Cost of agricultural injuries in the United States: Estimates based on surveillance, insurance, and government statistics.

BACKGROUND: Agriculture is a hazardous industry but the frequency and severity of agricultural injuries are not well documented as nonfatal injuries to self-employed farmers are excluded from national surveillance. The aim of this study was to provide new injury rate and cost estimates in US agriculture. METHODS: Injury data were obtained from 2018 to 2020 Farm and Ranch Health and Safety Surveys. Responses from 7,195 farm/ranch operators included injury frequency, medical expense, and lost work time data. These injury rate and cost data were used to estimate national injury costs for self-employed farmers using Census of Agriculture operator count, injury costs for hired agricultural workers using Bureau of Labor Statistics (BLS) nonfatal injury count, and fatal injury costs using BLS count of fatal injuries. RESULTS: The injury rate for self-employed farmers and ranchers was 15.25 injuries per 100 operators or 11.9 "recordable" injuries per 100 full time equivalent operators (FTE). Average costs for nonfatal injuries were: $10,878 for medical care, $4735 for lost work time, and $15,613 in total per injury case. The total national agricultural injury cost estimate was $11.31 billion per year; 11.3% higher than the earlier benchmark using 1992 data; both in March 2024 dollars. The cost burden was 2.1% of the US national gross farm income and 13.4% of the net farm income in 2019. CONCLUSIONS: Injuries result in significant economic losses to farm and ranch operators, their family members, workers, and society. Preventive efforts should be scaled up to reduce the frequency and costs of agricultural injuries.

Injury, Musculoskeletal Symptoms, and Stress as a Function of Aging in Agricultural Operators in the Central United States.

BACKGROUND: Studies show conflicting evidence on the association of age and occupational injury in agriculture, and few studies have addressed the effect of age on work-related chronic conditions or preventive practices among farmers. METHODS: We examined the probability of injury, work-related stress, musculoskeletal symptoms (MSS), and preventive practices for MSS as a function of aging using surveillance data of 7,711 farm and ranch operators in the central United States. FINDINGS: Segmented regression analyses of men (85% of sample) indicated that the probability of all four outcomes increased up to a certain age and then decreased; the changepoints in years of age being 59.6 for injury, 55.4 for work-related stress, 59.6 for MSS, and 67.9 for MSS preventive practices. Female operators had an increasing trend for stress up to age 29.7, while they showed no changepoints across their age spectrum in the proportion of injury, MSS, and prevention techniques. CONCLUSION/APPLICATION TO PRACTICE: These findings emphasize the need for preventive efforts particularly among younger and middle-aged farmers and ranchers, and the need to modify work duties to match work abilities at older ages.

Self-reported respiratory health symptoms and respiratory protection behaviors of young adult hog producers in the United States.

INTRODUCTION AND METHODS: In this study, we evaluated self-reported respiratory symptoms during agricultural work, respiratory protection use and experience, and perceived value of receiving respirators using Gear Up for Ag Health and Safety Program™ pre- and post-surveys from 703 to 212 young adult hog producers in the United States. To our knowledge, this is one of the most extensive survey data sets on self-reported respiratory symptoms and respiratory protection behaviors of collegiate-aged young adults working in US livestock production. RESULTS: About one-third (37%) of young adult hog producers stated that they have experienced cough, shortness of breath, fever, and chills after working in dusty areas on the farm. Most (76.2%) stated that they were already "always" or "sometimes" wearing filtering facepiece (N95-style) respirators, even before participating in an outreach program. About one-third (30%) reported experience wearing a cartridge-style respirator but only 5% reported having been fit-tested for a respirator. Young adult male producers were significantly more likely to report use of both respirator types when compared to females, both before and after the program. Male producers were also more likely than females to engage in high-risk farm tasks where respirators are recommended, such as cleaning out grain bins and mixing or grinding feed. Following an educational program, males and females reported using the respirators that they received at similar rates, and 20% of overall participants purchased additional respiratory protection. DISCUSSION: The study found that young adult hog producers in postsecondary education are already wearing respirators with some frequency and at rates higher than previously reported by agricultural workers. More research is needed to make effective task-based respirator-use recommendations and investigate some significant gender differences among young adult hog producers observed in this study.

Agricultural Injuries: Risk Factors and Severity by Affected Body Part among US (Midwest) Farmers.

OBJECTIVES: Statistics from the United States Bureau of Labor Statistics indicate that agriculture consistently ranks as the most hazardous industry in the US. To identify specific targets for prevention, we investigated injury risk factor profiles separately for each injured body site. We also characterized the severity of agricultural injuries by injured body site using the type of medical care and lost work time due to injury. METHODS: We used the Central States Center for Agricultural Safety and Health (CS-CASH) surveillance data for 2018 to perform descriptive statistics and regression modeling. RESULTS: We found that 12% (513/4351) of the participants experienced one or more injuries in the previous 12 months. Compared to female operators, male operators had 3.53 (95% CI: 1.17-10.68) times higher odds of back injury. Operators in livestock production had 2.77 times (95% CI:1.12-6.82), 2.28 times (95% CI:1.25-4.14), and 1.69 times (95% CI:1.10-2.59) higher odds of injury to the chest/trunk, finger, and leg/knee/hip, respectively, compared to operators in crop or mixed production. After adjusting for age and gender, operators who worked full time (vs. part-time) on the farm/ranch had 2.11 times (95% CI:1.03-4.34) higher odds of back injury. Arm/shoulder and leg/knee/hip injuries were more frequent in older age groups. CONCLUSIONS: Prevention measures should be tailored considering specifically livestock producers with emphasis on trainings on proper livestock handling, such as being gentle, establishing routine, keeping distance, and avoiding sudden and loud noise when handling animals. Applying these techniques avoid startling the animals and reduce the risk of injuries.

Self-reported Quad Bike Use, Safety Behaviors, and Safety Awareness among Young Adults in U.S. and Canadian Agriculture.

The number of agricultural fatalities and injuries related to agricultural quad bike use has risen substantially in the last two decades. Safe engineering design features such as crush protection and roll bars have proven potential to lessen the burden of injury but have traditionally not been included in many quad bike safety training programs. The aim of this study was to survey more than 700 young adults working in U.S. and Canadian agriculture to examine self-reported quad bike safety behaviors and awareness of quad bike safety design engineering features. We found that U.S. males continue to be at higher risk for quad bike-rollover incidents when compared to other groups. Even when accounting for other factors such as age and country, we found that participants who reported youth occupational quad bike use (≤14 years old) were up to 200% more likely to allow extra riders and up to 489% more likely to not wear a helmet when compared to participants who reported beginning occupational quad bike use in adulthood. These findings support the Agricultural Youth Work Guideline (AYWG) for occupational quad bike use at age 16. Less than 20% of young adults working in agriculture were aware of safe design features such as wide frames, stability ratings, crush protection devices, and accessories made by the original equipment manufacturer. There is tremendous need to educate the future agricultural workforce about the importance of choosing quad bikes with safer design features.

Coexposure to Solvents and Noise as a Risk Factor for Hearing Loss in Agricultural Workers.

OBJECTIVE: This study addressed the relationship of hearing loss and coexposure to solvents and noise among farmers and ranchers in central United States. METHODS: The surveillance study included surveys to stratified random samples of operations in 2018 and 2020 (n = 34,146), requesting information on injuries, illnesses, exposures, and preventive measures. Responses (n = 7495) were analyzed using hierarchical multinomial logistic regression, adjusting for personal and work characteristics. RESULTS: Nearly 60% of respondents exposed to both solvents and noise reported hearing loss. The exposures increased the adjusted odds of moderate/severe hearing loss as follows: solvents alone, (odds ratio [OR], 1.49; 95% confidence interval [CI], 0.93-2.38), noise alone (OR, 4.42; 95% CI, 3.39-5.76), and coexposure to both noise and solvents (OR, 6.03; 95% CI, 4.67-7.78). CONCLUSIONS: Solvent exposure, along with noise, should be considered in hearing conservation programs among farmers and ranchers.

Prevalence and Risk Factors for Pulmonary Conditions among Farmers and Ranchers in the Central United States.

This study was conducted to evaluate the prevalence and risk factors for work-related respiratory conditions (asthma, farmer's lung, sinusitis, rhinitis, and environmental allergies, diagnosed by a physician) among farm and ranch operators in the central US. A survey was conducted by the Central States Center for Agricultural Safety and Health (CS-CASH) in 2018, focusing on work-related injuries, illnesses, exposures, and preventive measures in a seven-state region (Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, and South Dakota). Farms and ranches (n = 16,818) with an email address and annual sales exceeding $5,000 were randomly selected for the survey. Agricultural production and weather data were merged with survey responses. The relationship between exposures and respiratory conditions was analyzed using generalized estimating equations. We received responses from 3,268 agricultural operations (19% response rate) containing information on 4,064 individual operators. The life-time prevalence of (any) respiratory conditions among farm/ranch operators was 18%. Risk factors for respiratory conditions included exposures to grain/hay/feed dust (OR 2.41), animal confinement dust (OR 1.57), field/road dust (OR 2.11), manure/silage gasses (OR 1.66), anhydrous ammonia (OR 1.51), fuels/solvents/paints (OR 1.92), older age group >70 vs. <43 (OR 1.40), female gender (OR 1.82), and being primary vs. third operator (OR 1.61). Farmers and ranchers have a high prevalence of respiratory conditions associated with dust and gas exposures at work. More effective protective measures are needed using the hierarchy of controls, including improved use of respiratory protection.

Social Network Analysis of an Agricultural Center: Stakeholders and the Transfer of Information.

We conducted a social network analysis (SNA) of Central States Center for Agricultural Safety and Health (CS-CASH) to describe stakeholder networks for agricultural Research and Education/Outreach. This was a two-phase study. First, the Leader Survey went to N = 9 CS-CASH leaders to identify their key stakeholders. Next, the Stakeholder Survey was sent to these stakeholders to learn about their stakeholder collaborations, interactions, and communications. The Pajek Network Analysis measured SNA metrics for density, centrality, betweenness, k-core, and created the sociograms. The Leader Survey had a 100% response rate and generated N = 337 unique stakeholders. Most were researchers (44%) and educators (20%), with a primary sphere of influence in Nebraska-only (40%). The Stakeholder Survey had 46% response rate, and generated N = 199 names in the extended Education/Outreach network and N = 140 in the extended Research network. Stakeholders in both networks were employed mostly in universities/schools (61%) or non-profits (15%). Both networks had a single main component and 7/9 CS-CASH leaders had central roles in these components. CS-CASH is well positioned in the extended stakeholder networks based on SNA metrics. Stakeholders utilize CS-CASH resources, and they seek and exchange information with its leaders. To strengthen knowledge transfer, it will be useful to build on connections with stakeholders outside academia.

Factors Associated with Musculoskeletal Discomfort in Farmers and Ranchers in the U.S. Central States.

Agricultural work involves ergonomic and psychosocial strain, which contribute to musculoskeletal conditions. The aim of this study was to assess if specific ergonomic, psychosocial, and preventive factors are linked to musculoskeletal pain or discomfort symptoms (MSS) in farmers and ranchers. We analyzed data from the Central States Center for Agricultural Safety and Health survey that was conducted in 2018 in a seven-state region of the central United States. MSS were assessed with questions from the Standardized Nordic Questionnaire. The survey included questions on demographic, ergonomic, psychosocial and preventive factors. Farm production variables were added from the Farm Market iD database. We analyzed the data using Generalized Estimating Equations. The overall prevalence of MSS for all body sites combined was 59% among 4,354 farmers and ranchers who responded (19% response rate). After controlling for age, sex, and operator status, three factors (high stress level, sleep deprivation, and exhaustion/fatigue) showed the strongest associations with MSS in any body site, with adjusted odds ratios (OR) ranging from 4.8 to 5.6. Forceful exertions, repetitive tasks, awkward postures, frequent manual labor, and vibration were also significantly associated with MSS, with adjusted ORs ranging from 1.8 to 3.3. Recommended preventive techniques were not protective for MSS. New effective strategies are needed to reduce the high burden of musculoskeletal outcomes among farmers and agricultural workers.

Work exposures and mental and musculoskeletal symptoms in organic farming.

This study focussed on harmful exposures and mental and musculoskeletal symptoms in organic and conventional farming using interview data of Finnish farmers over the winter of 2014-2015. The data consisted of 2,169 full-time farmers, out of whom 231 (11%) practiced organic farming and 1,938 (89%) conventional farming. Exposure to poisonous and irritating substances was less frequent while exposures to vibration and mould ('smell of root cellar') were more frequent on organic farms. Mental and musculoskeletal symptoms were slightly more common among organic farmers, but the associations were not statistically significant in regression modelling. Risk factors for mental symptoms included animal production, hired labour, female gender, constant hurry, working alone, economic uncertainty, and inadequate recovery from workdays. Risk factors for musculoskeletal symptoms included older age, female gender, constant hurry, economic uncertainty, difficult working postures, heavy lifting and carrying, and inadequate recovery. Workload and recovery, managing the transition period and better follow-up of the occupational well-being were identified as concerns among organic farmers. Practitioner summary: Converting from conventional to organic farming has become increasingly common. Farmer interviews indicated that exposure to poisonous and irritating substances was less frequent while exposures to vibration and mould were more frequent on organic farms. Mental and musculoskeletal symptoms and risk factors were similar in both types of farming.

What about the Rest of Them? Fatal Injuries Related to Production Agriculture Not Captured by the Bureau of Labor Statistics (BLS) Census of Fatal Occupational Injuries (CFOI).

Surveillance of injuries in production agriculture is necessary to inform stakeholders about workplace hazards and risks in order to improve and advance injury prevention policies and practices for this dangerous industry. The most comprehensive fatal injury surveillance effort currently in the United States is the Bureau of Labor Statistics (BLS) Census of Fatal Occupational Injuries (CFOI), which covers occupational fatalities in all U.S. industries, including production agriculture. However, this surveillance does not include many categories of fatalities that occur during agricultural work or on production agriculture worksites. To better capture the human cost of production agriculture, the authors of this paper call for the collection of additional data with a broader scope that supplements, not replaces, the current CFOI. This paper describes challenges in surveillance, highlights key procedural gaps, and offers recommendations for advancing national surveillance of fatal traumatic injuries associated with production agriculture.

Occupational stress among farm and ranch operators in the midwestern United States.

BACKGROUND: This study used surveillance data from 2018 and 2020 to test the stability of work-related strain symptoms (high stress, sleep deprivation, exhaustion) with demographic factors, work characteristics, and musculoskeletal symptoms among farm and ranch operators in seven midwestern states of the United States. METHODS: Cross-sectional surveys were conducted among farm and ranch operators in 2018 (n = 4423) and 2020 (n = 3492). Operators were asked whether, in the past 12 months, they experienced extended work periods that resulted in high stress levels, sleep deprivation, exhaustion/fatigue, or other work-related strain symptoms. Covariates included personal and demographic factors, work characteristics, number of injuries, work-related health conditions, and exposures on the operation. Summary statistics were tabulated for explanatory and outcome variables. The classification (decision) tree approach was used to assess what variables would best separate operators with and without reported strain symptoms, based on a set of explanatory variables. Regularized regression was used to generate effect estimates between the work strain variables and explanatory variables. RESULTS: High stress level, sleep deprivation, and exhaustion were reported more frequently in 2018 than 2020. The classification tree reproduced the 2018 model using 2020 data with approximately 80% accuracy. The mean number of reported MSD symptoms increased slightly from 1.23 in 2018 to 1.41 in 2020. Older age, more time spent in farm work, higher gross farm income (GFI), and MSD symptoms in six body regions (ankles/feet, knees, lower back, neck, shoulders, wrists/hands) were associated with all three work strain symptoms. CONCLUSIONS: Musculoskeletal pain and discomfort was a strong predictor for stress, sleep deprivation, and exhaustion among farmers and ranchers. This finding indicates that reducing MSD pain and discomfort is beneficial for both physical and mental health.

Assessing Nonresponse Bias in Farm Injury Surveillance Data.

HIGHLIGHTS: Despite a response rate of about 18%, there was scant evidence of nonresponse bias. Farm and ranch characteristics of operations responding to a mailed survey were similar to those not responding. Responders were significantly more likely to be married but only slightly older and more educated than nonresponders. Earlier survey responders reported more injuries and greater severity when injured compared to later responders. ABSTRACT: Nonresponse bias in a survey can result in misleading estimates of agricultural injuries and can misdirect prevention efforts aimed at reducing the burden of injuries on farmers. Responders (n = 2,977) and nonresponders (n = 13,849) were compared based on demographics and agricultural production characteristics to identify underrepresented subgroups. Injury characteristics were compared between early (n = 1,667) and late (n = 1,309) responders. Methods accounted for correlated data, sample size inflation of p-values, and assessment of meaningful differences. Few differences were identified between responders and nonresponders. Responders differed from nonresponders by state of residence, and responders were more likely to be married. Other characteristics (age, gender, education, farm size, crops grown, animals raised) were similar across groups. Early responders reported more injuries and more often sought medical care for an injury than late responders. The differences identified between responders and nonresponders were minimal and not likely to create bias. Differential reporting of injury and injury severity between early and late responders is worthy of further investigation.

Comparing Objective and Subjective Measures of Sleep Loss with Balance Performance in Farmers.

HIGHLIGHTS The farming population is at risk of injury due to sleep deprivation. Loss of sleep during previous night affects balance performance in farmers. Objective measures of sleep are more reliable than subjective measures for predicting balance performance. ABSTRACT. This study aimed to investigate the ability of both subjective and objective sleep measures to predict balance difficulty in agricultural workers. Seven male farmers from rural Nebraska were analyzed for static balance performance following a bout of sleep. Actiwatches were used to measure objective sleep hours and subjective questionnaires, including the Epworth Sleepiness Scale and the Pittsburgh Sleep Quality Index, were used to measure subjective hours of sleep and sleep quality. The participants were observed for 12 sessions, with six in planting season and six in harvest season. Static balance testing consisted of measuring the area, total displacement, and maximum range in the anteroposterior and mediolateral directions of the individual's center of pressure with Tekscan pressure mats. Overall, it was found that objective measures had a higher correlation with the magnitude of balance deviations than subjective measures.

Occupational Injuries among Latino/a Immigrant Cattle Feedyard Workers in the Central States Region of the United States.

Agriculture is a dangerous industry with high rates of occupational injuries. Immigrants comprise the majority of the hired agricultural workforce in the United States, and these workers may be at a higher risk for job-related injuries. This study addressed the frequency, characteristics, and risk factors of occupational injuries among Latino immigrant cattle feedyard workers. Data were collected through structured interviews with Latino immigrant cattle feedyard workers in Kansas and Nebraska (n = 243; 90.9% male). Descriptive statistics and logistic regression were used to identify risk factors for injury. Nearly three-fourths of participants (71.2%) reported having experienced one or more injuries in the past while working on a cattle feedyard. The most frequent types of reported injuries, including those not requiring medical care, were bruises/contusions (40%), cuts/lacerations (21%), and sprains/strains (12%). These injuries were mainly caused by animals/livestock (33%), chemicals (23%), falls (12%), and tools (9%). Significant risk factors for injury included male gender (OR 5.9), being over age 35 (OR 2.6), working on a large or an extra-large feedyard (OR 5.4), having 11 or more employees on the feedyard (OR 3.6), and working more than eight hours a day (OR 4.7). Having received safety training was also associated with greater risk of injury in a univariable model (OR 2.6). Cattle feedyard workers are at high risk for injury and require more effective preventive measures.

Agricultural Injuries among Farmers and Ranchers in the Central United States during 2011-2015.

The high risk of occupational fatalities in agriculture is well documented, but information on non-fatal injuries is lacking due to challenges in injury surveillance. This surveillance study explored the frequency, characteristics, and risk factors for non-fatal injuries among farmers and ranchers in the central United States. The Central States Center for Agricultural Safety and Health (CS-CASH), in collaboration with the USDA National Agricultural Statistics Service (NASS), conducted annual surveys (n = 34,777 sent) during 2011-2015 covering a seven-state region (Iowa, Kansas, Minnesota, Missouri, North Dakota, Nebraska, and South Dakota). The average response rate was 32% in the five consecutive annual surveys. The average injury incidence rate was 7.0 injuries/100 operators per year. Most injuries (89%) occurred during agricultural work. The most frequent sources of injury were livestock (22%), machinery (13%), and hand tools (12%). Risk factors for injury included: male gender, younger age (vs. 65+ years), farming as the primary occupation, greater work time, greater land area, ranch (vs. farm), organic farming, internet access, and production of several types of crops and animals. Most injuries (56%) required a doctor visit, and 12% required hospitalization. The average medical costs were $1,936 out of pocket and $8,043 paid by insurance. The combined average costs for most serious injuries were $7,858. Most injuries (66%) resulted in some lost time from agricultural work, and 13% were serious, resulting in more than 30 days of lost work time. The non-fatal injury rate for self-employed farmers and ranchers was higher than that of hired agricultural workers reported by the Bureau of Labor Statistics. This result reaffirms farming/ranching as a dangerous occupation and emphasizes the need for efforts to prevent agricultural injuries, especially those associated with identified injury sources and risk factors.

Determinants of Good Work Ability among Organic and Conventional Farmers in Finland.

Based on earlier studies, farmers have poorer work ability compared to workers in most other occupations. The aim of this study was to explore if organic production has a positive effect on producers' work ability while controlling for demographic and production characteristics. This study used telephone interview data collected by the Finnish Institute of Occupational Health in 2014-2015. The material consisted of 2,164 farmers: 231 in organic production and 1,933 in conventional production. Work ability was measured with a single question regarding the farmers' current work ability compared with their lifetime best on a scale of 0 to 10, with 0 meaning unable to work. The data were analyzed using multivariable logistic regression. Organic production had a negative effect on work ability, while larger farm size, experiencing economic uncertainty rarely/never/occasionally (vs. often), age under 55 years, having occupational health coverage, and experiencing low amounts of physical strain or mental strain had positive effects in a multivariable model. While this study could not consider potential biases from the farmers' existing health status at the time of switching to organic production and other sources, it is clear that greater attention needs to be paid to improving worker health, safety, and wellness in organic farming.

Redesigning a Sentinel Surveillance System for Collecting and Disseminating Near Real-Time Agricultural Injury Reports: System Usability Study.

BACKGROUND: Injury data and reports provide valuable information for both public and private organizations to guide programming, policy, and prevention, but in the increasingly complex and dangerous industry of US agriculture, the injury surveillance needed to produce this data is lacking. To address the gap, AgInjuryNews was established in 2015. The system includes fatal and nonfatal injury cases derived from publicly available reports, including occupational and nonoccupational injuries, occurring in the agricultural, forestry, and fishing (AFF) industry. OBJECTIVE: The study aimed to develop a stakeholder-engaged redesign of the interactive, up-to-date, and publicly available dataset of US AFF injury and fatality reports. METHODS: Instructor-led heuristic evaluations within a 15-student undergraduate course, data from 8 student participants of laboratory-based usability testing and 2016 and 2017 AgInjuryNews-registered user surveys, coupled with input from the National Steering Committee informed the development priorities for 2018. An interdisciplinary team employed an agile methodology of 2-week sprints developing in ASP.NET and Structured Query Language to deliver an intuitive frontend and a flexible, yet structured, backend, including a case report input form for capturing more than 50 data points on each injury report. RESULTS: AgInjuryNews produced 17,714 page views from 43 countries in 2018 captured via Google Analytics, whereas 623 injury reports were coded and loaded, totaling more than 31,000 data points. Newly designed features include customizable email alerts, an interactive map, and expanded search and filter options. User groups such as the Bureau of Labor Statistics and the Agricultural Safety and Health Council of America have endorsed the system within their networks. News media have cited or referenced the system in national outlets such as the New York Times, Politico, and the Washington Post. CONCLUSIONS: The new system's features, functions, and improved data granularity have sparked innovative lines of research and increased collaborative interest domestically and abroad. It is anticipated that this nontraditional sentinel surveillance system and its dataset will continue to serve many purposes for public and private agricultural safety and health stakeholders in the years to come. .