Child Farm Injuries are Never “Accidents”

Headlines like “child dies in tractor accident” or “farm accident takes toddler’s life” are all too common in U.S. news outlets, and expressions such as “accidents happen” arise in general conversation. But words matter. An “accident” suggests there is no fault, no guilt, no control, and that the situation was unpreventable and could not have been anticipated. We know better. It is time to get serious and influence the adoption of appropriate terminology. There is ample evidence that farm injuries and deaths are both predictable and preventable. And when it happens to a child, the term “accident” is especially misleading. It exonerates adults from their responsibility. It avoids a serious investigation of the event, and it hampers efforts to alter unsafe environments or conditions in which children are present. In some cases, it denies justice to the child victim.

Across the professional discipline of agricultural safety and health as well as the agricultural media, we have not kept pace with other injury prevention or occupational safety groups that have transitioned their terminology from “accident” to “incident” or some other phrase that describes the event, such as tractor crash. This is particularly true in the case of children (<18 years) where precipitating factors are controlled by adults. General childhood injury cases often add the terms “abuse” or “negligence” reflecting the role of the parent or adult supervisor.

Terminology such as injury control, safety promotion, and injury prevention are used in different ways by different groups. Sometimes the words are affected by translation from other languages. Here in the U.S., using the English language, the facts are clear – agriculture lags behind many occupations and transportation systems that have adopted protocols for avoiding the term “accident” when describing unintentional injury events. To justify a shift away from “accidents” within agriculture, it helps to take an historical look at the terminology shift over the past seven decades.

Historical roots

As far back as 1949, the problem of “accidents” was addressed as a medical issue in the American Journal of Public Health, noting that injuries were measurable and worthy of epidemiologic study.¹ Research then followed to study injury causes such as collisions and energy exchange from mechanical, thermal, radiant, chemical or electrical sources.² By the 1960s additional concepts were introduced, such as active and passive prevention strategies for before, during, and after an injury event, known as the Haddon Matrix.³ In 1984 the landmark text “The Injury Fact Book” was published by Susan Baker and colleagues at Johns Hopkins School of Public Health,⁴ and the science of injury prevention was beginning to blossom. Then in 1985 the U.S. Surgeon General, C. Everett Koop, reported that injuries were the number one killer of children (<14 years) in the U.S. and referred to them as a terrible epidemic. In 1993, Koop called upon the U.S. Congress to set public policy to safeguard children by requiring child safety seats, smoke alarms, and bicycle helmets – strategies many of us now take for granted.⁵

The first major terminology shift outside of academia occurred in the 1960s when the National Highway Traffic Safety Administration (NHTSA) recognized that automobiles “crashed”, and other types of equipment “collapsed” or were “crushed”. The agency made it official in 1997 that motor vehicle accidents (MVAs) would now be referred to as motor vehicle crashes.⁶

An in-depth, public-private approach and call to action for overall injury prevention was laid out in a 1999 textbook, Injury Prevention and Public Health: Practical Knowledge, Skills and Strategies by Christoffel and Gallagher.⁷ By the end of the century, schools of public health and programs of occupational safety had eliminated the term “accident” from their training.

Current initiatives

In 2023, a search was undertaken by the National Farm Medicine Center (NFMC) to document the frequency of the word “accident” within the Agricultural Injury News (AIN) database of publicly available news reports.⁸ Analysis of cases limited to youth ages 0 to 17 over a 7-year period (2016 to 2022) revealed the word “accident” was present in 276 (38.4%) of 719 reports and/or present in the narrative description of the event in 451 (62.7%) of the reports. These cases were then compared with 4,246 adult (>17 years) reports and revealed the word “accident” is used less often – in 31.7% of headlines and 51% of narrative reports of adult victims (Burke R. unpublished analysis of terminology in AgInjuryNews, 2023). It is speculated that reporters often choose to minimize shame or remorse of parents who have lost a child by referring to an event as an “accident.”

Following this, the NFMC team conducted a pilot study to assess agricultural journalists’ willingness to replace the word “accident” with an alternate term in their news outlets.⁹ News reports of childhood fatal and nonfatal farm injuries from June 2022 to January 2023 were reviewed. If the term “accident” was used, the news outlet and author were identified. After securing approval from the Institutional Research Board (IRB), 30 reporters were contacted by email and given the NFMC’s Media Guidelines media_guidelines_en.pdf (cultivatesafety.org) that explain why “accident” verbiage should be avoided. From here, 28 reporters indicated a willingness to respond to a single question, with an option to comment. In the end, 12 reporters followed up with an explanation of why they chose to use the word “accident.” Most reporters indicated a willingness to replace the word “accident” with an alternate term in future news reports. Together, these findings suggest, at least in the case of children, there is a need and a true potential to influence a shift away from referring to childhood farm-related injuries and fatalities as “accidental.”

What is to be gained by a shift in terminology? Whenever a child is seriously or fatally injured, there are a plethora of reactions and responses by the family, community, news reporters, and sometimes law enforcement. It is especially difficult when the event occurs in a hazardous work setting where a child may be playing or simply standing by observing work. In such cases, the term “accident” is mainly troubling, because it suggests the event was not preventable. Indeed, interviews with law enforcement personnel revealed that in-depth investigations of child events on farms rarely occur, because the initial report was filed as an “accident” (Lee BC, Benny CP. unpublished interview notes from Waupaca County, WI meeting with District Attorney, CPS, and law enforcement personnel). A study by Benny et al.¹⁰ revealed that over a 6-year period, only 12 of the thousands of serious injuries or hundreds of deaths to children on farms were followed up with legal action, holding an adult responsible. These findings indicate that removing the “accident” word in reports by first responders and law enforcement might lead to closer review of precipitating circumstances and, ultimately, enhance the culture of safety on farms where children are present.

Summary and call to action

For nearly four decades my focus has been on safeguarding children who are working, visiting, and living on U.S. farms. Over the years, with rather fragmented data, we know the incidence of serious injuries and deaths is declining. Yet we have not kept pace with the world outside of agriculture that has adopted appropriate terminology and descriptions of injury events. Personally, I feel very frustrated every time the news describes a childhood farm injury incident as an “accident” or, worse yet, “a freak accident.”

Words matter, because the choice of words can impact perceptions and, ultimately, behaviors. The intent is not to penalize adults who have made innocent errors of judgement or lack resources such as off-farm childcare, but to influence behavioral changes that increase safeguards for children and young workers in agricultural settings.

We have the evidence and experience to justify avoiding the word “accident” – in reports in the news, emergency responses, medical records, law enforcement, safety resources, and our everyday conversations. Our actions will speak louder than words if we take the time to reach out to journalists following their reports of “accidents”. We can encourage news outlets to adopt standards and style guides that reflect appropriate terminology. Within the discipline of agricultural safety and health, we can promote widespread awareness of the importance of terminology through different channels. Safety training materials should be modified with updated terminology. Further, we could work with associations representing first responders, law enforcement, and child protective service (CPS) agencies, with requests to adopt language standards that reflect the reality of injury events. Let’s make that happen. Because child farm injuries are NEVER accidents.