Farm-related injuries among Old Order Anabaptist children: developing a baseline from which to formulate and assess future prevention strategies.

Old Order Anabaptists are a religiously based North American subculture that is often identified with simple lifestyles, limited reliance on modern technologies, and unique farming methods, including dependence upon horse-drawn vehicles and farm equipment. Members of this group generally have large numbers of children and begin involving them in work around the home or farm at an early age. Children are called upon to participate in a wide range of activities that most farm children are no longer exposed to due to the adoption of modern technologies and changing roles of children in contemporary society. Preliminary research suggested that farm-related injuries and fatalities may be an increasing problem among Old Order Anabaptist children, thus posing the need for a better understanding of causative factors, which could then contribute to the design of more effective intervention strategies. This present study employed a national injury surveillance process to expand Purdue University's Old Order Anabaptist Injury Database in order to develop a baseline of Old Order child-related farm injury information for the year 2002 and then analyzed that data in reference to specific underlying factors. From the expanded database, 217 farm-related injuries to children under the age of 18 from 14 states and Canada were identified as having occurred during the year 2002. The most common primary source of injury was falls, and the most common nature of injury was bone fractures. The age of victim most commonly reported was 14, with the peaks in injuries occurring at ages 3-4 and 13-15. Culture-specific factors played a role in many of the incidents, the main ones being direct animal contact, hay-hole falls, and horse-drawn equipment runovers. Fourteen of the 217 recorded injuries resulted in fatalities, of which 6 were attributed to equipment runovers and the rest to a crush or pin, a fall, being struck by an object, direct animal contact, or engulfment in feed/grain. Animal behavior was cited as the secondary source of injury in 6 of the fatality cases. Based upon the findings of this study, a body of recommendations was developed for formulating culturally sensitive childhood injury prevention strategies in Old Order communities for use by parents, Old Order parochial school teachers, employers, extension educators, health workers, and others. Those recommendations focus specifically on resources and actions for each group involved as well as on possible topics for further research. The baseline data also provides a means to assess the impact of future injury prevention efforts targeting the Old Order population.