title: Trends in non-fatal agricultural injuries requiring trauma care.
abstract: BACKGROUND
  Efforts to control agricultural injuries have been underway for years. Yet, very little is known about their trends over time. We examined trends in non-fatal agricultural injuries through analyzing injuries reported in a state trauma registry.
  
  
  METHODS
  Using Iowa Trauma Registry data collected by the Iowa Department of Public Health, we examined trends in non-fatal agricultural injuries reported by acute care hospitals accredited as Level I, II, and III Trauma Care Facilities from 2005 to 2013. Rate ratios and corresponding 95 % confidence intervals were used to examine the burden of non-fatal agricultural injuries across this period. Negative binomial regression was used to calculate the average annual change in agricultural injury rates over time. Joinpoint regression analysis was used to examine the average annual change in the number of injuries over time.
  
  
  RESULTS
  Between 2005 and 2013, a total of 1238 agricultural injuries were reported to the trauma registry by Level I, II and III trauma facilities. From 2005 to 2013, the rate of agricultural injuries per 100,000 hired workers, ranchers, and farm operators increased by 11 % for every unit increase in year and had nearly tripled over this time period. From 2005 to 2008 there was a significant annual increase of 31.74 % in the number of agricultural injuries whereas from 2008 to 2013 there was a non-significant annual increase of 3.70 %. The number of moderate and severe/critical injuries increased steadily and significantly over the study period, with annual percent increases of 13 and 20 %, respectively.
  
  
  CONCLUSIONS
  Non-fatal agricultural injuries are rising, although the documented increases could be influenced in some part by treatment patterns in the trauma system, reporting bias or increases in farm work exposure. However, these issues do not likely account for all of the increase found, and this calls for an increase in priority of agricultural safety programs. Since the majority of research involves fatal injuries, information about non-fatal injuries may help inform new intervention approaches.
authors.affiliation: Injury Prevention Research Center, University of Iowa, 2190 WL, Iowa City, IA 52242 USA ; Department of Epidemiology, College of Public Health, University of Iowa, 145 N. Riverside Drive, Iowa City, IA 52242 USA.
authors.forename: Celestin
authors.initials: C
authors.lastname: Missikpode
authors.affiliation: Injury Prevention Research Center, University of Iowa, 2190 WL, Iowa City, IA 52242 USA ; Department of Occupational and Environmental Health, College of Public Health, University of Iowa, 145 N. Riverside Drive, 100 CPHB, S143, Iowa City, IA 52242 USA.
authors.forename: Corinne
authors.identifier: 0000-0001-9472-2538
authors.initials: C
authors.lastname: Peek-Asa
authors.affiliation: Injury Prevention Research Center, University of Iowa, 2190 WL, Iowa City, IA 52242 USA.
authors.forename: Tracy
authors.initials: T
authors.lastname: Young
authors.affiliation: Injury Prevention Research Center, University of Iowa, 2190 WL, Iowa City, IA 52242 USA.
authors.forename: Amanda
authors.initials: A
authors.lastname: Swanton
authors.affiliation: Iowa Department of Public Health, 321 E. 12th Street, Des Moines, IA 50319 USA.
authors.forename: Kathy
authors.initials: K
authors.lastname: Leinenkugel
authors.affiliation: Department of Epidemiology, College of Public Health, University of Iowa, 145 N. Riverside Drive, Iowa City, IA 52242 USA.
authors.forename: James
authors.initials: J
authors.lastname: Torner
keywords: Agriculture; Injury; Non-fatal; Trends