{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T23:05:24Z","timestamp":1769123124487,"version":"3.49.0"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,11,16]],"date-time":"2018-11-16T00:00:00Z","timestamp":1542326400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000226","name":"Ontario Ministry of Health and Long-Term Care","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000226","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Rural Health"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Background<\/jats:bold>: Agricultural work involves hazards that may harm long\u2010term well\u2010being. We evaluated the risk of long\u2010term disability and death for agricultural workers compared to construction workers with similar demographics. We hypothesized that delays to emergency care and subsequent long\u2010term disability following injury might be worse for agricultural workers compared to those injured in construction.<\/jats:p><jats:p><jats:bold>Methods<\/jats:bold>: We evaluated all adults severely injured on farms or on construction sites in Ontario, Canada, between April 1, 2009, and March 31, 2012, according to the Ontario Trauma Registry. We excluded individuals living outside of the province, those missing a valid health card number, or youth less than 17 years old. Our primary outcome was death or the subsequent application for disability support.<\/jats:p><jats:p><jats:bold>Results<\/jats:bold>: In total, 353 patients were injured on a farm or construction site during the study period. Delays to emergency care exceeding 12 hours were more frequent for agricultural workers compared to construction workers (43% vs 23%, <jats:italic>P<\/jats:italic> &lt;.001). After a 5\u2010year follow\u2010up, agricultural workers had a death or disability rate marginally higher than construction workers (23% vs 14%, <jats:italic>P<\/jats:italic> = .068), equivalent to a hazard ratio of 1.62 that was marginally statistically significant (95% confidence interval 0.96\u20102.75, <jats:italic>P<\/jats:italic> = .072). The risk of death and disability was greatest for patients who had the longest delays to emergency care.<\/jats:p><jats:p><jats:bold>Interpretation<\/jats:bold>: Agricultural workers experience a substantial delay in receiving emergency care and a marginally higher risk of death or disability in the years following injury compared to construction workers.<\/jats:p>","DOI":"10.1111\/jrh.12336","type":"journal-article","created":{"date-parts":[[2018,11,16]],"date-time":"2018-11-16T21:41:16Z","timestamp":1542404476000},"page":"429-435","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Medical Emergencies in Farmers"],"prefix":"10.1111","volume":"35","author":[{"given":"Sharon C.M.","family":"Reece","sequence":"first","affiliation":[{"name":"Department of Family and Community Medicine University of Toronto  Toronto Ontario Canada"},{"name":"Michael Garron Hospital Toronto East Health Network  Toronto Ontario Canada"},{"name":"Institute of Clinical Evaluative Sciences (ICES) in Ontario  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deva","family":"Thiruchelvam","sequence":"additional","affiliation":[{"name":"Institute of Clinical Evaluative Sciences (ICES) in Ontario  Toronto Ontario Canada"},{"name":"Evaluative Clinical Sciences Sunnybrook Research Institute  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donald A.","family":"Redelmeier","sequence":"additional","affiliation":[{"name":"Institute of Clinical Evaluative Sciences (ICES) in Ontario  Toronto Ontario Canada"},{"name":"Evaluative Clinical Sciences Sunnybrook Research Institute  Toronto Ontario Canada"},{"name":"Department of Medicine Sunnybrook Health Science Centre  Toronto Ontario Canada"},{"name":"Division of General Internal Medicine University of Toronto  Toronto Ontario Canada"},{"name":"Institute for Health Policy Management and Evaluation University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,11,16]]},"reference":[{"key":"e_1_2_6_2_1","volume-title":"Injury Facts","year":"2015"},{"key":"e_1_2_6_3_1","volume-title":"Vital Statistics of the United States","year":"2014"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.4700180210"},{"key":"e_1_2_6_5_1","first-page":"1843","article-title":"Fatal farm injuries in Canada","volume":"160","author":"Pickett W","year":"1999","journal-title":"Can Med Assoc J"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.21994"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1748-0361.2003.tb00575.x"},{"key":"e_1_2_6_8_1","volume-title":"Agricultural Fatalities in Canada 1990\u20132008","author":"Canadian Agricultural Injury Surveillance Program","year":"2008"},{"key":"e_1_2_6_9_1","first-page":"2903","article-title":"Work\u2010related mortality among older farmers in Canada","volume":"45","author":"Voaklander DC","year":"1999","journal-title":"Can Fam Physician"},{"key":"e_1_2_6_10_1","volume-title":"Agricultural Injuries in Canada for 1990\u20132000","author":"Canadian Agricultural Injury Surveillance Program","year":"2003"},{"key":"e_1_2_6_11_1","unstructured":"MayerF RossN BerthelotJM WilkinsR.Disability\u2010free life expectancy by health region. 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