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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Public Health</journal-id>
<journal-title>Frontiers in Public Health</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Public Health</abbrev-journal-title>
<issn pub-type="epub">2296-2565</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3389/fpubh.2022.1059297</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Public Health</subject>
<subj-group>
<subject>Opinion</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Safeguarding youth from agricultural injury and illness: The Australian experience</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author" corresp="yes">
<name><surname>Franklin</surname> <given-names>Richard C.</given-names></name>
<xref ref-type="corresp" rid="c001"><sup>&#x0002A;</sup></xref>
<xref ref-type="author-notes" rid="fn002"><sup>&#x02020;</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/1652138/overview"/>
</contrib>
</contrib-group>
<aff><institution>Public Health and Tropical Medicine, College of Public Health, Medical and Veterinary Sciences (CPHMVS), James Cook University</institution>, <addr-line>Townsville, QLD</addr-line>, <country>Australia</country></aff>
<author-notes>
<fn fn-type="edited-by"><p>Edited by: Cheryl Beseler, University of Nebraska Medical Center, United States</p></fn>
<fn fn-type="edited-by"><p>Reviewed by: Salimata Traore, Universit&#x000E9; Ouaga II, Burkina Faso</p></fn>

<corresp id="c001">&#x0002A;Correspondence: Richard C. Franklin &#x02709; <email>richard.franklin&#x00040;jcu.edu.au</email></corresp>
<fn fn-type="other" id="fn001"><p>This article was submitted to Children and Health, a section of the journal Frontiers in Public Health</p></fn>
<fn fn-type="other" id="fn002"><p>&#x02020;ORCID: Richard C. Franklin <ext-link ext-link-type="uri" xlink:href="https://orcid.org/0000-0003-1864-4552">orcid.org/0000-0003-1864-4552</ext-link></p></fn></author-notes>
<pub-date pub-type="epub">
<day>04</day>
<month>01</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="collection">
<year>2022</year>
</pub-date>
<volume>10</volume>
<elocation-id>1059297</elocation-id>
<history>
<date date-type="received">
<day>01</day>
<month>10</month>
<year>2022</year>
</date>
<date date-type="accepted">
<day>13</day>
<month>12</month>
<year>2022</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#x000A9; 2023 Franklin.</copyright-statement>
<copyright-year>2023</copyright-year>
<copyright-holder>Franklin</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/"><p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p></license> </permissions> 
<kwd-group>
<kwd>children</kwd>
<kwd>Australia</kwd>
<kwd>injury</kwd>
<kwd>safety</kwd>
<kwd>home</kwd>
<kwd>death</kwd>
<kwd>farm</kwd>
</kwd-group>
<counts>
<fig-count count="0"/>
<table-count count="0"/>
<equation-count count="0"/>
<ref-count count="25"/>
<page-count count="4"/>
<word-count count="3151"/>
</counts>
</article-meta>
</front>
<body>
<sec id="s1">
<title>1. Background</title>
<p>As of 31 March 2022, there were 25,890,773 estimated resident population in Australia across the eight states and territories (<xref ref-type="bibr" rid="B1">1</xref>). In the 2020&#x02013;21 Financial year, there was 387 million hectares of agricultural land (50% of Australia&#x00027;s land mass), of which the majority (86%) was used for grazing (<xref ref-type="bibr" rid="B2">2</xref>). There were 228,372 people in the Australian agricultural workforce in 2016, 69% were males, the median age was 56 years, and a third (37%) were owner operators (<xref ref-type="bibr" rid="B3">3</xref>).</p>
<p>In Australia, fatalities on Australian farms have remained steady over the last decade, with 1,584 between 2001&#x02013;2020 (<xref ref-type="bibr" rid="B4">4</xref>). Children represent approximately 15% of these deaths (<xref ref-type="bibr" rid="B5">5</xref>, <xref ref-type="bibr" rid="B6">6</xref>). Issues that have been found to be of importance to farmers about the safety of their children on farms in Australia include: general danger avoidance and safety, machinery, moving vehicles, bike safety, animal handling, personal protective equipment (PPE), supervision, speed, water safety and chemicals (<xref ref-type="bibr" rid="B5">5</xref>).</p>
<p>Peachey et al. (2020) explored the 222 deaths of children (&#x0003C; 15 years) on Australian farms over a 19-year period (2001&#x02013;2019) (<xref ref-type="bibr" rid="B6">6</xref>). Of the 222 deaths, 51% were less than 5 years of age, 22% were 5&#x02013;9 years and 27% were 10&#x02013;14 years (<xref ref-type="bibr" rid="B6">6</xref>). The majority (68%) of these deaths were residents of the farms (<xref ref-type="bibr" rid="B6">6</xref>). In the final years (2017&#x02013;2019) of the study there were 13.0 cases per annum, a significant reduction from 1989&#x02013;1992 where there were 29 deaths per annum (<xref ref-type="bibr" rid="B6">6</xref>, <xref ref-type="bibr" rid="B7">7</xref>). Common agents involved in child deaths have not changed much over time, with the exception of quadbike-related deaths of which there were four between 1989&#x02013;1992 and 32 in the 2001&#x02013;2019 period, with drowning in dams continuing to be a major cause of death (<xref ref-type="bibr" rid="B6">6</xref>, <xref ref-type="bibr" rid="B7">7</xref>). Interestingly, while water safety accounts for 31% of deaths on farms this was not seen as the highest priority by parents (<xref ref-type="bibr" rid="B5">5</xref>, <xref ref-type="bibr" rid="B6">6</xref>). Farm dams remain an ongoing challenge for farm safety (<xref ref-type="bibr" rid="B8">8</xref>, <xref ref-type="bibr" rid="B9">9</xref>), partly due to changing climatic conditions with dam water level ranging dramatically from year to year. Other common agents, also reflected in the concerns of parents included quadbikes, tractors, utes (farm pick-up), cars, motorcycles and horses (<xref ref-type="bibr" rid="B6">6</xref>).</p>
<p>The leading organization responsible for improving safety on farms in Australia is Farmsafe Australia (FSA). FSA is a not-for-profit organization dedicated to improving the wellbeing and productivity of Australian agriculture through enhancing health and safety practices. FSA grew from local action in the 1980&#x00027;s and has operated as Australia&#x00027;s leading agricultural health and safety organization. FSA develops and delivers a range of resources and programs in Australia and has recently (2019) received multi-year funding from the Australian Government to enhance farm safety (<xref ref-type="bibr" rid="B10">10</xref>). Recent activity from FSA has included the production of community service announcements, reports, refreshed guides and brochures, data collection around safety issues, conferences, and attendance at field days (<ext-link ext-link-type="uri" xlink:href="http://www.farmsafe.org.au/">www.farmsafe.org.au</ext-link>).</p>
<p>Toward the end of the 2000&#x00027;s and into the 2010&#x00027;s a number of research activities around child safety reached their culmination, this included work around developing an evidence base for child injury prevention priorities for Australian farms (<xref ref-type="bibr" rid="B11">11</xref>), safe play areas (<xref ref-type="bibr" rid="B9">9</xref>, <xref ref-type="bibr" rid="B12">12</xref>), water safety (<xref ref-type="bibr" rid="B8">8</xref>, <xref ref-type="bibr" rid="B9">9</xref>, <xref ref-type="bibr" rid="B13">13</xref>), and links to the Australian curriculum (<xref ref-type="bibr" rid="B14">14</xref>). A recent literature review (<xref ref-type="bibr" rid="B15">15</xref>) identified 41 peer reviewed papers exploring child safety on farms, the review noted that there is limited literature on child safety on farms, that factors which contribute to child injuries on farms include; exposure to hazards, risk-taking, lack of supervisions, children working, lack of regulations including understanding of the hierarchy of control, lack of supervision, financial challenges and poor uptake of safe play areas (<xref ref-type="bibr" rid="B15">15</xref>). Unfortunately, there is limited information about the relationship between injuries and work for children on farms in Australia, an area requiring further research.</p>
<p>There is no doubt that child safety on farms represents a &#x0201C;wicked problem&#x0201D; (<xref ref-type="bibr" rid="B16">16</xref>), that is a problem that requires multifactorial solutions due to its complexity. To address child injury on farms, FSA has used the hierarchy of control approach [i.e., removing the hazard, substituting for a lesser hazard, engineering solutions, management solutions and lastly personal protective equipment (<xref ref-type="bibr" rid="B17">17</xref>)] and this is then reflected in the material they produce and the way safety is communicated.</p>
</sec>
<sec id="s2">
<title>2. Current activities</title>
<p>There has been a wide range of resources developed for child safety on farms in Australia over the years, the following is a summary of those that are still available or known to the Author. Farmsafe Australia has played a significant role in the development of these resources. However, other organizations such as Kidsafe, Royal Life Saving Society &#x02013; Australia and doctor groups have also been involved. These resources have ranged from practical advice such as the &#x0201C;Child Safety on Farms: A Practical Guide&#x0201D; (<xref ref-type="bibr" rid="B18">18</xref>) to pamphlets, brochures, television shows and commercials.</p>
<p>An early example of an integrated child safety program was Giddy Goanna. This program originated in Queensland and went Australia-wide. It included books, activities, television program, a mascot (Giddy Goanna &#x02013; which was hot to wear) and addressed all farm activities from working with sheep and cattle to chemicals, farm machinery, water safety and feeding pets. The resources as still found in schools and are available to purchase (at Dec-2022) and includes merchandise.</p>
<p>Recently FSA has partnered with &#x0201C;George the Farmer&#x0201D; (<ext-link ext-link-type="uri" xlink:href="https://www.georgethefarmer.com.au">https://www.georgethefarmer.com.au</ext-link>) to produce a song with a video about child safety and an educator&#x00027;s guide (<xref ref-type="bibr" rid="B19">19</xref>). George the Farmer was developed as a tool for educating children about where their food and fiber come from and is used in schools as an education tool <italic>via</italic> videos and booklets. The educator&#x00027;s guide links to the Australian Curriculum for Year 4 in science, technologies, English, health and physical education (<xref ref-type="bibr" rid="B19">19</xref>), however, can also be used with younger children. It provides safety information around jobs and activities on farms and has activities to help embed the learning outcomes.</p>
<p>This work builds on the child safety on farm &#x02013; a practical guide (<xref ref-type="bibr" rid="B18">18</xref>) material and the RIPPER resources (<xref ref-type="bibr" rid="B14">14</xref>). The practical guide provides specific advice on how to prevent drowning, injuries due farm motorbike, farm vehicles, horses, tractors and machinery and more general advice around other hazards, it also include a section on &#x0201C;Safe Play Areas&#x0201D; (<xref ref-type="bibr" rid="B18">18</xref>). The RIPPER material provides information about farm safety for teachers, links to the curriculum and has a wide range of activity sheets (<xref ref-type="bibr" rid="B14">14</xref>). Both of these are still widely used across Australia.</p>
<p>A significant activity of Farmsafe and its partners has been the promotion of safe play areas. This concept originally develop in the USA, was then adopted in Australia with a range of resources to promote the concept to Australian farmers (<xref ref-type="bibr" rid="B20">20</xref>). It is especially relevant to farms with young children, as they have been found to wander far from the farm house and end up drowning in dams (<xref ref-type="bibr" rid="B8">8</xref>). The program includes information about the benefits of safe play areas&#x00027;, how to make an effective barrier and safe play area, and the role of supervision (<xref ref-type="bibr" rid="B20">20</xref>). This work has meant that the number of farms with safe play areas has increased, although only two-thirds of parents reported that it would be secure enough to prevent children from wandering away (<xref ref-type="bibr" rid="B12">12</xref>).</p>
<p>Other activities include &#x0201C;Farm Safety Days for Children&#x0201D;, these activities normally take children onto farms and have a range of safety talks, experiential learning, chats about farming and practical advice and involve the local hospital/doctors, Farmsafe, Kidsafe, Royal Life Saving, schools, farmers, stock and station agents, machinery dealers and retailers, parents, and other interested parties. Farmsafe also includes strategies within other areas, for example quadbikes where children are expressly mentioned (<xref ref-type="bibr" rid="B21">21</xref>).</p>
<p>Kidsafe (<ext-link ext-link-type="uri" xlink:href="https://kidsafe.com.au">https://kidsafe.com.au</ext-link>) and the Royal Life Saving Society &#x02013; Australia (<ext-link ext-link-type="uri" xlink:href="https://www.royallifesaving.com.au/">https://www.royallifesaving.com.au/</ext-link>) have also developed a range of resources to help parents keep their children on farms safe. This includes videos, books, brochures, guides (<ext-link ext-link-type="uri" xlink:href="https://www.kidsafewa.com.au/resources/">https://www.kidsafewa.com.au/resources/</ext-link>) and a sign about shutting the gate (<ext-link ext-link-type="uri" xlink:href="https://www.royallifesaving.com.au/stay-safe-active/locations/farm-water-safety">https://www.royallifesaving.com.au/stay-safe-active/locations/farm-water-safety</ext-link>). This material is used widely as part of their community outreach. The Kidsafe parent guide is in its third edition and includes information around how to prevent injuries, safe play areas, specific hazards and what to do in an emergency.</p>
<p>Finally, we should not forget legislative approaches. In Australia, there are two significant areas of legislation, workplace health and safety legislation and child employment legislation. Workplace health and safety legislation takes a risk management approach using the hierarchy of control, however, the child needs to be old enough to be working for this legislation to be relevant. The child employment legislation covers how old, when and what activities children can undertake (<xref ref-type="bibr" rid="B22">22</xref>). While these laws are state and territory specific, the general approach is that children should not be working full-time until they are older than 15 years, with some work allowed under this age, however, it should not interfere with school (i.e., should not be during school hours, or be of such a volume that it would impact on learning with some states specifying times when children cannot work), nor place the child in danger with some states specifically banning some types of work (for example dangerous machinery, dangerous substances, working at height, service of alcohol, gambling services, etc.). Often excluded from these provisions is working for family or domestic chores, volunteer work (i.e., unpaid work) or traineeships. This means that work on farms is often excluded from scrutiny under the legislation and thus other strategies to ensure child safety on farms are required (<xref ref-type="bibr" rid="B22">22</xref>).</p>
</sec>
<sec id="s3">
<title>3. Impacts and challenges</title>
<p>It is difficult to tell what impact any given resource has had in preventing child injuries and deaths on farms, as there has been very little evaluation of any specific initiative, this is an area that requires further work. Peachey et al. (<xref ref-type="bibr" rid="B6">6</xref>) in their exploration of child deaths found that the average number of deaths on farms had decreased from 17.6 deaths per annum in 2001&#x02013;2003 to 13.0 in 2017&#x02013;2019, while this is good news overall, unfortunately the death rate remained unchanged representing a decrease in the number of children living on farms (<xref ref-type="bibr" rid="B6">6</xref>). Safe play areas have been widely promoted and its uptake has been varied (<xref ref-type="bibr" rid="B12">12</xref>) and it is not clear how long the barriers last, noting that it should also be accompanied by a set of rules to guide the child and parents.</p>
<p>Growing up on a farm provides many life experiences that other children do not get to experience, these life experiences are often encouraged by parents, however, there is a need to ensure that they occur safely and that parents understand what they need to do to ensure the safety of their children.</p>
<p>It appears that exposure to hazards continues to be a challenge, especially for children under the age of 5 years (<xref ref-type="bibr" rid="B15">15</xref>). With the number of children who are living on farms decreasing and overall smaller family sizes, there is an ongoing need to ensure that new parents are aware of what can be undertaken to ensure the safety of their children. Child care continues to be a challenge for those living and working on farms, especially those away from population centers (<xref ref-type="bibr" rid="B23">23</xref>). With a connected world, noting that this is still a challenge for many rural Australians, there is a need to continue to innovate to ensure that safety information is accessible, engaging and valid for the next generation of parents.</p>
</sec>
<sec id="s4">
<title>4. Future directions</title>
<p>While the number of deaths on farms has decreased, mainly due to fewer young children living on farms, little is known about non-fatal injuries of children on farms, and there is a lack of evidence about what works to prevent injuries, both areas that need further exploration. As farms adapt to the changes in legislation [note in 2011, Australia started to update its workplace health and safety legislation to be more consistent (<xref ref-type="bibr" rid="B24">24</xref>)] and improve their safety performance, it is hoped that this then flows into the child safety area. This needs to be tested around the impact on farming practices and the safety of children on farms.</p>
<p>The next steps in Australia should be around bringing together all the interested parties in child farm safety and working toward a nationwide coordinated effort, which will hopefully develop a child safety on farms strategy, linked to the hierarchy of control approach, as the guiding principle outlined in workplace health and safety legislation in Australia (<xref ref-type="bibr" rid="B25">25</xref>). This would expectantly bring new energy and resources to the cause and thus continue to drive down child deaths and reduce the number of injuries on farms while at the same time ensuring that children continue to develop as young farmers. This will require improving the evidence base for what works, ensuring that researchers, practitioners and policymakers work together and that we continue to develop new and adapt current recourses to the task.</p>
</sec>
<sec sec-type="author-contributions" id="s5">
<title>Author contributions</title>
<p>The author confirms being the sole contributor of this work and has approved it for publication.</p>
</sec>
</body>
<back>
<ack><p>I would like to acknowledge all the work that has been undertaken by a wide range of organizations and individuals in child farm safety in Australia over the years. It is a substantial body of work that has been led by Farmsafe Australia and the Australian Centre for Agricultural Health and Safety at Sydney University.</p>
</ack>
<sec sec-type="COI-statement" id="conf1">
<title>Conflict of interest</title>
<p>RF is a board member of Farmsafe Australia, Kidsafe, Royal Life Saving Society - Australia, and Auschem Training.</p>
</sec>
<sec sec-type="disclaimer" id="s6">
<title>Publisher&#x00027;s note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
</sec>
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