Objective: This study examined potential causal explanations for observed associations between parents' and children's agricultural injuries. Methods: The Regional Rural Injury Study-II included a population-based, nested case-control study involving 7,420 agricultural households. Comprehensive demographic, exposure, and injury data were collected for household members for one year. A total of 379 injured children (cases) and 1,562 randomly- selected controls were identified for analyses. Children's risk of injury was estimated in reference to parental injury experiences. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using logistic regression, controlling for high-risk behaviors and agricultural work exposures. Directed acyclic graphs guided selection of additional covariates. Results: While accounting for behaviors and work exposures, children whose fathers were injured prior to the study period, compared with those whose fathers were not injured, had nearly twice the risk of injury (OR ¼ 1.9, CI ¼ 1.4-2.5). Children also had increased risks if mothers were injured before the study (OR ¼ 2.1, CI ¼ 1.6-2.9) or during the study (OR ¼ 2.1, CI ¼ 1.2-3.6). Those whose mothers were injured during both time periods had a five-fold increased risk (OR ¼ 5.3, CI ¼ 2.4-11.9). Conclusions: These results indicate that factors beyond the identified behavior and exposure variables drive observed parent-child injury associations. There is a need for family-focused interventions, and for further research into shared social, physical, and behavioral environments on family farms and ranches.
Age-factors; Age-groups; Agricultural-workers; Agriculture; Behavior; Behavior-patterns; Biological-systems; Children; Environmental-factors; Environmental-hazards; Epidemiology; Exposure-assessment; Exposure-levels; Exposure-methods; Families; Farmers; Injury-prevention; Occupational-exposure; Occupational-hazards; Psychological-factors; Psychological-reactions; Psychological-responses; Quantitative-analysis; Risk-analysis; Risk-factors; Safety-education; Safety-measures; Safety-practices; Standards; Statistical-analysis; Work-environment; Work-organization; Work-practices