The effects of arthritis, mobility, and farm task on injury among older farmers

Tractor Injuries in the Upper Midwestern United States: a retrospective analysis of four trauma centers

OBJECTIVES

The purpose of the present study was to characterize the incidence, injury characteristics, and outcomes of patients presented to four trauma facilities located in the upper Midwest with tractor-related agricultural injuries.

METHODS

We performed a retrospective review of the facility level trauma registries of four trauma centers located in North Dakota, South Dakota, and Minnesota between January 1, 2010 and December 31, 2021. We characterized the incidence, severity and outcomes of traumatic tractor-related agricultural injuries for pediatric and adult patients. We 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) and Abbreviated Injury Scale (AIS).

RESULTS

Findings indicated that farmers aged 65 and older experience polytraumatic, severe tractor-related agricultural injuries and fatalities. Of the 177 tractor patients analyzed, 40 patients were between the ages of 65 and 74 years and 45 patients were 75 and over. Male farmers aged 65 and older are injured year-round, many are discharged to skilled nursing facilities for additional care, are spending more time in the hospital, and have the highest rate of critical injuries out of all age groups. Moreover, the patients who died as a result of tractor-related agricultural injuries were men over 65 years. The most common tractor-related agricultural injuries include falls from tractors (n = 53), struck by object falling/propelled from tractor (n = 25), rollovers (n = 26), and runovers (n = 24). Falls from tractors accounted for 33% of all tractor-related upper extremity fractures, 36% of head injuries and 29% of chest injuries.

CONCLUSION

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

The neuropathic phenotype of the K/BxN transgenic mouse with spontaneous arthritis: pain, nerve sprouting and joint remodeling

The adult K/BxN transgenic mouse develops spontaneous autoimmune arthritis with joint remodeling and profound bone loss. We report that both males and females display a severe sustained tactile allodynia which is reduced by gabapentin but not the potent cyclooxygenase inhibitor ketorolac. In dorsal horn, males and females show increased GFAP⁺ astrocytic cells; however, only males demonstrate an increase in Iba1⁺ microglia. In dorsal root ganglia (DRG), there is an increase in CGRP⁺, TH⁺, and Iba1⁺ (macrophage) labeling, but no increase in ATF3⁺ cells. At the ankle there is increased CGRP⁺, TH⁺, and GAP-43⁺ fiber synovial innervation. Thus, based on the changes in dorsal horn, DRG and peripheral innervation, we suggest that the adult K/BxN transgenic arthritic mice display a neuropathic phenotype, an assertion consistent with the analgesic pharmacology seen in this animal. These results indicate the relevance of this model to our understanding of the nociceptive processing which underlies the chronic pain state that evolves secondary to persistent joint inflammation.

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.

Work-related musculoskeletal disorders in senior farmers: safety and health considerations

Aging farmers are at high risk musculoskeletal disorders due to occupational exposures. The development of musculoskeletal conditions can increase older farmers' risk for additional injuries because many older farmers continue to work past typical retirement age. Occupational health nurses with agricultural expertise can assist farmers by evaluating their health and safety needs. Possible interventions include ergonomic improvements in farm equipment, safety improvements in farm environment, and referrals to programs that assist older farmers in modifying their farms to improve safety.