Graduation Date

Summer 8-14-2015

Document Type


Degree Name

Doctor of Philosophy (PhD)


Environmental Health, Occupational Health, and Toxicology

First Advisor

Risto H. Rautiainen


Purpose- Agriculture is the most hazardous industry in the United States. The effectiveness of intervention programs for injury prevention can be improved by acquiring knowledge of risk factors for occupational injury in agricultural operators. The landscape of agriculture is changing in the U.S. Agricultural populations, environments and risk factors are changing as well with the changes in the structure of farms and ranches. The objective of this study was to identify significant risk factors for agricultural injury based on the literature and three years of injury surveillance data covering seven U.S. states. Methods- We conducted a systematic review of reported risk factors for agricultural injury. Studies that reported adjusted odds ratio or relative risk estimates were identified from PubMed and Google Scholar. Pooled risk factor estimates were calculated using meta-analysis. We also analyzed agricultural injury surveillance data to evaluate risk factors for severe injury. The Central States Center for Agricultural Safety and Health (CS-CASH), in collaboration with the National Agricultural Statistics Service (NASS), gathered these data from 6,953, 6,912 and 6,912 farms/ranches in 2011, 2012 and 2013, respectively, covering Iowa, Minnesota, Missouri, Nebraska, North Dakota, South Dakota, and Kansas. Results- The systematic review identified 33 risk factors for agricultural injury and 25 of them were statistically significant in meta-analysis. Analysis of injury surveillance data led to the identification of 13 significant risk factors; three of them were not found in the systematic review. The risk factors were related to demographic characteristics, farm environments, behaviors and work practices. Conclusion- A total of 25 identified factors significantly increased the risk of injury. Several factors are well-established in numerous studies while others need further exploration. The identified risk factors should be: a) considered when selecting high-risk populations for interventions, and b) considered as potential confounders in intervention studies.