ORIGINAL ARTICLE Evaluation of Farm Tractor-Related Fatalities Kamil H. Dogan, MD,* Serafettin Demirci, MD,* Guven S. Sunam, MD,† Idris Deniz, MD,* and Gursel Gunaydin, MD* Abstract: Farm tractors are the major cause of occupational fatalities in agricultural regions. Fatalities typically result from being run over or crushed by the tractor, becoming entangled in the moving parts of the tractor, accidents on roadways, and tractor rollovers, which involve the tractor tipping sideways or backwards and crushing the operator. In this study, tractor-related fatalities in the Konya province of Turkey are retrospectively evaluated. Out of the 3940 cases on which a death examination and/or autopsy was performed between the years 2000 and 2007 at The Konya Branch of Forensic Medicine Council, 86 (2.2%) of the death cases were caused by tractor accidents and are included in this study. The ages of the victims varied between 3 and 80 years old with a mean age of 31.7  22.3. Sixty-eight (79.1%) of the cases involved males, while 18 (20.9%) of the cases involved females. In 32 (37.2%) of the cases, the deaths due to tractor accidents occurred when the tractor overturned. In 37 (43.0%) of the cases, the tractor-related fatalities involved the passengers and the drivers were involved in 34 (39.5%) of the cases. In conclusion, tractor accidents are preventable and deaths from tractor accidents can be significantly reduced if drivers are required to wear safety belts and helmets and frequent checks are implemented to enforce the ban on carrying passengers. Key Words: tractor, farm, death, accident, forensic medicine (Am J Forensic Med Pathol 2010;31: 64 – 68) T he hazards of farm tractors have been widely recognized since tractors replaced horses as the primary power source for farm- ing. 1 Farm accidents are a frequent occurrence in many countries; for example, in the United States, farming is rated second only to mining in terms of occupational danger. 2 According to some studies, agricultural machinery has been identified as a principal cause of farming-related injuries and the cause of death or disability in many cases. 3–8 Tractors account for a large proportion of nonfatal injuries and the majority of fatal farm injuries, 3,8,9 where rollovers are the most frequent mechanism by which these fatalities occur. 8,10,11 The aim of this study was to evaluate the features of farm tractor-related fatalities in Konya, Turkey. MATERIALS AND METHODS Cases whose death examinations and autopsies were per- formed at The Konya Branch of Forensic Medicine Council between 2000 and 2007 were retrospectively investigated. Death cases iden- tified as tractor-related were examined for their sociodemographic characteristics, the month when the accident occurred, the type and location of the incident, the position of the victim, the region of injury, the location of death and the presence of a rollover protective structure (ROPS). RESULTS Out of the 3940 cases on which death examinations and/or autopsies were performed between the years 2000 and 2007 at The Konya Branch of Forensic Medicine Council, 86 (2.2%) of the death cases were caused by tractor accidents are included in this study. The rate of deaths caused by tractor accidents was 4.6% among the 1853 death cases caused by traffic accidents that occurred during the same period. A total of 85 tractor accidents occurred, of which 1 person died in 84 (97.7%) of the cases, while 2 persons died in one (2.3%) of the cases. Sixty-eight (79.1%) of the cases involved males and 18 (20.9%) of the cases involved females. The ages of the cases varied between 3 and 80 years old with a mean age of 31.7  22.3. When the fatalities were evaluated considering the age groups, the 0 to 9 age group had the highest number of fatalities with 19 (22.1%) of the cases. The 20 to 29 and 40 to 49 age groups followed with 15 (17.4%) cases of tractor-related death for each group (Fig. 1). All the victims were members of the farming families. The month of July contained the highest number of deaths with 15 (17.4%) of the cases, which was followed by August with 14 (16.3%) of the cases and October with 13 (15.1%) of the cases (Fig. 2). In 32 (37.2%) of the cases, death occurred due to a tractor rollover, 20 (23.3%) of the cases involved a victim that was runover by tractor and 17 (19.8%) cases involved victims who had fallen from the tractor or trailer (Table 1). Thirty-seven (43.0%) of the cases were passengers on the tractor, which was followed by 34 (39.5%) cases involving the drivers (Fig. 3). When the location of the incident was evaluated, it was observed that 53 (61.6%) of the victims had died when the tractor had an accident in a field, a field road or a ridgeway. Twenty-two (25.6%) of the deaths occurred on an urban road (Fig. 4). Death occurred due to a fatal trauma to the head in 29 (33.7%) of the cases, trauma to the head and chest in 14 (16.3%) of the cases, and trauma to the chest and abdomen in 11 (12.8%) of the cases (Table 2). Death occurred during treatment in the hospital in 54 (62.8%) of the cases, at the location of the incident in 24 (27.9%) of the cases, and during transfer to the hospital in 8 (9.3%) of the cases. When the features of the tractors involved in the accident were considered, 81 (95.3%) of the tractors did not have ROPS and 4 of the cases involved tractors that were equipped with ROPS. DISCUSSION Among the agricultural hazards, the farm tractor has been consistently associated with the greatest number of farm fatali- ties. 5,12 Fatalities associated with farm tractors are the most common cause of work-related death in the US agricultural industry. 13 Trac- tor accidents account for an estimated 600 fatalities a year in the United States. Rollovers account for more than half of these deaths. 14 In Turkey, there are no published statistical data concern- ing farm tractor accident-related fatalities. According to the data of the Turkish Statistics Association, there are 13,022,945 road motor Manuscript received December 4, 2008; accepted March 18, 2009. From the Departments of *Forensic Medicine, and †Thoracic Surgery, Meram Medical School, Selcuk University, Konya, Turkey. Presented at the 1st International Eurasian Congress of Forensic Sciences, Istan- bul, Turkey, October 8, 2008 to October 11, 2008. Figures can be viewed in color at http://amjforensicmedicine.com. Reprints: Kamil H. Dogan, MD, Department of Forensic Medicine, Meram Medical School, Selcuk University, 42080 Meram, Konya, Turkey. E-mail: drhakan2000@gmail.com. Copyright © 2010 by Lippincott Williams & Wilkins ISSN: 0195-7910/10/3101-0064 DOI: 10.1097/PAF.0b013e3181c21bf0 Am J Forensic Med Pathol • Volume 31, Number 1, March 2010 64 | www.amjforensicmedicine.com