Older farmers at high risk of animal-caused injuries

In 2000, two elderly brothers were fatally injured by a bull on the Iowa farm where they had lived and worked for nearly 30 years. Both had multiple rib fractures, suggesting they had been butted repeatedly against the barn. They were found by a third brother, who had just returned from the hospital after being treated for injuries caused by the same bull a few days earlier.

Although the story is uniquely tragic, it isn't unique. In the United States, about 20 people die of livestock-related injuries each year. Most are older men who are injured while working with cattle in enclosed spaces such as pens and chutes or while herding livestock into a trailer.

Not all cattle attacks are fatal. Thousands of farmers are seriously injured, and some permanently disabled, by animals each year. Data from trauma centers in the United States and a Canadian surveillance study published in the journal Injury Prevention found that about 30 percent of farm injuries are cattle related.

Martin D. Zielinski, M.D., a trauma surgeon at Mayo Clinic's campus in Rochester, Minnesota, says most of these injuries involve blunt trauma to the chest — often when a farm worker is crushed against a wall or door.

"When someone is trampled or crushed by a heavy farm animal, we can see a host of injuries, ranging from rib fractures and broken bones in the upper or lower extremities to pneumothoraxes and significant internal trauma to the liver or spleen. Head trauma isn't as common, but riders who are bucked off a horse can sometimes experience devastating brain injuries," he says.

Managing farm trauma

All farm injuries should be managed using standard advanced trauma life support protocols.

"If, after a thorough evaluation, a rural hospital feels comfortable taking care of a particular injury, then there may be no need to transfer the patient. But it depends on the type of injury, how far the hospital is from a higher level of care, how long it would take to get the patient there by ambulance or helicopter — even what the weather is like," he explains. "It's often a case-by-case call, but rural hospitals generally won't have the necessary blood products to treat massive hemorrhaging, for instance. Whether to perform imaging tests before transfer is also a judgment call, but transfer shouldn't be delayed in order to do them."

Injury prevention

Many animal-related injuries and fatalities on the farm are preventable. Research has shown that most accidents involving cattle have some factors in common, including:

  • Aggressive bulls that are allowed to remain in the herd
  • Pens and handling facilities without exit gates or protected areas for handlers
  • Lack of protective gear, including a helmet when riding horses
  • Working alone
  • Not understanding or following good animal-handling techniques, such as using gentle, slow, calm movements and avoiding loud noises and rapid changes from darkness to light

Farmer age also is a critical factor. One-third of principal farm operators are 65 and older — the fastest-growing segment of farm workers in the United States. Older farmers have nearly three times as many work-related fatalities as younger farmers do and fewer but more-severe injuries. Diagnosed arthritis, impaired mobility and hearing difficulties further increase the risk. Tractor rollovers are the leading cause of occupational injuries among older farmers; animal accidents are a close second.

Dr. Zielinski says providers can help change these statistics by suggesting injury prevention strategies to older farmers and their families and by providing treatments that target arthritis, mobility and hearing issues.

For more information

Pickett W, et al. Surveillance of hospitalized farm injuries in Canada. Injury Prevention. 2001;7:123.