Photo: US Air Force

Around 200 people in the U.S. die every year from run-ins with animals, according to a new study, which found that over one million emergency room visits and approximately $2 billion in healthcare spending are attributable annually to problematic animal encounters.

While bear or shark attacks might spring to mind, the majority of the deaths were either from venomous attacks by insects, encounters with dogs, or farm incidents.

“The risk of death due to domesticated animals such as farm animals and dogs far outweigh those due to any wild animals,” lead author Jared A. Forrester, with Stanford University’s Department of Surgery, told Earther. “The rates of death due to wild animals remained exceedingly low.”

During the study period from from 2008-2015, there were about 86 deaths annually from venomous encounters, with the most lethal being stings and subsequent anaphylaxis from bees, wasps, and hornets. For comparison, the U.S. averages less than 20 shark attacks per year, and only one shark-related fatality every other year.

According to the study, “Africanized” honey bees, or killer bees, may be particularly lethal when they swarm, something that’s increasingly common in the southern and western U.S. Similar to more docile European honeybees, Africanized bees, which are invasive, are extremely aggressive and are known to chase anything that disturbs the hive.

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Forrester said a large price increase recently in epinephrine autoinjections, essential in the treatment of anaphylaxis, “may impact the risk of death in this category,” though it’s too early to tell.

As for nonvenomous encounters, a range of domestic and human-associated mammals including cats, horses, cows, pigs, and raccoons made up the bulk of the fatalities, most of which occurred on farms. The two largest culprits for human mortality were horse or cattle accidents. While the database doesn’t reveal exactly how individual animal-related deaths occurred, the study states that humans can be harmed by animals through “bites, stings, strikes, crushing, or contact.”

Forrester believes that public health initiative to prevent potentially fatal farm animal encounters should be better promoted and supported, and that opportunities exist to improve safety measures and injury reporting on farms in the U.S. Agriculture is already one of the most potentially hazardous work environments, according to the study, and “severe injuries and fatalities on the farm can result from these interactions with large animals.”

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In comparing new data to 1999-2007 numbers from the Centers for Disease Control and Prevention, the authors determined that deaths due to human-animal encounters did not decrease. In total, between 2008 and 2015, 1,610 people were killed during animal encounters.

For kids under four years old, one type of animal encounter is especially troubling: dogs. The rate that young children meet dog-related fatality—4.6 deaths per 10 million persons—was four times higher than most other age groups. There were an average of 34 dog-related deaths per year.

Forrester said that educating children under four to properly interact with dogs “is not very fruitful” and “therefore preventing these interactions until they are at an age of comprehension is quite important.”

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“The burden of fatality upon young children after dog encounters remains troubling,” he said. “These are preventable deaths.”