Farming and Amputations
By Cliff D. Dedeaux, Occupational Therapist
Mississippi AgrAbility Project
Farm work consistently ranks in the top three most hazardous types of employment participated in by Americans, with mining and construction being the other two. Farm accidents are 2 times more likely to end in amputations than in any other industry.
Eleven percent of all farming accidents involve amputations. Farmers often explain getting in a hurry and taking shortcuts as the reason for losing their limb.
Location and cost of amputations
Amputations can involve numerous locations including: finger, hand, below-elbow and above elbow of the upper extremity and toe, foot, below knee and above-knee of the lower extremity (see picture to right - percentage of amputation by location). The farther up the extremity an amputation occurs (finger vs. above-elbow), the harder and longer the recovery process will last.
Generally, hospital stays cost approximately $500 to $1000 dollars a day (a conservative estimate). Simple prosthetics (artificial limbs) cost thousands of dollars, while the more complicated ones cost approximately the same as a new truck ($15,000 to over $20, 000).
Causes of limb loss
There are many causes of amputations. Approximately 74% of all amputations are due to a disease process, such as a tumor (i.e. cancer),peripheral vascular disease (i.e. diabetes), or chronic infection (gangrene). Limb removals in these instances are usually performed in a life saving measure. External causes of amputation include trauma, chemical, thermal, and electrical injuries.
On the farm, amputation accidents generally fall into four categories. The first consists of entanglement. This is when clothes, jacket or shoe strings, gloves, long hair, etc. get caught in moving parts (e.g. PTO shafts, belts, pulleys, balers, and combines). The best way to prevent entanglement is to completely shut down and disable machinery prior to working or moving next to the equipment. A second cause of limb loss is entrapment. Combine heads and augers would be an example because they are designed to trap and pull. Augers should always have guards on them and remember to turn off machine prior to working on it. A third general cause of limb loss is crushing. Usually this occurs from post drivers or heavy equipment pinning certain body parts. This type of
injury usually causes internal damage, to the arm or leg, and eventually ends in amputation. Finally, the fourth way limb loss occurs is infection. This is usually due to a dirty wound. The limb may survive initial trauma but amputation is eventually required following days or weeks of intensive therapy.
Beware of potential hazards
Some farm hazards happen when farmers become relaxed and less careful with a procedure and/or equipment. Farm workers should try to avoid complacency with farm equipment. A farmer becoming more comfortable with his or her equipment, combined with the equipment ageing (e.g. missing guards, exposed pulleys, chains,augers, etc.) leads to a potential farming hazard.
Shortcuts equal shorter limbs
Getting in a hurry or taking shortcuts are usually the reasons given by farm workers for their accidents. Instead of using shortcuts to save time, take a few extra seconds to do the activity safely. Dr. Carol J.Lehtola and Mike Brown of the University of Florida Extension office put together a table to put in perspective the small amount of time it takes to be safe.
General info about prosthetics
A prosthetic is an artificial device that replaces a missing limb or other part of the body. Some prostheses are simple (e.g. only for looks) while others are more complicated (e.g. muscle generated moving parts). A team approach might be used to make the transition a smooth one for a new prosthesis user. Possible team members include:
the doctor, the prosthetist (makes and fits the prosthesis), physical and occupational therapists,rehab nurses, social workers, and psychologists.
Farming with prosthetics
Risks of further injuries are possible when wearing a prosthetic. Possible hazards include prosthetic entanglements or “wearing out” the unaffected arm from overuse. Iowa’s Easter Seal Society has compiled a list of safety tips provided by farmers with upper and/or lower extremity prostheses:
Upper extremity prostheses tips include:
1. Don’t rely on the prosthetic when climbing.
2. Be careful not to catch the prosthetic onto chains, collars, ropes, halters, or other materials attached to livestock. If using a prehensile hand, leave in the far most grip so that a lead rope or chain can be released more easily.
3. Use one handed nail starters.
4. When appropriate, consider using a quick release chest harness in case the prosthetic gets entangled on objects in the working environment.
5. When using a prosthetic with an internal elbow lock, be careful not to carry objects that exceed the strength of the elbow lock.
6. Be careful of electric fences and other electrical currents that could deliver a current and shock through the terminal device to the arm, the shoulder, or back.
Lower extremity prostheses tips include:
1. Consider using outdoor mobility aids when maneuvering around rough terrains. Possible aids include: manual or electric wheelchairs,ATV's, and golf carts.
2. Use special cane tips (for better traction) for snow, ice, and loose gravel should be considered.
3. Start with the stronger leg when mounting and the weaker leg when dismounting a tractor.
4. A manlift, non-slip steps, wider steps,additional steps, and hand holds help compensate for decreased mounting and dismounting abilities.
5. Extreme caution should be used when in direct access with livestock due to their unpredictability. Some suggestions to eliminate direct livestock interaction include:
fence line feeders, automated feed systems,using round bales, raised decks for hogs, or have someone else perform potentially dangerous tasks.
6. Use automatic gate openers or automatic hitches to save energy.
7. When climbing over fences or walking on unstable ground, lock knee into place to add stability.
Agricultural production and related occupations is a way of life for millions of Americans. Many find this line of work to be both productive and satisfying. To continue a fulfilling life, both with and without an amputation, remember to take a little time to be a lot safer.
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Video is courtesy of "Partners Video Magazine" by the USDA Cooperative State Research, Education and Extension Service and the Kentucky AgrAbility project.
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