Agriculture is one of the most hazardous industries in Minnesota and rural Minnesota adolescents are frequently employed in both agricultural and non-agricultural jobs. Previous surveillance studies of agricultural work and injury have generally been limited to emergency room data, surveys of only farm families, or inclusion of only paid work activities. Consequently, the broader scope of work experiences, injuries and illness among adolescents in rural or agricultural communities has been less well characterized. The purpose of this study was to develop and implement surveillance methods to more broadly characterize injury, work, and asthma occurrence among rural Minnesota adolescents. The specific aims of this study were: ( 1 ) determine the magnitude and scope of agricultural injury and asthma among adolescents in 9th - 12th grades in rural Minnesota; (2) describe the change in work hours between 9th and 12th grades in terms of total work hours, and the shift in work hours between agribusiness, traditional family farm work, and non-farm work; (3) evaluate the reliability of adolescent self-reported information about agricultural and non-agricultural work hours and injury experiences; and (4) use a cohort analysis to calculate rate ratios for risk factors for injury and to facilitate planning for future prevention and intervention activities. Methods: Self -completed in-school questionnaires were developed and used to ascertain injuries, work experiences, asthma, and potential risk factors among adolescents attending a stratified random sample of 41 rural Minnesota high schools from four agricultural regions and three categories of school size. Questionnaires were administered to students four times over two consecutive school years. Fall surveys ascertained events from the previous summer while spring surveys ascertained events during the school year. All 9th, 10th, and 11th grade students were asked to complete the questionnaires during the first year, and all 10th, 11th, and 12th grade students were asked to complete the questionnaires the second year. Participation declined with each survey; the initial survey included 13,869 participants from 41 high schools, while the fourth and final survey included 7,802 participants from 35 schools. A brief midyear work and injury survey was administered to a sample of students during the second year to evaluate differing periods of recall. Results: Using a very broad definition of work (paid or unpaid work or chores), this study found that the vast majority of rural Minnesota adolescents are engaged in work or chores. Data from the most complete surveys (first year) showed that just over 80% of 9th-11th grade students reported some work during the summer, while 65% worked at some point during the school year. More girls reported working than boys both during the summer and school year, and the proportion of adolescents working, as well as their work hours, increased with grade level and age. About one out of ten reported jobs were related to agriculture. The majority of agricultural jobs were with traditional farms and there appeared to be no shift toward agribusiness work versus traditional farm work. Among students who completed all four surveys, 23% reported at least one agricultural job over the two-year period. About 9% of adolescents reported one or more injuries both during the summer and during the school year. About one in five injuries occurred at work during the summer and about one in eight injuries occurred at work during the school year. Agricultural injuries were reported by 0.5% of students during the summer and by 0.3% of students during the school year. In a multivariate analysis, age, current smoking, agricultural work, farm residence, obesity, and increased work hours were significantly associated with work-related injury during both the summer and school year. Male gender and reduced sleep hours were also significantly associated with work-related injury during the summer. Among students who completed all four surveys, about 4.5% of working students reported at least one agricultural injury. Ever-diagnosed asthma was reported in 12.6% of students during the initial survey and smoking, female gender, and obesity were significantly associated with risk of asthma, while farm residence was protective. There was inconsistent evidence of a recall bias for injury and work. Conclusions: This survey confirms that the great majority of rural Minnesota adolescents participate in work or chores, both during the summer and school year. Many rural youth are engaged in agricultural work activities, regardless of whether they reside on a farm. About one in ten jobs were related to agriculture and there was no evidence of a shift in patterns of agricultural work over the span of this study. Work-related injuries comprised only a small portion of total injuries, and agricultural injuries represented a small proportion of total work-related injuries. Nearly one in eight students reported ever-diagnosed asthma. Falling participation rates and a sharp decline in reported rates of multiple-item survey questions (injury , work, asthma) on the second year surveys limited their usefulness and suggest that fewer or shorter surveys are warranted. Survey data should be useful in targeting intervention and prevention activities.
Center for occupational health and safety, Chronic Disease and Environmental Epidemiology Section, Health Promotion and chronic Disease Division, Minnesota Department of Health, 85 East seventh Place, St. Paul, MN 55101