2 tables omitted
During 2003-2007, deaths occurring in the production of crops and animals in the United States totaled 2,334; of these, 108 (5%) involved cattle as either the primary or secondary cause.1 During the same period, Iowa, Kansas, Missouri, and Nebraska accounted for 16% of the nation's approximately 985,000 cattle operations and 21% of the nation's cattle and calf herd.2 To better characterize cattle-caused deaths in these four states, investigators reviewed all such deaths occurring during the period 2003-2008 that were detected by two surveillance programs, the Iowa Fatality Assessment and Control Evaluation (IA FACE) and the Great Plains Center for Agricultural Health (GPCAH). This report summarizes that investigation, which identified 21 cattle-related deaths. These deaths occurred throughout the year, and decedents tended to be older (aged ≥60 years) (67%) and male (95%). Except in one case, the cause of death was blunt force trauma to the head or chest. Circumstances associated with these deaths included working with cattle in enclosed areas (33%), moving or herding cattle (24%), loading (14%), and feeding (14%). One third of the deaths were caused by animals that had previously exhibited aggressive behavior. To reduce the risk for death from cattle-caused injuries, farmers and ranchers should be aware of and follow recommended practices for safe livestock-handling facilities and proper precautions for working with cattle, especially cattle that have exhibited aggressiveness.
Data gathering and analysis were performed collaboratively by IA FACE (operated by the University of Iowa on behalf of the Iowa Department of Public Health) and GPCAH (part of the University of Iowa's College of Public Health). Both programs are funded by CDC and collect surveillance data on agricultural deaths.* IA FACE collects basic information on all traumatic occupational fatalities in Iowa as identified primarily through multisource surveillance of the media, including newspapers, radio, television, and the Internet. Once alerted to a potential occupational death, IA FACE requests reports from investigating authorities such as the local police and sheriff's departments, emergency medical services, and the medical examiner. GPCAH surveillance is based solely on reports from Iowa, Kansas, Missouri, and Nebraska newspapers and other periodicals. Since 2003, GPCAH has been building a press report database, which includes descriptive information about the victim, event, circumstances, and nature of the injuries in fatal and nonfatal farm and agricultural injury events within the four states.
In this analysis, cases were defined as occupational fatalities caused by cattle that occurred in Iowa, Kansas, Missouri, or Nebraska during 2003-2008. Fatalities that occurred when motor vehicles crashed into cattle on roadways (such as while cattle were being herded with an all-terrain vehicle or pickup truck in a pasture) were excluded.
A total of 21 deaths met the case definition for 2003-2008. Four fatalities occurred in 2003, two in 2004, six in 2005, and three each year during 2006-2008. During these years, eight of the fatalities occurred in Iowa, two in Kansas, seven in Missouri, and four in Nebraska. The 21 decedents ranged in age from 8 to 86 years, with a median age of 65 years (mean age: 61 years). Only one of the victims was female. One of the victims was a boy aged 8 years who was helping castrate cattle when he was crushed against a squeeze chute. One third of the deaths occurred in March and April.
The victims' most common activities at the time of death were working with and treating cattle in enclosed spaces such as pens and chutes (n = 7) and moving or sorting cattle toward pens, barns, or pastures (n = 5). Incidents also occurred while loading cattle into trucks or trailers (n = 3), feeding (n = 3), or working in an open pasture (n = 3).
Ten of the 21 fatalities involved attacks by individual bulls, six involved attacks by individual cows, and five involved multiple cattle. In seven attacks (whether witnessed or not), the bull or cow was known to have exhibited aggressive behavior in the past. In 16 of the cases, the animal was deemed to have purposefully struck the victim; five other deaths were caused by being crushed against a stationary object or struck by a gate (secondary to the action of cattle). All but one death resulted from blunt force trauma to the chest and/or head; one resulted from inadvertent injection of the antibiotic Micotil 300 (tilmicosin phosphate) from a syringe in the victim's pocket when he was knocked down by a cow.
The following case summaries illustrate the most common circumstances of the cases identified for this report.
In August 2005, a woman in Missouri aged 65 years was removing a dead, newborn calf from a pasture when a cow knocked her down, stomped her, and butted her while she was lying on the ground. The coroner reportedly stated that death resulted from blunt force trauma to the woman's head and chest. No autopsy was performed.
In November 2005, a man in Iowa aged 65 years was helping his son sort beef cattle for loading onto a truck. He was attempting to guide one of the animals toward the truck when it turned into him, crushing him against the barn door. According to witnesses, he stopped breathing immediately. The medical examiner's report stated that death was caused by blunt force trauma to the man's chest.
In April 2006, a man in Iowa aged 63 years was herding cattle into his dairy barn for milking when a bull came into the barn and repeatedly butted him, pinned him against a fence, and stomped him. According to the attending physician's death record, the man sustained multiple rib fractures, lacerated pulmonary arteries, and head injuries. The man's family said that the bull was known to be dangerous and had been threatening in the past.
In August 2007, a man in Iowa aged 45 years who was working alone in a pasture was attacked by a bull that had been bottle-fed and raised by the family but, according to family members, had become more aggressive recently. The attack was not witnessed, but the man was able to call his wife for assistance on his cell phone before he died and told her he had been attacked. According to the state medical examiner's autopsy report, he died of blunt force injuries to the chest.
WT Sanderson, PhD, MD Madsen, MBA, Great Plains Center for Agricultural Health and the Injury Prevention Research Center, College of Public Health, Dept of Occupational and Environmental Health, Univ of Iowa, Iowa City.
Large livestock are powerful, quick, protective of their territory and offspring, and especially unpredictable during breeding and birthing periods.3-5 Mothering livestock often protect their young aggressively. Dairy bulls, which have more frequent contact with humans than do beef cattle, are known to be especially possessive of their herd and occasionally disrupt daily feeding, cleaning, and milking routines.5 The findings in this report confirm earlier research substantiating the risk for death to farmers and ranchers from contact with cattle.3-8 Previously published reports have described the nature and frequency of cattle-related deaths and injuries. Among 739 patients admitted to a referral trauma center in Wisconsin during a 12-year period because of injuries incurred while farming, 30% involved injuries from farm animals.6 Working with bulls involves higher risk for injury. In a study of farm worker injuries based on surveillance data from New York, bulls were found to account for 25% of animal-related injuries.7 Among the deaths described in this report, four (19%) were caused by dairy bulls during feeding or milking operations.
Of the decedents mentioned in this report, 13 of 20 (65%) were men aged ≥60 years. The methodology used in this analysis did not allow the calculation of age-specific risks and could not determine whether this age and sex profile reflected the demographics of farmers involved in close contact with cattle in the four states, or a greater risk for death among older farmers and ranchers. A case-control study of Iowa livestock farmers found that use of a hearing aid (odds ratio [OR] = 5.4) and doctor-diagnosed arthritis or rheumatism (OR = 3.0) were significantly associated with injuries related to animals.8 Age-related reduced hearing and reduced ability to react might contribute to this risk. Because approximately one third of the deaths described in this report occurred when the farmer was working alone, some of these deaths might have been prevented if a coworker had been present to help observe cattle behavior and movement and to provide prompt aid in case of injury. This might be especially useful when working with bulls or cows known to be aggressive, given that seven of the deaths described in this report involved such cattle.
The findings in this report are subject to at least two limitations. First, IA FACE surveillance, which involves more in-depth follow-up, only captured fatalities associated with work in Iowa. GPCAH surveillance, which is conducted in Iowa, Kansas, Missouri, and Nebraska, only captured accounts that appeared in newspapers or other periodicals. Therefore, reports from coroners or medical examiners, law enforcement, and emergency services were not obtained in Kansas, Missouri, or Nebraska. As a result, details about incidents in these three states often were limited (e.g., the age and sex of the decedent always were reported, but occasionally the decedent's activities and surroundings were not well reported). Second, reliance primarily on news reports means that some fatalities might go unreported. In Iowa, during 2003-2007, all seven of the fatalities caused by cattle that were documented by the state-based Census of Fatal Occupational Injuries (CFOI) of the U.S. Department of Labor's Bureau of Labor statistics also were captured through IA FACE and GPCAH surveillance. However, CFOI documented four cattle-caused fatalities in Kansas, seven in Missouri, and four in Nebraska, whereas GPCAH captured only two fatalities in Kansas, six in Missouri, and two in Nebraska. These data indicate that in states where only press clips were used to document agricultural fatalities, five out of 15 (33%) of the fatalities were unreported, suggesting a sensitivity of 67%. However, the advantage of using press reports is that more information regarding the circumstances of the deaths might be collected. In published studies, the sensitivity of newspapers as an injury surveillance source has varied according to the type of injury.9
Previously published reports have recommended that cattle handling facilities be designed for optimum safety, such as the placing of sturdy barriers between cattle and persons, allowing for directed movement of cattle, and providing means for rapid exit from the cattle area.10 Information on safe cattle handling and safe cattle-handling facilities is available from the National Agricultural Safety Database at http://www.nasdonline.org/menu/topic/animals.html.
This report is based, in part, on contributions by participating state agencies; Bureau of Labor Statistics staff; FACE program staff; J Kraemer, Iowa Office of the State Medical Examiner; K Leinenkugel, Occupational Safety and Health Surveillance Program, Iowa Dept of Public Health; and JR Myers, National Institute for Occupational Safety and Health, CDC.
*Additional information about IA FACE is available at http://www.public-health.uiowa.edu/face. Information on GPCAH is available at http://www.public-health.uiowa.edu/gpcah.
Fatalities Caused by Cattle—Four States, 2003-2008. JAMA. 2009;302(21):2314-2315. doi: