The cost of a harvest: sickle-related injuries

Background: Agricultural injuries caused by hand-held tools, such as sickles, remain an underrecognized yet preventable public health challenge. Despite increased mechanization, hand-held tools are still widely used, especially in rural areas in low- and middle-income countries, where significant injuries are reported. Sickle injuries, in particular, frequently lead to amputations, tendon disruptions, and permanent neurovascular damage. This study examined the demographic, seasonal, and clinical patterns of sickle-related injuries and their treatment outcomes at a tertiary care center in South India. Methods: A retrospective observational study was conducted at a tertiary care teaching hospital in South India; patient records from January 2021 to December 2023 were reviewed to identify sickle-related injuries receiving surgical or nonsurgical treatment in the Emergency Department. Demographic details, injury patterns, seasonal trends, clinical interventions, and treatment outcomes were collected and analyzed quantitatively through descriptive and inferential statistics. Results: The study included 108 patients, predominantly males (78%), with the majority of the injuries occurring among the middle-aged population (40–60 years). Most injuries occurred in the morning and peaked during the crop harvest season (September–December). Upper limb injuries, particularly to the left hand, were most common, with lacerations being the predominant type of injury. Surgical interventions were required for 68% of the patients, and a significant correlation was observed between injury severity and length of hospital stay. Conclusions: Sickle-related injuries are a significant occupational hazard among agricultural workers in rural India, often resulting in disability and financial hardship. Middle-aged male farmers are disproportionately affected, with a clear seasonal and temporal pattern linked to agricultural activity. Upper limb trauma, particularly lacerations and neurovascular damage, is common. Despite existing legislation, policy gaps persist regarding nonpowered tool safety. Our findings highlight a persistent, underrecognized public health issue and the urgent need for targeted safety training, ergonomic tool redesign, and policy reform.

Sickle-related injuries; Sickle cut; Agricultural injuries; Trauma; Hand injuries; Emergency medicine

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