摘要：Objective. The child labor laws are intended to protect young workers from the most dangerous jobs. However, children who work on their parents’ farms are exempt from these laws. We evaluated the potential for preventing the occurrence of farm injuries among children by changing the US Federal Child Labor Laws, Hazardous Occupations Orders for Agriculture. Methods. A retrospective case series of 1193 farm injuries among children from the United States and Canada was assembled. The Hazardous Occupations Orders were systematically applied to each case. Injury preventability was estimated. Results. A total of 286 (24%) cases of injury involved immediate family members engaged in farm work. Among these children, 33% of those aged younger than 16 years and 36% of those aged 16 or 17 years were performing work prohibited under the Hazardous Occupations Orders. Conclusions. Removing the family farm exemption from the Hazardous Occupations Orders and raising the age restriction for performing hazardous agricultural work from 16 to 18 years would be efficacious in preventing the most serious injuries experienced by young family farm workers. Potential reductions in injury would meet Healthy People 2010 goals for reducing traumatic injury in the agricultural sector. Child labor laws were designed to protect the most vulnerable workers from unsafe and unhealthy work and work environments. In the United States, federal child labor laws limit the hours and times of day that children younger than 16 years may work and set minimum age standards for various types of work. 1 , 2 They also identify, under the Hazardous Occupations Orders, hazardous jobs that cannot be performed by children younger than 18 years in nonagricultural occupations and younger than 16 years in agricultural occupations. However, children who work on their parents’ farms are explicitly exempted from these federal child labor laws. To illustrate: “A child of any age may be employed by his or her parent or person standing in place of the parent at any time in any occupation on a farm owned or operated by that parent or person standing in place of that parent.” 2 Agriculture is the most hazardous industry in the United States for young workers. 3 Nearly half of all work-related fatalities among children occur in agriculture 3 with a risk for fatal injury that is 3 to 4 times that of young workers in other occupational settings. 4 , 5 Furthermore, 76% of fatally injured agricultural workers younger than 16 years were working in a family business that was exempt from the child labor laws. 3 Existing approaches to the prevention of farm injuries among children have emphasized education and training with little consideration of public policy approaches. 6 However, public health professionals and child safety advocates recommend policy-oriented approaches as more efficacious alternatives for prevention. 7 , 8 The National Research Council and the Institute of Medicine jointly recommended 2 policy changes related to children and agriculture in their 1998 report on the health and safety implications of US child labor: (1) establishment of a minimum age of 18 years for all hazardous work regardless of whether the setting is an agricultural or nonagricultural occupation, and (2) compulsory compliance with the Hazardous Occupations Orders “whether the minor is employed by a stranger or by a parent or other person standing in for the parent.” 7 Before initiating these changes in policy, those involved in and affected by these changes should be aware of their potential efficacy. The goal of this study was to evaluate the National Research Council and the Institute of Medicine’s joint policy recommendations with respect to their potential efficacy for injury prevention. Our objectives were to review existing cases of traumatic farm injury to children and (1) describe the characteristics of the injured children according to worker status, (2) identify farm jobs prohibited and not prohibited by the Hazardous Occupations Orders that are most often associated with injuries, (3) estimate the proportion of work-related injuries that could potentially be prevented if the family farm exemption was removed from the Hazardous Occupations Orders (because the child would be restricted from doing the hazardous job), and (4) estimate the proportion of work-related injuries that could be prevented if the age standard for the Hazardous Occupations Orders was raised from 16 to 18 years (because the child would be restricted from doing the hazardous job). The Hazardous Occupations Orders are authorized by the Fair Labor Standards Act (FLSA) of 1938 2 and are contained at Subpart E-1 of Regulations, 29 CFR Part 570. The FLSA was amended in 1966 to address young people working in agriculture. The final regulations became effective in 1970 9 and have been virtually unchanged since that time. A listing of the hazardous agricultural activities that were identified as prohibited for minors younger than 16 years are available as a supplement to the online version of this article at http://www.ajph.org . 2
