Injury Related to Agriculture Requiring Medical Care

The U.S. Bureau of Labor Statistics (BLS) consistently ranks agriculture among the most dangerous industries from year to year. In 2014, the rate of fatal occupational injuries in agriculture was 25.6 deaths per 100,000 workers in the United States, a rate over 7-fold higher than the all-industry fatality rate of 3.4 deaths per 100,000 workers.

With some 75,000 farms, agriculture is a significant industry in Minnesota, ranking 5th in the United States with a total overall sales of agricultural products at just over $21 billion in 2012. Although this industry group makes up approximately 2% of Minnesota's employed population, it accounted for 34% of all worker fatalities in Minnesota in 2014.

Although fatal occupational injuries are well-documented, non-fatal occupational injuries that occur on family farms are not generally included in existing injury reporting systems such as workers' compensation data or OSHA injury logs. To address this shortfall this indicator was created using the Minnesota Hospital Association's (MHA) hospital discharge billing dataset to identify injuries that might relate to agricultural work.

This indicator tracks injuries with a potential relationship to agriculture using "external cause of injury codes" (E codes) that were part of the ICD-9-CM medical coding system until ICD-10-CM was implemented in October, 2015. E codes describe the nature, cause, location, and mechanism of injury. The intended purpose of the E code is to provide information detailing how, where, and why an injury occurred. A set of seven E codes were identified with a potential relationship to agriculture. Two of the seven codes have a very obvious relationship to agriculture, the remaining five codes have a possible relationship to agriculture. Due to the uncertainty present in the E codes the cases identified were grouped into two different categories: probable and possible. Examples of agriculture-related injuries include crushing from machinery, poisoning from agricultural chemicals, trampling by animals, and tractor rollovers. Serious farm related injuries can prevent employees from participating in normal work activities and extremely impact the employee, the employee's family, and the direct profitability of a farm.

The indicator captures injuries serious enough to have required medical attention, including both inpatient and emergency room visits.

The identified set of seven hospital discharge codes (E codes) used to identify injuries with a potential relationship to agriculture:

Probable:

• E849.1: Place of occurrence, farm
• E919.0: Accidents caused by agricultural machinery

Possible:

• E827: Animal drawn vehicle accident
• E828: Accident involving an animal being ridden
• E863.0 - E863.9: Accidental poisoning by agricultural and horticultural, chemical and pharmaceutical preparations other than plant foods and fertilizers
• E906.8: Other specific injury caused by animal (butted by animal, fall from a horse or other animal not being ridden, being gored)
• E980.7: Poisoning by solid or liquid substances, undetermined whether accidentally or on purpose inflicted—agricultural and horticultural chemical preparations other than plant food and fertilizers

The numbers, rates, and trends of agricultural injuries in Minnesota from 2000 to 2014 are shown in the graph and table below. From 2000 to 2014 the data shows a statistically significant increasing trend for the total number of cases per year, with the driving force for this increase among injury cases identified as occurring with animals.

A limitation of this indicator is the use of E codes within the hospital discharge billing data. There is no mandate in Minnesota to collect and use E codes and the frequency of use is unique to each hospital. Despite not being mandated, 90% of all hospitalized injury cases in Minnesota have an accompanying E code. As the indicator makes use of billing data there are preferences for certain types of E codes, particularly those that will justify billing practices. As such there may be details not captured in the billing record that would have identified an injury as related to agriculture. Even though this indicator will not have captured every case, it does provide a much needed estimation of serious farm injuries. As ICD-10-CM data becomes available for complete years, a new (and expanded) set of more specific codes will be utilized to identify agricultural injuries.

This indicator provides health and safety professionals and agricultural employers with information about the rates and trends of serious agricultural injuries in the state of Minnesota. This information could be useful in identifying high risk activities, setting priorities for prevention efforts or simply understanding the risks associated with farming.

Number of Injuries with a Potential Relationship to Agriculture

Rates of Agriculture Related Injuries Requiring Medical Care, 2000-2014