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Rural Health Information Hub

Rural Agricultural Health and Safety

Agriculture is one of the most hazardous industries in the United States. According to the National Institute for Occupational Safety and Health (NIOSH), 417 farmers and agricultural workers died from a work-related injury in 2016, a rate of 21.4 deaths per 100,000 workers. Each day, agricultural workers experience 100 non-fatal lost-work-time injuries. Transportation incidents, including tractor rollovers, were the leading cause of death, but many other hazards exist on the farm.

Agriculture is different from many industries in that it can present hazards to people not actively involved in the industry, such as family members living on the farm and visitors, in addition to workers. Additionally, hazards may exist for emergency medical services personnel and other healthcare professionals as they provide assistance and care to victims of farm accidents.

This topic guide focuses specifically on the health and safety issues inherent in the agricultural industry. This includes migrant workers hired to work on farms who are included in data relating to agricultural health and safety. However, if you are interested specifically in the health and healthcare of migrant or seasonal workers, see RHIhub's Rural Migrant Health topic guide.

Frequently Asked Questions

What chronic and acute health risks are farmers and farmworkers exposed to?

Health risks for farmers and farmworkers include:

  • Exposure to farm chemicals, such as pesticides and fertilizers, as well as toxic gases which may be produced from common farm practices like manure decomposition and silo crop storage
  • Exposure to high levels of dust, which can contain mold, bacteria, and animal droppings, among other things
  • Falls from ladders, farm equipment, grain bins, or other heights
  • Exposure to ultraviolet rays from the sun, which can result in skin cancer
  • Joint and ligament injuries, which can result in arthritic conditions affecting mobility
  • Exposure to loud noises and sounds from machinery and equipment which can result in hearing loss
  • Stress from environmental factors, such as droughts, floods, wildfires, pests, and diseases affecting crops and livestock, as well as from working long hours, financial concerns, and feelings of isolation and frustration
  • Risk of suffocation in a grain bin if a person is engulfed by the grain
  • Risk of heatstroke, frostbite, or hypothermia from working outside in extreme weather conditions
  • Risk of injury from operating farm equipment and motorized vehicles
  • Risk of injury from working with livestock
  • Risk of electrocution to persons operating large equipment that can contact overhead power lines

What are some mental health concerns for farmers and ranchers and their families?

In addition to physical injuries, farmers are also at risk of behavioral and mental health issues such as anxiety, depression, substance use, and death by suicide. Due to environmental, financial, and social factors, there are a number of stressors inherent in farming and farm ownership.

In this brief video, experts from national farm organizations discuss the challenges facing today’s farmers, warning signs of suicide, and how communities can help farmers and their families:

According to a 2014 study of farmers in Eastern North Carolina, the top three farm-related stress factors were:

  • The weather
  • Concern over the future of the farm
  • Outsiders not understanding the nature of farming

The top three financial stressors were:

  • Market prices for your crops/livestock
  • Taxes
  • Health care costs

The top three social stressors were:

  • Not enough time for family
  • Distance from doctors or hospitals
  • Limited social interaction opportunities

Many of these stressors are common in the agricultural industry and are often out of the individual farmer's control. These stressors can lead to anxiety, depression, feelings of loneliness, or isolation. Farmers and agricultural workers suffer from higher rates of suicide. A 2018 study shows that from 1992-2010, farm operators and workers had significantly higher rates of suicide (0.36-0.95 per 100,000 people) than all other occupations (0.13-0.19 per 100,000 people). Like much of rural America, farm families have been dealing with the opioid epidemic. According to a 2017 survey by the American Farm Bureau Federation, 74% of farmers and farmworkers have been directly impacted by opioids, compared with 45% of rural adults.

One of the programs that can help alleviate the financial stress of farming is the Agricultural Mediation Program. Funded by USDA through the Farm Service Agency, the Agricultural Mediation Program works on the state-level to help farmers resolve financial disputes and potentially avoid litigation and bankruptcy.

Additional resources to help farmers and agricultural workers find information and support regarding mental health and substance abuse include:

  • FarmTownStrong – Provides resources and information for farm families dealing with the opioid epidemic.
  • Farm Crisis Center – Provides national and local resources for farmers facing a farming-related, financial, or personal crisis.
  • Farm Aid's Farmer Resource Network – An online directory that connects farmers with local resources for a variety of needs.

Mental Health First Aid training to recognize and aid someone experiencing a mental health crisis may be helpful for community members who regularly interact with farmers, such as:

  • Family members
  • Neighbors
  • Lenders
  • Government agency personnel
  • Staff at local cooperatives and businesses
  • Clergy

For information on mental health in rural America more broadly, see the Rural Mental Health topic guide.

How many children are involved in agricultural injuries? What resources are available related to preventing farm accidents among children and youth?

According to a 2019 report from the National Children's Center for Rural and Agricultural Health and Safety, every day about 33 children are injured in agriculture-related incidents. Injuries to children that occur while living, working, or visiting agricultural work environments (primarily farms) are considered agricultural injuries, whether or not the child was actively involved in farming at the time. Children who might be injured on farms include youth hired to work on the farm, farm children actively involved in the farming operations, farm children not involved in farming operations, and even children who are visiting the farm. Hazards for children on the farm include animals, farm equipment, grain bins, heights, ponds/water, chemicals/gases, all-terrain vehicles, and many others.

The Childhood Agricultural Injury Survey is a national survey of farm operators which collects information about youth under 20 living and working on farms, including any injuries to those children. According to the survey's results, transportation-related incidents are the leading cause of injury for rural children, followed by falls, slips, and trips, and contact with objects. The survey's results also reveal that the incidence of injuries to youth from farm accidents has decreased since 2001.

Selected Childhood Agricultural Injury Survey Data
  2001 2006 2009 2012 2014
Number of Youth (<20) Living and Working on US Farms
Household (lives on farm) 1,352,948 1,121,392 1,033,803 955,406 892,836
Hired 425,317 306,734 230,387 258,835 265,604
Household youth also working on farm (%) 54% 53% 50% 49% 51%
Estimates of Farm Injuries to Youth (<20) by Type
Total Injuries 29,227 22,894 15,876 13,996 11,942
Household 22,144 11,654 7,715 7,784 7,469
Working household 6,644 3,601 2,585 1,323 2,972
Other working youth 2,948 2,301 993 1,416 1,064
Injuries to household youth where child was working (%) 30% 31% 34% 17% 40%
Estimates of Farm Injuries to Youth (<20) by Age Group
<10 years 9,698 6,435 4,111 4,235 3,220
10-15 years 13,368 10,159 6,912 5,766 5,376
16-19 years 5,977 6,049 4,149 3,443 3,010
Unknown age 185 251 704 553 337
Source: Childhood Agricultural Injury Survey (CAIS) Survey Results; Demographic Tables and Injury Tables

Fatalities also occur as a result of child farm accidents. According to the most recent data from the National Institute for Occupational Safety and Health (NIOSH), from 1995-2002 the average number of annual agricultural fatalities for youth under 20 years of age was 113 youths. The 2019 Fact Sheet: Childhood Agricultural Injuries in the U.S. lists machinery accidents, motor vehicles, and drowning as the main causes of death.

The following resources provide tips, information, and assistance related to the safety of youth working in agriculture, as well as those that live on or visit farms:

  • Youth in Agriculture – Resource from the Occupational Safety and Health Administration (OSHA) which identifies common agricultural hazards and provides safety solutions for employers and young workers to prevent accidents and avoid injury in agricultural related jobs.
  • Childhood Agricultural Injury Prevention Initiative – NIOSH resource which raises awareness about childhood agricultural injury, and develops and encourages the use of prevention strategies.
  • National Children's Center for Rural and Agricultural Health and Safety – Provides technical assistance and resources regarding children and adolescents living in rural areas and working in agriculture and is funded by NIOSH. NCCRAHS also produces Cultivate Safety, which provides information, guidelines, and resources about children's farm safety for parents and other responsible adults.
  • Agricultural Employment – U.S. Department of Labor information on federal and state labor laws pertaining to agriculture.
  • Invest in Your Health – AgriSafe online or onsite course with training materials available to ag educators. Provides lessons and activities on five key areas of ag health and safety.

Which local agencies can help support the development of an agricultural health and safety program?

Local and county cooperative extension offices and public health offices often can provide resources to develop an agricultural health and safety program. Use this directory of local health departments to find the local public health office in your area. State resources that support research and education on agricultural health and safety can be found in the Resources section of the OSHA website.

Also, local service clubs and faith-based organizations may provide some assistance with the development of an agricultural health and safety program.

What federal agencies focus on agricultural health and safety?

Several federal agencies concentrate on agricultural health and safety issues.

The USDA's National Institute of Food and Agriculture (NIFA) Farm Safety program supports Cooperative Extension Service programs that promote safety by training workers in appropriate field practices, safe use of equipment, and proper maintenance of equipment.

The CDC's NIOSH Centers for Agricultural Disease and Injury Research, Education, and Prevention promote the health and safety of agricultural workers and their families. NIOSH's Agriculture, Forestry, and Fishing Research Program works to identify long-term safety and health research for production agriculture. Also, NIOSH's Office of Agriculture Safety and Health (OASH) sets strategic directions for, supports, and monitors and reports progress on safety and health research in agriculture.

The U.S. Department of Labor's Occupational Safety & Health Administration (OSHA) supports safe and healthful working conditions by setting and enforcing standards and by providing training, outreach, and education.

The Environmental Protection Agency's Occupational Pesticide Safety and Health program focuses on worker safety in industries that use pesticides and sets requirements for safe pesticide handling, such as the Agricultural Worker Protection Standard (WPS).

The Health Resources & Services Administration's Federal Office of Rural Health Policy offers funding opportunities and resources to support rural health projects.

Are there funding sources available for nonprofits to support agricultural health and safety programs?

The NIOSH-funded Centers for Agricultural Safety and Health may offer funding opportunities for activities such as pilot programs, research initiatives, and education and outreach.

The CHS Seeds for Stewardship Grants provide matching grants to cooperatives for projects designed to develop the next generation of agricultural leaders, improve agricultural safety, and enhance rural vitality.

As part of Grain Bin Safety Week, the Grain Bin Rescue Equipment and Training Contest, offers awards of grain bin rescue tubes and hands-on rescue training to selected rural first responders.

A current list of federal, state and foundation grants and programs supporting the development of agricultural health and safety projects is available by visiting the Funding & Opportunities section of this guide.

What programs or resources are available that can assist agricultural employers to develop safety measures to protect their employees?

The U.S. Department of Labor's Occupational Safety & Health Administration (OSHA) Agricultural Operations provides a variety of resources and statistics on the hazards of working in agriculture.

The USDA NIFA's Cooperative Extension System is an educational network providing practical, research-based information to agricultural producers, small business owners, youth, consumers, and rural communities nationwide.

The NIOSH Centers for Agricultural Disease and Injury Research, Education, and Prevention conduct research, education, and prevention projects that support the health and safety of agricultural workers.

The National Center for Farmworker Health is a private, not-for-profit organization providing information, training, and technical assistance on agricultural safety and health.

The National Education Center for Agricultural Safety provides education and training focused on promoting safety, and preventing illnesses, injuries, and deaths among farmers and ranchers, agricultural and horticultural workers, their families, and their employees.

The National Tractor Safety Coalition is a multi-sector working group with the mission of preventing tractor related deaths in the U.S. agricultural industry.

The NIOSH Cost-effective Rollover Protective Structures (CROPS) is a program that provides rollover protective structures for older-model tractors that are commercially difficult to find.

Are resources available that provide special training to healthcare personnel when treating farm injuries and chemical exposures?

In rural areas where agriculture is common, first responders and healthcare personnel must be prepared to treat agricultural injuries. In addition to providing proper care to the patient, personnel must be able to identify when hazards exist for themselves. For instance, if EMS personnel respond to a grain bin engulfment, they must be careful to avoid becoming engulfed. Likewise, if a farmworker presents at the emergency room due to chemical exposure, proper protocols should be used to ensure that healthcare workers aren't also exposed.

Several national organizations provide training on agricultural medicine to healthcare personnel, including:

  • The AgriSafe Network participates in agricultural medicine core courses in several areas in the country, providing the skills necessary for health and safety professionals to identify and prevent occupational illnesses and injuries among agricultural workers. An 18-hour continuing education course, AgriSafe Nurse Scholar, as well as several additional individual continuing education courses for nurses, are also available through AgriSafe.
  • OSHA offers a Clinicians section with information and resources to aid clinicians working with farmworkers, including information on Evaluating Occupational Exposures and Injuries for farmworkers.
  • The Migrant Clinicians Network offers Pesticides information, with clinical tools to help clinicians recognize and manage pesticide exposure in farmworkers.
  • The Environmental Protection Agency (EPA) National Agricultural Center and the Medical University of South Carolina published the Recognition and Management of Pesticide Poisonings manual giving healthcare providers a reference source on toxicology and for treating patients with exposure to pesticides.
  • The NIOSH Pocket Guide to Chemical Hazards (NPG) presents information and statistics to inform workers, employers, and occupational health professionals about hazardous chemicals that may be found in agriculture.

Last Reviewed: 8/29/2019