Childhood injuries in Washington agriculture.
Alexander-BH; Keifer-MC; Rivara-FP
Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, R01-CCR-516767, 2002 Jul; :1-40
The objective of this study was to characterize the distribution, determinants, and circumstances of medically treated agriculture related injuries to children and adolescents in the Yakima Valley of Washington State, and to evaluate the utility of existing records in local medical facilities for identifying agriculture related injuries. The study was a case-control study with a potential for a nested case-crossover sub-study. Eligible cases children and youth under age 20 who were treated for an agriculture related injury at one of five hospitals or three farm worker clinics in the Yakima Valley of Washington State. The emergency room logs and emergency room personnel were the primary source of screening information at the hospitals. Records for potentially eligible injuries were reviewed and all likely candidates were contacted by letter then telephone or in person to verify the injury as eligible and recruit the participant for the study. Up to 2 controls were selected from the neighborhood where the case lived using a structured door-to-door selection protocol. The controls were matched on age group, gender, and the child's relationship to agriculture. The latter matching criterion was used to ensure that the control population represented the exposure experience of the population from which the case arose. Although this method provided a theoretically more valid control sample, it was difficult 0 carry out. After obtaining informed consent an in-person interview was conducted with the case or control, and the parent of the participant if the child was under age 18. Demographic, work history, personal habits, history of injury and illness and safety behavior information was collected, as well as a description of the injury event from the case. Of the 398 potentially eligible injuries, 173 were determined ineligible when the case was contacted, 81 were potentially eligible, but could not be located, 63 were eligible for inclusion, but declined to participate, and 81 injury cases completed the study. Of the 81 participating cases 66 were work-related injuries. Sixty percent of the participating cases were age 17 and older and 72% were male. The predominant injuries resulted from ladder falls while working in tree fruit orchards (N=12) and seven injuries were lacerations caused by knives used to harvest asparagus. Contact with or falls from animals accounted for another 15 injuries. Few identifiable factors were strongly associated with the risk of injury other than the type of job being done. One exception was that the risk of injury was lower for persons who were usually supervised in their job (OR=0.24, 95% CI=0.08-0.76) and for those who reported receiving formal safety training (OR=0.32, 95% CI = 0.12-0.82). Barriers to identifying and enrolling cases of agriculture related injuries treated at these facilities was a major limitation of this study. Less than 50% of the eligible injuries identified participated and it was clear that the procedures under-ascertained these injuries. Consequently the results must be interpreted with extreme caution.
Agricultural-workers; Age-groups; Age-factors; Children; Humans; Case-studies; Injuries; Ladders; Animal-husbandry-workers; Tractors; Agricultural-machinery; Traumatic-injuries
Final Grant Report
NTIS Accession No.
National Institute for Occupational Safety and Health
Division of Environmental and Occupational Health, School of Public Health, University of Minnesota, MMC 807 Mayo Building, 420 Delaware St., S.E., Minneapolis, MN 55455