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This study adds substantial evidence that hearing loss acts as a risk for agricultural injuries. Prevention of hearing loss and noise exposure may be important in reducing the burden of agricultural injuries.

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The selected studies provided no evidence that educational interventions are effective in decreasing injury rates among agricultural workers. Financial incentives could reduce injury rates. Legislation to ban pesticides could be effective. Legislation expanding the use of safety devices (ROPS) on new tractors was associated with a decrease in fatal injuries.

The objective of this study was to identify significant risk factors for agricultural injury based on the literature. The authors conducted a systematic review of commonly reported risk factors. Studies that reported adjusted odds ratio (OR) or relative risk (RR) estimates for the selected risk factors were identified from PubMed and Google Scholar. Pooled risk factor estimates were calculated using meta-analysis. A total of 441 (PubMed) and 285 (Google Scholar) studies were found in the initial searches; of these, 132 and 78 studies, respectively, met the selection criteria for injury outcomes, and 32 of these reported adjusted OR or RR estimates. One study was excluded because it did not meet the set Newcastle-Ottawa Scale quality criteria. Finally, 31 studies were used for meta-analysis. The pooled ORs for the risk factors were as follows: male gender (vs. female) 1.68, full-time farmer (vs. part-time) 2.17, owner/operator (vs. family member or hired worker) 1.64, regular medication use (vs. no regular medication use) 1.57, prior injury (vs. no prior injury) 1.75, health problems (vs. no health problems) 1.21, stress or depression (vs. no stress or depression) 1.86, and hearing loss (vs. no hearing loss) 2.01. All selected factors except health problems significantly increased the risk of injury, and they should be (a) considered when selecting high-risk populations for interventions, and (b) considered as potential confounders in intervention studies.

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.