Nonfatal tractor-related injuries presenting to a state trauma system.
OBJECTIVE
To identify tractor-related injuries using data from a statewide trauma system, to characterize the mechanisms of nonfatal tractor-related injury, and to determine which injuries are associated with higher severity injury.


METHODS
A retrospective observational study was conducted using the Iowa State Trauma Registry to identify cases of nonfatal tractor-related injuries over an 11-year period from 2002 to 2012. Frequency of injury was reported by age, sex, severity, and nature. Injuries were classified by mechanism and a polytomous regression model was used to predict injury severity adjusting for sex and age.


RESULTS
Five-hundred thirteen nonfatal tractor-related injuries were identified with 18% classified as severe. Injuries were most frequent among males and among those ≥45years of age. Rollovers were the most frequent mechanism of both total (25%) and severe injury (38%), although the frequency of injury mechanism varied by age. Falls were the next most frequent mechanism of injury (20%) but resulted in fewer high-severity injuries. Collision (adjOR=1.89, 95% CI=1.01-3.51), rollover (adjOR=2.03, 95% CI=1.21-3.40), and run over/rolled on (adjOR=2.06, 95% CI=1.17-3.62) injuries were significantly associated with higher injury severity. Advanced age was also a significant predictor of higher severity injury (adjOR=1.82, 95% CI=1.06-3.12).


CONCLUSIONS
Mechanisms of nonfatal tractor-related injuries are heterogeneous, differ by age, and are associated with varying level of severity.


CONCLUSIONS
This work shows the burden of nonfatal tractor injuries on a rural state trauma system. These findings also demonstrate the heterogeneous nature of nonfatal tractor injuries and underscore the need for a multi-level approaches to injury prevention.
Injury Prevention Research Center, University of Iowa, 2190 WL (Westlawn), Iowa City, IA 52242, USA; Carver College of Medicine, University of Iowa, 375 Newton Road, Iowa City, IA 52242, USA. Electronic address: Amanda-swanton@uiowa.edu.
Amanda R
AR
Swanton
Injury Prevention Research Center, University of Iowa, 2190 WL (Westlawn), Iowa City, IA 52242, USA.
Tracy L
TL
Young
Iowa Department of Public Health, 321 E. 12th Street, Des Moines, IA 50319, USA.
Kathy
K
Leinenkugel
Injury Prevention Research Center, University of Iowa, 2190 WL (Westlawn), Iowa City, IA 52242, USA; Department of Epidemiology, University of Iowa, 145 N. Riverside Drive, Iowa City, IA 52242, USA.
James C
JC
Torner
Injury Prevention Research Center, University of Iowa, 2190 WL (Westlawn), Iowa City, IA 52242, USA; Department of Occupational and Environmental Health, University of Iowa, 145 N. Riverside Drive, Iowa City, IA 52242, USA. Electronic address: Corinne-peek-asa@uiowa.edu.
Corinne
C
Peek-Asa
D000062:Accidents, Occupational / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000383:Agriculture; D005260:Female; D006801:Humans; D007484:Iowa / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D018986:Motor Vehicles / Q000706:statistics & numerical data*; D012042:Registries; D012189:Retrospective Studies; D012424:Rural Population; D015599:Trauma Severity Indices; D014947:Wounds and Injuries; D055815:Young Adult
Agriculture; Farm equipment; Injury surveillance; Tractor; Trauma registry