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Amish farm kids have different types of accidents from other country children, according to a recent study published in a pediatrics journal. Five authors at the Hershey Medical Center of Penn State University studied the records of 135 admissions of Amish children to the trauma center at the Children’s Hospital from January 1997 through November 2004. Those 135 children represented five percent of the total admissions during the period. Hershey is close to the large Amish communities of Lancaster and nearby counties.

 The analysis of the hospital data focused on the causes of the injuries to the children and the outcomes of the admissions. As might be expected, the causes of the injuries were quite different from the causes of injuries to non-Amish children. The three most frequent causes of injuries were falls (39 percent), accidents between Amish buggies and motor vehicles (16 percent), and injuries from animals (15 percent).

Some of the details are curious. The authors report that 49 percent of the falls were through hay-holes. Unfortunately, they don’t elaborate further, though one might guess that those accidents occurred on farms where the hay is not baled but instead is stacked loose in the hay mows of the barns. The accidents most likely occur when children are either playing in the hay and fall through a hole to the lower floor, or they are helping pitchfork hay into the mow to help lay it correctly. The mean height of the falls was 10 feet.

The fact that the second highest cause of traumatic injuries are accidents involving motor vehicles and buggies is not surprising. The authors provide more detailed information about animal-related injuries, the third highest cause of injuries. They say that 80 percent of the animal injuries were caused by animals assaulting the children—attacks by dogs, kicking or trampling by cows, mules, and horses—and falls from horses.

Among the other types of injuries were accidents with machinery, ingesting toxic substances, sledding accidents, lightning strikes, and being hit by heavy objects. The records that showed locations for the accidents included, in order of frequency, the barn, elsewhere on the farm, on the road, in the home, and miscellaneous other locations. From all the traumatic injuries, four children died: two from accidents with motor vehicles and two from falls.

The authors indicate that the literature on pediatric farm accidents in non-Amish communities shows they are most frequently due to farm machinery. The authors also mention their surprise that few of the accidents affecting Amish children were reported as being work-related.

The authors suggest several ways that authorities might intervene to help lessen the numbers of accidents to Amish farm children. One approach might be to bring educational materials into the Amish schools to help teach the children themselves to avoid dangers on their farms. This approach has been tried out, successfully, with non-Amish children in other parts of the country.

Approaches that involve pediatricians and family-practice doctors providing materials to families, tried in other rural areas, probably would not work since the Amish tend to not bother with routine office visits to doctors. Officials might be more successful, according to the authors, if they were to suggest to the Amish community that they modify the designs of their barns in order to help alleviate the dangers of falls by children.

Vitale, Melissa A., et al. 2006. “The Impact of Pediatric Trauma in the Amish Community.” Journal of Pediatrics 148:359-365