Surveillance of Injuries in Agriculture

AUTHOR ABSTRACT

There has been no comprehensive data system to identify the magnitude of the injury problem in the rural farming community or the potential risk factors that may be associated with this problem. Serious discrepancies among the existing data sources, pertinent to occupational morbidity and mortality, limit identification of the true magnitude of the problem. Based on a recent National Academy of Sciences report, it has been documented that fatal as well as non-fatal occupationally-related injuries have been greatly undercounted. In part, these discrepancies in mortality and morbidity data are due to variations in definitions, the worker populations included, methods of case ascertainment, and the data sources utilized.

Fatality rates, identified for agriculture, have ranked among the highest for many years. However, given the overall discrepancies among the data systems and the reporting limitations for agriculture, these would appear to be extremely conservative estimates. A major barrier to progress in the prevention of agricultural injuries has not only been a lack of knowledge about the magnitude of the problem but also a lack of knowledge about specific causes or risk factors due to the lack of analytical studies. This paper includes an historical perspective of surveillance and its importance to the problem of injuries in the agricultural community. Special emphasis is placed upon the data sources and methodological approaches that have been used in agricultural surveillance, including advantages and limitations.

Among the agricultural injury surveillance efforts that will be discussed, are two major population-based efforts, conducted by a multidisciplinary team, using a methodology that can also serve as a model for long term surveillance efforts at the state, regional and national levels. These efforts are the Olmsted Agricultural Trauma Study (OATS) and the Regional Rural Injury Study (RRIS):

• The overall purpose of the Olmsted Agricultural Trauma Study (OATS) was to identify the magnitude and characteristics of the injury problem among all farms in Olmsted County, Minnesota, using a telephone interview methodology, validated through medical records. Data pertinent to the household members, characteristics of the farm operation, and injury events (farming and non-farming related; intentional and unintentional) were collected. In concert with this effort, a case-control study to facilitate identification of risk factors as well as an inter-/intra-rater reliability study of E-coding and a follow-up pilot investigation of machinery-related injury events were also conducted. Specific findings, including injury rates, characteristics of the injuries and injury events, and risk factors are presented with regard to implications for surveillance.
• The OATS provided the basis for the Regional Rural Injury Study (RRIS), currently being conducted in a five state region: Minnesota, Wisconsin, North Dakota, South Dakota, and Nebraska. Data collection covers a twelve month period of time for over 4000 rural households, utilizing computer assisted telephone interviews (CATI). This effort will enable the identification of injury rates for each state and the region as well as multiple analytic substudies, including tractor- rollovers and animal-human injuries. The project also includes application of the results to the development of intervention strategies, to be achieved by convening nationally recognized experts and the regional participants in the Rural/Agricultural Injury Prevention and Control Workshop.

SOURCE: 1991. n.p.

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