Agriculture remains the primary occupation for a large proportion of the Indian population, much of it in informal or family-based settings. Unlike organised industry, farm work in India is rarely governed by strict occupational safety standards. Increasing use of tractors, power tillers, threshers, and electric irrigation pumps has improved productivity but introduced high-energy hazards into environments lacking guards, lockout systems, or formal training.

Indian hospital-based and autopsy studies repeatedly report devastating injuries from tractor rollovers, thresher entanglement, chaff cutter amputations, animal goring, pesticide exposure, and falls into wells or from trees during fruit harvesting. However, routine injury surveillance is fragmented between police records, hospital registers, and compensation systems, leading to underestimation of the true burden.

Forensic medico-legal analysis allows precise mapping of mechanism to injury pattern, for example:

• Thresher entanglement → traumatic amputations
• Tractor rollover → thoracoabdominal crush polytrauma
• Fall into well → head injury/asphyxia
• Live irrigation wire contact → electrical burns and cardiac arrest

Such pattern recognition can guide targeted, low-cost prevention suited to Indian villages. This study applies a forensic epidemiology approach to agricultural injuries in an Indian district and integrates community perspectives to design practical prevention strategies.

Study design

Mixed-methods:

1. Retrospective medico-legal record review
2. Community survey and focus group discussions

Setting

District hospital emergency and medico-legal unit with referral mortuary serving predominantly rural farming communities in India.

Inclusion criteria

• Farmers, family farm workers, or hired agricultural labourers
• Work-related injuries registered as medico-legal cases
• All autopsy-confirmed occupational deaths

Exclusion criteria

• Non-work domestic accidents in farms
• Incomplete records lacking mechanism or outcome

Sample size

Total cases analysed: 326
Fatal (autopsy): 92
Non-fatal: 234

Variables

• Mechanism/agent: tractor, thresher, chaff cutter, power tiller, hand tools (sickle/axe), cattle/bull injury, fall (tree/well/field), electrical pump/wire, pesticide exposure, snake/insect bite.
• Injury type: laceration, fracture, crush injury, amputation, head injury, burns, poisoning/asphyxia.
• Severe outcome: death, ICU admission, or permanent disability.

Analysis

Descriptive statistics and multivariable logistic regression (p < 0.05 significant).

Ethics

De-identified data; institutional approval and community consent obtained.

Table 1. Demographic profile (N = 326)

Inference: Prime working-age men and economically vulnerable labourers were most affected.

Table 2. Activity at time of injury

Inference: Mechanised post-harvest processing and tractor use formed the largest high-risk window.

Table 3. Mechanism of injury and fatality

Inference: Tractor incidents and electrical injuries had the highest lethality.

Table 4. Nature of primary injury

Inference: Dual pattern of frequent minor cuts and fewer but catastrophic crush/head injuries.

Table 5. Body region involved

Inference: Hand and arm injuries dominate, but fatalities cluster in head and trunk trauma.

Table 6. Factors associated with severe outcome

Inference: Modifiable workplace factors strongly influence severity.

Table 7. Multivariable predictors of severe injury

Inference: Engineering controls on machinery are the strongest protective opportunity.

Table 8. Community-prioritised prevention options (n = 240)

Inference: Villages favour visible, affordable, and quickly deployable solutions.

The present Indian district-level analysis shows that tractors and powered post-harvest machinery are the dominant contributors to severe and fatal agricultural injuries. This mirrors several recent Indian hospital and autopsy series where tractor rollovers, run-over events, and thresher entanglement were leading mechanisms of traumatic death and limb loss (1–3). In many parts of rural India, tractors are used for passenger transport, towing overloaded trailers, and operating on uneven field embankments, all of which increase rollover risk in the absence of rollover protective structures (ROPS) and seatbelt use (1,2).

High rates of upper limb trauma in our study reflect close manual interaction with sickles, fodder cutters, and threshers. Contemporary Indian clinical reports on agricultural hand injuries also demonstrate a predominance of deep lacerations, crush injuries, and amputations related to chaff cutters and threshers, often occurring during attempts to clear jams while the machine is running (4,5). These findings are consistent with international syntheses identifying machinery entanglement as a principal pathway to catastrophic injury and amputation in farming populations (6).

Fatalities in the present cohort clustered around head and trunk trauma following tractor overturning and falls into unprotected wells or from trees during harvesting. Similar mechanism–injury patterns have been described in recent Indian forensic studies, where head injury and thoraco-abdominal crush were the commonest autopsy findings in tractor and fall-related farm deaths (2,3,7). The contribution of animal-related trauma, particularly cattle goring and trampling, also aligns with Indian rural injury profiles where close human–animal contact is routine and often occurs without physical barriers or safe handling systems (3,8).

Electrical injuries during night irrigation showed very high lethality in our dataset. This is concordant with Indian reports of electrocution from exposed irrigation wiring, illegal tapping, and wet field conditions, which substantially increase conduction and cardiac arrest risk (9,10). The independent association between night/low-light work and severe outcome in our regression model is plausible in the Indian context, where irrigation commonly occurs at night due to power supply schedules, leading to fatigue, poor visibility, and slip/fall hazards (9).

Non-use of basic protective gear (gloves and boots) increased the odds of severe injury. While heavy industrial PPE is often impractical in hot field conditions, Indian occupational health literature shows that simple, locally available protective gear can reduce the severity of hand and foot injuries during threshing, cutting, and pesticide handling (4,11). Behavioural gaps in PPE use have been repeatedly documented among farmers and labourers, underscoring the need for culturally appropriate, task-specific safety promotion (11).

Engineering controls emerged as the strongest protective opportunity. The robust association between unguarded rotating parts and severe injury in this study echoes both Indian and international evidence that machine guarding and safe maintenance practices are critical to preventing entanglement and amputation (5,6,12). Importantly, our community survey indicated strong support for retrofitted guards on threshers and chaff cutters, tractor safety training, and physical covers for open wells and borewells—interventions that are visible, affordable, and quickly deployable. Implementation research in agricultural safety consistently shows higher uptake for such practical, low-cost engineering and environmental modifications compared with complex regulatory approaches (12,13).

Finally, community prioritisation of village first-aid capacity and rapid transport reflects the well-recognised impact of delayed access to definitive trauma care in rural India. Strengthening local referral pathways and basic prehospital response can mitigate preventable deaths from haemorrhage and airway compromise following farm injuries (7,13).

Taken together, the Indian scenario highlights a concentrated, preventable burden around tractors, unguarded threshers/chaff cutters, unsafe electrical irrigation, and open wells. Aligning forensic injury patterning with community-endorsed, low-cost engineering controls and rapid response systems provides a pragmatic roadmap to reduce both frequency and severity of agricultural occupational injuries (1–6,9,12,13).

In rural India, preventable severe agricultural injuries are concentrated around tractors, unguarded threshers and chaff cutters, night-time irrigation hazards, and open wells. Forensic pattern analysis combined with community input identifies clear, affordable targets for intervention. Immediate gains can be achieved through machine guarding, tractor safety training, improved field lighting, protective covers for wells, and strengthened village emergency response systems.

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