: Evaluations of Trauma in Hispanic Farm Workers
Principal Investigator: Bernward Steinjorst, MD, MA
Project Type: Core Research Feasibility
Context:In spite of the attention directed at the problem of occupational injuries within the farm environment and at the general health status of migrant farm workers in the United States, there have been no studies focusing on the risk for traumatic injury in general for this disadvantaged group. The Level I Trauma Center at the University Health Systems of Eastern Carolina serves a rapidly growing number of Hispanic patients many of whom are farm workers.
Purpose:Trauma affecting Eastern North Carolina Hispanic farm workers was quantified and certain risk factors were found.
Methods:Through chart review and retrieval of trauma registry information patient occupational history, injury patterns, treatment variables as well as outcome and hospital charges for male Hispanic farm workers were determined and compared with data for Hispanic construction workers and other service area males.
Findings: 256 male Hispanic farm workers were admitted to the trauma center from July1992 to June 2002. Thus their risk to be injured severely enough to warrant hospital admission was comparable to the risk (0.1%) for an age matched service area male.Only 5% of injuries occurred during farm work. Half of the patients were injured in motor vehicle crashes, where seat belt use was reported significantly less than in the group of age matched other males. Alcohol as contributing factor played a more important role in farm worker trauma than in cases, where age matched males were injured (66% vs. 51%, p<0.001). Injury characteristics resembled those of the general male population: One fifth of the injuries were penetrating.The respective injury severity scores (ISS) for Hispanic farm workers was 12.4 and equaled the other groups. Nine (3.8% vs. 5.5% other males) of the farm workers died as a result of their injuries. The mean charges for hospital services benefiting injured farm workers accounted to $15,741. Only 36.3% of farm workers had some insurance to help paying those bills compared with 71.8% of other age matched male patients (p<0.001)
Conclusion: Most trauma affecting Hispanic farm workers in Eastern North Carolina is not directly occupational and happens in conjunction with recreational activity, where alcohol is an important risk factor. Consequentially, many of the patients, who suffer injuries due to motor vehicle crashes do so because of drunken driving. One fifth of the admitted Hispanic farm workers were injured due to an altercation, where in a lot of instances alcohol was involved as well. It has thus become clear that the mobile home parks, where those mostly Mexican farm workers live in eastern North Carolina have come to resemble some poverty stricken inner city neighborhoods with their social isolation and cultural deprivation leading to alcohol and drug problems, risk taking behavior and interpersonal violence. The human and financial cost resulting from those injuries is of such magnitude, that it deserves consideration by everybody who is involved in shaping policies in agriculture, immigration and rural public health.
Annual Report 2003
Steinjorst, B. et al 2006. Trauma in Hispanic Farm Workers in Eastern North Carolina: 10 Year Experience at a Level I Trauma Center. Journal of Agromedicine. Journal of Agromedicine, Vol. 11(3/4) 2006.