Fatal and hospitalized agricultural machinery injuries to children in Ontario, Canada.

OBJECTIVES To assess rates and patterns of agricultural machinery injuries in farm children in order to both determine priorities and develop strategies for injury control in this population. METHODS Coroners' files and hospital discharge data were examined for Ontario farm children aged 0-19 who had agricultural machinery injuries over a five year period ending 31 March 1990. Injury rates were described by age, sex, geographic region, type of machinery, and mechanism of injury. Common patterns of injury deserving of priority for prevention were then identified and described. RESULTS 283 machinery injuries to children were identified. Injury rates were 116 and 25/100,000/year for boys and girls respectively. Boys were at increasing risk relative to girls as their ages increased. Young children were at greatest risk for fatal injury. There is a prominent summer peak in occurrence. The farm tractor was the machine most commonly associated with these injuries (33.2%), and entanglement, usually of clothing, was the mechanism cited most often (36.3%). The case fatality ratio (ratio of hospitalizations:deaths) was generally low whether assessed by machinery type or by mechanism of injury. This provides an indication of the lethality of these injuries. Common patterns associated with injury risk included: (1) inadequate supervision of small children; (2) permitting children to be in the area of moving or unguarded machinery; (3) allowing children to accompany workers using farm machinery; and (4) having children performing work related tasks inappropriate for their age. CONCLUSIONS Machinery related injuries are not uncommon in farm children and have a high case fatality rate. These rates changed little over the five year study period. Feasible strategies for prevention of these injuries, four of which are presented here, need to be developed and implemented by public health professionals working in cooperation with members of the agricultural industry.