Children living in rural areas are at significantly greater risk of unintentional injury-related death than children living in urban areas. These children are especially at risk from agricultural injury, motor vehicle crashes, drowning, residential fires and alternative modes of transportation. This higher risk is due to a combination of environmental, behavioral and economic factors, including poorer access to trauma care, lower restraint use and a disproportionate share of people living in poverty.

Agricultural injury is of particular concern as children are often exposed to hazards simply by living in the farm environment. It may be difficult to provide constant supervision when parents are performing farming duties. In addition, children may perform work-related tasks inappropriate for their ages.

RURAL DEATHS AND INJURIES

• Each year, approximately 70 children ages 14 and under die from injuries occurring on a farm.
  
• An estimated 150,000 children suffer a preventable injury associated with production agriculture each year. Although fatal farm-related injuries among children have declined in recent years, the non-fatal farm-related injury rate has increased.
  
• In 1998, more than 14,000 children ages 14 and under were treated in emergency rooms for equestrian-related injuries. Nearly 40 percent of equestrian injuries result in hospitalization. Head injury is the most common cause of equestrian-related death and serious injury.
  
• In 1998, at least 43 children ages 14 and under died from All Terrain Vehicle (ATV)-related injuries.
  
• In 1998, more than 23,500 children ages 14 and under were treated in emergency rooms for ATV-related injuries and nearly 800 children were treated for snowmobile-related injuries.
  
• In 1998, 15 children ages 14 and under died as occupants in the beds of pickup trucks.
  
• Fire death rates in rural communities are roughly double the rates in larger cities and roughly triple the rates in large towns and small cities.
  
• Drowning rates for all age groups are three times higher in rural areas compared to urban areas.
  

WHEN AND WHERE RURAL DEATHS AND INJURIES OCCUR

Farm-Related Injuries

• The primary causes of injuries among children on farms include tractors, farm machinery, livestock, drowning, transportation vehicles, fires, building structures and falls. Nearly 40 percent of farm deaths among children are due to machinery and another 23 percent are due to drowning.
  
• Younger children, ages 6 and under, primarily suffer from injuries on the farm due to falls, large animals and close proximity to tractor incidents. These injuries may result from a lack of adequate parental supervision and physical barriers between young children and farm hazards.
  
• Older children, ages 6 to 12, are more likely to suffer from mutilating farm equipment injuries that result from attempting age-inappropriate farm tasks.
  

Transportation-Related Injuries

• For all ages, nearly 60 percent of motor vehicle-related fatalities occur in rural areas. Passengers involved in fatal rural crashes are nearly twice as likely to be ejected from the vehicle and are more than twice as likely to be involved in a rollover.
  
• The majority of pickup truck bed-related injuries and fatalities among children occur in rural areas, during the summer months and in evening hours.
  
• ATV-related injuries are six times more likely to result in hospitalization and 12 times more likely to result in fatalities when compared to bicycle-related injuries per 1,000 vehicles.
  
• Snowmobile-related injuries occur more often during the winter season and in the northern states. In addition, excessive speed and operator error are primary causes of snowmobile-related injuries.
  

Home Fire-Related Injuries

• Use of alternative heating equipment such as wood stoves and space heaters explains much of the high rural fire-related death rate. Deaths due to cooking equipment, appliances and electrical fires also are more common in rural areas.
  
• The remoteness of, and limited resources in, rural areas are problems in detecting and extinguishing rural fires.
  

Rural Drowning

• Fifty-seven percent of rural drownings occur in fresh water. These include drownings in irrigation canals, ponds, rivers and lakes. The risk of drowning increases in unclear or muddy waters.
  

WHO IS AT RISK

• One-third to one-half of childhood agricultural injuries occur to children who do not live on farms.
  
• Children have a higher farm-related injury rate than adults when statistics are adjusted for time exposed. Farm injuries among children peak at age 4 and again at age 14.
  
• Among children ages 14 and under, males are more than twice as likely to suffer a nonfatal farm-related injury and more than five times as likely to sustain a fatal farm-related injury. At very young ages, boys and girls are at almost equal risk.
  
• Children ages 14 and under are more likely to suffer head injuries when thrown from a horse if they are not wearing equestrian helmets.
  
• Male children ages 14 and under are more likely to suffer transportation-related injuries and deaths as occupants of motor vehicles, while riding in pickup truck beds, and while riding on ATVs and snowmobiles.
  
• Children ages 3 and under are more likely to drown in farm ponds than older children.
  

RURAL INJURY PREVENTION LAWS AND REGULATIONS

• Only about five percent of farms in the United States are covered by safety regulations specified in the Occupational Safety and Health Act. Youths of any age may work at any time in any job on a farm owned or operated by their parents.
  
• At least 27 states, the District of Columbia and Puerto Rico have restrictions on passengers riding in pickup truck beds, but these laws contain huge gaps in coverage.
  
• The sale of three-wheeled ATVs ended in 1988 due to a consent decree between the U.S. Consumer Product Safety Commission and ATV distributors. Guidelines also were established for the sale of ATVs for use by children under age 16.
  

PREVENTION TIPS

• Do not allow children to perform farm tasks unsupervised or inappropriate for their age, physical size, strength, cognitive ability and prior experience. Construct barriers to prevent children from entering hazardous areas and keep children away from machinery. Ensure that safety shields are intact and in place on all farm machinery.
  
• Always use child safety seats and/or safety belts correctly every time you ride. Restrain children ages 12 and under in the back seat and never allow anyone to ride in the bed of a pickup truck.
  
• Never allow children ages 14 and under to operate ATVs, snowmobiles or tractors. In addition, never allow extra riders on tractors, mowers, minibikes or ATVs.
  
• Always supervise young horseback riders. Select a horse based on your child’s cognitive development and riding ability. Ensure that children always wear equestrian helmets that meet safety standards when riding and grooming.
  
• Install smoke alarms on every level of your home and in every sleeping area. Ensure that heating equipment is correctly installed and have your chimney inspected and cleaned annually.
  
• Install barriers around open bodies of water and ensure that children use personal flotation devices when on or near the water.

12/99 This information was compiled by the National SAFE KIDS Campaign.