Conor Deasy is well placed to know a lot about farm accidents. He is a consultant in emergency medicine at Cork University Hospital (CUH) and he is also the clinical lead for major trauma audit in Ireland. The National Office of Clinical Audit reports on all patients who present at hospitals with life-changing or life-threatening injuries.

Farming stands out as an industry that is particularly associated with serious injury, he says.

“It’s twice as common as in other industries, so that is a concern. Farms are family homes so when these traumas occur they are devastating. Farmers need to make greater efforts to improve safety on farms because the effects of these traumas are catastrophic.”

Large animal trauma

While doctors still see injuries related to machinery unfortunately, trauma related to animals is more common now. “We’re surprised about the level associated with animals, be that farmers gored by bulls or farmers getting crushed by cows. Large animal trauma causes very significant injuries.”

He is also concerned about the age of farmers being hurt on Irish farms.

“Farmers who are coming in with injury are 54 years old on average, but 27% of trauma on Irish farms is occurring among people over the age of 65. That really is something to think about because someone who is that much older also has other illnesses and factors that make the management of their trauma more difficult.”

He questions why farmers don’t retire like other sectors do.

“Across other sectors people retire at 65 for a reason. You would wonder are we being unfair to our over-65s by having them exposed to this risk on farms. I get the fact that these are family farms but…”

Doctors like Conor have seen lots of farm-related injuries over the years.

“We have seen machine and animal trauma, falls, lacerations, chainsaw injuries too. If a person’s leg is sliced when a chainsaw or log slips, for example, it is a very debilitating injury and requires plastic as well as orthopaedic surgery and that farmer will be not able to work for three to six months.”

Low falls – from less than two metres – are the second most common trauma after animal trauma

PTO shaft injuries are not as common as they were - something he is glad about.

“That said when it happens it happens badly. You’re talking very catastrophic limb injury or more.”

He makes another point about older farmer injuries.

“Low falls – from less than two metres – are the second most common trauma after animal trauma and can have serious consequences. A young animal or a calf knocks someone over or they trip over something in the yard - if they are on medication to thin their blood or have osteoporosis then that low fall has the potential to cause limb fractures, rib fractures and underlying lung injury. If they are on blood thinners they have the risk of a brain bleed as well, which can be life-threatening or life-changing.”

I ask him what the worst injury is that he has ever dealt with.

“We see kids dying on Irish farms and they are brought in to emergency departments for resuscitation. They are,” he pauses, “awful events.”

The CUH consultant is asking farmers to think safety first. Don’t take shortcuts. Ask yourself:

1 What happens if this goes wrong?

2 What will the impact be on my family, the farm and farm income if I’m not able to work?

Sligo Consultant in emergency medicine

Fergal Hickey is a consultant in emergency medicine at Sligo University Hospital.

“For us the big three injuries related to farming are animals, machinery (power take offs/balers/combine harvesters leading to limb loss and worse) and quad bikes,” he says. “Quad bikes are a newer but very significant problem.

“I remember a time when tractors didn’t have cabs or roll bars. Injuries were more horrendous then but quad bikes have no protection whatsoever. Often land is rough and not designed to be driven over so you get quad bikes overturning. They are not devices for young people to be driving. Cop-on is needed and a high level of driving skill. Young people don’t realise the power of them.”

Doctors at Sligo University Hospital also see lots of fracture/dislocations of ankles.

“That’s from going over on rough ground. We also see simple fractures, both closed and open (compound), lacerations needing washing out and closure, and chemical injuries too. Also, farmers not uncommonly fall from shed roofs and ladders often resulting in serious head injuries.”

Farmers are quite stoic as a group but this can lead to problems as they tend to present late with established injury, he says, “Those established injuries could be mal-united fractures or infection (contaminated wounds) which can be much harder to deal with at that stage and may do less well than they would have done had they presented at an earlier stage.

“Being overcome by fumes from slurry is also a potential fatal event and occasionally we have seen drownings where a farm has water on it too.”

Like Conor Deasy, he is very concerned about the increase in animal injuries. “It’s human versus animal. Half ton crush injuries are nasty multiple injuries. Farmers should be aware of the risk when handling stock.”

Doctors deal with the results of corner-cutting all the time, he says.

“Jobs are familiar and farmers have done them a thousand times but the 1001st time they get hurt. They’ve cut corners and left out the safety bit. Safety should always come first. Think of the risk, get help if needed and don’t take chances.”

Eyes: some of the greatest dangers

Dr Mary Jo Ryan at work in her Wexford clinic. \ Patrick Browne

Mary Jo Ryan is a medical eye specialist based in Wexford town and says that the two farmwork-related injuries that can most endanger one’s sight are hammering (metal on metal) and getting limestone in an eye.

“Farmers are very ‘hands-on’,” she says. “They have to be handy, they can’t be calling a mechanic every five minutes so they tend to be doing a lot of DIY mechanical jobs themselves and I think that a lot of the time they don’t take the necessary precautions.”

The most common statements that Mary Jo hears from those who attend her walk-in clinic are that they either don’t wear safety goggles at all or they don’t wear them all the time and they get caught out “doing a little bit at the end”.

“Their goggles may not fit them properly as well,” she says.

“You have to remember the velocity that a little bit of metal travels off an angle grinder. If you are helping someone hold something you should wear goggles as well and if you are passing or nearby look away and cover your eyes.”

Hammering can be deadly

A major mistake is not wearing safety goggles when hammering, she says.

Eye injuries related to hammering metal on metal and getting lime in an eye are the most serious farm-related eye injuries. \ Patrick Browne

“Hammering is probably way more dangerous than grinding as the bit of steel may perforate the eye. Farmers don’t seem to realise the danger of hammering at all. It’s one injury that will cause a person to lose their eye.”

She also mentions that old scar tissue from grinding injuries over the years can affect your eyesight in the long-term.

“If the metal hits the surface of your eye and it’s central, it’s going to heal with a scar and affect your central vision. This will affect your driving and reading down the line. An added complication from a foreign body in the eye, if it perforates the surface, is that it might cause a cataract. This would involve a surgical procedure in order to correct this.”

Always have eye wash handy

Working underneath machines is dangerous too.

“A lot of farmers are working underneath vehicles where particles can fall into your eye very easily. They say that goggles fog up if it’s warm so they don’t wear them. If they are doing that kind of work they should always have some sterile eye wash nearby and wash out the eye straight away.”

She has this tip that may help in minor situations.

“Very often stuff lodges underneath the eye lid,” she says. “If you wash out your eye straight away and then pull the top eyelid down over the bottom one by catching your eyelashes, you’ll often dislodge what’s gone in but you may need professional help.”

Chemical splashes

She stresses the importance of wearing safety glasses when lifting cans of spray also. “The glasses should have sides on them to stop splashes getting in. Crop sprays are dangerous and corrosive. An acid splash in your eye will burn you and you’ll end up with a very dry eye afterwards too as it can damage the mucous producing that keep your eye moist.”

Limestone is lethal

Getting alkali in your eye is even more dangerous, she says.

“A big thing that farmers use is lime. Lime in your eye will blind you because it binds the cells in the eye and continues to damage the eye hours after the product has gone in.”

Treatment for lime in the eye involves very intensive washing out.

Tyres contain metal and if they explode the metal will travel at high velocity

“It’s irrigation of the eye, a procedure done in a hospital. Immediate first aid involves going to a tap and washing the eye out repeatedly. Hold your head back and pour water into it constantly from a bottle. In a recent case I advised putting the person in the back of the car and pouring water into his eye all the way to the hospital. That’s how urgent it is. People think they can just wash lime out once and they’ll be okay but they won’t.”

Other eye injuries she has seen include those from batteries exploding.

“Never put a battery on a bonfire,” she says. “Wear safety glasses any time you are pumping up tyres using your own compressor also. Tyres contain metal and if they explode the metal will travel at high velocity. Wear safety glasses when strimming as well and be careful when handling animals that you never have your head over the animal’s head. You could get a bang that would break your cheek bone which, of course, is your eye socket so your eye could be damaged.”

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