Are pre-hospital deaths from accidental injury preventable?

OBJECTIVE--To determine what proportion of pre-hospital deaths from accidental injury--deaths at the scene of the accident and those that occur before the person has reached hospital--are preventable. DESIGN--Retrospective study of all deaths from accidental injury that occurred between 1 January 1987 and 31 December 1990 and were reported to the coroner. SETTING--North Staffordshire. MAIN OUTCOME MEASURES--Injury severity score, probability of survival (probit analysis), and airway obstruction. RESULTS--There were 152 pre-hospital deaths from accidental injury (110 males and 42 females). In the same period there were 257 deaths in hospital from accidental injury (136 males and 121 females). The average age at death was 41.9 years for those who died before reaching hospital, and their average injury severity score was 29.3. In contrast, those who died in hospital were older and equally likely to be males or females. Important neurological injury occurred in 113 pre-hospital deaths, and evidence of airway obstruction in 59. Eighty six pre-hospital deaths were due to road traffic accidents, and 37 of these were occupants in cars. On the basis of the injury severity score and age, death was found to have been inevitable or highly likely in 92 cases. In the remaining 60 cases death had not been inevitable and airway obstruction was present in up to 51 patients with injuries that they might have survived. CONCLUSION--Death was potentially preventable in at least 39% of those who died from accidental injury before they reached hospital. Training in first aid should be available more widely, and particularly to motorists as many pre-hospital deaths that could be prevented are due to road accidents.     

Injury patterns in cyclists attending an accident and emergency department: a comparison of helmet wearers and non-wearers.

OBJECTIVES--To study circumstances of bicycle accidents and nature of injuries sustained and to determine effect of safety helmets on pattern of injuries. DESIGN--Prospective study of patients with cycle related injuries. SETTING--Accident and emergency department of teaching hospital. SUBJECTS--1040 patients with complete data presenting to the department in one year with cycle related injuries, of whom 114 had worn cycle helmets when accident occurred. MAIN OUTCOME MEASURES--Type of accident and nature and distribution of injuries among patients with and without safety helmets. RESULTS--There were no significant differences between the two groups with respect to type of accident or nature and distribution of injuries other than those to the head. Head injury was sustained by 4/114 (4%) of helmet wearers compared with 100/928 (11%) of non-wearers (P = 0.023). Significantly more children wore helmets (50/309 (16%)) than did adults (64/731 (9%)) (P < 0.001). The incidence of head injuries sustained in accidents involving motor vehicles (52/288 (18%)) was significantly higher than in those not involving motor vehicles (52/754 (7%)) (chi 2 = 28.9, P < 0.0001). Multiple logistic regression analysis of probability of sustaining a head injury showed that only two variables were significant: helmet use and involvement of a motor vehicle. Mutually adjusted odds ratios showed a risk factor of 2.95 (95% confidence interval 1.95 to 4.47, P < 0.0001) for accidents involving a motor vehicle and a protective factor of 3.25 (1.17 to 9.06, P = 0.024) for wearing a helmet. CONCLUSION--The findings suggest an increased risk of sustaining head injury in a bicycle accident when a motor vehicle is involved and confirm protective effect of helmet wearing for any bicycle accident.     

Aspects of the epidemiology of Chlamydia psittaci infection in a population of koalas (Phascolarctos cinereus) in southeastern Queensland, Australia

A population of free-ranging koalas in southeastern Queensland was examined to determine the prevalence of Chlamydia psittaci infections. Although C. psittaci was isolated from 46 of 65 (71%) koalas studied, only six (9%) of these had clinical signs of disease. Most adult females (82%) had back or pouch young present even though 67% of them were infected. There were no significant correlations between age, sex or site of sampling (urogenital versus conjunctival tissues) and the isolation of C. psittaci. No other important bacterial or fungal pathogens were isolated. The complement fixation test had a sensitivity of 7% and a specificity of 94% in detecting chlamydial infections, suggesting that it is unsuitable for use as a screening test. Chlamydia psittaci infection within this population appeared to represent a generally well-balanced host-parasite relationship and few animals had clinical signs of disease. Only four of 27 (15%) healthy koalas infected with C. psittaci followed for 24 wk after sampling developed eye disease or "dirty tail." Two koalas with keratoconjunctivitis recovered without treatment during the study period. Additional factors, including the stresses imposed by loss of habitat, may act to produce overt disease in koalas with latent C. psittaci infections.     

Seasonal Variation of Falling Asleep while Driving: An Examination of Fatal Road Accidents

Road accidents related to sleep show a clear time‐of‐day pattern. Following the previous finding that such accidents in Finland happen more often (absolutely and relatively) during the summer months, especially during the afternoon, the main aim of this study was to reveal the factors behind such seasonality. The data included the computerized database of the Finnish fatal road accident investigation system restricted to nonprofessional, nonintoxicated car drivers (N=1464) and sample of the original folders (N=101). The results of the analysis on the sample of the original folders showed that investigation teams adequately documented and explained their decisions concerning falling‐asleep accidents and that the observed seasonality is a real phenomenon, not a result of bias of the teams. With the exception of 26–35‐year‐olds, men of all of the other age groups had a notable absolute and relative increase of sleep‐related accidents in the summer. Young male drivers (≤25 yrs), followed by the oldest group (≥66 yrs) had the highest increase in the absolute number of sleep‐related accidents between the summer and winter months, while the relative change was the highest for ages 56–65. Women showed similar trends. A detailed analysis of 44 cases of summer afternoon falling‐asleep accidents revealed that many drivers were engaged in unusual activities the day or night before the accident. The findings are discussed in relation to different driving and lifestyle habits between seasons, including sleep quality.     

封闭群五指山小型猪主要脏器重量与体重的相关性分析

目的测定封闭群五指山小型猪主要脏器重量和脏器系数,对脏器重量与体重的相关性进行分析,并计算出相应的直线回归方程和多元回归方程。方法实验选用6-10月龄普通级封闭群五指山小型猪30头（其中♂16头、♀14头）,分别测定体重和7个主要脏器重量,计算脏器系数,通过SAS软件进行脏器系数的性别间比较和各脏器重与体重间的相关与回归分析。结果性别间比较,小型猪仅有心脏的脏器系数差异有显著性（P〈0.05）。除公猪的胃脏和母猪的肺脏外,所测脏器重量与体重间均有明显的正相关线性关系;多因素分析显示公猪的肝脏和肾脏,母猪的心脏、肝脏和肾脏对各自体重有影响。结论封闭群五指山小型猪主要脏器系数性别间差异较小,其体重与某些脏器重量存在一定的线性关系。     

Neonatal effect of clomiphene and o,p'-DDT on hepatic oxidative metabolism of male rats.

The hepatic oxidative metabolism of dehydroepiandrosterone (DHA) and aminopyrine has been investigated in adult rats of both sexes treated neonatally with either clomiphene citrate (100 mug on day 3) or o,p'-DDT (1 mg daily on days 2-3). The rates of 16 alpha-, 7 alpha- and 7 beta-hydroxylase activities of DHA and the N-demethylase activities of aminopyrine in hepatic microsomes of normal males were significantly (p less than 0.05) higher than those of females. Treatment with clomiphene citrate reduced significantly (p less than 0.05) the 16 alpha-hydroxylase activities of males and appeared to suppress the 7 alpha-hydroxylase and N-demethylase activities to a lesser extent. Neonatal o,p'-DDT also reduced these hepatic oxidative activities. Neither treatment affected the 7 beta-hydroxylase activities. On the other hand, no significant differences in these activities were observed between the control and the treated females, all of which had persistent vaginal estrus. Therefore, it appears that treatment of male neonates with these weak estrogenic compounds antagonizes the androgen-mediated expression of the DHA-16alpha-hydroxylase activity in liver.     

Causes of fatal childhood accidents involving head injury in northern region, 1979-86.

OBJECTIVE--To examine the causes and circumstances surrounding fatal accidents involving head injuries in children in the Northern region. DESIGN--Retrospective review of the hospital case notes, necropsy reports, and records of the coroners'' inquests. SETTING--Northern Regional Health Authority. PATIENTS--All 255 children aged less than 16 years who died with a head injury during 1979-86. MAIN OUTCOME MEASURES--Cause of injury and circumstances of accident according to reports of inquests; injury severity score; number of fatal accidents and mortality per 100,000 children in 10 groups of local authority wards ranked according to their score on the overall deprivation index; and distance of site of accident from child''s home. RESULTS--Of the 255 children who died after a head injury, 136 (53%) children were playing at the time of the accident. 195 (76%) children sustained the head injury in road traffic accidents, 135 as pedestrians, 35 as cyclists, and 25 as passengers in a vehicle. In 120 accidents in child pedestrians the primary cause of accident was the unsafe behaviour of the child. 172 (67%) accidents occurred within one to two km of the child''s home and 153 (63%) between 3 pm and 9 pm. The mortality was significantly related to social deprivation; excluding eight children injured while on holiday in the region, 15-fold decrease in mortality was recorded between the local authority wards that ranked highest on the overall deprivation index and those that ranked lowest (14.0/100,000 children, group 10 v 0.9/100,000, group 1 respectively, p less than 0.00001). CONCLUSIONS--The finding that most accidents occurred in children living in deprived areas who were playing unsupervised near their home suggests that childhood mortality might be appreciably reduced if children at play were protected from traffic, particularly in socially deprived areas.     

Inquilines of Brachymenes dyscherus nests with special reference to Monobia schrottkyi (Hymenoptera,Vespidae, Sphecidae)

Sixty-four inactive nests of the solitary mud-daubing wasp Brachymenes dyscherus, reused by 5 inquiline species, were collected at Fazenda Santa Carlota, Cajuru, S?o Paulo, Brazil in 1995 and 1996. Monobia schrottkyi used 52 nests; among the 717 cells available for use, 502 were reused. The number of cells per nest varied from 3 to 24; 1 to 16 individuals emerged from September to April (154 males and 112 females). Forty-six cells were parasitized by Melittobia sp. (n = 44) and Ichneumonidae (n = 2). Monobia curvata used 3 nests; among the 50 cells available for use, 38 were reused and 15 males and 8 females emerged from August to November. Three cells were parasitized by Ichneumonidae. Montezumia petiolata occupied 1 nest; among the 8 available cells, 7 were reused and 2 males and 3 females emerged in September. Podium denticulatum used 2 nests; the 20 cells available for use were reused and 11 males and 4 females emerged in August. Trypoxylon rogenhoferi used 5 nests that had 65 available cells; 48 of them were reused, from which 19 males and 11 females emerged from September to November. Three cells were parasitized by Ichneumonidae (n = 2) and Chrysididae (n = 1).     

Relationships between physical activity and musculoskeletal disorders in former athletes

The purpose of the study was to determine the prevalence and risks for musculoskeletal disorders (MSD) in relation to previous athletic status and current physical activity level in former athletes. Main anthropometric data, sports history, current physical activity and MSD were estimated using a questionnaire in 219 (148 males, 71 females) former athletes (35-75 years old) and 79 controls (33 males, 46 females). According to the previous participation in top-level sports, former athletes were divided into three groups: (a) endurance, n=120 (76 males, 44 females); (b) speed-power, n=57 (43 males, 14 females); (c) team sports, n=42 (29 males, 13 females). The most prevalent MSD among the male and female ex-athletes were back and knee pain. The endurance ex-athletes group (both males and females) had significantly higher risk for the knee problems than the control group (Odds ratio--OR 5.9, 95% CI 1.7-20.00, p < 0.05). Team sports athletes (males and females) showed significantly higher risk for Achilles' tendon injuries (OR 3.19 95% CI 1.19-8.5, p < 0.05) as compared to controls. Back pain did not show any significant associations with previous physical activity and current physical activity level. Current physical activity was significantly associated with a lower risk for the knee and hip pain. Body mass index was positively associated with knee problems. In conclusion, our study results revealed that previous participation in enduranve sports events is associated with a significantly higher risk for knee problems. At the same time current regular physical exercise 6-11 times per month is associated with a lower prevalence of knee and hip problems as compared to those who exercised less than 6 times per month.     

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Abstract

Inappropriate elimination accounted for 33% of the feline behavioral problems treated over an 18-month period at the Companion Animal Practice, The University of Queensland, Australia. Problems include spraying (35%), urinating (19%), defecating (31%), or a combination of these (16%). There were 7 entire males in the sample but they featured most often in the elimination problems (15 cases), 7 castrated males (7 cases), 7 entire females (7 cases), and 5 spayed (ovariohysterectomized) females (10 cases). Inappropriate elimination in specific locations can be managed using behavioral modification (sometimes aversion techniques), a change in routine, or synthetic progestins. The owners of the entire males refused castration for them for spraying although it was suggested there was about a 90% chance of success. Random elimination can be more difficult to treat and requires careful management. Spending more scheduled time actively playing with the cat proved to be a very important element of owner behavior modification.     

Traffic Deaths—A Preliminary Study of Urban and Rural Fatalities in California

An analysis by the California Department of Public Health of California Highway Patrol reports for 1961 showed that traffic accidents injured one and one-half times as many people per 1,000 population in rural California counties (under 50,000 people) as in urban counties (over 500,000 people), also persons injured in rural counties were almost four times as likely to die of their injuries as those injured in urban counties.A death certificate study was undertaken of 782 traffic deaths (excluding pedestrians) occurring in rural and urban California counties during 1961. Accidents occurring in rural counties tended to be single vehicle accidents which resulted in less severe injuries, while those in urban counties tended to be two vehicle and multiple vehicle accidents resulting in more serious injuries. The anatomic distribution of injuries was the same for both urban and rural accidents. However, people dying in rural accidents more frequently died at the scene of the accident, died sooner after injury, and died of less serious injuries than did those injured in urban accidents. For injuries where theoretically few lives should be salvaged by prompt emergency care, the time between injury and death was about the same in urban as in rural counties. Where such care should delay or prevent death because the injury was possibly or probably salvageable, those injured in rural counties died more quickly.Thirty-two per cent of fatalities in rural counties happened to urban and out-of-state residents, while only 12 per cent of fatalities in urban counties were to rural or out-of-state residents, suggesting that traffic accidents to non-residents may place an excessive load upon medical care resources in rural areas.     

Retrospective case evaluation of gender differences in sports injuries in a Japanese sports medicine clinic

Background: Although both gender- and sports-specific injuries exist among athletes, gender differences in the types of injuries caused by sports activities, except for anterior cruciate ligament (ACL) injury and anterior knee pain, are not well established.Objective: An observational study with a retrospective case-series design was conducted to investigate gender-specific differences in the types of injuries sustained while engaging in sports activities common to both males and females.Methods: We analyzed injuries sustained during sports activities including basketball, volleyball, tennis, skiing, track and field, and swimming, using data on age, sex, sports activities, activity levels, and sports injuries that had been computerized at our sports medicine (orthopedics) clinic. Inclusion criteria were sports activities that had a record of >100 injuries in total and athletes aged <50 years who were engaging in only 1 sports activity. We determined the absolute number of patients in each category and their percentage (proportion) of our cohort. The proportions of common injuries caused by sports activities were investigated, and gender-specific differences in the types of common injuries caused by sports activities were clarified. The Fisher exact test was used to determine the significance (P < 0.01) of the gender-specific differences in the types of sports injuries.Results: According to our database, during the 14-year period between October 1992 and December 2006, a total of 2989 athletes (1624 males and 1365 females) aged <50 years who engaged in 1 of the 6 sports activities described consulted our sports medicine clinic. The most common sports injuries were ACL injury (14.3%) and knee pain (13.7%), followed by ankle sprain (9.4%), lumbar disc disease (7.0%), meniscus injury (5.1%), stress fracture (2.9%), low back pain (2.5%), patellar tendinitis (2.1%), injury of the medial collateral ligament of the knee (2.0%), lumbar spondylolysis (1.7%), and muscle strain (1.5%). Among these 11 types of sports injuries, a significantly higher proportion of females who engaged in basketball (24.4% vs 10.5%), volleyball (20.5% vs 4.5%), or skiing (41.4% vs 26.5%) presented with an ACL injury, compared with their male counterparts (all, P < 0.001). There was also a significantly higher proportion of females than of males among the track and field athletes who presented with stress fractures (18.7% vs 3.9%; P < 0.001).Conclusion: The findings of this retrospective study suggest that there are gender-specific differences in the types of injuries sustained during sports activities.     

短时高温对莲草直胸跳甲成虫存活及繁殖的影响

采用短时高温处理研究了40～47℃高温对莲草直胸跳甲Agasicles hygrophila Selma & Vogt成虫存活以及40～44℃对雌成虫繁殖的影响。结果表明:(1)处理1h后,随着温度的上升,莲草直胸跳甲雌雄成虫的存活率均随着温度的上升而下降,44℃时,雌成虫的存活率开始显著高于雄成虫;处理温度为40℃时,雌雄成虫存活率也随着处理时间的延长而下降,7h时,雌成虫的存活率开始显著高于雄成虫。此外,雌成虫致死90%的温度和时间分别高于雄成虫1.31℃和1.29h,均表明雌成虫的耐热能力比雄成虫强,但差异仅在胁迫强度偏大时表现为显著;(2)40～44℃短时高温影响莲草直胸跳甲成虫的繁殖。与对照处理相比,40、42和44℃高温处理1h后,雌成虫的寿命和产卵量变化不显著,但均引起了其产卵前期的延长和10日龄成虫产卵停滞,44℃时,平均停滞时间达2.62d,子代卵的孵化率则从40℃的88.67%下降到44℃的79.84%,44℃时显著低于对照。     

Seasonal variation of falling asleep while driving: An examination of fatal road accidents

Road accidents related to sleep show a clear time-of-day pattern. Following the previous finding that such accidents in Finland happen more often (absolutely and relatively) during the summer months, especially during the afternoon, the main aim of this study was to reveal the factors behind such seasonality. The data included the computerized database of the Finnish fatal road accident investigation system restricted to nonprofessional, nonintoxicated car drivers (N=1464) and sample of the original folders (N=101). The results of the analysis on the sample of the original folders showed that investigation teams adequately documented and explained their decisions concerning falling-asleep accidents and that the observed seasonality is a real phenomenon, not a result of bias of the teams. With the exception of 26-35-year-olds, men of all of the other age groups had a notable absolute and relative increase of sleep-related accidents in the summer. Young male drivers (≤25 yrs), followed by the oldest group (≥66 yrs) had the highest increase in the absolute number of sleep-related accidents between the summer and winter months, while the relative change was the highest for ages 56-65. Women showed similar trends. A detailed analysis of 44 cases of summer afternoon falling-asleep accidents revealed that many drivers were engaged in unusual activities the day or night before the accident. The findings are discussed in relation to different driving and lifestyle habits between seasons, including sleep quality.     

The sexual preference of female rats is influenced by males' adolescent social stress history and social status

Ongoing development of brain systems for social behaviour renders these systems susceptible to the influence of stressors in adolescence. We previously found that adult male rats that underwent social instability stress (SS) in mid-adolescence had decreased sexual performance compared with control males (CTL). Here, we test the hypotheses that SS in adolescence decreases the “attractiveness” of male rats as sexual partners compared with CTL rats and that dominance status is a protective factor against the effects of SS. The main prediction was that females would spend more time with CTL males than SS males, and that this bias would be greater for submissive than for dominant rats. Among dominant pairs (n = 16), females preferred SS males, spending more time with and visiting more often SS than CTL males (each pair tested 5 ×), and SS males had shorter latencies to ejaculation, shorter inter-ejaculation intervals, and made more ejaculations compared with CTL males. Among submissive pairs (n = 16), females spent more time with, visited more often, and displayed more paracopulatory behaviour with CTL than with SS males, and differences in sexual performance between SS and CTL males were modest and in the opposite direction from that in dominant pairs. The heightened motivation of SS males relative to CTL males for natural rewards may have attenuated differences in sexual performance in a paced mating context. In sum, the experience of stress in adolescence leads to long-lasting changes in males that are perceptible to females, are moderated by social status, and influence sexual behaviour.     

Epidemiology of Mycobacterium ulcerans infection in koalas (Phascolarctos cinereus) on Raymond Island, southeastern Australia

Mycobacterium ulcerans infections were found in 11 koalas (Phascolarctos cinereus) between 1980 and 1985, in a population of approximately 200 koalas on Raymond Island in southeastern Australia. Ulcers caused by the infection occurred on the face, forearm, rump, groin and footpads. Seven koalas had multiple ulcers. All the infected animals were mature (age classes 4, 5 and 6), and eight were male. The distribution of ulcers corresponded with the distribution of wounds in a sample of 87 koalas. Many of these wounds were associated with social behaviour.     

Male mate choice by the lizard Anolis carolinensis: a preference for novel females

Laboratory and field manipulations tested whether male Anolis carolinensis lizards and discriminate preference for novel females over resident females. In 16 laboratory trials, we videotaped social interactions between paired males and females during baseline session (male and resident female housed together 1-3 weeks), resident-female session (male and reintroduced resident female), and novel-female session (male and novel female with resident female removed). We examined 22 behavioural variables. Male behaviours did not differ significantly between baseline and resident-female sessions, nor did female behaviours differ significantly between baseline, resident-female and novel-female sessions. However, between resident-female and novel-female sessions, males significantly increased display rate (320%), volleys of repetitive displaying (300%) and volley length (150%), and significantly decreased the distance (375%) and number (430%) of movements travelled away from the female. We concluded that males discriminate novel females from resident females independently of female behavioural or chemical cues. In each of 18 field trials, we first videotaped baseline social interactions of the resident male and females in a naturally occurring, polygynous, breeding group. The next day, we released two novel females into the territory (so at least one female remained) and videotaped subsequent social interactions. In comparison to baseline observations, males significantly increased the proportion of time spent in female-directed activities (from 5% towards resident females to 53% towards the novel female) and the proportion of displays directed towards novel females (from 6% towards resident females to 51% towards the novel female), and significantly decreased the proportion of time spent in territorial activities (from 75% to 19%) and the proportion of displays used in territorial activities (from 94% to 44%). Data from both experiments indicate that males appear to distinguish among individual females, and use this ability to increase reproductive success by identifying and preferentially pursuing novel females over previously inseminated resident females. From the perspective of cognitive ethology, we suggest a model by which males control mating decisions within their territories. Copyright 2002 The Association for the Study of Animal Behaviour. Published by Elsevier Science Ltd. All rights reserved.     

Free-Ranging Male Koalas Use Size-Related Variation in Formant Frequencies to Assess Rival Males

Although the use of formant frequencies in nonhuman animal vocal communication systems has received considerable recent interest, only a few studies have examined the importance of these acoustic cues to body size during intra-sexual competition between males. Here we used playback experiments to present free-ranging male koalas with re-synthesised bellow vocalisations in which the formants were shifted to simulate either a large or a small adult male. We found that male looking responses did not differ according to the size variant condition played back. In contrast, male koalas produced longer bellows and spent more time bellowing when they were presented with playbacks simulating larger rivals. In addition, males were significantly slower to respond to this class of playback stimuli than they were to bellows simulating small males. Our results indicate that male koalas invest more effort into their vocal responses when they are presented with bellows that have lower formants indicative of larger rivals, but also show that males are slower to engage in vocal exchanges with larger males that represent more dangerous rivals. By demonstrating that male koalas use formants to assess rivals during the breeding season we have provided evidence that male-male competition constitutes an important selection pressure for broadcasting and attending to size-related formant information in this species. Further empirical studies should investigate the extent to which the use of formants during intra-sexual competition is widespread throughout mammals.     

Microflora of the pouch of the koala (Phascolarctos cinereus).

Microflora of the pouch epithelium of 17 female koalas (Phascolarctos cinereus) were examined in relation to their current reproductive status and recent reproductive history. No microbial growth was observed in pouch swabs from 13 of 17 (76%) koalas, including four females without young, seven with pouch young and two with back young (i.e. permanently emerged from the pouch). Growth of bacteria or yeasts was observed in pouch swabs from four koalas, each of which had experienced mortality of its pouch young during the current breeding season. Seven species of microorganisms were isolated, including Pseudomonas aeruginosa, Serratia marcescens and Enterococcus faecalis. Based on the absence of microflora in the majority of females examined, we propose that the pouch epithelium normally provides a hostile environment for microbial colonization.     

Farm accidents in children.

OBJECTIVE--To examine the problem of accidental injury to children on farms. DESIGN--Prospective county based study of children presenting to accident and emergency departments over 12 months with injuries sustained in a farm setting and nationwide review of fatal childhood farm accidents over the four years April 1986 to March 1990. SETTING--Accident and emergency departments in Aberystwyth, Carmarthen, Haverfordwest, and Llanelli and fatal accidents in England, Scotland, and Wales notified to the Health and Safety Executive register. SUBJECTS--Children aged under 16. MAIN OUTCOME MEASURE--Death or injury after farm related accidents. RESULTS--65 accidents were recorded, including 18 fractures. Nine accidents necessitated admission to hospital for a mean of two (range one to four) days. 13 incidents were related to tractors and other machinery; 24 were due to falls. None of these incidents were reported under the statutory notification scheme. 33 deaths were notified, eight related to tractors and allied machinery and 10 related to falling objects. CONCLUSIONS--Although safety is improving, the farm remains a dangerous environment for children. Enforcement of existing safety legislation with significant penalties and targeting of safety education will help reduce accident rates further.