High Risk Environments and Agricultural Injuries in Children, Youth, and Young Adults
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Background: Children who live on farms experience high rates of fatality, morbidity, and disability when compared to children from the general population. There is an existing body of research describing injury rates and common patterns of agricultural injuries in pediatric populations in Canada; however, these studies are dated. Few contemporary studies have focused on the etiology of pediatric agricultural injury, particularly in a Canadian context. Objectives: This study provides updated epidemiological information on agricultural injury in Canadian children and youth and investigates relationships between high-risk farm activities and the occurrence of agricultural injuries in youth and young adults on farms. Methods: Manuscript 1 describes the incidence and patterns of pediatric agricultural fatalities and hospitalizations in the provinces of Ontario and Saskatchewan using surveillance data from the Canadian Agriculture Injury Reporting System. Manuscript 2 involved performance of cross-sectional analyses of written questionnaire data from 1135 youth and young adults from the Saskatchewan Farm Injury Cohort, an on-going study of active farm populations. Results: In manuscript 1, the overall age-adjusted annual rates of agricultural injuries per 100,000 persons were: 7.8 (95%CI: 6.2-10.0) for Saskatchewan fatalities, 6.9 (95%CI: 5.6-8.5) for Ontario fatalities, 80.2 (95%CI: 73.9-87.1) for Saskatchewan hospitalizations, and 74.5 (95%CI: 69.9-79.4) for Ontario hospitalizations. Leading mechanisms of injury in both provinces were: falls from heights, animal-related mechanisms, machine entanglements, machine runovers and rollovers, and drowning. In manuscript 2, the prevalence of farm injury was estimated at 4.9%/year (95%CI: 3.7-6.2). After adjustment for important covariates relative to baseline (<10 hours/week), duration of farm work was strongly associated with the occurrence of injury [RR 8.0 (95%CI: 1.7-36.7) for 10-34 hours/week vs. baseline; RR 10.3 (95%CI: 2.2-47.5) for those working 35+ hours/week]. Tractor maintenance, tractor operation, chores with large animals, herd maintenance activities, and veterinary activities were identified as risk factors. Conclusions: Together, these manuscripts demonstrate that there is a considerable burden of agricultural injury among children, youth, and young adults on farms and that experiences of injury are related to the amounts and type of exposure to farm work and related occupational hazards.