Graduation Date

Summer 8-19-2016

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Programs

Epidemiology

First Advisor

Shinobu Watanabe-Galloway

Second Advisor

Risto Rautiainen

Third Advisor

Gleb Haynatzki and Rosa Gofin

Abstract

Agriculture is a major industry in the U.S. with high rates of fatal and non-fatal occupational injuries. The dynamic nature of the U.S. agriculture industry, regional variations in farming practices, and the diverse workforce make surveillance of injuries challenging. A recent National Academies (U.S.) evaluation reported that data for non-fatal agricultural injury are scarce, and mainly available through national surveys. Limited data are available for employees in the agriculture sector, especially farm owners and operators. The objectives of this study were to- 1) review and evaluate existing survey-based systems for surveillance of non-fatal agricultural injuries on U.S. farms, and 2) determine the incidence of non-fatal agricultural injuries, and risk factors of injuries among farm operators in seven Midwestern states (Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota and South Dakota), aka Central States region.

This study evaluated six national-level surveys for non-fatal agricultural injuries using the updated Center for Disease Control and Prevention guidelines for evaluating public health surveillance systems. The system evaluation used information from published reports, peer-reviewed articles, and surveillance system websites. The incidence of injuries and risk factors of injuries were evaluated using data from an annual Central States Farm and Ranch Injury Survey (CS-FRIS) linked with Census of Agriculture data. The CS-FRIS collected data from farm operators in the Central States region in 2011 (n=6953), 2012 (n=6912), and 2013 (n=7000).

The evaluation of surveillance systems identified critical gaps- 1) under coverage of the farm population, 2) insufficient data quality and 3) lack of interoperability among systems reviewed, and with other data sources. The analysis of CS-FRIS data estimated an average 44,887 non-fatal agricultural injuries (6.8/100 operators) per year among farm operators in the Central States during 2011-13. About 88% of injuries were work-related, and 73% required professional medical care. Male gender, age between 35 and 64 years, farming occupation, and cattle and hog farming increased the risk of injury. In conclusion, the national-level survey-based systems in the U.S. have limited usability attributed to data limitations. The analyses of CS-FRIS data identified males, middle-aged groups (35-64), full-time farmers, and livestock farmers as high-risk groups for farm injuries, and injury prevention efforts for farm operators in the Central States region should consider these findings.

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