Injury Surveillance

Surveillance #1: New York State farm fatality and injury tracking

A. Fatality tracking, death certificates and news clips

NYCAMH has established an ongoing agriculture and forestry fatality tracking system, based on annual death certificate review. Agricultural fatality records as far back as 2000 are collected an analyzed, to identify trends over time. Moving forward in time, both agriculture and forestry fatalities will be tracked. This is a critical data set for identifying new trends, as well as evaluating the impact of NYCAMH programs on farm fatalities. The diagram below shows a preliminary comparison between agricultural fatalities during 1996-2000 and five years later, during the 2006-2010 period. We see in this table that tractor fatalities have gone down along with the overall fatality rate. It appears that this is related to the overall reduction in the number of tractors per farm.

B. Surveillance methods research: EMS as a data source for non-fatal farm injuries

Across the US, there are no good data on farming injuries. This is a major challenge in planning and prioritizing interventions and in evaluating impact. The NEC injury surveillance initiative utilizes an innovative method to track farm-related injuries and fatalities in New York State. Centrally processed EMS pre-hospital care reports ("ambulance reports") are reviewed for farm injuries. To supplement ambulance report data, monthly telephone surveillance with county-level municipal officials is conducted to supplement the ambulance reports and account for cases where EMS transport was not utilized. The long-term objective of this research is to develop an accurate but logistically simple and cost-effective system for tracking farm-related injuries and fatalities statewide.

Progress to Date

To date, over 275,000 ambulance reports from the 10 study counties have been scanned for agricultural injury cases. Thus far, ambulance reports have provided significant detail helping to identify the root causes of injury. In the ten-county study region, 142 agricultural injury cases were identified for 2007 (using both ambulance reports and community surveillance). This corresponds to an estimated 2,417 agricultural injuries for all of New York State requiring ambulance transport in 2007.

Surveillance #2: New Surveillance Strategy for Farming and Forestry Injury

The growing availability of electronic administrative datasets has provided an opportunity to explore these data for agricultural and forestry related injury and fatality. Inpatient and emergency department records, pre-hospital care reports (ambulance reports) and death certificates are used to identify non-fatal and fatal injury cases. Six northeastern states (ME, NH, VT, NY, NJ, and MD) are part of the study.

In addition, NYCAMH contracts with a new scanning consultant that regularly reviews over 100 electronic news sources for reports of farm or forestry fatalities in these states. This is believed to be an inexpensive and efficient source of fatality data that can be used on its own or to supplement other data sources. This will provide NYCAMH information on fatality trends beyond New York State across the NEC region.

Surveillance #3 Northeast tracking of emerging issues in Agriculture, Forestry and Fishing

In keeping with the Center's charge to continually monitor the agriculture, forestry and fishing industry, in order to determine whether economic or technological changes are presenting new safety and health challenges, the NEC conducts annual reviews of the AFF sector.

2010 Assessment - In 2010, the NYCAMH Surveillance group undertook a comprehensive assessment of the agriculture, fishing and forestry health and safety needs in the Northeast. This was largely focused on the Northeast Center as it was preparing to develop a new five-year program plan. Researchers combined four types of information:

  • Input from agricultural stakeholders from all over the Northeast Region
  • Outcomes of previous NEC research and expertise
  • Available epidemiologic data from the Region and the US
  • Input from NYCAMH Advisory Board and our Northeast Center members

What resulted from this 18 month process was a clear definition of priority areas for Northeast Agriculture, Forestry and Fishing (AFF) work for the coming five years. Researchers were then challenged to present study and program ideas that fit into those priority categories.

  • Addressing major health & safety threats to NE agriculture
  • Expand focus to more fully address forestry and fishing
  • Developing the capacity of these industries to identify & address their health & safety problems
  • Collaborating with other centers to address national level health threats

In responding to these needs, the Northeast Center identified its major strengths:

  1. Epidemiology (surveillance, evidence-based)
  2. Engineering solutions
  3. Social marketing/behavioral science
  4. Vulnerable populations
  5. On-the-farm programming

These complement NYCAMH's strong medical and mental health service program, and its on-farm training and prevention capabilities. This framework was utilized for developing the 2010 Northeast Center.