Risk Factors for Serious Injury in Finnish Agriculture Risto H. Rautiainen, PhD, 1 * JohannesLedolter, PhD, 2 Kelley J. Donham, DVM, 1 Robert L. Ohsfeldt, PhD, 3 and Craig Zwerling, MD, PhD 1 Background Previous studies indicate 20% of injuries represent 80% of injury costs in agriculture. To help prevent the most costly injuries, we aimed to identify characteristics and risk factors associated with serious injuries. Methods We analyzed insurance records of 93,550 self-employed Finnish farmers. We ranked injury causes by claim cost and used multiple logistic regressions to identify risk factors for ( any) injury and serious injury ( injuries exceeding claim costs of s2000). Results A total of 5,507 compensated injuries occurred in 2002 ( rate 5.9/100 person- years), and 1,167 or 21% of them ( rate 1.25/100 person-years) were serious. The causes/ sources resulting in highest average claim costs were motor vehicles; stairs, scaffoldings, and ladders; trailers and wagons; floors, walkways, and steps; other structures and obstacles; augers, mills, and grain handling equipment; horses; combines and harvesting equipment; tractor steps; and uneven and slippery terrain. Older age, male gender, higher income level, greater field size, residing on the farm, Finnish language (vs. Swedish), occupational health service ( OHS) membership, and animal production were risk factors for injury. The risk factors for serious injury were similar; however, the effects of age, income level, and the raising of horses were more prominent. Language, residence, ownership status, and OHS membership were not risk factors for serious injury. Conclusions Cost-effective prevention efforts should address the following risk factors: older age, male gender, larger income and operation size, livestock production (particularly dairy, swine, and horses), motor vehicle incidents, falls from elevation, and slips, trips and falls. Am. J. Ind. Med. 52:419–428, 2009. ß 2009 Wiley-Liss, Inc. KEY WORDS: agriculture; injury; accident; insurance; workers’ compensation INTRODUCTION Agriculture is a hazardous industry. In Finland, the occupational fatality rate in 2002 was 11/100,000 among self-employed farmers and 2/100,000 for all industries com- bined. The non-fatal injury rate was 5.8/100 among self- employed farmers and 2.8/100 in all industries [Eskola et al., 2003; Ministry of Social Affairs and Health, 2006]. The US agricultural fatality rate was three times higher (32/100,000) and the all-industry rate was twice as high (4/100,000) compared to Finland [CFOI, 2007]. The US OSHA record- able injury rates were 6.1/100 full-time employee years (FTE) among hired agricultural workers and 4.3/100 FTE among all workers in private industries [Bureau of Labor Statistics, 2007]. In 1996 the direct insurance cost of agricultural injuries Accepted5January2009 DOI10.1002/ajim.20688.PublishedonlineinWileyInterScience (www.interscience.wiley.com) Contract grant sponsor: National Institute for Occupational Safety and Health (NIOSH); Contractgrantnumber:KO1OH008300. *Correspondence to:Risto H.Rautiainen,PhD, Assistant Professor,Deputy Director,Great PlainsCenterforAgriculturalHealth,TheUniversityofIowa,103IREH,OakdaleCampus,Iowa City,IA52242-5000.E-mail:risto-rautiainen@uiowa.edu 1 Department of Occupational and Environmental Health, College of Public Health, TheUniversityofIowa,IowaCity,Iowa 2 DepartmentofManagementSciences,TippieCollegeofBusiness,TheUniversityofIowa, IowaCity,Iowa 3 Health Policy & Management Department, School of Rural Public Health,Texas A&M, HealthScienceCenter,CollegeStation,Texas AMERICAN JOURNAL OF INDUSTRIAL MEDICINE 52:419–428 (2009) ß 2009 Wiley-Liss,Inc.