VanWormer Jeffrey J, Barnes Kathrine L, Waring Stephen C, Keifer Matthew C
Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Foundation, United States.
National Farm Medicine Center, Marshfield Clinic Research Foundation, United States.
Injury. 2017 Jul;48(7):1444-1450. doi: 10.1016/j.injury.2017.05.027. Epub 2017 May 21.
Accidents are common in the agricultural industry, particularly among dairy farmers. How said farmers get hurt is well established, but far less is known about how distal, socio-environmental factors influence injuries. This study examined associations between medically-attended agricultural injuries and: (1) personal sociodemographic characteristics, and (2) farm environment features and general safety practices.
A cross-sectional survey was implemented with linked data from electronic health records on prior agricultural injuries that occurred between 01/01/2002-12/31/2015. The sample included adult dairy producers who resided in north-central Wisconsin (USA) and were medically-homed to the Marshfield Clinic Health System. Multiple logistic regression was used to analyze associations between socio-environmental characteristics and agricultural injuries.
There were 620 dairy farmers in the analytical sample, with 50 medically-attended agricultural injuries observed during the 14-year study time period (5.7 injuries per 1000 dairy farmers per year). In the multivariable model, the odds of agricultural injury were significantly greater among farmers who have private individually-purchased health insurance (OR=4.25; 95% CI: 1.31, 13.84), do not live at their dairy operation (OR=2.91; CI: 1.27, 6.67), and do not provide safety training to their workers (OR=4.27; CI: 1.00, 18.21).
Dairy farmers in this analysis who did not live at their dairy operation, did not provide safety training to all their workers, or had individually-purchased health insurance were more apt to get injured, but more research is needed to confirm these findings in prospectively designed studies. How these factors can be directly addressed or otherwise used to better focus farm injury prevention initiatives should also be explored.
事故在农业行业很常见，尤其是在奶农中。奶农受伤的方式已广为人知，但关于远端社会环境因素如何影响伤害的了解却少得多。本研究调查了需就医的农业伤害与以下因素之间的关联：（1）个人社会人口学特征，以及（2）农场环境特征和一般安全措施。
采用横断面调查，链接了2002年1月1日至2015年12月31日期间发生的既往农业伤害的电子健康记录数据。样本包括居住在美国威斯康星州中北部、在马什菲尔德诊所医疗系统就医的成年奶农。采用多因素逻辑回归分析社会环境特征与农业伤害之间的关联。
分析样本中有620名奶农，在14年的研究期间观察到50起需就医的农业伤害（每年每1000名奶农中有5.7起伤害）。在多变量模型中，拥有个人购买的私人健康保险的农民（OR=4.25；95%CI：1.31，13.84）、不住在奶牛场的农民（OR=2.91；CI：1.27，6.67）以及未为工人提供安全培训的农民（OR=4.27；CI：1.00，18.21）发生农业伤害的几率显著更高。
本分析中不住在奶牛场、未为所有工人提供安全培训或拥有个人购买的健康保险的奶农更容易受伤，但需要更多研究在前瞻性设计的研究中证实这些发现。还应探索如何直接解决这些因素或以其他方式利用这些因素，以便更好地聚焦农场伤害预防措施。
