CHILDHOOD AGRICULTURAL INJURY PREVENTION INITIATIVE

Etiology and Consequences of Injuries Among Children in Farm Households: A Regional Rural Injury Study

National Institute for Occupational Safety and Health
Childhood Agricultural Safety and Health Research
RFA 817

Abstract Research Grant Awarded in Fiscal Year 1998
October 26, 1998
(For 3 year grant)

Project Title: Etiology and Consequences of Injuries Among Children in Farm Households: A Regional Rural Injury Study

Principal Investigator: Susan G. Gerberich, Ph.D.

Affiliation: University of Minnesota

City & State: Minneapolis, Minnesota

Grant Number: 2 R01 CCR514375-02

Start & End Dates: 09/30/1998 - 09/29/2001

Abstract:

Unlike other occupational settings, agricultural operations commonly involve persons of all ages, including children. Although there is some evidence in the literature about the magnitude of agricultural-related fatality among children, there is limited information about morbidity and the risk factors for both morbidity and mortality - information that is essential as a basis for developing relevant prevention and control strategies. The proposed project addresses both etiology and outcomes of agricultural injury in the five region of Minnesota (MN), Wisconsin (WI), North Dakota (ND), South Dakota (SD), and Nebraska (NE), using research procedures developed by the investigators in previous population-based studies and associated analytic efforts; these states are characteristic of the major types of agricultural production in the United States and among the leading producers of crops and livestock in the nation. Lists of farm operations for each state, maintained by the United States Department of Agriculture, will be sampled randomly to select farms for participation in the project. The research design employs an estimated eligible cohort of 8,000 farm households and 26,000 persons, including 8,800 children less than or equal to 19 years of age representative of the region. It provides a unique methodolgy for collecting data, simultaneously, for both risk factors and incidence and consequences of agricultural injuries and can serve as a basis for surveillance. Critical risk factors for injuries to children in the farming environment will be identified by incorporating both case-control and case-crossover studies that can be implemented, in cohort with data collection on the incidence and consequences of injuries, using the computer assisted telephone interview (CATI) system and specially designed instruments. Data will be collected on the characteristics of the farm and persons within the farm household and pertinent injury experience. All cases (identified through the initial portion of the interview) and controls (identified through an algorithm encoded into the CATI system), less than or equal to 19 years of age, will be interviewed to obtain data on the designated exposures and confounding and modifying variables. Follow-up every six months over a period of one year will identify individuals who were injured (cases) in the previous six month periods. The case-crossover study enables comparisons between exposures at the time of injury to exposures during various time periods prior to the injury among the cases while the case-control study enables comparison of exposures during various time periods between the injured and the population-at-risk to determine specific risk factors. For the case-control study, a minimum of three controls per case will be included from the population at risk during the study period, using the density method of control selection. With this method of control selection, the odds ratio equals the incidence density (hazard) ratio, a fundamental measure of exposure effect with direct epidemiological interpretation. The ability to identify the risk factors, incidence rates, and consequences of injury are critical for providing sound scientific data for the development of focused intervention strategies. This approach is essential to reduce morbidity and mortality from injuries in the agricultural community and can be used as a model for other regions in the nation.