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Determinants of agricultural injury: a novel application of population health theory
  1. William Pickett1,2,
  2. Louise M Hagel3,
  3. Andrew G Day4,
  4. Lesley Day5,
  5. Xiaoqun Sun4,
  6. Robert J Brison1,2,
  7. Barbara L Marlenga6,
  8. Matthew King1,
  9. Trever Crowe7,
  10. Punam Pahwa3,8,
  11. Niels Koehncke3,
  12. James Dosman3
  1. 1Department of Community Health and Epidemiology, Queen's University, Kingston, Canada
  2. 2Department of Emergency Medicine, Queen's University, Kingston, Canada
  3. 3Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada
  4. 4Clinical Research Centre, Kingston General Hospital, Kingston, Canada
  5. 5Accident Research Centre, Monash University, Melbourne, Australia
  6. 6National Children's Center for Rural and Agricultural Health and Safety, Marshfield Clinic Research Foundation, Marshfield, USA
  7. 7Department of Agricultural and Bioresource Engineering, University of Saskatchewan, Saskatoon, Canada
  8. 8Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Canada
  1. Correspondence to Dr William Pickett, Emergency Medicine Research, Queen's University, Angada 3, Kingston General Hospital, 76 Stuart St, Kingston, ON K7L2V7, Canada; will.pickett{at}


Objectives (1) To apply novel population health theory to the modelling of injury experiences in one particular research context. (2) To enhance understanding of the conditions and practices that lead to farm injury.

Design Prospective, cohort study conducted over 2 years (2007–09).

Setting 50 rural municipalities in the Province of Saskatchewan, Canada.

Subjects 5038 participants from 2169 Saskatchewan farms, contributing 10 092 person-years of follow-up.

Main measures Individual exposure: self-reported times involved in farm work. Contextual factors: scaled measures describe socioeconomic, physical, and cultural farm environments. Outcome: time to first self-reported farm injury.

Results 450 farm injuries were reported for 370 individuals on 338 farms over 2 years of follow-up. Times involved in farm work were strongly and consistently related to time to first injury event, with strong monotonic increases in risk observed between none, part-time, and full-time work hour categories. Relationships between farm work hours and time to first injury were not modified by the contextual factors. Respondents reporting high versus low levels of physical farm hazards at baseline experienced increased risks for farm injury on follow-up (HR 1.54; 95% CI 1.16 to 1.47).

Conclusions Based on study findings, firm conclusions cannot be drawn about the application of population health theory to the study of farm injury aetiology. Injury prevention efforts should continue to focus on: (1) sound occupational health and safety practices associated with long work hours; (2) physical risks and hazards on farms.

  • Agriculture
  • cohort study
  • epidemiology
  • farming
  • population health
  • environment
  • farm
  • models
  • public health
  • socio economic status

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  • See Editorial, p 361

  • Linked article 028175.

  • Funding This study, initiated and conducted by the investigators, was supported financially, in part, by a research agreement with the Canadian Institutes of Health Research (Operating Grant: MOP-145294) and a pilot study grant from the Canadian Centre for Health and Safety in Agriculture (also funded by the Canadian Institutes of Health Research, Operating Grant: CDA-66151). LD is supported by a Senior Research Fellowship (ID 236880) from the National Health and Medical Research Council of Australia.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the University of Saskatchewan.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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