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Farmers in the U.S. are becoming more diverse; the average age of the farmer is increasing, as is the number of women and minority farm operators. There is limited research on injury risk factors in these special populations of farmers. It is especially important to study the risk factors for injury in these growing and at-risk groups. A longitudinal survey was conducted of farmers (n = 1,394) age 50 and older who resided in Kentucky and South Carolina. The questionnaire was administered by telephone and mail surveys four times between 2002 and 2005 to the fixed cohort of farmers, obtained by convenience sample. Approximately half of the cohort was female, and the majority of the cohort worked less than 40 hours per week. This cohort reported a crude, non-fatal injury rate of 9.3 injured farmers per 100 per year. Farmers reporting chronic bronchitis/emphysema (estimated odds ratio [EOR] = 1.57), back problems (EOR = 1.37), arthritis (EOR = 1.31), 3 to 4 restless nights in the past week (EOR = 2.02), or 5 to 7 restless nights in the past week (EOR = 1.82) were at significantly higher odds of sustaining a farmwork-related injury as calculated by the generalized estimating equations (GEE) regression method Farmers operating equipment on highways (EOR = 1.51) or climbing higher than eight feet (EOR = 1.69) were at significantly higher odds of sustaining a farmwork-related injury, and females were at higher risk of injury when performing animal-related tasks (EOR = 3.00) or crop-related tasks (EOR = 2.21). Identified factors associated with farmwork-related injury should better inform agricultural health policies and guidelines for older farmers, such as policies governing the allowable number of hours worked per week and rest breaks, guidelines that advise appropriate types of farm tasks, and ergonomic engineering advances on farming equipment.

Part-time farmers who hold off-farm jobs may be at risk for injuries because of impaired performance resulting from inadequate sleep. For this study, 1004 part-time male Kentucky farmers completed a telephone interview for the 1994 to 1995 National Institute for Occupational Safety and Health-funded Farm Family Health and Hazard Surveillance Project. Questions were included about demographics, sleep habits, and injury occurrence. Twelve percent of the farmers reported an injury requiring medical intervention in the previous year. Farmers reported sleeping an average of 7.6 hours daily. Approximately 6.7% of the sample had three symptoms of sleep apnea. Although hours of sleep were not related to injury incidence, sleep medication use (odds ratio [OR] = 2.11, 95% confidence interval [CI] = 1.01 to 4.40) and presence of three sleep apnea symptoms (OR = 2.48, 95% CI = 1.13 to 5.41) were related to injury incidence. These data support the need for further research to examine sleep habits and promote strategies that reduce the risk for injuries caused by lack of sleep.

Hidden within the pastoral setting of rural America are the struggles of farm families who must cope with a decreasing economy, increasing technology, and one of the highest injury rates of any industry. Wives of farmers often juggle household responsibilities, hold an off-farm job, and work on the farm. Too often, wives are first on the scene of a serious injury to their spouses. All attention is focused on the farmer but the wife must cope with caregiving, her usual work, and the added full responsibility of the farm. This grounded theory study examined the process of spousal coping after a permanently disabling injury occurred to their farmer husbands. Interviews conducted with 12 farm wives elicited four themes in the coping process. These findings may help identify critical points of mental stress and form interventions to assist spouses of injured farmers in their adjustment to changing roles and responsibilities.

Objective: Develop and test a farm health and injury prevention educational intervention for high school agriculture students., Setting: Twenty one high schools in Kentucky, Iowa, and Mississippi., Methods: A quasiexperimental crossover design was used to test the effectiveness of two sets of instructional materials designed through participatory action research with agriculture teachers and students. Narrative simulations based on farm work stories and simulations of farm work while students pretended to have a disability were completed in 14 schools (n = 373) over the academic year. Students in seven control schools (n = 417) received no intervention but completed, in the same time frame as students in the treatment schools, demographic surveys and premeasures and post-measures of farm safety attitudes and intent to change safety behaviors. One year after the intervention, 29 students from the treatment group received farm visits to measure their farm safety behaviors., Results: Students engaged in hazardous work on farms. Thirty two were involved in tractor overturns and 11 had received injuries from rotating power take-off mechanisms. One fourth reported hearing problems, and 21% had respiratory symptoms after working in dusty farm surroundings. Students who completed at least two physical and two narrative simulations of the Agricultural Disability Awareness and Risk Education (AgDARE) curriculum showed statistically significant positive changes in farm safety attitude and intent to change behaviors., Conclusions: Adolescents engage in farm work that places them at risk for injury and illness. The AgDARE curriculum may be an effective and efficient method of teaching farm safety in high school agriculture classes.

Objective: To summarize the literature on farm child nonfatal injury incidence and the subsequent disability to children., Search Strategy: We used a systematic process to search the following databases: MEDLINE, EMBASE, ERIC, NTIS and NIOSHTIC. The reference lists from each potentially eligible study were checked and experts in the field contacted for additional reports., Selection Criteria: Studies for selection had to meet the following criteria: published in the last 20 years (1979-1998); located in North America; and include nonfatal farm injury cases for children under age 20., Data Collection and Analysis: Thirty-two studies met the inclusion criteria and were examined for study design, location, sample size, injury rate, injury sources, and functional outcomes., Results: Among the 32 studies, there were 9 case series, 11 secondary analyses of administrative databases, 2 case-control studies, 6 cross-sectional surveys, one mixed-method study, 2 prospective case series reports, and 1 cohort study. Twenty-two of the studies confined the sample to agriculture, but nine of these combined children within a larger sample, creating considerable difficulty in examining only agricultural injuries to children. Only one study focused on outcome measurement. Although nearly all the reports provided some discussion about injury severity, these comments were generally limited to injury severity scores or injury type., Conclusions: Despite increasing attention on farm-related child injury, the literature continues to report primarily descriptive studies that rely on small samples focusing on the nature of the injury event and immediate consequences. Analysis of larger databases, such as worker compensation claims, trauma registries, and agricultural injury surveillance, still lacks valid denominators; thus, incidence rates cannot be calculated. Very little was found regarding disability among children who experienced agricultural injury, even though the literature clearly proclaims the severity and seriousness of child injury on farms. To complete the portrait of the burden of this continuing problem, research must include functional outcome measures.