Farm injuries in children: a review

Farming is one of the most dangerous occupations in the United States. Unfortunately, risk of injury and death extends not only to adults, but to children that live, play, and work on the farm. This article reviews the epidemiology, pathogenesis and prevention of farm injury in children and adolescents. In Wisconsin 39 children were killed in the agricultural setting between 1995 and 1999. Nationwide, over 100 children per year are killed and 27,000 injured on farms. The age distribution of injury in children is bimodal, with one peak at 3-4 years of age and a second peak at 13-16 years. Boys are much more likely to be injured on the farm than girls. Of the agents associated with the injury of children, tractors are most commonly implicated and are the most deadly. Drownings, injury by cows and horses, and other farm implements and machinery make up the remainder of most farm accidents. The head and face are the sites involved in preschoolers whereas the limbs are more likely to be injured in older children. Poor supervision, unreasonable expectations, financial difficulties and lack of safety devices are associated with risk of injury. Prevention or injury involves patient and family education, regulation and safety devices. Important resources are available for farm families and health care providers to prevent farm accidents in children.