Background. To strengthen occupational surveillance, this effort focused on the high-risk agricultural industry to provide a better understanding of the magnitude of injuries for all persons and risk factors for childhood agricultural injuries. The Phase 1 (1999) Regional Rural Injury Study-II (RRlS-II), designed to determine the etiology and consequences of agricultural injury in a five-state region of the United States (U.S), served as the basis for this effort. Methods. As in the 1999 cohort, a random sample of 16,000 farm operations was selected for Phase 2 from lists maintained by the U.S. Department of Agriculture, yielding 16,322 persons (8,178 children under age 20). Unique methods were applied to collect data on incidence and consequences of agricultural injuries, as well as exposures, pertinent to the agricultural operation. Computer-assisted telephone interviews (CATI) included a nested case-control design to identify risk factors for agricultural-related injuries to children. Participants were contacted every six months to identify injuries (cases) in the previous six-month periods of 2001. All cases, <19 years of age and controls (approximately 4: 1), (identified through an algorithm encoded into the CATI system), were interviewed to obtain relevant exposure data. The analyses, both univariate and multivariate (based on a directed-acyclic-graph causal model), will be compared to those from the 1999 RRlS-II baseline effort. Results. Preliminary analyses of 1999 data found boys at increased risk of injury (O.R., 1.9; 95% C.I., 1.4-2.6), compared with girls, and varying risk with age (0-4 years, reference): 5-9 (1.6; 0.8-3,0); 10-14 (3.0; 1.7-5.5); 15-19 (2.2; 1.2-4.0). However, rates per 100,000 working hours were slightly lower for boys (6.3) than girls (7.9); rates by age group demonstrated a reverse trend: 5-9 (11.7); 10-14 (7 .5); 15- 19 (4.7). Animals were the modal source of injury (40%). Univariate analyses indicated increased risks for working with beef (O.R., 2.4; 95% C.I., 1.7-3.3), dairy (1.8; 1.2-2.7), swine (1.9; 1.2-3.1), machinery (2.0; 1.4-2.9), operating tractors (2.1; 1.5-2.9), and riding on tractors (2.2; 1.6-3.0). Initial multivariate analysis of animal-related injuries, controlling for age, gender and hours worked, found increased risks for exposures to beef cattle (2.0; 1.4-2.8) and horses (2.5; 1.7-3.7). Conclusions. Ongoing surveillance to identify incidence and consequences of injury, as well as risk factors, will provide sound scientific data for the development of focused intervention strategies and pertinent evaluation that cannot be accomplished through traditional Surveillance efforts. This is essential to reduce morbidity and mortality from injuries in the agricultural community.
Agricultural-industry; Agricultural-processes; Agricultural-workers; Agriculture; Animal-husbandry-workers; Animal-products-workers; Animals; Children; Demographic-characteristics; Families; Farmers; Injuries; Mathematical-models; Morbidity-rates; Mortality-rates; Risk-analysis; Risk-factors; Statistical-analysis; Work-environment; Worker-health; Work-practices; Workplace-studies; Age-groups; Sex-factors; Dairy-products; Agricultural-machinery; Tractors; Injuries; Injury-prevention; Health-surveys; Environmental-exposure; Exposure-assessment