Action Learning is a problem-solving process that is used in various industries to address difficult problems. This project applied Action Learning to a leading problem in agricultural safety. Tractor overturns are the leading cause of fatal injury to farmworkers. This cause of injury is preventable using rollover protective structures (ROPS), protective equipment that functions as a roll bar structure to protect the operator in the event of an overturn. For agricultural tractors manufactured after 1976 and employee operated, Occupational Safety and Health Administration (OSHA) regulation requires employers to equip them with ROPS and seat belts. By the mid-1980s, US tractor manufacturers began adding ROPS on all farm tractors over 20 horsepower sold in the United States (http://www.nasdonline.org/document/113/d001656/rollover-protection-for-farm-tractor-operators.html). However, many older tractors remain in use without ROPS, putting tractor operators at continued risk for traumatic injury and fatality. For many older tractor models ROPS are available for retrofit, but for a variety of reasons, tractor owners have not chosen to retrofit those ROPS. The National Institute for Occupational Safety and Health (NIOSH) attempted various means to ameliorate this occupational safety risk, including the manufacture of a low-cost ROPS for self-assembly. Other approaches address barriers to adoption. An Action Learning approach to increasing adoption of ROPS was followed in Virginia and New York, with mixed results. Virginia took action to increase the manufacturing and adoption of ROPS, but New York saw problems that would be insurmountable. Increased focus on team composition might be needed to establish effective Action Learning teams to address this problem.

A descriptive analysis of work-related fatal injury in older workers in Australia 2000-2009

The objective of this study is to describe the extent, nature, age distribution and external causes of older-worker fatalities and to provide baseline data for future studies. The methods included retrospective descriptive cohort study using existing population-based mortality data. The study examined work-related fatalities aged 55 years and older, 2000-2009, in Australia following coronial investigation. Of the 336 fatalities identified, almost all (96.3%) were male. The industry with most deaths was agriculture, forestry and fishing (37.8%), followed by transport, postal and warehousing (19.3%) and construction (16.6%). The most frequent injury mechanism was transport-related (40.4%). With predicted workforce ageing, older-worker deaths will become a significant public health issue. Employers and authorities will need to understand older-workers characteristics and vulnerabilities to enable appropriate injury prevention strategy implementation.

A spatial cluster analysis of tractor overturns in Kentucky from 1960 to 2002

BACKGROUND

Agricultural tractor overturns without rollover protective structures are the leading cause of farm fatalities in the United States. To our knowledge, no studies have incorporated the spatial scan statistic in identifying high-risk areas for tractor overturns. The aim of this study was to determine whether tractor overturns cluster in certain parts of Kentucky and identify factors associated with tractor overturns.

METHODS

A spatial statistical analysis using Kulldorff's spatial scan statistic was performed to identify county clusters at greatest risk for tractor overturns. A regression analysis was then performed to identify factors associated with tractor overturns.

RESULTS

The spatial analysis revealed a cluster of higher than expected tractor overturns in four counties in northern Kentucky (RR = 2.55) and 10 counties in eastern Kentucky (RR = 1.97). Higher rates of tractor overturns were associated with steeper average percent slope of pasture land by county (p = 0.0002) and a greater percent of total tractors with less than 40 horsepower by county (p<0.0001).

CONCLUSIONS

This study reveals that geographic hotspots of tractor overturns exist in Kentucky and identifies factors associated with overturns. This study provides policymakers a guide to targeted county-level interventions (e.g., roll-over protective structures promotion interventions) with the intention of reducing tractor overturns in the highest risk counties in Kentucky.