Hospitalized head injuries in agricultural settings: who are the vulnerable groups?

Pediatric Traumatic Injuries Due to Agrarian Hay-Hole Falls

Hay-holes are a design feature in many traditionally built barns that serve as a portal through which stored hay is passed to the lower level where animals are fed. Unfortunately, children sometimes fall through the hay-hole to the concrete or packed earth below. Available data on the frequency and types of hay-hole injuries is limited. The purpose of this study was to better characterize the resultant injuries and identify prognostic factors that predict outcomes from them. We performed a retrospective review of 53 children admitted to the Penn State Hershey Children's Hospital at the Penn State Hershey Medical Center with injuries due to a fall through a hay-hole over 15 years. Compared to urban trauma, hay-hole falls more frequently involve younger children and craniofacial injuries. Although they may result in significant injuries, they are rarely fatal. Greater fall height is associated with longer length of stay (LOS) but not with a greater frequency of intubation, intracranial hemorrhage, or skull fracture. A re-examination of barn design may help to reduce the frequency of this injury type.

Injuries and illnesses to children in commercial fishing in Alaska: A brief report

BACKGROUND

Commercial fishing is the most hazardous occupation in the United States. While the epidemiology of adult injuries and fatalities are well documented, injuries to children (<18 years old) are not described. The purpose of this report was to describe the characteristics of nonfatal injuries to children involved in commercial fishing.

METHODS

Nonfatal commercial fishing injuries to children were identified in the Alaska Fishermen's Fund. The Alaska Fishermen's Fund is an emergency fund payor of last resort. Data on nonfatal injuries to victims aged 17 or younger were analyzed. Descriptive statistics were used to characterize demographics and injury characteristics.

RESULTS

Forty-four nonfatal child injury claims were made between 2012 and 2016. The mean age at the time of claim was 15.6 years (SD = 1.8) and 84% were male. The most common types of injuries among children were sprains and strains and the most commonly injured body parts were upper extremities and the trunk. Most injuries occurred in salmon fisheries.

CONCLUSIONS

Children are participating in commercial fishing. Based on the results of this analysis, children are also experiencing occupational injuries. The results of this analysis underscore the need for additional safety and health information, guidance for supervisors, and intervention to prevent injuries to children participating in commercial fishing.

Gender in occupational health research of farmworkers: a systematic review

Background

Farmwork is one of the most hazardous occupations for men and women. Research suggests sex/gender shapes hazardous workplace exposures and outcomes for farmworkers. This paper reviews the occupational health literature on farmworkers, assessing how gender is treated and interpreted in exposure-outcome studies.

Methods

The paper evaluates peer-reviewed articles on men and women farmworkers' health published between 2000 and 2012 in PubMed or SCOPUS. Articles were identified and analyzed for approaches toward sampling, data analysis, and use of exposure indicators in relation to sex/gender.

Results

18% of articles reported on and interpreted sex/gender differences in health outcomes and exposures. Sex/gender dynamics often shaped health outcomes, yet adequate data was not collected on established sex/gender risk factors relating to study outcomes.

Conclusion

Research can better incorporate sex/gender analysis into design, analytical and interpretive approaches to better explore its mediation of health outcomes in light of emerging calls to mainstream gender research. Am. J. Ind. Med. 57:1344–1367, 2014. © 2014 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Hospitalized head and spine injuries on Saskatchewan farms

INTRODUCTION

With over 44,000 individual farms, farm dwellers account for 11% of the population of Saskatchewan. There is limited data on brain and spine injuries acquired on farms. The objective of this study was to evaluate the epidemiology of head and spine injuries on Saskatchewan farms to assist the development of injury prevention initiatives.

METHODS

Using the Canadian Centre for Agricultural Health and Safety's Saskatchewan Farm Injury Surveillance Database, farm-related head and spine injuries hospitalized > 24 hours were examined (1990-2007). We collected information regarding the type and mechanism of injury as well as the geographic location of both the injury and treatment.

RESULTS

The database captured 390 brain injuries and 228 spine injuries, including 16 spinal cord injuries. The majority of patients were male (73.3% of head injuries and 84.2% of spine injuries). The highest risk age groups were 50-59 years, with 24.1% of the spine injuries, and 40-49 years, with 19.2% of the head injuries. The most common causes of injury were falls and/or machinery-related. The average annual incidence of farm-related spine and head injury were 10.8 and 17.6 per 100,000 farm population, respectively. All patients included in this study were hospitalized for over 24 hours, with 44.7% of spine injuries spending over one week in hospital, and 20% of head injuries spending over three days in hospital.

CONCLUSIONS

Injury prevention initiatives should be targeted towards males aged 40-59 years residing in the southern areas of the province, with increased awareness towards the dangers of falls and operating tractors.

Incidence and cost of injury among youth in agricultural settings, United States, 2001-2006

OBJECTIVE

Estimate the annual US incidence and cost of fatal and nonfatal youth injury in agricultural settings.

METHODS

We used 2001-2006 Childhood Agricultural Injury Survey data to estimate the incidence of nonfatal injury and 2001-2006 Multiple Cause of Death data to estimate the incidence of fatal injury. To estimate the costs for injuries suffered by youth working/living in agricultural settings, we multiplied the number of injuries times published unit costs by body part, nature of injury, and age group.

RESULTS

An average of 26 655 agricultural injury incidents occurred annually to youth (ages 0-19) in the United States during the period 2001-2006 (95% confidence interval [CI]: 24 263-29 046). These injuries cost society an estimated $1.423 billion per year in 2005 dollars (95% CI: $1.333 billion-$1.513 billion). Fatalities alone cost an estimated $420 million per year. Work related injuries annually cost $347 million or 24.4% of the total cost (95% CI: 20.3%-28.5%). Most agricultural youth injuries were not work related.

CONCLUSIONS

We found that, similarly to adult agricultural injuries, youth agricultural injuries tend to be more severe and more costly than nonagricultural injuries. Only 1.4% of injured youth in the United States were hospitalized in 2000, but 14% of youth injured in agriculture were hospitalized in 2001-2006. To address this serious problem, prevention should focus on better controlling both child access to agricultural recreational activities and child assignment to agricultural work tasks that exceed developmental norms.