STOCKTON — What was supposed to be an average day on the farm changed Doug Boswell’s life.
On a cold November day in 2017, Boswell was feeding his cows in Stockton and left the gate open. When he returned to feed them, he realized three of the cows had escaped.
He managed to corral two of them back with his tractor, but one was still loose. So he got on the nearby all-terrain vehicle and chased the cow. But then, his ATV flipped.
He tried to move, but he couldn’t.
“I just couldn’t believe I was paralyzed,” he said.
Boswell lay on the ground for about 45 minutes. He didn’t have his phone with him. His wife, Teresa, was waiting for him in the truck by the barn. They were planning to eat after he fed the cows.
Eventually, his wife realized something was wrong. She walked down the hill from the barn and saw the still-running tractor with two bales on it.
“Then I looked over to the right, and I saw my four-wheeler on its side, and then I looked down and I saw him. And then I just ran,” she said.
She called 911, and when first responders arrived, they checked Boswell’s pulse. It was low. The ambulance to take him to the trauma center was too far away, so they called a helicopter to take him to the hospital.
“All I remember was the scream when they rolled him over to put him on board the helicopter," Teresa Boswell said. "It was pretty intense.”
Her husband had shattered his right shoulder, punctured a lung and broken several ribs and his back. And he was paralyzed.
Dozens of accidents like this one happen every year on farms across the state.
Every day, tasks on a farm carry the risk of injury or death. Tractors tip over and crush the operator. Farmers drown in grain silos. Grain augers tear off limbs. Heads are scalped when hair gets caught in spinning tractor parts.
Agriculture is one of the most hazardous industries alongside construction, according to the National Safety Council. In 2015, almost 36,000 farmworkers experienced an injury, according to the Bureau of Labor Statistics' Survey of Occupational Injuries and Illnesses.
The injury rate on farms in Missouri is almost double the national average for all occupations, according to a survey by the Central States Center for Agricultural Safety and Health, located in Omaha, Nebraska.
Farm injury and safety is an ongoing issue, said Scott Heiberger, health communications manager for the Marshfield Clinic Research Institute, based in Wisconsin, and president-elect of the International Society for Agricultural Safety and Health.
“Whenever I go into a room of farmers or people who work on farms and I just ask for a show of hands: ‘How many people in here personally know somebody who was killed in a farm incident?’ Hands always go up."
‘How many people have personally experienced a serious farm injury?’ And hands always go up. … That tells us that farm injury and farm safety is an ongoing issue,” Heiberger said.
Missouri is home to nearly 100,000 farms. Those farms make up two-thirds of the state’s land, according to the Missouri Department of Agriculture. More than 96 percent of the state's farms are considered family-owned, according to the national Census of Agriculture.
Small farms — those with fewer than 10 people working on it — are exempt from federal investigations into workplace injuries. The Occupational Safety and Health Administration doesn’t enforce workplace safety on any farm operation with 10 or fewer employees. So if there is a traumatic injury or death on a small farm, OSHA does not investigate.
For families, an investigation helps them understand exactly what happened to their loved ones, said Tonya Ford, a workplace advocate and executive director of the United Support and Memorial for Workplace Fatalities.
“It also provides answers to the farm or the company in regards to what happened and how we can prevent it from happening again, so others don’t get injured or killed doing the same job,” Ford said. “So a lot of it is prevention and making sure it doesn’t happen again.”
Finding data on small farm injuries can be difficult. The Central States Center for Agricultural Safety and Health collects news clippings on farm injuries and deaths. It also conducts a survey sent to farmers in several states, including Missouri.
The news clips counted more than 250 incidents since 2012 in Missouri. More than 100 of these incidents were fatalities, and the main cause was related to some type of tractor accident.
Some tractor accidents involved riders being ejected or pinned beneath their tractors. In others, someone was run over by a tractor.
In 2018, a 69-year-old man in Mammoth Spring, Arkansas, at the Missouri-Arkansas border, died when he was pinned by his tractor while trying to unload barrels from the bucket of the tractor. Another man died while pinned under a tractor with a rotary cutter after running into a tree while cutting on a slope in Doniphan, Missouri.
“Missouri has a phenomenal rate of tractor rollover incidents,” said Ellen Duysen, community outreach specialist for the Central States Center, which is funded by the National Institute for Occupational Safety and Health.
Duysen said she believes many of Missouri’s farms are small and have outdated equipment, which adds to the injury risk.
Other fatalities have included ATV accidents, suffocating in a grain bin, getting entangled in heavy machinery and being killed by an aggressive bull.
Missouri had 5.66 injuries per year per 100 farmers, according to the Central States Center survey. That was fewer than the other six states in the survey, but about twice the rate of injuries for all jobs reported to OSHA in 2015.
Across the seven states surveyed, 56 percent of injuries required a doctor or clinic visit and 12 percent required hospitalization. The average cost per incident was $35,000, including medical costs and lost productivity.
All told, the Boswells have had more than $1 million in expenses since the accident, Teresa Boswell estimated. Boswell had a long road to recovery. When he arrived at Mercy Hospital in Springfield, he needed two surgeries — one on his back and one on his shoulder.
He was in the hospital for about three weeks, transferred to another hospital for three weeks and a nursing home for another five before physical therapy began at Craig Hospital in Denver.
All together, it was four months before he could go back home.
Simple, life-saving equipment is available to prevent tractor deaths. Roll-Over Protective Structures, otherwise known as rollover bars, prevent a tipped tractor from crushing the operator. But only 62 percent of tractors were equipped with rollover bars in 2014, according to the National Institute for Occupational Safety and Health.
Dennis Murphy, an emeritus professor of agricultural engineering at Pennsylvania State University, has worked on farm safety projects for years.
He said rollover bars have been around since the 1960s, but they were optional, and most farmers decided not to add them to small- and medium-sized tractors. OSHA passed a regulation in 1976 requiring their use, but it does not apply to small family farms.
By 1985, most manufacturers equipped new tractors with rollover bars. Even so, Murphy said, there are still tractors without them.
“There’s an awful lot of old tractors on farms," he said. "I mean, there are tractors that are 30, 40 years old that are still actively being used on farms.”
Funding for agricultural research has not kept up with inflation over the years, Murphy said. NIOSH stopped doing internal research on agriculture safety, but it funds agricultural centers in the states.
NIOSH stopped conducting national agricultural injury surveys because the number of injuries declined, said Stephanie Stevens, a health communication specialist for NIOSH. The agency uses numbers from the Bureau of Labor Statistics.
“The declines made data collection more costly and more resource intensive because larger sample sizes were required,” she said.
Cost of safety
Many farmers can’t afford to pay for safety, either.
“If you talk to a Missouri farmer, they know their farms aren’t safe, and it is too expensive to make it safe,” said Karen Funkenbusch, rural safety and health specialist with MU Extension.
Farm income is down as commodity rates have dropped and production costs have gone up, according to the Kansas City Federal Reserve.
Retrofitting rollover bars and safety belts on tractors can cost hundred of dollars for the farmer. With tight budgets, farmers often must choose between upgrading safety and paying for parts so their tractor will continue to run. In most cases, the decision is straightforward.
If there were some kind of government incentive program in place, Funkenbusch believes farmers would be able to have safer farms.
The National ROPS rebate program, based in New York, tries to help farmers by offering rebates to those who install rollover protection.
The program is on a first-come, first-served basis, and at least 750 farmers are on a waitlist, including 23 from Missouri, said Pam Tinc, junior research associate for the program.
There are typically three approaches to farm safety, Heiberger said: education, engineering and enforcement.
“You get a room full farm safety experts in a room, and everyone has their favorite prong on that,” Heiberger said.
Missouri seems to be taking the education approach. Missouri has programs like Show-Me Farm Safety, a joint effort between multiple organizations such as the Missouri Department of Agriculture, University of Missouri Extension and Missouri Farm Bureau. The group brings information from the academic, private and public sectors together to create awareness and safety campaigns, said David Baker, MU extension broader impacts administrative consultant and co-chair of the program.
Culture of independence
Farmers work in a culture of independence where hard work and self-reliance are prized. That applies even to injuries.
Bob Haworth, the fire chief of a volunteer fire department in Belgrade, said some farmers will drive themselves to a hospital. Sometimes, they even fix their injuries themselves.
“I have seen a lot of people get a good laceration to the leg, and they'll use super glue and glue it up themselves,” Haworth said.
Farmers generally don’t want “regulatory kinds of folks coming onto their farms to tell them ... what to do, and how to do it and why to do it,” Funkenbusch said.
Steve Kimker, a farmer from Bourbon, agrees.
“Everybody always wants to overregulate everything. And that’s usually not the issue,” Kimker said. “Half the time the regulations they put into place are more dangerous than the problems they’re trying to prevent by extra shields and safety stuff."
Farmers have experience with their equipment and are not reckless when working, Funkenbusch said. However, even with the most experienced and cautious farmers, there is always a risk that something can go wrong. Farm life is unpredictable, which adds to the risk of injury, she said.
Kimker had an accident on his farm in 1996 when his tractor tipped over. He cracked several ribs and his sternum and bruised his lung.
“It’s just inattention,” Kimker said. “It’s those little things, and they don’t think, and it’s those three seconds that end up costing them for the rest of their lives.”
Path to recovery
Boswell said he has heard stories about farm machinery accidents over the years, but he never thought about the danger while working on his farm.
Boswell’s father, Roy, who has farmed most of his adult life, said he believes injuries are inherent to farming. Roy Boswell, now 76, got into an ATV accident himself in 1989 and needed 56 stitches in his head.
“When you’re on a farm, getting hurt is part of it,” he said. “There’s so many things that you do that you take for granted as you do it. And you do that so many times, the odds get stacked up against you. And sooner or later, you’re going to get whacked.”
Doug Boswell wanted to continue farming after his accident, even though he was paralyzed. In the Denver hospital, Boswell connected with AgrAbility, an organization that helps disabled farmers find the resources to keep working.
AgrAbility worked with the Missouri Division of Vocational Rehabilitation to help fund the technology Boswell needed. Now, he uses a track chair — a motorized wheelchair with treads. He also uses a chair lift to get into his car and tractor.
Funkenbusch, who is also the director of the Missouri AgrAbility program, said they can’t pay for assistive technology, but they can put him in touch with organizations that can potentially help pay. AgrAbility conducts roughly 80 farm assessments for disabled farmers each year, Funkenbusch said.
The Boswells continue to work on the farm and plan to build a house that is ADA accessible.
On the farm one day this spring, Boswell spent the morning using a system called a bud box to vaccinate his cattle. Cows were guided into the box and Boswell pulled a lever to keep their heads still and gave them a shot in the neck.
He had people to help, but soon he will be able to do it by himself. Later that day, he used hand controls to drive his truck to the barn and changed the oil in his tractor.
Working on the farm now is a slower process, he said, and there can still be difficulties. It took two hours for him to get his tractor out of his barn one day, for example.
The four-wheeler still sits in a shed on the farm.
“That four-wheeler, I used it all the time working cattle,” Boswell said. “And why I went end over end, I don’t know that day. I’ve played it over and over in my head.”
This story was produced in cooperation with the Midwest Center for Investigative Reporting by students in a spring 2019 Investigative Reporting class at the University of Missouri School of Journalism taught by associate professor Sara Shipley Hiles.