Agricultural Hazards

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


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


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


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


Source of Injury (%)

51%

26%

19%4%

Overturn

Runover

Other

PTO


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

[email protected]

(920) 320-2670 (office)Assistant Clinical ProfessorSection of Emergency MedicineUniversity of Wisconsin SMPH

mailto:[email protected]

Documents

Agricultural Hazards