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Agricultural Hazards
Todd A. Nelson, MD, MS, FACEP
Assistant Clinical Professor, Section of Emergency Medicine
University of Wisconsin School of Medicine and Public Health
Flight Physician, Med Flight, UW Health
Objectives
• Discuss characteristics that make farm life so dangerous
• Discuss epidemiology of ag injuries
• Discuss mechanisms of injury
• Discuss injury control measures
• Provide listing of resources
National Safety Council, 2001
Death Rates(Deaths/100k)
0 5 10 15 20 25
Mining
Agriculture
Construction
Trans/Utilities
Manufacturing
Government
Trade
Services
All Industries
Wisconsin Farm Fatalities
Fatalities 2005 2004 1993
Number 30 25 37
Rate* 45 35 48
* Per 100,000 workers University of Wisconsin Cooperative Extension Service, 2006
National Safety Council, 2005
Occupational Injuries# of workers # of disabling
injuries
All industries 132,722,000 3,800,000
Agriculture 3,450,000 140,000
Mining 618,000 30,000
Construction 8,045,000 410,000
Transportation 20,666,000 650,000
Manufacturing 7,713,000 380,000
Trade 20,087,000 730,000
Services 45,575,000 900,000
Government 19,618,000 560,000
Number of Farms
2007 1997 1987
United States 1,911,859 1,925,300 2,087,759
Wisconsin 65,602 67,959 75,131
Illinois 73,051 77,610 88,786
Minnesota 73,367 75,,079 85,079
Iowa 90,792 96,543 105,180
• Behavior• Machinery• Structures• Environment (home/work, weather, EMS)• Animals• High risk groups: the young and old• Little formal training• No governing body
Farming Risk Factors
• Machinery
• Animals
• Structures
• Hazardous Materials
Sources of Injury/Illness
• Month: varies state to state
• Day of week
• Time of day: bimodal peaks 1000 and 1600
Time of Injury
9%
21%
32%
30%
8%14 and under
15-24
25-44
45-64
65 and up
National Safety Council, 2005
Farm Work Injuries by Age
Childhood Ag Injuries
• 103 deaths per year
• 27,000 injuries per year
• In Wisconsin: 39 children died from farm injuries over the period 1999-2004. 27 were 14 or younger
• farm machinery deaths only exceeded by MVA, fires and drownings
Percent of Childhood Farm Injuries by Age
0
2
4
6
8
10
12
141 2 3 4 5 6 7 8 9
10
11
12
13
14
15
16
17
18
Age
%
Childhood Injuries
• Peak at 3-4 years increased mobility and curiosity
lack the judgment to avoid injury
• Peak in teenage years increased time working
increased risk taking behavior
performing tasks that exceed child’s motor skills
36%
19%5%4%7%
4%
25%Tractor
Ag Machinery
Animal
Truck
Other vehicle
Fall
Other
National Safety Council, 2005
Mechanism of Death
Wisconsin Ag FatalitiesFatalities 2005 2004 2003
Tractors 16 7 10Farm machines 3 5 12Confined Spaces 2 2 0Falls 3 3 4Animals 4 7 5Trucks/Vehicles 1 0 0Other 1 1 6 Total 30 25 37
Slight Severe Permanent Fatal
Agricultural Machinery 15.2 18 47.5 13.3
Animal 17.4 17.2 7.5 3.3
Truck or other vehicle 17.4 12.9 11.3 16.7
Tractor 6.2 8.5 7.5 26.7
Hand tool 8 7.4 2.5 0
Power tool 5 4.6 10 0
Fall 16.8 15.2 2.5 19.9
Other/unknown 14 16.2 11.2 30
National Safety Council, 2005
Source of Injury (%)
51%
26%
19%4%
Overturn
Runover
Other
PTO
National Safety Council, 2005
Distribution of Tractor-Related Deaths
• 1892 First tractor developed
• 1920 “Row crop” or tricycle chassis introduced
• 1940 Rubber tires replaced steel and then tractors were on the roadways
• 1960 Narrow front-end designs phased out
• 1966 Rollover protective structure (ROPS)
Tractor History
Even with ROPS need to wear seatbelt!!
• Shaft that transmits power to the mechanism of an accompanying machine
• PTO driven equipment include: mowers, balers, grain augers, self-unloading wagons, choppers, or feed mills
• Entanglement usually with loose clothing
• PTO at 540 rpm makes nine rotations per second. If driveline 4” in circumference, 36” pulled per second
Power Take Off (PTO)
What is wrong in this picture??
• Move material from one point to another
• Found in self-unloading wagons, grain bins, combine grain tanks, feed mixers, and silos
• Portable augers used to move large quantities of grain, feed or fertilizer quickly and easily
• Entanglement and electrocution are major causes of injury
Augers
• Small round baler50-150 lb/bale
• Conventional rectangular baler50-150 lb/baleEntanglement in twine
• Large round balerEntanglement in pick-up mechanismCrush injuries1200 lb/bale
Balers
Balers
• Header: cutting unit
• Snapping rolls: snap the corn ears from stalks
• Straw walkers: separate grain from the straw
• Grain tank augers: leveling auger at the top and an unloading auger on the bottom. Tank with sloped sides.
Combine
• Cotton picker
• Ensilage cutter
• Mixing wagon
• Manure spreader
• Disc
• Chain saw
Other Machinery
Animals
• Animals are unpredictable
• Horses: bite, kick, thrown from, fallen on
• Cattle: kick, bite, butt, gore, squeeze
• Pigs: bite
• All animal facilities are heavily contaminated with bacteria, viruses, and molds--need tetanus and possibly antibiotics
Job Security!!
• Barns• Confined Spaces
Grain BinSiloManure Pit
Structures
Grain Bins
• Used to store grain after harvest• Mechanisms of injury
Engulfment in a column of flowing grain– 52 cu ft/min-->185# person in 8 seconds
Collapse of a horizontal crusted grain surface
Collapse of a vertical crusted grain surfaceFallGas/pesticide exposure
Flowing Grain
Grain “Drowning”
Horizontal Crusting
Vertical Crusting
Silos
• ConventionalPoured concrete, concrete blocks, or
wood
• Oxygen-limitingSealed, steel coating with glass on
inside and blue epoxy on outside
• BunkerCovered with plastic
Maillard Reaction• heat generated as material ferments
• if moist enough water in forage will conduct heat away from silage mass and prevent overheating
• if too wet (>40%) or too dry (<25%) heat will not dissipate
• when temperature >130ºF heat kills organisms and breaks down forage by pyrolysis-->produces flammable gases which can ignite with oxygen exposure
• extremely dangerous in oxygen limiting silos as cannot hose down-->explosion
Confined Space Gases
Anhydrous Ammonia• Fertilizer
• Means “without water”
• Composed of 82.25% nitrogen and 17.75% hydrogen
• Gas at standard temperature and pressure, under pressure stored as liquid
• As liquid weighs slightly more than 5lb/gallon
• High affinity to water
• 1300 gallons of gas can be absorbed by 1 gallon of water
• Anhydrous + water = AMMONIUM HYDROXIDE
Anhydrous Exposure• Boiling Liquid Expanding Vapor Explosion
(BLEVE)• Excessive pressure causing a hose to burst or
a tank end to separate• Leaks from tank control valves
How Anhydrous Injures
• Freeze– Liquid stored in tank has temperature of
-28ºF
• Burn– Ammonium Hydroxide
• Dehydration– Removes water from tissues
Hydraulic Fluids
• Under extremely high pressure (2000-2700 psi or more)
• Petroleum-based hydrocarbons that contain highly caustic antifoaming and anticorrosive additives
Mechanisms of Injury
• Injection
• Tissue necrosis
• Thermal burns
• Significant morbidity if petroleum-based chemicals and additives if reach bloodstream
Treatment
• Scene safety!!
• Call for Emergency Help
• FTLS?? (Farm Trauma Life Support)
Injury Control Measures
“Pull out Betty!! Pull out…You hit an artery!”
• Prevention
– Centers of research
– Outreach programs
• Engineering
– Cell Phones
– Global Positioning Systems
– Alarms
• Legislation
• Pre-planning
– FARMEDIC
– Farm Grids
Injury Control Measures
Resources• University of Wisconsin Ag Safety and Health
www.bse.wisc.edu/wiscash
• National Farm Medicine Center
www.marshfieldclinic.org/nfmc
• National Institute for Farm Safety
www.ag.ohio-state.edu/~agsafety/NIFS/nifs.htm
• National Center for Farmworker Health
www.ncfh.org
• National Safety Council
www.usda.gov/agencies/agencies
• AgrAbility Unlimitedwww.agrabilityusa.org
• Breaking New Ground Center--Purdue University
• Consumer Product Safety Com.www.cpsc.gov
• National Safe Kids Campaignwww.safekids.org
• FARMEDICwww.farmedic.com
Resources Continued
Todd A. Nelson, MD, MSChairman, Department of Emergency MedicineMedical Director, Emergency and Trauma ServicesEMS Medical DirectorHoly Family Memorial Medical Center
(920) 320-2670 (office)Assistant Clinical ProfessorSection of Emergency MedicineUniversity of Wisconsin SMPH
