46 PAFE: Prevention of farm accidents in children

Abstract

Farm accidents are a major cause of mortality and morbidity in the pediatric population. Many accidents occur when children are assigned work normally performed by adults, and much of this work is beyond their developmental abilities. Consideration of child development has led to the development of the North American Guidelines for Children’s Agricultural Tasks (NAGCAT). NAGCAT is a collection of guidelines designed to help parents assign suitable tasks to children aged 7 to 16 living or working on farms. The primary objective is to describe the caracteristics of injured children and leading mechanisms of injury. Secondary objectives are to assess the potential of prevention of the NAGCAT and to identify the NAGCAT farm work that was most commonly associated with these injuries. This research is a retrospective case series study. The study population is 282 hospitalized children and 18 children who died from 2002 to 2016 following an agricultural trauma in Quebec. Hospitalization data were consulted at the INSPQ offices. The mortality data was sent to us by the coroner’s office. Sociodemographic data, hospital stay and injury characteristics were recorded for hospitalization cases. The applicability of NAGCAT was evaluated for the most common injury mechanisms. We looked at the age at which the injuries occurred and compared it to the recommended minimal ages for the different farm activities described in the guidelines. Injuries that occurred in the context of an activity not recommended for age were considered preventable. The main mechanisms of injury were tractor related incident, other farm equipment related incident and falls. Boys aged 5 to 9 and 15 to 19 years were the most affected by agricultural trauma. It was possible to evaluate the applicability of NAGCAT on 66% of hospitalizations and 100% of deaths. Of these, 67% of hospitalizations and 83% of deaths were preventable by NAGCAT recommendations on age. For traumatic injuries among hospitalizations from 2006 to 2015, 11% of patients had a diagnosis of intracranial injury, 8% had a broken leg, 6% had a skull fracture and 6% a traumatic amputation of the hand. Boys aged 5 to 9 and 15 to 19 years are the groups with the highest risk possibly due to the more reckless temperament among adolescents, lack of supervision and assignment of age-inappropriate tasks to children. The results suggest that it is imperative to focus on farm accidents and that NAGCAT would be an effective tool in terms of prevention.