A Comparison of Pediatric Traumatic Injuries on Farms and Residences from 2009 to 2014

Children injured on farms in the United States are hospitalized at 14 times the rate of children with injuries unrelated to farming. This study characterizes pediatric injuries occurring on farms compared to injuries in homes.

We examined the National Trauma Data Bank from 2009 to 2014 to identify children ages 0-17 with ICD-9 E-codes reflecting a farm or residential place of injury occurrence. Appropriate nonparametric tests were used to compare patient, injury, and hospitalization characteristics by injury locale. Mixed effects models for binary responses were used to examine the odds of an injury occurring on a farm versus at home, and we controlled for random effects of trauma center after adjustment for potential confounding variables including age, sex, and categorical injury severity.

There were 2,776 injuries on farms, and 133,119 injuries at homes. Children injured on farms had a median age of 10 years compared to 4 years at homes (P < .001). Machinery injuries were 19 times more frequent on farms (P < .001), and injuries to multiple anatomic locations were twice as frequent on farms (P < .001). Children injured on farms required helicopter transport 4 times as often as those injured at home. Additionally, children injured on farms were nearly 2.5 times more likely to have a length of stay greater than 7 days.

Injuries occur during the course of childhood; however, injuries sustained in a farming environment are more severe and require greater clinical management than injuries which occur in the home.