Objectives To evaluate the short- and long-term physical, psychosocial, and economic consequences of injuries to youth on agricultural operations.

Methods Baseline and follow-up telephone interviews were completed with 1474 eligible agricultural operation households in five Midwestern U.S. states. Two 6-month injury ascertainment periods followed baseline with annual follow-up for 2 years. Case and control households were compared for changes between baseline and follow-up on household metrics and child work characteristics 4 weeks prior to each interview. Cumulative logit models analysed differences in ordinal scales between case and control households, at each follow-up period, controlling for baseline.

Results In the two injury collection periods there were: 1) 100 case (122 Injuries), 366 control; and 2) 115 case (138 injuries), 414 control households. Among these, 35% of children and 7% of other household members lost agricultural work time; 5% and 7%, respectively, lost non-agricultural work time. 1-year post-injury case households had increased risk of lost time from operation-related work due to children's health issues (OR 2.1, 95% C.I. 1.1 to 4.1). Injured children versus their non-injured siblings in case households and children in control households had lower work effort ratings at 1-year post injury (OR and 95% CI 1.7, 1.0 to 2.7 and 1.4, 1.0 to 2.0 respectively). Injured children completed work/chores less frequently (OR 1.5, 95% C.I. 1.0 to 2.2) than children in control households. These associations did not persist in the second year of follow-up.

Conclusions Injuries to children on agricultural operations may affect work time and quality of work at the child and household level.