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BACKGROUND: Agriculture ranks among the most hazardous industries. Farmers are at high risk for fatal and nonfatal injuries, as well as their family members, who often share the work and live on the premises. While NH ranks forty-eighth for agricultural exports nationally, in 2011 there were 4,150 farms in New Hampshire. Local agriculture accounted for 9,000 employees (11% of total NH food system employment). In 2011, there was a total of 470,000 acres of farmland in NH with an average farm size of 113 acres. There is little information specific to farm injuries in New Hampshire. This study attempts to characterize the burden of farm injuries by developing a method to define these injuries utilizing external cause of injury codes (e-codes) in the hospital discharge data. These methods may be useful to other states doing similar surveillance.
METHODS: Data were derived from the emergency department and inpatient hospital discharge data for the state of New Hampshire from 2001 to 2009. Census data were used for population of state and counties. We used primary and secondary e-codes for external causes of injury. These results were then narrowed down into cases that were “sure to be farm injuries” and cases that were “suspected to be farm injuries.” Other parameters included in the analysis were NH State of residence, a focus on ages 15 and above to better understand work -related events (but all ages were included in data analysis) , gender , and primary payer source. Descriptive epidemiology was used to calculate frequencies by age, gender, county, payer source and medical outcome.
RESULTS: Of the data analyzed within the definition of farm injury, there were 404 injuries that were “sure to be farm injuries,” and 152 “suspected to be farm injuries.” Of note, the highest number of farm injuries was among the age group 35 to 44. Workers’ compensation and private insurance paid more of the “sure to be farm injury” claims than those of the “suspected farm injury” group. The top primary diagnoses for “sure to be farm injuries” were physical wounds mostly to body extremities and were caused by falls or agricultural machinery. For the “suspected to be farm injuries,” the top diagnoses were more chemical poisonings and respiratory problems caused by toxic effects of chemicals.
CONCLUSIONS: Expanded surveillance measures, including a broad review of hospital discharge data e-codes, can provide a better understanding of injuries that may occur in a farm setting.