ABSTRACT
Farmers are exposed to various risks due to the nature of the agricultural environment, and occupational injuries occur consistently. Hence, this study aimed to investigate the characteristics and predictors of major non-fatal occupational injuries among farmers by analysing incidents of non-fatal occupational injuries resulting in at least 1 day off work using the Korean Agricultural Workers’ Occupational Disease and Injury Survey data. Multivariate logistic regression was performed to identify the predictors of agricultural occupational injuries, and the results indicated that the risk for non-fatal injuries was higher among older individuals, individuals with pre-existing physical limitations and individuals who use agricultural machinery. The predictors were generally similar for most types of non-fatal injuries. By type of injuries, the risk for trip or slip was higher among women than men. The risk for injuries caused by excessive force or motion was higher among farmers doing rice farming, which is substantially mechanised, than field crop farmers or livestock farmers. The risk of falling from a height was higher among male orchard and greenhouse farmers. The risk of solo farm vehicle crash was higher among male farmers, older farmers, rice farmers, farmers with pre-existing physical limitations and farmers using agricultural machinery. The findings of this study may be useful for developing tailored policies and supportive projects for the Korean farmer population.
Keywords: Public Health, Farm, Occupational injury
WHAT IS ALREADY KNOWN ON THIS TOPIC.
WHAT THIS STUDY ADDS
Our study identified the distinct risk factors for each injury type.
HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY
Our results could help determine high-risk groups and identify the specific hazards necessitating precautions during farming activities. This information can guide the creation of tailored incident prevention programmes and support related safety projects.
Background
Nearly 2.7 million people worldwide have died from occupational injuries and illnesses, with over 7500 deaths occurring annually due to occupational incidents.1 The annual costs associated with medical treatment, rehabilitation and work reintegration programmes for work-related injury and illnesses amount to US$3.4 trillion globally; most countries consider them significant concerns.2 Particularly in the agricultural sector, occupational injuries are as prevalent as in the mining and construction industries, exacerbating farmers’ socioeconomic challenges due to increased healthcare expenses and loss of physical capabilities.3
Farmers commonly sustain injuries while engaging in farming activities, such as pesticide spraying and using farming equipment. Consequently, farming is perceived as a hazardous occupation. Eurostat and the US National Agricultural Workers Survey provide statistics on farming injuries, shedding light on the risk factors and types of accidental experienced by farmers.4 5 In Korea, the Rural Development Administration (RDA) conducts the Korean Agricultural Workers’ Occupational Disease and Injury Survey to examine the occurrence of injury during farming activities and promote the health and safety of farmers. As of 2021, the estimated occupational injury rate among Korean farmers is 2.3%, suggesting that approximately 2 out of every 100 farmers experience injuries per year.6
Previous studies have generated statistics on work-related injuries and investigated the common types of injury and their predictors to aid in preventing farming injuries. Work-related injuries among farmers have been found to be influenced by factors such as farm size, work hours, gender, age and crop type.7 8 The most frequently reported work-related injury among Korean farmers was tripping or slipping, followed by excessive force or motion, and contact, cuts, or punctures from objects.6 Although previous research has contributed to the development of preventive measures and educational materials for each type of injury, there is a lack of research focusing on the specific predictors of these injuries. While some past studies have analysed the major sociodemographic predictors of work-related injuries among farmers, further research is necessary to enhance injury prevention since farming-related injuries encompass many incidents, including trips or slips, and falls.
Within this context, this study analyses the factors that influence the major types of work-related injuries among farmers in Korea, using data from the Korean Agricultural Workers’ Occupational Disease and Injury Survey. Our ultimate aim is to provide foundational data to enhance safety among farmers through policy recommendations and tailored educational materials based on farmers’ gender and the type of crop they cultivate.
Method
Study data and participants
In this study, we combined the injury data from the 2019 and 2021 Korean Agricultural Workers’ Occupational Disease and Injury Survey conducted by the RDA for analysis. This nationally approved statistical survey, which was exempt from review by the Institutional Review Board due to its classification as a national statistics survey, investigated diseases and injuries every even and odd year, respectively. The survey was conducted on a sample population derived through multi-step stratified sampling based on the 2015 Census of Agriculture, Forestry and Fishery conducted by Statistics Korea. The sample consisted of 14 492 farmers aged 19 years and over from 10 020 farms in 335 regions nationwide in 2019 and 17 770 farmers aged 19 years and over from 12 000 farms in 400 regions nationwide in 2021. Trained enumerators with agricultural experiences administered the survey by visiting the assigned villages through one-to-one interviews.
Survey items
The Korean Agricultural Workers’ Occupational Disease and Injury Survey consists of 43 categories, including characteristics of members of the sample households, characteristics of farmers’ health and agricultural activities, and characteristics of farmers’ farming-related injuries. The 2019 survey was conducted from 1 January 2018 to 31 December 2018, and the 2021 survey was conducted from January 2020 to 31 December 2020. In this study, we used the item ‘How did the farming-related injury and poisoning (eg, pesticide poisoning) occur?’ to identify the predictors of the most common types of farming-related injuries. The respondents chose their responses from 14 options (vehicle-to-vehicle crash, solo farm vehicle crash, trips or slips, falls, use of excessive force or motion, struck by falling/flying object, contact/cut/puncture, trapped in equipment, injury by animals, exposure to chemicals, exposure to high- or low-temperature environment, pedestrian crash and others).
Data analysis
After combining the 2019 and 2021 data, the incidence rate and percentages of each non-fatal farming-related injury were presented using descriptive statistics, with non-fatal injury defined as an injury resulting in at least 1 day off work. Furthermore, we analysed the differences in the five major farming-related injuries (trips or slips, excessive force or motion, contact/cut/puncture, fall, solo farm vehicle crash) according to the sociodemographic characteristics of farmers (gender, age, primary crop), health characteristics (restrictions in agricultural activity due to physical limitations), farming-related characteristics (use of agricultural machinery) and characteristics of health awareness (subjective safety awareness) with cross-tab analysis. To identify the predictors of each of the major injuries, logistic regression was conducted using gender, age, primary crop, restrictions in agricultural activities due to physical and mental difficulties, use of agricultural machinery, and subjective safety awareness as the independent variables and occurrence of farming-related injury and type of major injury as the dependent variables. The logistic regression analysis was conducted using only agricultural workers who had occupational injuries. The regression results were presented as OR and 95% CI. The independent variables for the logistic regression were the variables that were significant in the univariate analysis (figure 1). The data were analysed using the SAS V.9.4 (SAS Institute, USA) statistical package.
Figure 1. Flow chart for the analysis of occupational injuries among farmers.
Results
Distribution of farming-related injuries
With non-fatal injuries among farmers defined as injuries resulting in at least 1 day off work, there was a total of 1031 cases of injuries among 32 262 farmers. By type, the most common injury was trips or slips (379 cases, 36.8%), followed by use of excessive force or motion (130 cases, 12.6%), contact/cut/puncture (128 cases, 12.4%), falls (114 cases, 11.1%), solo farm vehicle crash (90 cases, 8.7%), hit by thrown or dropped object (38 cases, 3.7%), injury by animals (32 cases, 3.1%) and body trapped in rotating or running equipment (30 cases, 2.9%) (table 1).
Table 1. Distribution of injuries.
| Type | Number of injuries (N, %) |
|---|---|
| Trip or slip | 379 (36.8) |
| Excessive force/motion | 130 (12.6) |
| Contact/cut/puncture | 128 (12.4) |
| Fall | 114 (11.1) |
| Solo farm vehicle crash | 90 (8.7) |
| Struck by falling/flying object | 38 (3.7) |
| Injury by animals | 32 (3.1) |
| Trapped in equipment | 30 (2.9) |
| Exposure to high-temperature and low-temperature environments | 23 (2.2) |
| Exposure to chemicals (pesticide, hazardous substance poisoning) | 22 (2.1) |
| Vehicle-to-vehicle crash | 19 (1.8) |
| Pedestrian crash | 8 (0.8) |
| Other (eg, collapse, electrical accident, fire, drowning) | 18 (1.7) |
| Total | 1031 (100.0) |
Sociodemographic distribution by major injury type
Cross-tab analysis showed that 60.4% of trips and slips occurred in female farmers, and 39.6% occurred in male farmers. The rate of trips and slips increased with increasing age. Trips and slips were more common among upland farmers (49.3%) and rice farmers (43.3%). Approximately 50.8% of injuries caused by excessive force or motion occurred in female farmers, while 49.2% occurred in male farmers. By primary crop, injuries caused by excessive force or motion were higher among upland farmers (43.1%) and rice farmers (32.3%). Approximately 68.8% of contact/cut/puncture injuries occurred in male farmers, while 31.3% occurred in female farmers. By primary crop, these injuries mostly occurred in upland farmers (47.7%) and rice farmers (31.3%). Further, these injuries were higher among those who use agricultural machinery (71.1%). Fall injuries more commonly occurred in male farmers (69.5%) and orchard farmers (34.2%). Solo farm vehicle crash injuries occurred mostly in male farmers (88.9%) and rice farmers (54.4%). Furthermore, these injuries more commonly occurred among those who use agricultural machinery (88.9%) (table 2).
Table 2. Major non-fatal injuries by demographics.
| Category | Total (N) | Number and percentage of non-fatal occupational injury cases (N, %) | |||||
|---|---|---|---|---|---|---|---|
| Trip or slip | Excessive force/motion | Contact/cut/puncture* | Fall | Solo farm vehicle crash | |||
| Gender | Male | 16 223 (50.3) | 150 (39.6) | 64 (49.2) | 88 (68.8) | 69 (60.5) | 80 (88.9) |
| Female | 16 039 (49.7) | 229 (60.4) | 66 (50.8) | 40 (31.3) | 45 (39.5) | 10 (11.1) | |
| Total | 32 262 (100.0) | 379 (100.0) | 130 (100.0) | 128 (100.0) | 114 (100.0) | 90 (100.0) | |
| Age | <50 | 1245 (3.9) | 1 (0.3) | 3 (2.3) | 6 (4.7) | 4 (3.5) | 2 (2.2) |
| 50–59 | 3351 (10.4) | 20 (5.3) | 16 (12.3) | 19 (14.8) | 3 (2.6) | 6 (6.7) | |
| 60–69 | 9188 (28.5) | 95 (25.1) | 43 (33.1) | 31 (24.2) | 47 (41.2) | 18 (20.0) | |
| ≥70 | 18 478 (57.3) | 263 (69.4) | 68 (52.3) | 72 (56.3) | 60 (52.6) | 64 (71.1) | |
| Total | 32 262 (100.0) | 379 (100.0) | 130 (100.0) | 128 (100.0) | 114 (100.0) | 90 (100.0) | |
| Primary crop | Rice | 13 442 (41.7) | 164 (43.3) | 42 (32.3) | 40 (31.3) | 34 (29.8) | 49 (54.4) |
| Dry field crop | 14 374 (44.6) | 187 (49.3) | 56 (43.1) | 61 (47.7) | 32 (28.1) | 29 (32.2) | |
| Orchard | 3005 (9.3) | 15 (4.0) | 20 (15.4) | 25 (19.5) | 39 (34.2) | 10 (11.1) | |
| Greenhouse | 1102 (3.4) | 9 (2.4) | 9 (1.6) | 2 (1.6) | 8 (7.0) | 1 (1.1) | |
| Livestock | 331 (1.0) | 4 (1.1) | 3 (2.3) | 0 (0.0) | 1 (0.9) | 1 (1.1) | |
| Total | 32 254 (100.0) | 379 (100.0) | 130 (100.0) | 128 (100.0) | 114 (100.0) | 90 (100.0) | |
| Agricultural restriction | No | 24 233 (75.1) | 286 (75.5) | 96 (73.8) | 93 (72.7) | 86 (75.4) | 69 (76.7) |
| Yes | 8029 (24.9) | 93 (24.5) | 34 (26.2) | 35 (27.3) | 28 (24.6) | 21 (23.3) | |
| Total | 32 262 (100.0) | 379 (100.0) | 130 (100.0) | 73 (100.0) | 79 (100.0) | 62 (100.0) | |
| Use of agricultural machinery | No | 16 858 (56.2) | 208 (54.9) | 54 (41.5) | 37 (28.9) | 38 (33.3) | 10 (11.1) |
| Yes | 15 404 (47.7) | 171 (45.1) | 76 (58.5) | 91 (71.1) | 76 (66.7) | 80 (88.9) | |
| Total | 32 262 (100.0) | 379 (100.0) | 130 (100.0) | 128 (100.0) | 114 (100.0) | 90 (100.0) | |
| Safety awareness | Do not care at all | 18 135 (56.2) | 220 (58.0) | 85 (65.4) | 73 (57.0) | 79 (69.3) | 62 (68.9) |
| Do not care in general | 9575 (29.7) | 118 (31.1) | 33 (25.4) | 39 (30.5) | 16 (14.0) | 22 (24.4) | |
| Care slightly | 3747 (11.6) | 33 (8.7) | 9 (6.9) | 13 (10.2) | 15 (13.2) | 5 (5.6) | |
| Care considerably | 805 (2.5) | 8 (2.1) | 3 (2.3) | 3 (2.3) | 4 (3.5) | 1 (1.1) | |
| Total | 32 262 (100.0) | 379 (100.0) | 130 (100.0) | 128 (100.0) | 114 (100.0) | 90 (100.0) | |
The total values for each category are the same: total (32 262, 100%), trip or slip (379, 100%), excessive force/motion (130, 100%), contact/cut/puncture (128, 100%), fall (114, 100%), solo farm vehicle crash (90, 100%).
Predictors of farming-related injuries
Logistic regression was performed to identify the predictors of farming-related injuries. The risk for injury was 0.75 times higher among female farmers than male farmers, and the risk increased with age. Regarding primary crops, the risk for farming-related injury was higher among livestock farmers (OR=1.15; 95% CI 0.62 to 2.13) than rice farmers. The risk of injury was 4.11 times higher among farmers with restrictions in agricultural activities due to physical limitations than those without, and 1.99 times higher among farmers who use agricultural machinery than those who do not. In terms of subjective safety awareness, the risk for injury was 1.16 times higher among those who chose ‘care considerably’ than those who chose ‘do not care at all’ (table 3).
Table 3. Predictors of major non-fatal occupational injuries among farmers.
| Variables | Categories | Crude ORs (95% CI) | Adjusted* ORs (95% CI) |
|---|---|---|---|
| Gender | Males | 1 | 1 |
| Females | 1.04 (0.88 to 1.23) | 0.75 (0.66 to 0.85) | |
| Age (years) | <50 | 1 | 1 |
| 50–59 | 1.31 (1.76 to 2.24) | 1.54 (0.94 to 2.53) | |
| 60–69 | 1.49 (0.91 to 2.45) | 2.17 (1.38 to 3.43) | |
| ≥70 | 1.42 (0.87 to 2.31) | 2.27 (1.44 to 3.55) | |
| Primary crop | Rice | 1 | 1 |
| Dry field crop | 1.05 (0.92 to 1.22) | 0.99 (0.86 to 1.13) | |
| Orchard | 1.21 (0.95 to 1.54) | 1.43 (1.17 to 1.75) | |
| Greenhouse | 1.17 (0.79 to 1.74) | 1.03 (0.72 to 1.48) | |
| Livestock | 1.13 (1.54 to 2.34) | 1.15 (0.62 to 2.13) | |
| Agricultural restriction | No | 1 | 1 |
| Yes | 4.05 (3.32 to 4.94) | 4.11 (3.37 to 5.02) | |
| Use of agricultural machinery | No | 1 | 1 |
| Yes | 1.78 (1.50 to 2.11) | 1.99 (1.72 to 2.31) | |
| Safety awareness | Do not care at all | 1 | 1 |
| Do not care in general | 0.59 (0.36 to 0.96) | 0.79 (0.51 to 1.23) | |
| Care slightly | 0.65 (0.41 to 1.02) | 0.86 (0.57 to 1.30) | |
| Care considerably | 0.77 (0.49 to 1.20) | 1.16 (0.74 to 1.66) |
Adjusted for gender, age, primary crop.
ORs, odds ratios.
Predictors of each of the major farming-related injuries (trips or slips, excessive force or motions)
Logistic regression was performed to identify the predictors of each major farming-related injury. The risk for trips or slips was 1.46 times higher among female farmers than male farmers. The risk increased with increasing age, where the risk for trips or slips was 16.53 times higher among farmers aged 70 years and over than those under 50. By primary crop, the risk for trips or slips was 1.29 times higher among livestock farmers than rice farmers. The risk was 4.02 times higher among farmers with restrictions in agricultural activities due to physical limitations than those without, and 1.36 times higher among farmers using agricultural machinery than those without. The risk for injuries caused by excessive force or motion was 1.04 times higher among female farmers than male farmers. The risk was higher among farmers aged 50–59 years than those under 50 (OR=1.97; 95% CI 0.60 to 6.20). By primary crop, the risk for injury was higher among upland, orchard, greenhouse and livestock farmers than rice farmers, with the highest risk among livestock farmers (OR=2.84; 95% CI 0.86 to 9.31) and greenhouse farmers (OR=2.57; 95% CI 1.24 to 5.33). The risk was 13.56 times higher among farmers with restrictions in agricultural activities due to physical limitations than those without (table 4).
Table 4. Sociodemographic predictors of major injuries (after adjustment).
| Variables | Categories | Adjusted* ORs (95% CI) | ||||
|---|---|---|---|---|---|---|
| Trip or slip | Excessive force/motion | Contact/cut/puncture | Fall | Solo farm vehicle crash | ||
| Gender | Males | 1 | 1 | 1 | 1 | 1 |
| Females | 1.46 (1.19 to 1.80) | 1.04 (0.74 to 1.47) | 0.46 (0.31 to 0.67) | 0.64 (0.44 to 0.95) | 0.11 (0.06 to 0.23) | |
| Age (years) | <50 | 1 | 1 | 1 | 1 | 1 |
| 50–59 | 7.13 (0.95 to 53.20) | 1.97 (0.57 to 6.77) | 1.27 (0.50 to 3.18) | 0.29 (0.06 to 1.30) | 1.29 (0.26 to 6.41) | |
| 60–69 | 12.15 (1.69 to 87.30) | 1.93 (0.60 to 6.20) | 0.78 (0.32 to 1.83) | 1.70 (0.61 to 4.74) | 1.53 (0.35 to 6.61) | |
| ≥70 | 16.53 (2.31 to 117.97) | 1.51 (0.47 to 4.80) | 0.93 (0.40 to 2.16) | 1.10 (0.39 to 3.05) | 2.91 (0.71 to 11.91) | |
| Primary crop | Rice | 1 | 1 | 1 | 1 | 1 |
| Dry field crop | 1.03 (0.83 to 1.27) | 1.24 (0.83 to 1.85) | 1.50 (1.00 to 2.25) | 0.91 (0.56 to 1.49) | 0.64 (0.40 to 1.02) | |
| Orchard | 0.44 (0.26 to 0.74) | 2.11 (1.24 to 3.61) | 2.79 (1.67 to 4.65) | 5.30 (3.33 to 8.43) | 0.99 (0.51 to 1.95) | |
| Greenhouse | 0.80 (0.40 to 1.57) | 2.57 (1.24 to 5.33) | 0.58 (0.14 to 2.42) | 3.08 (1.41 to 6.72) | 0.29 (0.04 to 2.10) | |
| Livestock | 1.29 (0.47 to 3.52) | 2.84 (0.86 to 9.31) | – | 1.42 (0.16 to 9.37) | 0.94 (0.13 to 6.88) | |
| Agricultural restriction | No | 1 | 1 | 1 | 1 | 1 |
| Yes | 4.02 (2.87 to 5.62) | 13.56 (6.17 to 29.78) | 4.70 (2.74 to 8.04) | 3.92 (2.20 to 6.97) | 6.30 (2.93 to 13.57) | |
| Use of machinery | No | 1 | 1 | 1 | 1 | 1 |
| Yes | 1.36 (0.08 to 1.72) | 2.08 (1.31 to 3.30) | 2.29 (1.53 to 3.43) | 2.33 (1.44 to 3.77) | 4.75 (2.34 to 9.65) | |
Adjusted for gender, age, primary crop.
ORs, odds ratios.
Predictors of each of the major farming-related injuries (contact/cut/puncture, fall, solo farm vehicle crash)
The risk for contact/cut/puncture injuries was 0.46 times higher among female farmers than male farmers. The risk was 1.27 times higher among farmers aged 50–59 years than those under 50. By primary crop, the risk for injury was the highest among orchard farmers (OR=2.79) compared with rice farmers. The risk was higher among farmers with restrictions in agricultural activities due to physical limitations than those without, and also higher among farmers who use agricultural machinery than those who do not (OR=2.29; 95% CI 1.53 to 3.43). The risk for fall injuries was 0.64 times higher among female farmers than male farmers. The risk was 1.70 times higher among farmers aged 60–69 years than those under 50. By primary crop, the risk for injury was the highest among orchard farmers (OR=5.30) compared with rice farmers. The risk for solo farm vehicle crash injuries was higher among male and female farmers, and the risk increased with age. By primary crop, the risk for injury was the highest among rice farmers, and the risk of fall injury was 6.30 times higher among farmers with restrictions in agricultural activities due to physical limitations than those without, and 4.75 times higher among farmers who use agricultural machinery than those who do not (table 4).
Discussion
The most common work-related injury among Korean farmers was trips or slips, followed by injuries caused by excessive force or motions, contact/cut/puncture injuries, fall injuries and solo farm vehicle crash injuries.6 On the other hand, the US Centers for Disease Control and Prevention reported the most common farming injuries to be equipment-related accidents, followed by falls and animal attacks.9 The differences in the most common types of farming-related injuries across countries are attributed to the differences in the agricultural environments. In the USA, farming equipment is typically used due to large-scale farming owing to the large farmlands, resulting in more common equipment-related injuries.9 10 In contrast, farming in Korea is typically smaller scale, and a relatively higher percentage of farms rely on human work instead of farming equipment. Furthermore, trips, slips and injuries from excessive force and motions appear to be more common in Korea because most Korean farmers are older and have diminished physical capacity, as evidenced by the high population ageing in Korea compared with other Organisation for Economic Co-operation and Development countries.
To identify the predictors of farming-related injuries, we analysed the overall incidence of farming-related injuries in relation to the farmers’ characteristics. The results revealed that the risk for injuries was higher among male farmers and older individuals. According to the Korean Agricultural Workers’ Occupational Disease and Injury Survey conducted by the RDA, the incidence of injury was higher among male farmers, while the prevalence of illness was higher among female farmers.6 This is primarily because male farmers tend to engage in higher-intensity farming activities11 or use farming equipment more often than female farmers owing to the physical differences between sexes, and as a result, they are at higher risk for exposure to various injuries. Farm equipment-related injuries were also the most common type of injury among farmers in the USA, and these injuries generally occurred in men.12
By primary crop, the risk for injury was higher among upland and livestock farmers than rice farmers, consistent with previous findings showing that a high percentage of farming injuries are related to animal husbandry activities.13 In addition, studies have also reported that the risk for injury is potentially higher among farmers with physical (lower limb) limitations, such as ankles, due to stroke,14 with a higher risk for injury among older adults due to physical limitations.15 Our results also showed that the risk for injury was higher among farmers with physical limitations than those without. A previous study about subjective safety awareness reported that farmers with a history of injury develop a higher awareness for safety,16 and our results also indicated that farmers with a history of farming injury were more concerned about safety during agricultural activities than those without such history. It appears that the experience of accidental or injury causes individuals to recognise the importance of and pay more attention to safety.
For the different types of common injuries, logistic regression revealed that the risk for trips and slips was 1.46 times higher among female farmers than male farmers. The US Department of Agriculture also showed that trips or slips were 20% more common among female farmers than male farmers in the USA from 2003 to 2011. Agriculture and Agri-Food Canada also reported that trips and slips are more common among female farmers than male farmers.17 18 Although diminished physical abilities and muscle strength are common between sexes as they age, men tend to maintain their muscle strength for a longer time than women.19 20 21 Thus, female farmers may have a higher risk for trips and slips than their male counterparts due to the quicker loss of muscle strength as they age. Regarding major crops, livestock farmers had the highest risk for trips and slips (OR=1.29 ref rice farmers). The risk for trips and slips is considered high in livestock environments due to moving animals and slippery floors. A previous study reported that pig farmers are exposed to slippery working environments caused by wet manure and excrement.22
Injuries caused by the use of excessive force or motion were more common among female farmers than male farmers and among upland, orchard, greenhouse and livestock farmers than rice farmers. More specifically, the risk was the highest among livestock farmers and greenhouse farmers. Whereas rice farming is mostly mechanised, livestock and greenhouse farming rely heavily on manual labour. The 2020 Occupational Injury Statistics for Korean Farmers show that lifting weights of 20 kg or more was most prevalent among livestock farmers, and lifting weights has been associated with musculoskeletal injuries caused by excessive force. Moreover, a recognised ergonomic risk is handling fertilisers, harvested crops and heavy agricultural materials during farming.23 Due to various internal and external environmental factors, achieving complete automation in farming is challenging, and there are still many activities that require manual labour by farmers. Thus, it is important to develop convenient equipment and ameliorate existing tools in order to prevent injury among farmers.
Contact, cut and puncture injuries by farming machinery and objects occur constantly. Since male farmers generally operate these equipment and machines, the risk of these injuries is higher among male farmers. In terms of primary crops, the risk was highest among orchard farmers. A previous study reported that the incidence of cut injuries is high among fruit harvesters due to the use of pruning shears.24
The risk for fall injuries was higher among male farmers than female farmers and among orchard farmers than other farmers. The most common causes of falls in farming are unstable posture when using tools such as a ladder, slippery floors and worker carelessness.25,27 Particularly, ladders are frequently used in orchard farming in Korea, which is speculated to be the reason for the high risk of fall injuries among orchard farmers. The Korean Agricultural Workers’ Occupational Disease and Injury Survey also showed that 51.9% of injuries were caused by farm equipment.6 According to previous studies, 7% of accidents on a farm in the USA involved a ladder, and most cases occurred during orchard work.28 Falls mostly occur when using a ladder while working in an orchard, but they also occur during rooftop work and greenhouse repairs and maintenance. To prevent falls, farmers must wear personal protective equipment (PPE), such as helmets, and relevant authorities should provide safety education and foster safe work environments.
The risk of solo farm vehicle crash was higher among male and rice farmers. Male farmers generally operate motor farm vehicles due to the complexity of manipulation and large size, and this contributed to the higher risk for injury among male farmers than female farmers. Furthermore, the higher risk among rice farmers may be attributed to the fact that most processes during rice production, such as rice transplanting and harvesting, are mechanised,29 meaning that rice farmers typically use farm equipment.
The incidence of occupational injuries in agriculture is higher than in other industries, and the risk for injuries is rising due to the rapid ageing rate among farmers. In light of the findings stating that major risk factors differ across different types of farming-related injury, it is crucial to provide tailored safety education considering factors such as gender, age and crops. Previous studies have reported that farmers participating in safety education demonstrate increased knowledge and awareness of agricultural safety.30,32 Therefore, providing customised safety education for farmers will enable more effective prevention of work-related injuries. Additionally, the risk of injuries will be reduced further by ameliorating the work environment, facilitating periodic safety management in farms, and ensuring the appropriate use of PPE during farming activities.
This study has a few limitations. Although the specialised statistical data provided estimates of the entire farming population in Korea, there is an inherent risk of response errors due to the advanced age of the participants, and the potential recall bias hinders the use of affected items as study variables. Despite these limitations, however, this study also has strengths. The study used an adequately large sample to estimate the trends of work-related injuries among Korean farmers, trained enumerators administered the questionnaire one-to-one, trained surveyors conducted individual interviews, and the survey data were obtained from a nationally representative population of farmers in Korea.
Based on the results of this study shedding light on the most common types of work-related injuries and their predictors in Korean farmers, future studies can develop materials for age- and gender-specific education programmes that promote safety. Furthermore, considering that agricultural training in Korea is provided for each type of crop periodically at agricultural technology centres run by each local government system in Korea, the results of this study will be useful for identifying the major and important risk factors associated with specific crops. The findings can serve as valuable references for improving safety management and work environments and as foundational data for the research and development of essential PPE for farmers to reduce work-related injuries among farmers.
Conclusion
Identifying the major risk factors for the most common types of work-related injuries farmers will help determine high-risk groups and shed light on the hazards that require precautions during farming activities. Such results will also be useful for developing prevention measures for each type of injury. Furthermore, developing individualised education programmes tailored to injury type, gender and crops will increase safety awareness among farmers. The results of this study will serve as foundational data for setting directions of strategies, policies and support programmes for preventing major injuries among Korean farmers.
Acknowledgements
I would like to express my gratitude to my coauthors who helped me write this paper and to the Rural Development Administration for providing the research project that allowed us to use the data.
Footnotes
Funding: This work was carried out with the support of 'Cooperative Research Programme for Agriculture Science and Technology Development (Project No. PJ01623902)' National Academy of Agricultural Science, Rural Development Administration, South Korea.
Patient consent for publication: Not applicable.
Provenance and peer review: Not commissioned; externally peer reviewed.
Patient and public involvement: Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Contributors: ML led study conceptualisation with input from KY. ML conducted data analysis with input from JP and DC. ML drafted the manuscript with input from WJ and YS. All authors were involved in subsequent edits and revisions, and approved the submitted version. ML is responsible for the overall content as guarantor.
Ethics approval: This study was exempted from review by the Institutional Review Board (IRB) at the National Academy of Agricultural Sciences (approval number: HR-202107-02).
Data availability statement
Data are available upon reasonable request.
References
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Data Availability Statement
Data are available upon reasonable request.