New York Center for Agricultural Medicine and Health/ Northeast Center for Agricultural and Occupational Health, Bassett Healthcare Network, One Atwell Road, Cooperstown, NY.
Ann Epidemiol. 2011 Oct;21(10):767-72. doi: 10.1016/j.annepidem.2011.07.005.
Agriculture ranks as one of the most hazardous industries in the nation. Agricultural injury surveillance is critical to identifying and reducing major injury hazards. Currently, there is no comprehensive system of identifying and characterizing fatal and serious non-fatal agricultural injuries. Researchers sought to calculate a multiplier for estimating the number of agricultural injury cases based on the number of times the farm box indicator was checked on the ambulance report.
Farm injuries from 2007 that used ambulance transport were ascertained for 10 New York counties using two methods: (1) ambulance reports including hand-entered free text; and (2) community surveillance. The resulting multiplier that was developed from contrasting these two methods was then applied to the statewide Emergency Medical Services database to estimate the total number of agricultural injuries for New York state.
There were 25,735 unique ambulance runs due to injuries in the 10 counties in 2007. Among these, the farm box was checked a total of 90 times. Of these 90, 63 (70%) were determined to be agricultural. Among injury runs where the farm box was not checked, an additional 59 cases were identified from the free text. Among these 122 cases (63 + 59), four were duplicates. Twenty-four additional unique cases were identified from the community surveillance for a total of 142. This yielded a multiplier of 142/90 = 1.578 for estimating all agricultural injuries from the farm box indicator. Sensitivity and specificity of the ambulance report method were 53.4% and 99.9%, respectively.
This method provides a cost-effective way to estimate the total number of agricultural injuries for the state. However, it would not eliminate the more labor intensive methods that are required to identify of the actual individual case records. Incorporating an independent source of case ascertainment (community surveillance) increased the multiplier by 17%.
农业是全美最危险的行业之一。对农业伤害进行监测对于识别和减少重大伤害危险至关重要。目前，还没有一种全面的系统来识别和描述致命和严重的非致命性农业伤害。研究人员试图根据救护车报告中检查农场箱指标的次数来计算一个乘数，以估计农业伤害病例的数量。
使用两种方法确定了 2007 年使用救护车转运的来自纽约 10 个县的农场伤害：（1）包括手工输入的自由文本的救护车报告；（2）社区监测。从这两种方法对比中得出的乘数，然后应用于全州紧急医疗服务数据库，以估计纽约州的农业伤害总数。
2007 年，10 个县共有 25735 次因受伤而使用救护车的独特救护车运行。其中，农场箱共检查了 90 次。在这 90 次中，有 63 次（70%）被确定为农业伤害。在未检查农场箱的伤害运行中，从自由文本中又发现了 59 例。在这 122 例（63+59）中，有 4 例是重复的。从社区监测中又发现了 24 例独特的病例，总计 142 例。这得出了一个乘数，即从农场箱指标估计所有农业伤害的 142/90=1.578。救护车报告方法的敏感性和特异性分别为 53.4%和 99.9%。
该方法为估算全州农业伤害总数提供了一种具有成本效益的方法。然而，它并不能消除识别实际个别病例记录所需的更耗时的方法。纳入独立的病例确定来源（社区监测）使乘数增加了 17%。
