The association between parents' past agricultural injuries and their children's risk of injury: Analyses from the regional rural injury study-II

Objective: To examine associations between parents' and children's agricultural injuries in a cohort of farming and ranching households. Design: Analyses from a population-based, nested case-control study. Setting: The 1999 Regional Rural Injury Study-II, involving a cohort of 3765 agricultural households. Demographic, injury, and exposure data were collected for household members for 1 year. Participants: A total of 203 injured children (cases) and 755 randomly selected control children were identified for the study. Main Exposure: Children's risk of injury was estimated in reference to individual and combined parental injury experience. Two periods were evaluated, separately and in combination. Main Outcome Measures: Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by using logistic regression; directed acyclic graphs guided selection of potential confounders. Results: When controlling for potential confounders, children whose fathers were injured before the study year had twice the risk of injury of those whose fathers were not injured (OR, 2.1; 95% CI, 1.5-3.0). Children had increased risk of injury if their mothers were injured before the study (OR, 2.5; 95% CI, 1.7-3.8) or during the study (OR, 2.0; 95% CI, 0.9-4.2). Children whose parents both reported agricultural injuries before the study had a 4-fold increase in injury risk over those with neither parent injured (OR, 4.2; 95% CI, 2.6-6.9). Conclusions: Positive associations between parents' and children's injuries were observed, with a potential additive effect if both parents were injured. These results indicate a need for further research into the social and/or physical environments driving these associations so that appropriate interventions for pediatric injury can be determined.