Agricultural Hazards

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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
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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

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Death Rates(Deaths/100k)
National Safety Council, 2001
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Wisconsin Farm Fatalities
Fatalities 2005 2004 1993
Number 30 25 37
Rate 45 35 48
University of Wisconsin Cooperative Extension
Service, 2006
Per 100,000 workers
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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
National Safety Council, 2005
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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
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Farming Risk Factors

• Behavior
• Machinery
• Structures
• Environment (home/work, weather, EMS)
• Animals
• High risk groups the young and old
• Little formal training
• No governing body

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Sources of Injury/Illness

• Machinery
• Animals
• Structures
• Hazardous Materials

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Time of Injury

• Month varies state to state
• Day of week
• Time of day bimodal peaks 1000 and 1600

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Farm Work Injuries by Age
National Safety Council, 2005
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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

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Percent of Childhood Farm Injuries by Age

Age
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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 childs motor skills

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Mechanism of Death
National Safety Council, 2005
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Wisconsin Ag Fatalities

• Fatalities 2005 2004 2003
• Tractors 16 7 10
• Farm machines 3 5 12
• Confined Spaces 2 2 0
• Falls 3 3
  4
• Animals 4 7
  5
• Trucks/Vehicles 1 0 0
• Other 1 1
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• Total 30 25
  37

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Source of Injury ()
National Safety Council, 2005
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Distribution of Tractor-Related Deaths
National Safety Council, 2005
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Tractor History

• 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)

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Even with ROPS need to wear seatbelt!!
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Power Take Off (PTO)

• 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

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What is wrong in this picture??
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Augers

• 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

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Balers

• Small round baler
• 50-150 lb/bale
• Conventional rectangular baler
• 50-150 lb/bale
• Entanglement in twine
• Large round baler
• Entanglement in pick-up mechanism
• Crush injuries
• 1200 lb/bale

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Balers
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Combine

• 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.

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Other Machinery

• Cotton picker
• Ensilage cutter
• Mixing wagon
• Manure spreader
• Disc
• Chain saw

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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

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Job Security!!
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Structures

• Barns
• Confined Spaces
• Grain Bin
• Silo
• Manure Pit

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Grain Bins

• Used to store grain after harvest
• Mechanisms of injury
• Engulfment in a column of flowing grain
• 52 cu ft/min--gt185 person in 8 seconds
• Collapse of a horizontal crusted grain surface
• Collapse of a vertical crusted grain surface
• Fall
• Gas/pesticide exposure

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Flowing Grain
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Grain Drowning
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Horizontal Crusting
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Vertical Crusting
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Silos

• Conventional
• Poured concrete, concrete blocks, or wood
• Oxygen-limiting
• Sealed, steel coating with glass on inside and
  blue epoxy on outside
• Bunker
• Covered with plastic

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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 (gt40) or too dry (lt25) heat will not
  dissipate
• when temperature gt130ºF heat kills organisms and
  breaks down forage by pyrolysis--gtproduces
  flammable gases which can ignite with oxygen
  exposure
• extremely dangerous in oxygen limiting silos as
  cannot hose down--gtexplosion

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Confined Space Gases
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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

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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

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How Anhydrous Injures

• Freeze
• Liquid stored in tank has temperature of -28ºF
• Burn
• Ammonium Hydroxide
• Dehydration
• Removes water from tissues

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Hydraulic Fluids

• Under extremely high pressure (2000-2700 psi or
  more)
• Petroleum-based hydrocarbons that contain highly
  caustic antifoaming and anticorrosive additives

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Mechanisms of Injury

• Injection
• Tissue necrosis
• Thermal burns
• Significant morbidity if petroleum-based
  chemicals and additives if reach bloodstream

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Treatment

• Scene safety!!
• Call for Emergency Help
• FTLS?? (Farm Trauma Life Support)

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Injury Control Measures
Pull out Betty!! Pull outYou hit an artery!
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Injury Control Measures

• Prevention
• Centers of research
• Outreach programs
• Engineering
• Cell Phones
• Global Positioning Systems
• Alarms
• Legislation
• Pre-planning
• FARMEDIC
• Farm Grids

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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

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Resources Continued

• AgrAbility Unlimited
• www.agrabilityusa.org
• Breaking New Ground Center--Purdue University
• Consumer Product Safety Com.
• www.cpsc.gov
• National Safe Kids Campaign
• www.safekids.org
• FARMEDIC
• www.farmedic.com

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Todd A. Nelson, MD, MS Chairman, Department of
Emergency Medicine Medical Director, Emergency
and Trauma Services EMS Medical Director Holy
Family Memorial Medical Center
tnelsonmd_at_yahoo.com [phone] (office)
Assistant Clinical Professor Section of Emergency
Medicine University of Wisconsin SMPH