FARM ACCIDENTS INVOLVING POWER TAKE-OFF DEVICES

Agricultural trauma is an important cause of mortality and significant permanent disability. An occupational fatality rate1 of 21 deaths per 100000 agricultural workers per year was reported in the United State s by the National Institute for Occupational Safety and Health. This c ontrasted with an average of 7.8 deaths per 100000 workers for all occ upations combined. A survey2 conducted in an Irish county with a popul ation of 52 379, recorded 17 deaths during a 10-year period from 1977 to 1987. In addition, 150 non-fatal farm accidents were recorded durin g 1986 in the same geographical area. Significantly, fewer than three deaths in the series were beyond the control of the deceased or their guardians and many of the non-fatal incidents were associated with ris k taking by the victim. During a 12-year period, of 739 patients admit ted to a Wisconsin3 referral Trauma Centre with injuries incurred whil st farming, the injury mechanisms in 7% of cases involved a power take -off (PTO) shaft. Illustrative of the severity of this injury was the fact that three of the 16 deaths in the series occurred as a result of this device. State of Wisconsin statistics for fatal farm injuries fr om 1985 to 1989 ranked tractor roll-overs, PTO accidents and falls as the most common cause of death.3 Of the 47 accidents involving a PTO d evice in the Wisconsin3 trial, 32 resulted in upper limb trauma; there were six major amputations; 10 patients sustained serious injury to t he branchial plexus and peripheral nerves; one patient had a severe de gloving urogenital injury; and there were 3 near-strangulations. Addit ionally 20 patients had residual significant permanent disability. In this paper, five case summaries of PTO injuries collected from the adm issions to two West Dublin City hospitals over a 2-year period are pre sented and the injury precipitating factors are explored in relation t o this type of injury.