A Comparison of Pediatric Traumatic Injuries on Farms and Residences from 2009 to 2014

Abstract

Purpose Children injured on farms in the United States are hospitalized at 14 times the rate of children with injuries unrelated to farming. This study characterizes pediatric injuries occurring on farms compared to injuries in homes. Methods We examined the National Trauma Data Bank from 2009 to 2014 to identify children ages 0‐17 with ICD‐9 E‐codes reflecting a farm or residential place of injury occurrence. Appropriate nonparametric tests were used to compare patient, injury, and hospitalization characteristics by injury locale. Mixed effects models for binary responses were used to examine the odds of an injury occurring on a farm versus at home, and we controlled for random effects of trauma center after adjustment for potential confounding variables including age, sex, and categorical injury severity. Findings There were 2,776 injuries on farms, and 133,119 injuries at homes. Children injured on farms had a median age of 10 years compared to 4 years at homes (P < .001). Machinery injuries were 19 times more frequent on farms (P < .001), and injuries to multiple anatomic locations were twice as frequent on farms (P < .001). Children injured on farms required helicopter transport 4 times as often as those injured at home. Additionally, children injured on farms were nearly 2.5 times more likely to have a length of stay greater than 7 days. Conclusion Injuries occur during the course of childhood; however, injuries sustained in a farming environment are more severe and require greater clinical management than injuries which occur in the home.

Health and Poverty of Rural Children: An Under-Researched and Under-Resourced Vulnerable Population

“…For instance, prior literature of accident-related disparities has posited that environmental characteristics, specifically agricultural sources of employment among rural adolescents, may disproportionately expose rural children to trauma from excessive heat, dust, noise, pesticides and other chemicals, as well as exposure to machines that perform agricultural work. 5,26 Protocols and guidelines to lessen environmental exposures (eg, pesticides, chemicals, industrial waste) have the potential to lessen rural disparities in pediatric injuries. Other studies examining the disparity in childhood obesity have found that the rural built environment is less conducive to physical activity and healthy eating.…”

Accidents in agriculture involving muscle skeletal system in children. Analysis based on hospitalization in the Paediatric Orthopaedics and Rehabilitation Department University Children’s Hospital in 2010-2019

“…Our observations are consistent with the observations of other authors. The structure of the trauma, the mechanisms of trauma, types of the injuries and the treatment methods are comparable to those of other centers treating children [11,12,13]. In publications from the USA, accidents related to moving agricultural machines, especially tractors, occur as often as in our material [4].…”

“…The analyzed material was consisted with other reports, and shown that the reasons for many accidents were also: the inappropriate pace of work, haste, insufficient concentration on the work performed, excessive physical effort, and severe weather conditions [11,12,13].…”

Broadening Our Understanding of Farm Children’s Risk Exposure by Considering Their Parents’ Farming Background

“…Children growing up on farms are exposed to higher levels of risk compared to children from the general population [ 1 , 2 , 3 , 4 ]. In our study, about a third of farm parents reported that a child had suffered an injury at some point that required medical attention.…”

“…In the United States of America (USA), farm children are exposed to significantly more risks of injury and fatality than the general population [ 1 , 2 , 3 , 4 ]. Every day, about 33 children are seriously injured in agricultural-related incidents, and about every three days, a child dies [ 1 , 5 ].…”