title: Not just a rural occurrence: differences in agricultural equipment crash characteristics by rural-urban crash site and proximity to town.
abstract: OBJECTIVE
  Although approximately one-third of agricultural equipment-related crashes occur near town, these crashes are thought to be a rural problem. This analysis examines differences between agricultural equipment-related crashes by their urban-rural distribution and distance from a town.
  
  
  METHODS
  Agricultural equipment crashes were collected from nine Midwest Departments of Transportation (2005-2008). Crash zip code was assigned as urban or rural (large, small and isolated) using Rural-Urban Commuting Areas. Crash proximity to a town was estimated with ArcGIS. Multivariable logistic regression was used to estimate the odds of crashing in an urban versus rural zip codes and across rural gradients. ANOVA analysis estimated mean distance (miles) from a crash site to a town.
  
  
  RESULTS
  Over four years, 4444 crashes involved agricultural equipment. About 30% of crashes occurred in urban zip codes. Urban crashes were more likely to be non-collisions (aOR=1.69[1.24-2.30]), involve ≥2 vehicles (2 vehicles: aOR=1.58[1.14-2.20], 3+ vehicles: aOR=1.68[0.98-2.88]), occur in a town (aOR=2.06[1.73-2.45]) and within one mile of a town (aOR=1.65[1.40-1.95]) than rural crashes. The proportion of crashes within a town differed significantly across rural gradients (P<0.0001). Small rural crashes, compared to isolated rural crashes, were 1.98 (95%CI[1.28-3.06]) times more likely to be non-collisions. The distance from the crash to town differed significantly by the urban-rural distribution (P<0.0001).
  
  
  CONCLUSIONS
  Crashes with agricultural equipment are unexpectedly common in urban areas and near towns and cities. Education among all roadway users, increased visibility of agricultural equipment and the development of complete rural roads are needed to increase road safety and prevent agricultural equipment-related crashes.
authors.affiliation: University of Iowa, College of Public Health, Department of Occupational and Environmental Health, Injury Prevention Research Center, Iowa City, IA, USA; University of Iowa, Department of Emergency Medicine, Iowa City, IA, USA. Electronic address: kari-harland@uiowa.edu.
authors.forename: Karisa K
authors.initials: KK
authors.lastname: Harland
authors.affiliation: University of Iowa, College of Public Health, Department of Occupational and Environmental Health, Injury Prevention Research Center, Iowa City, IA, USA.
authors.forename: Mitchell
authors.initials: M
authors.lastname: Greenan
authors.affiliation: University of Iowa, College of Public Health, Department of Occupational and Environmental Health, Injury Prevention Research Center, Iowa City, IA, USA.
authors.forename: Marizen
authors.initials: M
authors.lastname: Ramirez
mesh_terms: D000062:Accidents, Occupational / Q000706:statistics & numerical data*; D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000383:Agriculture; D002947:Cities; D040362:Geographic Information Systems; D006801:Humans; D016015:Logistic Models; D015146:Midwestern United States; D015999:Multivariate Analysis; D016017:Odds Ratio; D012307:Risk Factors; D012424:Rural Population; D014505:Urban Population
keywords: Agricultural equipment; Epidemiology; Occupational accidents/injuries; Traffic accident