The 130th Annual Meeting of APHA

Abstract #48475

William Pickett, PhD, Emergency Medicine Research, Queen's University, Angada 3, Kingston General Hospital, 76 Stuart Street, Kingston, ON K7L 2V7, Canada, Barbara Marlenga, PhD, National Children's Center for Rural and Agricultural Health and Safety, 1000 North Oak Avenue, Marshfield, WI 54449, 715-389-3021, PickettW@post.queensu.ca, Robert Brison, MD, MPH, FRCP(C), Dept. of Emergency Medicine, Kingston General Hospital/Queens University, 76 Stuart St, Kingston, ON K7L 3V2, Canada, and Richard Berg, MS, Marshfield Medical Research and Education Foundation, 1000 North Oak Avenue, Marshfield, WI 54449.

The North American Guidelines for Children's Agricultural Tasks (NAGCAT) were developed to assist parents in assigning developmentally appropriate work to children. We are presently evaluating NAGCAT by systematically applying its content to case descriptions of pediatric farm deaths. Our purpose was: 1) to determine the proportion of pediatric trauma deaths that were not covered by NAGCAT and the reasons for this lack of coverage and 2) to describe common mechanisms and circumstances associated with these deaths. One hundred sixty-eight cases have been identified to date via manual review of files in five Chief Coroner’s Offices in Canada for the years 1990-2000. For each case, we recorded child demographics, a description of what the child was doing, the circumstances leading to injury occurrence, and the nature of supervision. The results show that a substantial portion of pediatric farm deaths would not have been prevented through the application of NAGCAT. Common reasons that these deaths were not covered were: 1) victims were under the age of 7 years (the threshold age for application of NAGCAT, n=82 [48%]), 2) extra-rider deaths (n=28), 3) drownings (n=28), and 4) bystander runovers (n=24). New guidelines should address the following issues: 1) supervision of young children on the farm; 2) minimizing the presence of children in the workplace when adults are working; 3) the physical separation of children from possible drowning, fall, and mechanical hazards; and 4) the prohibition of extra-riders on open station and cabbed tractors.

Learning Objectives: Participants will learn

• the extent to which application of NAGCAT would have prevented the occurrence of pediatric farm fatalities and
• situations that are commonly associated with these deaths, which provides direction for the development of additional guidelines.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.