Agricultural operations involve persons of all ages, including children, who are at particular risk for injury. The proposed effort, to strengthen occupational safety and health surveillance, focuses on this high-risk industry, and can provide a better understanding of the magnitude and scope of childhood agricultural injuries, as well as to provide methods to improve occupational surveillance. To accomplish this, the 1999 Regional Rural Injury Study-II (RRIS-II) will serve as the basis for this surveillance effort. The 1999 RRIS-II was designed to determine the etiology and consequences of agricultural injury in the five-state region of Minnesota, Wisconsin, North Dakota, South Dakota, and Nebraska. These states are characteristic of the major types of agricultural production in the United States, and are among the leading producers of crops and livestock in the nation. The new cohort will be selected in the same manner as the 1999 cohort using a random sampling procedure from the lists of farm operations in each state, maintained by the United States Department of Agriculture. This new cohort will consist of approximately 17,000 persons and include an estimated 8,600 children less than or equal to 19 years of age. Unique methods will be applied for collecting quality data for both incidence and consequences of agricultural injuries as well as types and amounts of exposures, pertinent to the farming operation and environment. Using a computer assisted telephone interview (CATI) system, and instruments specially designed for the 1999 RRIS-II, a nested case-control design will be used to identify critical risk factors for farming-related injuries to children, as well as the incidence and consequences of injuries. This design, which also allows for the collection of exposure information, provides an efficient and optimal method for identifying risk factors that cannot be accomplished through traditional surveillance efforts. Participants will be contacted every six months over a period of one year (2001) to identify individuals who were injured (cases) in the previous six-month periods. All cases, less than or equal to 19 years of age and controls (approximately 3:1) (identified through an algorithm encoded into the CATI system, using the density method of control selection), will be interviewed to obtain relevant exposure data. The analyses, both univariate and multivariate, will be conducted using analytic procedures comparable to those incorporated in the 1999 RRIS-II baseline effort. The ability to identify incidence rates, information pertinent to the injury events, the consequences of injury, and relevant exposures and risk factors, through ongoing surveillance, is critical to provide sound scientific data for the development of focused intervention strategies and pertinent evaluation. This is essential to reduce morbidity and mortality from injuries in the agricultural community and can serve as a model for other regions in the nation.
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