Background While the risk of injury from large agricultural machinery and tractors has been the focus of numerous studies, little is known about the risk for youth and adults using small equipment such as hand tools on agricultural operations.

Objectives Identify rates, consequences, and risk factors for small equipment-related injuries among youth (less than 20 years of age) and adults on agricultural operations.

Methods This study utilised data from the Regional Rural Injury Study-II, designed to identify incidence and consequences of agricultural injuries, among all ages, and potential risk factors among youth in the five-state region of Minnesota, Wisconsin, North Dakota, South Dakota, and Nebraska. For each study period (1999 and 2001), random samples of 16,000 agricultural operations were selected from the US Department of Agriculture’s National Agricultural Statistics Service Master ListFrame of farming operations. Demographics, exposures, and injury data were collected from the eligible responding 7,420 agricultural households. Adjusted injury rates were calculated using Poisson regression. Directed acyclic graphs guided multivariate logistic regression modelling to identify potential risk factors.

Results Rates and 95% confidence Intervals (C.I.) for small equipment injuries per 1,000 persons/year were 2.8 times lower among youth (6.8; 5.6–8.2) than adults (19.0; 16.9–21.4). Non-powered hand tools were the most frequent source of small equipment-related injuries among both youth (52%) and adults (39%). Cut/laceration/scratch was the most frequent injury type among both youth and adults (43%; 38%). Male, compared with female youth, were over four times more likely to incur a small equipment injury. Having prior, versus no prior, injury was associated with a two-fold increase in risk for youth (Odds Ratio 2.6; C.I., 1.5–4.5).

Conclusions Risk of small equipment-related injury among youth, compared with adults, was different and varied by gender and prior injury experience – results providing a basis for focused intervention development.