AGRICULTURE, FORESTRY AND FISHING
Inputs: NIOSH Funded Projects
Intramural Funded Projects
Exposure Assessment Among Pesticide and Herbicide Workers
In an effort to reduce acute chronic and respiratory disease among the vulnerable population of agricultural workers, this Public Health Practice Project will strengthen exposure assessments for pesticides and herbicides by completing and disseminating validated methods for measuring airborne and dermal exposures during pesticide and herbicide application and biomarkers in workers post-exposure. Specifically, this project will provide validated exposure assessment methods for workers exposed to airborne malathion, captans, tetrahydrophthalimides, cuomophos, chloropyrophosphate and butyltin chloride with validated methods for butyltin chloride in urine.
Prevention of Occupational Respiratory Disease in Agriculture
This project will address the knowledge gaps regarding respiratory health outcomes in agriculture including asthma, hypersensitivity pneumonitis, chronic bronchitis, and agricultural respiratory exposures. To accomplish the goal, NIOSH partnered with two existing studies to gather respiratory health outcomes data – the Agricultural Health Study (AHS) and the US Department of Agriculture (USDA), National Agricultural Surveillance System (NASS). The staff involved in both of the existing studies has expertise in epidemiology, occupational medicine, environmental health, and biostatistics, while the NIOSH staff provides its own expertise in respiratory disease, agricultural health and safety, data analysis and information dissemination.
The Agricultural Health Study (AHS) is one of the hallmark efforts currently underway on agricultural health in the United States. The study was initiated in 1993 by three lead organizations including: The National Cancer Institute (NCI), The National Institute of Environmental Health Scientists (NIEHS), and The US Environmental Protection Agency (EPA). The study uses a longitudinal cohort design and evaluates how lifestyle habits, genetic factors, and agricultural exposures at work and in the environment contribute to the risk of disease. Over 89,000 certified farmer pesticide applicators and their spouses from North Carolina and Iowa and licensed commercial pesticide applicators from Iowa are included in the study making it one of the largest agricultural health studies ever conducted in the United States.
Agriculture Health Study: Pesticide Exposure Among Farmer Applicators
The purpose of this project is to assess fungicide exposures, handling practices, and exposure determinants among orchard farmers participating in the Agricultural Health Study (AHS), a large prospective cohort study of farmers, spouses, and commercial applicators in North Carolina and Iowa. Captan will be measured in air, dermal patch, hand rinse, and urine samples collected on days farmers apply the fungicide. An AHS pesticide exposure intensity algorithm used to adjust cumulative exposure will also be evaluated.
Pesticide Exposure Studies
The purpose of this project is to evaluate pesticide exposures among workers and special populations exposed to pesticides, including farm children, farmers, and agricultural workers handling treated commodities. A secondary purpose of the project is to develop improved methods of exposure assessment for take-home exposures. There are three main objectives of this research study: 1) to evaluate the extent of home pesticide contamination and take-home pesticide exposures among families of farmers and agricultural workers; 2) to identify potential behavioral and environmental risk factors; and 3) to develop recommendations for the prevention of pesticide exposure to families of farmers and farm workers.
Health Survey of Minority Farm Operators
The purpose of this project is to provide national prevalence estimates for various health conditions, exposures, use of personal protective equipment, psychological distress, and health care access in white, minority, and female farm operators. This information will be disseminated to researchers, academicians, other government agencies, and State Agricultural Centers to reduce risk factors for adverse health conditions, and encourage the development of prevention and intervention activities to improve farm operator health.
Partnerships for Hearing Loss Prevention in Agriculture II
This is a feasibility study to determine the effectiveness of using members of influential agricultural community organizations to make agricultural workers aware of noise hazards that are inherent in agricultural settings by using NIOSH designed hearing loss educational sessions and pamphlets. Secondarily, the project will evaluate the diffusion of information into the community by means of a blog, where the members of these key community organizations can share the approaches they employed and who beyond their training participants were affected by the concepts and materials presented in their classes.
Community Partners for Healthy Farming Intervention Research
The purpose of the Community Partners for Healthy Farming Intervention Research (aka Community Partners) program is to utilize coalitions to implement and evaluate existing or new community-based interventions for reducing agriculturally-related injuries, hazards, and illnesses and to disseminate them, e.g. through intermediate audiences.
Pesticide Poisoning Surveillance Under SENSOR
This surveillance project provides intramural and extramural support for acute occupational pesticide-related illness and injury surveillance. Its goal is to support state-based surveillance systems and response activities, including: educational outreach to employers, workers, and health care providers; in-depth field investigations; worksite consultations; and referral to regulatory agencies. This project has a standardized case definition, severity index, and standardized core variables for acute pesticide-related illness and injury. The maintenance of a database software program (i.e., SPIDER) for collecting, managing and reporting the surveillance data is also done under this project. This surveillance activity identifies emerging pesticide hazards and populations at risk. It is also useful for assessing the magnitude and trends for this condition. Findings are important for guiding intervention and regulatory activities.
National Agricultural Workers Survey (NAWS) Health Surveillance
This project provides essential, ongoing occupational health surveillance of hired farm workers. By adding supplemental occupational health and hazard questions to the National Agricultural Workers Survey (NAWS) to describe the nature, extent and economic burden of occupational illness and hazards among hired seasonal and migrant crop workers, we can provide national occupational health prevalence data for agricultural researchers, advocacy groups, policy makers, and service providers. This project will improve data collection and existing databases to provide information on health disparities among vulnerable workers at risk workers.
Increasing Adoption of CROPS by Farmers and Manufacturers
The purpose of this project is to identify barriers from and approaches for stimulating farmers to retrofit their tractors with Cost-Effective Roll-Over Protection Structures (CROPS) using stakeholder input. The findings from this work will be incorporated into existing social marketing strategies developed through the National Agricultural Tractor Safety Initiative. It will also serve as a starting point to develop other marketing initiatives to increase the adoption rate of CROPS. Furthermore, this project will serve as a pilot to determine if using multiple approaches is an effective model for identifying barriers to adoption. If so, this model could be applied to engineering controls and other occupational safety and health interventions in future efforts to improve technology transfer.
Child Agricultural Injury Prevention
The goal of the Initiative is to reduce the risk of fatal and non-fatal injuries to child who live on, work on or visit farms. Since inception of the NIOSH Childhood Agricultural Injury Prevention Initiative, NIOSH has applied a triad approach of surveillance, research, and information dissemination. This project is designed to encompass the non-surveillance components of the Initiative. Activities within this project include: (1) Assuming a leadership role in federal efforts to prevent childhood agricultural injuries; (2) assisting in the development of a grant/cooperative agreement program to stimulate research and the use of empirical data to reduce agricultural injuries to children; (3) eliciting feedback from stakeholders on progress of the Initiative and strategies or ideas for improving research and prevention efforts; (4) providing technical and programmatic assistance to the National Children's Center for Rural and Agricultural Health and Safety; and (5) serving as a liaison for NIOSH research activities in order to achieve wide dissemination of research results to childhood agricultural safety and health practitioners.
Charting the Future of the North American Guidelines for Children's Agricultural Tasks
This project proposes to identify and convene a group of childhood agricultural safety and health experts to review the literature for scientific research which would impact recommendations in the current NAGCATs, plan a future course for the NAGCAT and provide recommendations for adding to or deleting any of the current NAGCATs. The goal is to have updated NAGCATs for the work which youth can safely do in agriculture based on child development principles and with the latest scientific evidence to plan a course of action for the continuation of the NAGCATs into the future. The continued relevancy of the NAGCATs to farm parents and encompassing the latest scientific findings as they relate to children’s safety while working in agriculture are of the highest concern.
Utilization of CROPS Designs in NYCAMH Retrofit Program
The objective of this research is to work collaboratively with agricultural partnerships to increase the use of CROPS on older tractor models without ROPS. This project will focus on two tractor models: the Ford 8N and Massey Ferguson 135. It will be an addition to the already established New York State ROPS retrofit program operated by The New York Center for Agricultural Medicine and Health (NYCAMH). The NYCAMH retrofit ROPS program has been in operation since November 2006. Since its inception 680 ROPS have been installed in New York State through their program.
ROPS Attribute Identification by Channel Intermediary
The purpose of this project is to establish stated preference criteria for characteristics of ROPS by members of a distribution channel intermediary with specialized and expert knowledge of design characteristics and constraints in adoption and supply, for the purpose of establishing user acceptance and rejection data for characteristics and attributes of protective equipment.
Occupational Injury Surveillance of Production Agriculture
The purpose of this project is to provide for the occupational injury surveillance needs of the agricultural production industry. Primary objectives are to monitor the magnitude and characteristics of fatal and nonfatal occupational agricultural injuries through the use of an ongoing periodic surveillance system. For nonfatal injuries, this has been accomplished through a series of surveys for determining the number of injuries occurring to farm workers in the US.
Childhood Agricultural Injury Surveillance
The purpose of this project is to provide a functioning surveillance approach to monitor childhood agricultural injuries in the US. Primary objectives are to track and assess the magnitude and characteristics of fatal and nonfatal injuries to youth on US farming operations. To achieve the objectives, NIOSH developed a surveillance system centered on relationships with the National Agricultural Statistics Service (NASS) and the US Department of Labor (USDOL). NIOSH provides funds to NASS to conduct surveys on farm operators to assess childhood safety and health issues occurring on farms. NASS provides the survey response data to NIOSH, who is responsible for data analyses and result interpretation.
Educational Products on Agricultural Hazards
This project will produce educational products on agricultural health hazards. Topics include recommendations for protecting workers from exposure to chemicals, including pesticides, and zoonotic agents. Prevention and control measures will be recommended. Partnerships will be pursued at the local, state, and national levels with interested agriculture and public health associations. These educational documents on occupational hazards will provide current information and recommendations to interested workers, employers, and public health officials. This project translates research into practice for safety and health professionals, employers, and workers in the agricultural sector.
Pandemic Influenza Guidance and Educational Products
This project will develop educational materials to address the needs of both poultry and swine workers for targeted easy-to-read materials that will inform them of their risks of exposure and provide recommendations for workplace protection. Partnerships will be developed with the poultry and swine industries, trade association, and related government agencies such as the USDA and NIEHS, to collaborate on these documents.
This project will also develop guidance materials for transportation workers to protect them from exposure to the pandemic influenza virus. Partnerships will be developed with other government agencies such as DHS and DOT to collaborate on the development of these documents. These guidance documents will be cleared through the HHS and OMB review systems and posted on pandemicflu.gov.
Fast Facts Safety & Health Cards for Immigrant Agricultural Workers
The purpose of this project is to produce easy-to-read, easy-to-understand educational materials that provide information about and recommendations for the prevention of agricultural health hazards for immigrant farm workers. Partners and stakeholders are currently being consulted on priority topics such as heat stress.
Immunodiagnostics for Occupationally Relevant Fungal Contaminants
The overall objective of this project is to identify and characterize the major allergens associated with hydrophilic and Pleosporalean fungi that are commonly encountered in agricultural, forestry and contaminated indoor environments.
PPT Surveillance in Agricultural Pesticide Handlers
The primary objective of the project is to determine the extent to which PPE practices are appropriate or inappropriate and to identify barriers to best PPE practices. A secondary objective of the study is to use the information obtained on barriers and practices in order to inform interventions and implement and evaluate them.
Prevention of Agriculture Fatalities and the Small-Farm Exemption
This project will examine whether the small farm exemption is a likely contributor to the occurrence of fatal injuries in agriculture. Ultimately, information developed by this project will be useful for reducing the high burden of serious and fatal injuries in the agriculture industry nationwide.
Improving Safety and Health for Forestry Service Workers
Through this public health practice project we will determine the best methods to provide occupational safety and health information to immigrant workers in the forestry industry using best practices and input from multiple stakeholders, implement a lay health worker program in one forestry worker community, evaluate the program and disseminate the findings.
Monitoring the Physiological Status of Loggers or Forest Workers with Smart Clothing
The purpose of the project is to 1) monitor the physiological responses to heat stress in a laboratory based study with subjects wearing logging PPE and exercising in an environmental chamber that exposes the subject to conditions similar to the logging environment, 2) monitor the physiological response to heat stress in loggers while “on-the-job” using wearable physiological monitoring systems, and 3) determine the efficacy of two hydration strategies (scheduled and ad libitum) on reducing heat stress in loggers.
Commercial Fishing Safety Research Program
The commercial fishing safety research program provides ongoing surveillance for fatal injuries in the commercial fishing industry. Information gathered has directed NIOSH and partners to identify areas where we can focus intervention efforts. NIOSH has provided epidemiologic assistance in describing the dangers of commercial fishing, developing interventions to decrease injuries in the industry, and evaluating the effectiveness of interventions.
Improving Stability of Commercial Fishing Vessels
The majority (52%) of fatalities among fishermen are due to the loss of a fishing vessel. This project seeks to decrease the number of fatalities due to vessels sinking by 50% by 2018 through targeted intervention research in three areas: epidemiological assessment, educational intervention, and engineering solutions.
Technology Transfer to Improve Safety in the Fishing Industry
The purpose of this project is to enhance the transfer of technology generated by the commercial fishing program to various stakeholders around the US by using a combination of traditional & social marketing techniques. The project will work on increasing adoption of the commercially available e-stop system for capstan winches. It will also focus on developing a public health campaign for the usage of Personal Flotation Devices (PFDs) to promote the findings of a recent evaluation project.
Extramural Funded Projects
Social Marketing of Rollover Protection: A Multistate Expansion
This project is testing the hypothesis that the social marketing approach employed in the New York State Tractor ROPS Rebate program model and its products can be adapted by state-based teams to produce an increase in farm tractor ROPS retrofitting in other states of differing characteristics. The NY team is assisting the state-based teams in completing formative assessments, audience segmentation, intervention design, pilot testing, and intervention introduction. State assets and stakeholder resources have been identified and recruited by an in-state project coordinator. Throughout this process instruments, techniques and messages developed in NY and elsewhere are available to the state teams for use or adaptation. Consultants in social marketing are assisting with formative work, message modification and marketing plans. The existing NY hotline assistance service is being re-designed to provide services to additional states. On-going evaluation is being done to seek shifts in behavioral intent among targeted farmers as well as increases in ROPS purchases tracked through the hotline. An assessment board composed of experts from other high-risk states meets every six months to evaluate adaptations to the NY model in each state and assess their impact. This project is systematically exporting the NY program to Pennsylvania and Vermont while simultaneously training experts from five other high-risk states. This is the first step to exporting a broadly successful approach to retrofitting rollover protection on farm tractors to other states. The grantee will disseminate a detailed understanding of this model and its adaptability to the five remaining states with the highest overturn fatality rates (WV, OH, KY, TN, and IL).
Evaluation of a Hearing Conservation Program for Farm Youth: A 15-Year Follow-up
The purpose of this study is to evaluate the long-term effectiveness of a 4-year hearing conservation program directed at junior and senior high school youth working in agriculture. The proposed study builds upon a previous NIOSH-funded randomized controlled trial conducted from 1992-1996. Former students who participate are being asked to complete a survey addressing occupational and recreational noise exposure and the use of hearing protection devices. They are also being scheduled for a pure tone audiometric threshold test. The results of the survey and audiometric threshold test will provide information on the role of early intervention in sustaining hearing protection behaviors and preventing noise-induced hearing loss in young workers. This is a rare and unique opportunity to develop a cohort study with long-term outcomes, and hence is quite important to occupational health.
Consequences of Agricultural Injuries
This research involves a cohort of agricultural operations in Minnesota, Wisconsin, North Dakota, South Dakota, and Nebraska. These states are representative of major types of agricultural production in the US, and are among the leading producers of crops and livestock in the nation. A randomly selected sample of 16,000 agricultural operations, generated from the lists of operations in these states, maintained by the USDA National Agricultural Statistics Service, was used in obtaining a final eligible cohort of about 4,000 agricultural operations (~16,000 persons total; ~8,000 persons aged 0-19). For all household members, including children/youth 0-19 years of age, baseline and follow-up data are being collected on health-related quality of life, including physical and mental health, disability due to agricultural injuries and other injury causes, and economic status. The injury experience (taking both agriculture and non-agriculture-related injuries into account) and concomitant short-term consequences will be determined prospectively for two six-month periods. In addition to description of injury incidence and associated characteristics, analyses will focus on identification of longer term (2.5 years) injury consequences, by examining potential changes between baseline and follow-up data, through a comparison between households with persons 0-19 years of age who incurred agriculture-related injuries and those that did not; relevant data are also being collected on adults to estimate and analyze rates and to control for potential confounding.
Pregnancy Health among Florida Farmworkers
Exposure to agricultural chemicals is a major occupational and reproductive hazard and other factors such as long periods of standing, exposure to heat and dehydration also have the potential to impact the health of pregnant women and their unborn children. In this exploratory study, investigators from Emory University and the University of Florida is partnering with the Farmworker Association of Florida and the Farmworker Health and Safety Institute to examine how female farmworkers assess the risks of certain environmental and occupational hazards to pregnancy. This partnership brings together experts in community-based participatory research and methods of education and organizing among farmworkers. Current perceptions of work hazards and pregnancy health among female farmworkers working in nursery and fernery operations in Florida and conduct a large community survey of the extent of exposures to heat, ergonomic and chemical exposures that have the potential to impact pregnancy outcomes among farmworker women are being examined. Biomarkers of pesticide exposure in a subsample of our female population are being assessed.
Development and Evaluation of a GPS-based Weeding System for Reducing the Risk of Musculoskeletal Disorders among Agricultural Workers
Weed control is a very important issue for farmers, particularly for those producing vegetable crops. Weeds are currently controlled by chemical herbicides and manual weeding, which is a strenuous task that exposes agricultural workers to various MSD and LBD risk factors. There is clear need to develop new and innovative methods of weed control in order to reduce the risk of musculoskeletal disorders associated with weed control, to reduce the introduction of herbicides into the environment, and to increase the competitiveness of farmers. The specific aims for this project are: 1) Develop a global positioning system (GPS)-based approach that can accurately map the location of each crop plant during transplanting, 2) Develop a weed knife system to remove weeds growing between the crop plants: a) Develop a GPS-controlled automatic weed knife for controlling weeds between plants; b) Develop the cutting system in such a way as to allow manual activation for use by small farmers and/or farmers who do not own a GPS system; 3) Develop a manual tool to replace traditional hand hoeing for precision weed control in areas close to the crop plant; and 4) Conduct biomechanical and subjective evaluations of the potential reduction in MSDs due to the newly developed approach as compared to the existing manual system.
Preventing Exposure to Ticks and Tick-borne Illness in Outdoor Workers
Tick-borne diseases represent a growing public health problem and an occupational hazard for outdoor workers. Currently, tick-bite prevention requires time-consuming reapplication of insecticides to clothing and exposed skin. Unfortunately, adherence to these procedures is poor. Recently, a factory-based method for long-lasting permethrin impregnation of clothing has been developed which allows clothing to retain insecticidal activity for over 70 washes (the effective lifetime of a garment). The treatment process has been approved by the US EPA and classified as non-toxic. Preliminary evidence from a small pilot project suggests that workers wearing this clothing have ~90% fewer tick bites than workers not wearing this clothing. This project is evaluating the effectiveness and safety of this clothing in protecting outdoor workers.
Reducing Pesticide Exposure in Farmworker Families: Research to Practice
Migrant and seasonal farm workers and their families are exposed to pesticides through occupational and para-occupational pathways. This population of contingent workers, largely born in Latin America, experiences a disproportionate level of pesticide exposure, relative to the rest of the US population. Research has established the health hazards of such exposure. Children and women are at special risk for adverse health outcomes, and may have significant risks due to their roles in the home, residence near treated fields, and use of pesticides in substandard housing. This project builds on over ten years of community-based participatory research (CBPR) conducted by a university-community partnership which has produced an effective lay health advisor intervention to reduce pesticide exposure among Latino farm workers and among their families. The goal of this project is to move an effective culturally- and educationally-appropriate pesticide safety intervention for farm worker families into public health practice. The specific aims are: (1) to implement a demonstration project translating an effective intervention to reduce pesticide exposure among families of Latino farm workers to a broader public health context; (2) to evaluate the potential translatability and public health impact of this pesticide exposure intervention; and (3) to disseminate the program through public health programs at the local, regional and national levels. This project will provide an effective, educationally- and culturally-appropriate pesticide safety program to families of Latino migrant and seasonal farm workers. Because pesticide exposure has long-term health effects on children and adults, this program can result in decreases in the neurological, cancer, and developmental defects that have been associated with exposure.
Non-Invasive Biomonitoring of Pesticides
This research project includes establishing a non-invasive biomonitoring capability to evaluate exposure to organophosphorus (OP) insecticides utilizing a sensitive, non-invasive, micro-analytical instrument for real time analysis of biomarkers of exposure and response in saliva. This project involves creating a miniaturized nano-bioelectronic biosensor that is highly selective and sensitive for the target analyte(s). In addition, a physiologically based pharmacokinetic and pharmaco-dynamic model (PBPK/PD) for the OP insecticide chlorpyrifos is being modified to incorporate a salivary gland compartment to quantitatively predict blood chlorpyrifos concentration and saliva cholinesterase (ChE) inhibition to estimate exposure based on a saliva specimen. The utilization of saliva for biomonitoring, coupled to real-time monitoring and modeling is a novel approach with broad application for evaluating occupational exposures to insecticides. An OP sensor will be developed based on a new biosensing principle of antigen-induced formation of nanoparticle-immuno complex nanostructure. A ChE sensor will also be developed based on the electro-detection of the ChE hydrolyzed reaction products choline and hydrogen peroxide.
Strategies for Safety of Older Adult Farmers
Farmers over age 55 make up over one-half of the principal operators of the 2.2 million US farms, with over 25% of the farms being operated by farmers over age 65. Fatalities to older farmers comprised over half of all adult farm fatalities between 1992 and 2004. Currently, there are no guidelines for fitness for work of aging farmers. Although farmers may be well informed about safety practices, knowledge alone is not enough to change behaviors. Strategies for safety that engage the farmer in decision making about his/her farm work choices and injury risks, that are founded on sound principles, and that include input of farmers and other professionals, should be developed. This exploratory project is a result of the first conference on the aging farmer, recent research on work and health of the aging farmer conducted by the Principal Investigator, and recently completed inquiry on aging farmer work guidelines in Canada. The project combines the expertise of leading researchers to take the first step toward injury prevention interventions that can be used by farmers and those that interact with them. This is replicating the consensus-development methodology used to develop The North American Guidelines for Children’s Agricultural Tasks (NAGCAT). The long term goal of the project is to develop strategies and products to assist older adults and their families in selecting appropriate and safe farm jobs that are acceptable to the senior farmers and their families.
Measures of Dust, Endotoxin, and Exhaled Nitric Oxide among Dairy Farm Workers
Respiratory disease is more common among agricultural workers compared to workers in other industries; however, little attention has been given to workers in the dairy industry. Over the past decade, the dairy industry has changed to rely on more employees. These workers may be exposed at a greater magnitude and duration to agents which cause lung inflammation. The presence of lung inflammation may also be an indicator of asthma, chronic bronchitis, or chronic obstructive pulmonary disease (COPD). Exhaled NO (eNO) has been used extensively as a tool to diagnose asthma and measure the effectiveness of asthma treatments, however eNO has not been used to evaluate lung inflammation among large herd dairy farm workers. Therefore, this study is measuring eNO among a sample of large herd dairy farm workers. Occupational exposure to dust and endotoxin are also being assessed among these workers. This project will provide information about dust and endotoxin exposures that dairy farm workers experience. It will also provide information about the relationship of exhaled nitric oxide and pulmonary symptoms to these dust and endotoxin exposures. Learning more about the magnitude, sources and health impact of these exposures will allow for the development of prevention strategies.
Targeting Airway Inflammation from Concentrated Animal Feeding Operation Dust
Farmers and workers in concentrated animal feeding operations (CAFOs) experience work-related respiratory disease, particularly chronic bronchitis and chronic obstructive pulmonary disease (COPD). Although multiple substances in CAFOs may contribute to disease, dust from these facilities is well recognized as an important respiratory health hazard. Previous work has focused on defining mechanisms by which CAFO dust results in lung inflammation. We have identified three critical elements of this CAFO dust-induced lung inflammation mechanism that we propose make excellent therapeutic targets for treatment of this important occupational lung disorder: 1) cytokine release, focusing on the TNF-alpha-dependent airway epithelial cell release of IL-6 and IL-8 with sequential activation of the airway epithelial protein kinase C isoforms (PKC), alpha followed by epsilon; 2) the anti-inflammatory effects of the cyclic AMP dependent protein kinase (PKA); and 3) pro-inflammatory proteases as triggers present in CAFO dust. We hypothesize that: CAFO dust-induced lung inflammation is treatable by blocking PKC isoform-triggered airway cytokine release, activating PKA and inhibiting dust-derived proteases and their cellular targets. This hypothesis is being tested via three specific aims: Aim 1: Establish how agents that specifically target TNF-alpha, IL-6, and IL-8 modulate dust extract-induced lung inflammation in vivo. Aim 2: Determine how agents that augment PKA, especially therapeutic beta-adrenergic agonists, dampen dust extract-induced PKC isoform activation and attenuate lung inflammation in vitro and in vivo. Aim 3: Determine the importance of proteases in dust extract-induced TNF-alpha/IL-6/IL-8 in vitro and in tissue inflammation in vivo and identify potential targets for attenuating the dust extract protease-induced inflammatory changes. This project is designed to provide pre-clinical cell, lung slice, and animal data that facilitate translational studies aimed at bringing potential interventions into the workplace.
Farm Worker Family Health Cohort Study
Hired farm workers provide the majority of the workforce for California's labor-intensive agricultural sector, and they also suffer the greatest health burden. California's hired farm workers face increased risks of morbidity and mortality from respiratory disease, musculoskeletal problems, infectious diseases, stress- related mental health disorders and lifestyle-related diseases such as obesity. The overall goal of this project is to continue with a longitudinal follow-up of a cohort of hired farm worker families in California that was established through supplemental funding from NIOSH. This project involves two follow-up assessments of the MICASA study cohort in Mendota, California to assess the incidence and prevalence of diseases in this population. These follow-up assessments are being conducted with the 400 families comprising our farm worker cohort in Mendota. All MICASA study participants (both the head of household and spouse) will be interviewed twice during the five-year study period. Pulmonary function, vital signs and anthropometric measurements will also be taken at two time periods in the population. The exposure assessment component is collecting quantitative data on particulate exposure in this population.
Irrigation Workers' Exposures to Antibiotic-resistant Bacteria and Antimicrobials
In agricultural environments, an important potential source of exposure to resistant bacteria and antimicrobial residues is reclaimed wastewater used for irrigation. However, exposures to these agents among irrigation workers have not been fully evaluated. The long-term goal of this study is to improve understanding of wastewater irrigation workers’ exposures to antibiotic-resistant bacteria and antimicrobials in two regions that are characterized by different climates. The central hypothesis of this study is that spray irrigation workers are exposed to these infectious and other agents through both inhalation and dermal routes of exposure. Our specific aims are as follows: 1) To evaluate air, wastewater, dermal swab and nasal swab samples collected during wastewater irrigation activities at sites in Maryland and Texas for the presence of antibiotic-resistant Staphylococcus aureus and Enterococcus spp.; and 2) To evaluate air and wastewater samples for the presence of residues from commonly used antimicrobials, including oxacillin, tetracyclines, and triclocarban.
Community/Worker Exposures to Pathogens from Industrial Food Animal Production
The overall goal of this project is to develop the evidence base for community and workers to respond to shared risks of pathogen exposures in rural areas where industrial food animal production operations are located. The overall hypothesis is that workers in food animal production and nearby communities share risks of exposure to and health impacts from exposure to community associated methicillin-resistant Staphylococcus aureus (CA-MRSA) of livestock origin, which is an emerging public health issue of major proportions in the US and for which there is growing evidence that industrial food animal production is a significant source especially for farmers, farm workers, and rural communities. The project is being carried out in partnership with representatives from community and national Non-Governmental Organizations (NGOs), labor unions, and other research groups. We will provide information on the following: (a) what is the prevalence of MRSA exposure in workers and communities in IFAP areas, (b) what are the workplace factors associated with risks of occupational exposure; (c) what are the pathways by which occupational exposures affect community health, including social networks and geospatial proximity, by which pathogen exposures may be transmitted across the work/environment nexus and among communities; (e) what populations are at special risk; and (f) what are the tractable barriers to risk reduction and effective actions by communities, public health officials, and government at all levels. The results of this research will be translated into public health actions through partnerships with communities, NGOs and labor. An accessible program for evaluation will be developed to ensure policy effectiveness and empowerment of labor and community stakeholders in this process.
Investigation of Occupational Exposure to and Infection by MRSA in Rural Iowa
The primary objectives of this project are to determine the prevalence of MRSA on Iowa livestock farms, and in farmers and their animals; to determine the duration of carriage of this bacterium and extent of secondary transmission to family members; and to determine the frequency and severity of symptomatic illness caused by this bacterium. Preliminary work, together with reports from Europe and Canada, suggest the emergence of another potential MRSA risk group: individuals in contact with live swine and other animals. Therefore, this organism is viewed as an emerging occupational hazard for livestock workers. Pilot studies have documented the presence of MRSA in US swine. We are building on this research to examine the epidemiology of MRSA, and methicillin-susceptible S. aureus (MSSA), in individuals in contact with livestock. We are also examining the molecular epidemiology of MRSA on farms, determining the frequency of different MRSA strains in occupationally-exposed individuals, and determining risk factors for colonization and/or infection with these (for example, working with swine versus cattle versus poultry, wearing protective gear, etc.).
This project involves developing a portable device that will protect firefighters from superheated air and carbon monoxide (CO) when trapped inside a fire shelter. Each year an estimated 80,000 fire fighters battle wildfires, spending long durations at the fire front where they are exposed to high levels of smoke and heat. Sudden changes in weather or fire conditions increase the chances of being entrapped by a wildfire or caught in the burnover of an advancing fire front. The single largest cause of death or injury is heat-damage to the airways or lungs, caused by breathing superheated air; this risk is actually greater than that from external burns. Fire experts stress that the MOST important aspect of protection when working near a wildfire is to protect the respiratory tract. Currently, there is no suitable device available to protect fire fighters from exposure to these dangers.
Agriculture, Forestry, and Fisheries in the Southeast: Immigrant Worker Health Conference
In October 2010, 22 occupational health researchers, health care providers, and advocates met to (1) consolidate and disseminate current knowledge on immigrant agriculture, forestry, and fisheries workers’ health and safety by commissioning experts to write reviews of the health and safety problems facing these workers; (2) delineate the most pertinent directions and areas for health and safety research for immigrant agricultural, forestry, and fisheries workers through the presentation and detailed discussion of the commissioned reports; and (3) facilitate the development of working groups to support the implementation of research, education, and engineering projects that can address the major directions and areas identified during the conference. Five reports based on this conference are being completed for publication in a refereed occupational health journal:
- Overview of Immigrant Worker Occupational Health and Safety for the Agriculture, Forestry, and Fisheries Sector;
- Organization of Work in Agricultural, Forestry and Fishing Sector;
- Health Care Workforce for Immigrant Workers in Agriculture, Forestry and Fisheries in the Southeast;
- Occupational Health Outcomes of Immigrant Workers in the Agriculture, Forestry and Fisheries Sector for the southeastern US, and
- Occupational Health Policy in the Agriculture, Forestry and Fisheries Sector.
Training Project Grants
Training Projects Grants are supported by NIOSH at academic institutions that primarily provide single-discipline graduate training in the industrial hygiene, occupational health nursing, occupational medicine, occupational safety, and closely related occupational safety and health fields.
Training Project Grant: Agricultural Safety and Health Training for Public Health Graduate Students
This project supports a Health of Agricultural Populations (HAP) Emphasis Area designation for students seeking a Master of Public Health (MPH) or Doctor of Public Health (DrPH) degree. Agricultural safety and health training is included across traditional public health coursework, research training and field experiences. Cross-cutting competencies for occupational safety and health in agriculture have been added to four public health disciplines: health services management, health behavior, epidemiology, and environmental health. MPH students in the HAP Emphasis Area take 20 semester hours directly related to agricultural health and safety and injury research. DrPH students must complete 23-29 semester hours. The University of Kentucky is committing $58,128 per year for tuition for students enrolled in this emphasis area. The program is increasing the number of public health practitioners and researchers who address agricultural occupational problems through prevention, intervention, practice and research.
Training Project Grant: Innovative Training for Occupational Medicine Residents in Non-Urban and Ag Settings
Despite centuries of recognition of the contribution of workplace factors to human health, disease, injury, disability, and death, occupational medicine remains an obscure specialty within the health care community. Following passage of the Occupational Safety and Health Act of 1970, there was a rise in the number of accredited residency training programs in occupational medicine, reaching a peak in the mid-90s. Since then, the number of such programs has declined rapidly by almost 25 percent in spite of a recognized shortfall of physicians with formalized training in this area. Rural communities in particular often lack the infrastructure for developing and sustaining a preventive approach to occupational disease and injury especially for specific work sectors such as agriculture and where the hired workforce may constitute the majority of employees. The objective of this project is to bring a dimension of training which concentrates on the occupational health needs of the rural workforce with special emphasis on agriculture. Specific aims for this training project are to:
- Sustain and improve the supply of qualified physicians, with specific competency skills, needed to address occupational health concerns in non-urban areas.
- Increase the number of occupational medicine residency graduates with training in agricultural occupational health regionally (Texas).
- Increase training opportunities in agricultural occupational health in 4 other US Public Health regions, through appropriate clinical rotations and field experiences.
- Enhance occupational medicine resident understanding of responsible and culturally appropriate research activities through formal instructional tools, awareness of current research activities, and creation of opportunities for participation in research projects sponsored by the NIOSH Agricultural Centers.
- Nurture partnerships for interdisciplinary clinical experience between regional accredited occupational medicine residency programs and community/migrant health centers through collaboration with the National Center for Farmworker Health (NCFH).
Training Project Grant: Commercial Fishing Safety Training-Continuing Education
The mission of AMSEA is to reduce the loss of life and injury in the marine environment, especially in commercial fishing. Commercial fishing is one of the top two most dangerous workplaces in the US. The long term goal of this project is to reduce the fatality rate in commercial fishing in Alaska. This is being accomplished by the following objectives:
- Enlarge the port based AMSEA instructor network through periodic regional Marine Safety Instructor Training (MSIT). This provides Alaska's far flung fishing ports with at least 20 new locally based qualified instructors per year, who can in turn instruct marine safety equipment and procedures. A least one of these MSIT courses may take place outside Alaska to create needed regional training infrastructure.
- Continue to provide updated instructional material to fishermen and fishers. These instructional materials make use of NIOSH, Coast Guard and National Transportation Safety Board statistics and casualty recommendations and include at least 3 issues of Marine Safety Update to 1,500 mariners per year.
- Continue to provide federally required Drill Instructor training to at least 350 people a year.
- Make available Drill Instructor refresher training to at least 65 people a year. Refresher training has been demonstrated to be vital (Lincoln, 2002) to improve survivability during a maritime casualty.
- Conduct one MSIT refresher course per year to update instructors in effective teaching and content.
- Continue to assess the relationship between the training in this project and survivability post casualty.
- Conduct a study on skills retention as a basis to educate about the need for refresher training.
NIOSH Agricultural Safety and Health Centers
The Centers for Agricultural Disease and Injury Research, Education, and Prevention represent a major NIOSH effort to protect the health and safety of agricultural workers and their families. The NIOSH Agricultural Centers were established as part of a Centers for Disease Control and Prevention (CDC) / NIOSH Agricultural Health and Safety Initiative in 1990. The Centers were established by cooperative agreement to conduct research, education, and prevention projects to address the nation’s pressing agricultural health and safety problems.& Geographically, the Centers are distributed throughout the nation to be responsive to the agricultural health and safety issues unique to the different regions.
High Plains Intermountain Center for Agriculture Health and Safety (HICAHS)
The High Plains Intermountain Center for Agricultural Health and Safety (HICAHS) at Colorado State University has an outstanding record of service to Public Health Region VIII (Colorado, Montana, North Dakota, South Dakota, Utah and Wyoming). HICAHS has been nationally and internationally recognized for research on organic dust aerosols and respiratory disease, pesticides and tractor roll-over protective structures (ROPS) engineering. Education and outreach, built on strong partnership with Cooperative Extension, have served as national models. The mission of HICAHS is to reduce morbidity and mortality in the agricultural population and translate research knowledge into community action. This Center has also coordinated the Agriculture Center Evaluation Project.
Individual HICAHS Center Projects
- Injury Risk Analysis in Large-Herd Dairy Parlors
This novel project is the first US study to address the health and safety of large-herd dairy workers. It is significant because of the national trend toward mass milk production operations and the lack of research addressing these new work environments. The long-term goal is to reduce the incidence of musculoskeletal injuries among dairy workers. Four primary aims are being addressed: 1) identify upper extremity risk factors associated with musculoskeletal symptoms (MSS) among workers in parallel, rotary, and herringbone style dairy parlors, 2) assess the risk for traumatic injury as related to worker body positioning and animal behavior in different parlor configurations, 3) determine the 12-month prevalence of MSS among workers in three types of dairy parlors, 4) determine the association between parlor exposures or personal factors with prevalent MSS among workers, and 5) identify safety interventions through active participatory partnerships with dairy operators. These aims are being accomplished using worker surveys (N=444), analysis of milking tasks from dairy parlors (N=50 dairy parlors) and focus groups with parlor workers (N=108). Multivariate analysis is being used to test the hypothesis that upper extremity MSS are associated with dairy parlor work stressors after controlling for potential confounding variables.
- Prospective Study of Occupational Lung Disease and Endotoxin Exposure in Naive (New) Dairy Workers
More than 1M dairy workers nationwide, mostly Hispanic, are at risk for respiratory disease from organic dust aerosols. The goals are to: characterize worker exposure to endotoxin-containing aerosols and evaluate respiratory outcomes including symptoms, pulmonary function and cellular/immune markers (cytokines) of inflammation (n = 184); compare exposures and health outcomes among Colorado dairy workers to a comparable study of California dairy workers (n = 200) (conducted by the Western Center for Agricultural Health and Safety); re-evaluate a subset of new (naive) workers (n = 92) at 1 month (n = 92) and at 1 year (n = 46) following their first assessment; evaluate whether endotoxin assay or GC/MS is the best predictor of biomarkers, symptoms, and changes in pulmonary function; survey genetic markers related to lung disease and endotoxin etiology TLR4, TLR9, MD2, CD14 gene mutations, and polymorphisms of IL1-RN, and TNF-alpha.6); and identify job factors associated with highest exposures/greatest risk of respiratory disease. HICAHS is working closely with the Integrated Livestock Management Initiative and the dairy industry to develop and disseminate cost-effective, culturally acceptable interventions.
- The goal is to boost the regional research to practice (r2p) of new knowledge and technologies in agricultural health and safety. The project builds on a foundation of established agricultural partnerships and a team of cross-disciplinary investigators from occupational health, animal science, technical communication, and occupational health psychology. Knowledge generated from community-initiated health and safety programs and from HICAHS research projects are being translated into user-specific media and disseminated using a participatory Agricultural Extension Model. Specific aims include: 1) augment regional agricultural health and safety education programs and 2) enhance the translation and dissemination of knowledge developed from agricultural community-initiated small grants and from HICAHS research to agricultural stakeholders. The project team is collaborating with agricultural organizations that have received community-initiated small grants and with HICAHS researchers involved in prevention and intervention projects, to collectively develop, revise, and execute their respective translation and dissemination activities.
Enhancing Translation and Dissemination through Agricultural Partners
Great Plains Center for Agricultural Health
The Great Plains Center for Agricultural Health (GPCAH) at The University of Iowa is a nationally recognized public health resource that develops and implements programs of research, intervention, translation, education, and outreach with the long-term goal of preventing occupational injury and illness among agricultural workers and their families.
The overall goals of the center are to:
- Conduct a multidisciplinary agricultural health and safety research program targeting national research priorities for agricultural health and safety.
- Develop and evaluate educational, outreach, and intervention programs to prevent disease, injury, and hazardous exposures among agricultural workers and their family members.
- Serve as a national resource for delivery of current agricultural health knowledge and expertise to industrial hygienists, epidemiologists, ergonomists, veterinarians, and physicians to enhance the national capacity to meet the agricultural health needs of the nation.
- Provide agricultural health and safety technical assistance and consultation in research methods, training, and education to health and safety professionals and community-based agricultural health organizations.
- Maintain and strengthen linkages with health professionals in academic institutions, state and federal agencies, and international organizations to promote agricultural health and safety research, training, and prevention programs
Individual Great Plains AG Center Projects
- Determinants of Gas and Dust Exposures Among Swine Workers
The long-term goal of this project is to protect workers from inhalation hazards in swine confinement buildings. The primary objective is to identify tasks and building characteristics that cause significantly elevated concentrations of gases and dusts in these buildings.
- The Keokuk County Rural Health Study: The Epidemiology of Agricultural Diseases and Injuries
The Keokuk County Rural Health Study (KCRHS) is a population-based, prospective study on the health status and environmental exposures of a large, stratified, random sample of residents in a rural Iowa County. The KCRHS focuses on primarily on injury and respiratory disease. The overall goal is to provide the scientific basis for agricultural disease and injury interventions through evaluations of health outcomes and risk factors.
- Building Capacity of Health and Safety Professionals
This project provides specialized training for health care professionals who treat farmers and their family members. Certificate and graduate programs at the University of Iowa also address the critical shortage of agricultural occupational health and safety researchers and program leaders by educating agricultural safety and health instructors. These “train the trainer” strategies support translation of research information into practice and help to disseminate educational and intervention programs. The project recently experienced another dramatic increase in activity. This was primarily due to incorporating distant learning methods (online courses and the use of systems such as Adobe Connect) to bring speakers to more distant sites (Vermont, Illinois) where the program was given.
National Children's Center for Rural and Agricultural Health and Safety
NCCRAHS strives to enhance the health and safety of all children exposed to hazards associated with agricultural work and rural environments. The major focus is to translate research findings into practice and to move childhood agricultural safety knowledge into practice through sustained partnerships. The Center conducts research, education, intervention, prevention, translation and outreach activities to enhance the health and safety of children exposed to hazards associated with agricultural work and rural environments. The Center provides a wide range of services related to children and adolescents living in rural areas and working in agricultural environments. NCCRAHS has a track record of synergistic efforts addressing national priorities while involving a range of stake-holders. Since 1997, NCCRAHS has been a leader in: (a) building new partnerships, (b) conducting research with practical implications, (c) generating consensus on complex issues, and (d) producing resources deemed useful to multiple audiences.
Individual Child Ag Center Projects
- Economics of Youth Farm Labor and Farm Injuries
This project is assessing the economics of youth working on family farms and the economic consequences of farm youth injury. Specific aims are to: estimate the number and cost of injuries and deaths of youth while working or living on a farm, with breakdowns by type of farm, by region, and by major source/event (e.g., tractor injury); estimate the permanent disability resulting from youth injury on farms; estimate the financial impact of youth injury on farm families for some types of farms; and compare injury rates and severities for hired youth, family youth, and adults doing farm work and analyze the cost-effectiveness of not letting children work on some type of farms from the perspective of a farm family.
- Motivating Farm Parents to Create Safe Play Areas on Farms: A Randomized Controlled Trial
This project is testing incentives to overcome barriers to building safe play areas. This project is a randomized controlled trial among three groups to evaluate the effectiveness of specific interventions to motivate parents to build safe play areas. An innovative element is a three-way partnership between a large insurance company, the National Children's Center for Rural and Agricultural Health and Safety, and the University of Iowa.
- Integrating Safety Guidelines for Adolescent Farm Workers into Field Supervisors' Practice
The long-term goal of this project is to improve agricultural supervisors' practices related to training and supervision of adolescent farm workers. This project uses newly developed Safety Guidelines for Hired Adolescent Farm Workers resources and currently existing training venues to test a new method for conducting training among field supervisors in production agriculture. Results from this project will demonstrate whether or not there is potential for influencing changes in owner/employer expectations of their field supervisors who train and supervise adolescent farm workers.
- Stakeholder Communications
The goal is to facilitate dissemination of outreach, intervention, education, and research outputs to a diverse, inclusive group of stakeholders. The specific aims will be accomplished by Children's Center staff and collaboration with internal and external partners proficient in maximizing dissemination to all potential audiences.
- Childhood Agricultural Safety Network
The overall goal is to strengthen partnerships and collaborative initiatives involving the agricultural community, child injury prevention organizations, and minority-serving associations through an effective Childhood Agricultural Safety Network (CASN). An effective Childhood Agricultural Safety Network can advocate for major changes on behalf of children who live and/or work on farms. CASN members serve as Knowledge Translation Advisors. Various Center projects call on CASN members to provide general guidance or participate as venues for translation of findings into appropriate avenues for outreach and community level interventions.
- Blueprint for Knowledge Translation
The goal is to move state-of-the-art knowledge on childhood agricultural injury prevention into practice. Specific aims are to: gather and synthesize findings from childhood agricultural injury research and interventions that have been conducted since the 2001 Summit on Childhood Agricultural Injury Prevention; identify strengths and weaknesses of known interventions based on: a) injury data, b) different audiences, and c) different levels of the Ecological Model; engage researchers, practitioners, and other stakeholders in developing a Blueprint for Childhood Agricultural Injury Prevention Knowledge Translation; activate the Blueprint through intermediaries and innovative technological communication strategies; and continually assess, modify, and expand translation opportunities based on participant feedback and updated knowledge regarding effective interventions and injury trends.
The Northeast Center of Agricultural Safety and Health
The Northeast Center (NEC) is a collaborative effort of investigators from institutions throughout the New England and Mid-Atlantic States. It is based at the New York Center for Agricultural Medicine and Health (NYCAMH) in Cooperstown, NY. NYCAMH was established by the New York Legislature in 1987 with funding to address research, educational and clinical consultative needs related to occupational problems in New York farming. Serving a twelve-state region from Maine through Delaware, NEC promotes farm health and safety research, education, and prevention activities. In partnership with other NIOSH centers, state and federal agencies, land grant universities, medical centers, and farm groups, NYCAMH/NEC uses injury and illness research findings to develop preventive teaching, educational health screening, demonstrations, interventions, engineering solutions and other related activities. NYCAMH/NEC's target audience includes: farmers and farm families, high school and college agricultural classes, vocational agriculture teachers, agribusiness and farm organizations, health professionals, engineers and safety specialists, members of the media and policy makers.
Individual Northeast Center Projects
- Social Marketing of Rollover Protection in New York, Vermont, New Hampshire and Pennsylvania
The long-term goal of the tractor initiative at the NEC is a reduction in fatalities and serious injuries due to tractor rollovers on Northeastern farms. The project has had an amazing response, and continues to be quite active. Farmers may apply for 70% of all costs (up to $765 maximum) for one tractor in this fourth year of the rebate program. To date there have been over 2607 inquiries about the program, and over 862 have purchased their ROPS with program assistance. Articles highlighting these programs and tractor safety efforts have been published in USA Today and the Wall Street Journal, as well as many popular farm journals and regional and local newspapers. Additionally, in a recent survey, 12% of the farmers responding reported dangerous incidents where death or injury was likely avoided due to the ROPS and seatbelt. Recent efforts have been dedicated to launching programs in VT, NY and PA, evaluating program impacts in all four states, ensuring rebate funding through state legislatures, agribusinesses, insurance companies and farm organizations and developing a risk assessment tool that will function to remind farmers to use protected tractors for dangerous tasks. Considerable energy has also been dedicated to documenting ROPS parts and installation issues and working with manufacturers to address these issues. Upcoming efforts will be directed towards implementing the risk assessment tool and the associated safety campaign, evaluating program impacts, and working with private industry and farm organizations to sustain the viability of these programs long-term. Preliminary evaluations indicate that these efforts have and will continue to increase the installation of these proven safety devices on unprotected tractors with attendant prevention of death and serious injuries.
- Research to Practice for Safe Entry into Confined Space Manure Storages
The long-term goal of this project is to reduce injuries and deaths related to asphyxiation and poisoning of personnel as a consequence of entering improperely ventilated on-farm confined-space manure storages. The specific objectives are to 1) develop and obtain approval/adoption of an ASABE/ANSI consensus safety standard for pre-entry ventilation of on-farm confined-space manure storages, and 2) develop an outreach educational program to promote implementation of the provisions of the consensus safety standard by a wide range of key clientele including farm families, emergency service providers, and dsigners, manufacturers, distributers, or installers of on-farm confined-space manure storages. Both have been achieved by the research team.
- Northeast Community Collaborations for Farmworker Health and Safety
The Northeast Community Collaborations for Farmworker Health and Safety Project is a participatory-based occupational health intervention in a community of migrant farmworkers in the Connecticut River Valley (CRV). It is being networked with existing community-based initiatives in Maine and New York. The intervention program builds on existing relationships and strengths among the coalition members to support an alliance of community teams with the capacity to intervene locally on recognized occupational health threats throughout the region.The project is evaluating the effect on previously observed rates of occupational injury or illness within the local community. Based upon priority decisions by a team of workers and employers hygiene and access to handwashing in the fields have been pursued in recent years. Additional work on noise exposure and back injury has been undertaken.
- Statewide Surveillance of New York State Farm Injuries
The surveillance research has identified the strengths and weaknesses of several different existing sources of farm injury data, and proposes a method of combining them to establish one comprehensive surveillance system that will make it possible to track fatal and non-fatal farm injury in a single system. In the past five years, researchers have focused on evaluating the potential of pre-hospital ambulance reports, and have established that non-fatal farm injury in New York state occurs roughly 14 times more often than fatal injury. In the next five years, researchers will further develop a surveillance model that may have utility for occupational injury surveillance across the U.S.
Other Northeast Center Translation Projects
The NEC ergonomic apple bucket has been extensively redesigned and is undergoing further orchard testing. The belt and bucket are undergoing further adjustments as advised by farmworkers in the orchard. At the same time, a new instrument that attaches to the apple bin is being developed and piloted, whose purpose is to reduce back strain while bending to unload the bin. Concurrently, an orchard safety video is being produced, that focuses primarily on ladder safety, ergonomics and use of appropriate eyewear.
The NEC Migrant Clinicians Manual was designed to enhance the occupational health skills of physicians and nurses working in migrant health clinics. In its current revision (2011), researchers are collaborating from several NIOSH agricultural centers to develop similar farmworker profiles, which describe common health issues for migrant and seasonal workers in particular agricultural sectors. During this revision, the website is being expanded, and its technical capabilities greatly enhanced.
Pacific Northwest Agricultural Safety and Health Center
The Pacific Northwest Agricultural Safety and Health (PNASH) Center is located at the University of Washington. It serves Alaska, Idaho, Oregon and Washington with the goal of reducing occupational disease and injury among agricultural operators, workers and their families. The Center is focused on safe and sustainable agricultural workplaces and communities with an emphasis on injury and illness prevention, especially among hired laborers, migrant/seasonal workers, and children. Their approaches include:
- Working in partnership with employers, workers, agencies and other research and service organizations.
- Developing innovative research and intervention programs that focus on problem solving.
- Taking solutions to the workplace through training, outreach, and participatory research.
Individual PNASH Center Projects
- Risk Factors for Cholinesterase (ChE) Depression Among Pesticide Handlers
This study is identifying and characterizing risk factors for ChE depression among handlers participating in the Washington State ChE monitoring program. To date, a total of 265 agricultural pesticide handlers have been enrolled in this study. During the past year, 48 handlers participated in the study, with a total of 50 visits (i.e., occasions when participating handlers completed the survey and/or provided a blood sample for PON1 testing). Self-reported information about potential sources of pesticide exposure was collected for a total of 50 participant visits during the 2010 spray season. Descriptive analyses of survey data from 154 study participants during the 2006-2007 spray seasons have been performed, and there is an ongoing analysis of the 2006-2010 data that will be completed by the end of 2010. Identified risk factors will be evaluated in terms of their impact on the prevalence of ChE depression and the prevalence of reported risk factors among participating handlers.
- Neurobehavioral Assessment of Pesticide Exposure in Children
The objective of this project is to identify and characterize organo-phosphorus pesticide exposure in the homes of pesticide mixer-loader-applicators and to relate those exposures to neurobehavioral performance of children of pesticide applicators over two years in a longitudinal study that examines neurodevelopmental changes. Two hundred and forty five families have completed home interviews and neurobehavioral testing. Dust samples were collected from homes where carpet was available (N=254). These samples are being analyzed at the University of Washington laboratory. Families tested in the winter of 2009 have been contacted and asked to complete questionnaires assessing pesticide exposure in the past year and to collect a second dust sample from their home. Eighty two of these families have completed the second year interview and neurobehavioral test session. Computer-based training (Safe Workplace, Safe Home/Sitio de Trabajo Seguro, Hogar Seguro) has been developed, and was given to 470 adults at the Hood River County Fair during 2010. Pre- and post-test knowledge was assessed along with demographic information.
- Enhancements to Cholinesterase Monitoring: Oxime Reactivation and OP-Che Adducts
This project is developing and validating two analytical methods to measure the interaction of OP pesticides with cholinesterase enzyme. The assays developed during this project will be incorporated into the OP pesticide exposure monitoring in Washington State.
- Interventions to Minimize Worker and Family Pesticide Exposures
The overall objective of this five-year project is to identify and test practical interventions that reduce pesticide exposures of agricultural workers and their families, and to disseminate these "best practices" into agricultural workplaces and workers' homes in the Northwest and around the nation. In Year 4, 32 practical solutions were identified by worksite walk-through evaluations and personal interviews with the farm mangers and pesticide handlers. All solutions were innovations developed on the farm. Twenty practical solutions have been evaluated by 29 pesticide safety educators and orchard managers (in English and Spanish). Solutions have also been evaluated by Hispanic pesticide handler audiences using an audience response system. The project has validated a quantitative method for using fluorescent tracers to evaluate application technologies.
- Introducing a Cholinesterase Test Kit into Clinical Practice
The Test-mate™ kit has been shown to be an effective, cost-efficient test that can provide rapid results for workers - important if they are shown to have a ChE depression. The center is bringing this technology to clinical providers and allowing them to conduct “on-the-spot” evaluations of workers.
- Storytelling to Translate Agriculture Health and Safety Research
This project uses the tradition of storytelling to translate health and safety research findings and education efforts for agriculture producers and workers on ladder injuries and heat stress. Three-minute Story Corps narratives were developed for placement in communication channels: manure pit entrapment, harrow rollover, combine amputation, fatal encounter with a bull, cervical spine fracture from hay bale blow, ladder fall, ATV rollovers (one fatal and one near miss), child finger-burn from a hay baler, and a tractor (with ROPS) rollover incident. Four comic dramas demonstrating the risk factors, signs and symptoms, and treatment of 5 heat illnesses were aired on two Spanish-language stations covering the northwestern and central eastern regions of the state. Both stations aired the novelas on a rotating basis at least three times per day.
- Assessment of Job-related Exposures for Diarrheal Illness in Farmworker Families
The primary objective is to assess job-related exposures for farmworkers and their families to three common zoonotic bacterial pathogens (Salmonella spp., Campylobacter spp., and E.coli O157:H7). The specific aims are to: adapt, develop, and/or validate methods for sampling of bacteria on surfaces (e.g. vehicle and household carpets, worker apparel, and other workplace, vehicle and household surfaces); assess fomitic surfaces, bioaerosol, and water as workplace exposure pathways; assess the paraoccupational (or take-home) exposure pathway for three zoonotic pathogens (Salmonella spp., Campylobacter spp., and E.coli O157:H7); and assess residential proximity to job-related livestock operations as an exposure pathway.
Southeast Center for Agricultural Health and Injury Prevention
The Southeast Center for Agricultural Health and Injury Prevention at the University of Kentucky is dedicated to developing and promoting transdisciplinary approaches to the occupational safety and health of agricultural workers and their families. The Center serves stakeholders in Kentucky, Tennessee, Alabama, Mississippi, North Carolina, South Carolina, Florida, Georgia, West Virginia, and Virginia. Recognizing the multiple linkages affecting public health (IOM, 2001) and the importance of strategic systems thinking when addressing challenges in public health, the Center’s investigators and staff work closely with colleagues from the UK Colleges of Medicine, Agriculture, Nursing, Education, Communications, and Engineering, and with researchers and practitioners from various external agencies and institutions. This transdisciplinary approach lends an array of resources and skills to the Center and enhances its capabilities in research, education, outreach, and prevention. The Southeast Center continues to focus on special populations; emerging, ignored or persistent agricultural safety and health concerns in the Southeast; cost analysis of tractor and other farm-related injuries; and education/training of public health professionals with an emphasis on agricultural safety and health.
Selected Southeast Center Projects
- Poison Center Surveillance of Agricultural Poisonings
This 3-year research project involved six poison control centers in Kentucky, Virginia, West Virginia, and Alabama. The participating sites tested a modification to the Toxicall® surveillance software system that is used in more than 70 percent of U.S. poison control centers. The modification was designed to improve the quantity and the quality of data obtained on agriculture-related pesticide exposures. Of 7,522 poison control center calls received involving 39 study pesticides, the enhanced protocol solicited additional information in 270 cases, thereby providing more precise etiological detail about reported exposures linked to production agriculture. The study technology may be used by poison control centers to enhance documentation of other exposures of eminent interest.
- Aquaculture Safety and Health
This 5-year study is one of the first in the nation to systematically address emerging hazards in aquaculture and to identify practical, evidence-based solutions. Principal Investigator Melvin L. Myers, MPA, and Dr. Henry Cole of the University of Kentucky work closely on this project with Dr. Robert Durborow of the Kentucky State University Aquaculture Research Center, one of the top 5 aquaculture programs in the United States. The research team has completed more than 29 operator interviews and walk-through surveys in Mississippi (catfish in ponds), South Carolina (clams in estuaries and bays; submerged nets), North Carolina (trout in raceways), Kentucky (trout, bass, and catfish in ponds and raceways), and British Columbia (salmon in ponds and net pens). Many of the control technologies, safe production strategies, and other best practices identified and evaluated by the project have been conceived and designed by farmers themselves. These and other field-tested solutions have the potential to transform safety in aquaculture as that sector continues to grow and evolve -- that is, before hazardous technologies or practices become deeply ingrained in day to day practice and farm culture.
- Economics of Preventing Agricultural Injuries to Adolescent and Adult Farmers
This prevention/intervention project targets four types of injury events that are prevalent among adolescents and adults who live and/or work on farms: (1) crush injuries to operators when tractors without rollover protective structures (ROPS) overturn; (2) collisions between farm tractors and other motor vehicles on public roadways; (3) traumatic brain injuries to horseback and ATV riders without helmets, and (4) hearing loss to individuals with long-term exposure to high frequencies and loud noises. To promote more effective farm safety education and increased use of personal protective equipment and other risk/hazard reduction behaviors, this project has tested and evaluated the online delivery of (1) interactive narrative simulation exercises that depict a typical case scenario for each of these injury categories across the pre-event, event, and post-event stages, and (2) an interactive Excel™-based Cost Tool that calculates the costs of each injury and the cost-effectiveness of its prevention. EOP materials incorporate readily into required core curricula content for high school students and vividly explain the impact of safety on farmers’ financial bottom line. The secure online data collection system devised for this project allows a virtually seamless transition of research-to-practice for both researchers and classroom educators.
- Developing a Smart ROPS Decision-making Guide
Tractor overturns are the leading cause of fatalities among agricultural workers. Although rollover protective structures (ROPS) used in combination with seatbelts are the single most effective way to prevent injury and death from tractor overturns, an estimated 2.4 million farm tractors in the U.S. lack ROPS and should be retrofitted. Until now, a major barrier to increasing the prevalence of tractors equipped with rollover protective structures had been lack of information about which companies supply retrofit ROPS, what ROPS are available for which tractors, and how to obtain these ROPS. To eliminate this barrier, Dr. Mark Purschwitz of the University of Kentucky College of Agriculture led development of the user-friendly Kentucky ROPS Guide, the only the only up-to-date, comprehensive online source of ROPS retrofit information in North America and perhaps anywhere in the world.
- Teaching Public Health Students about Agricultural Safety and Health:
This 5-year education/ translation project has continued the design, implementation, and evaluation of the Health of Agricultural Populations (HAP) emphasis area in the MPH, DrPH, and PhD programs in the UK College of Public Health.
- Nurse Agricultural Education Project
Led by Deborah Reed, RN, PhD, Professor, University of Kentucky College of Nursing, this project addresses the critical need for increasing the agricultural safety and health knowledge of nurse educators, nurse researchers, and students. NAEP has provided traditional and innovative technology-based formats for training of nurse educators, researchers, and students about agricultural illness and injury prevention. Through project-related activity in more than 20 states, NAEP continues to build a growing network of nurses with relevant skills and interests in agricultural occupational safety and health.
Southwest Center for Agricultural Health, Injury Prevention and Education
The Southwest Center for Agricultural Health, Injury Prevention and Education (SW Center) is located at the University of Texas Health Science Center at Tyler. The center currently focuses on innovative approaches to address work-related issues in special agricultural populations including: migrant children, Vietnamese shrimpers, Navajo farm¬ers/ranchers, and youth in agriculture. The guiding principle of the Center is to improve the health and safety of the agricultural community. The Center has developed a broad range of partners for conducting agricultural safety and health research, intervention and outreach activities through-out Arkansas, Louisiana, New Mexico, Oklahoma and Texas. These partners represent the diversity of the workforce and the range of agricultural production in the region.
Individual Southwest Center Projects
- Migrant Adolescent Health Research Study
This cross-sectional and prospective cohort study of students from two South Texas high schools along the Texas-Mexico border is examining the prevalence of, and the risk factors for, hypertension, obesity, diabetes, and back pain. Data on modifiable risk factors in young farmworkers are being collected to compare migrant farmworker students to other Hispanic students. The ultimate goal is to transfer findings to interventions (including policy development) to prevent chronic diseases and back pain in children and adults.
- Innovative Approaches To Worker Health Protection Among Shrimp Fisherman Of The Gulf Coast
The long-term objectives are to: 1) characterize selective workplace factors and lifestyle behaviors which may contribute to morbidity and mortality among Gulf Coast shrimp fishermen (shrimpers) and 2) utilize a community based approach to planning, implementing, and evaluating prevention and education measures directed at priority workplace factors and lifestyle behaviors. The project is a collaboration with the United States Coast Guard and other partners to identify, survey, and conduct noise level monitoring, audiometry, and spirometry among convenience samples of Gulf Coast shrimpers in Texas and Louisiana.
- Model Farmers Dissemination Project
This project is enhancing the capacity of Navajo model farmer "opinion leaders" to provide consulting expertise on best management practices and pesticide safety application procedures through training, equipment and supplies. The effectiveness of this intervention is being assessed using farm yield, safety behaviors and environmental effects (levels of agricultural chemicals in the run-off water). Recommendations about "model farms" and "model farmers" are being developed and will be used to help disseminate best practices to neighboring farmers on the Navajo Nation and to other culturally differentiated groups where health disparities may be common.
- Promoviendo Farmworker Safety- Heat Stress Prevention
Intervention Mapping is the framework used to identify and address cultural and logistical barriers to heat stress prevention for hired farmworkers. A bi-lingual (Spanish) educational toolkit is being developed and validated for promotores (lay health educators) 1) to be certified by the TX Department of State Health Services as competent to teach heat stress prevention to farmworkers, and 2) to teach standardized information that is culturally and linguistically appropriate for Spanish-speaking farmworkers. The toolkit includes a photonovella, flipchart, PPE examples, and intervention report forms.
The Western Center for Agricultural Health and Safety Center
The Western Center for Agricultural Health and Safety (WCAHS) at UC Davis has made strides in areas of research, prevention/intervention and education/outreach. It is uniquely situated to address and affect the health and safety of farmers, farm family members, hired farm workers and their families because of its co-location with the UC Davis Schools of Medicine and Veterinary Medicine, its Colleges of Agriculture and Engineering, and the California’s Central Valley, one of Western agriculture’s most intensive and productive regions. WCAHS has taken a leadership role in addressing western agricultural health and safety issues, including health among migrant and seasonal (hired) farm workers, ergonomics of labor-intensive crop work, respiratory hazards in dry-climate farming, health of women and children in agriculture and pesticide safety. The public (general and agricultural) have been recipients of educational programs. WCAHS’ electronic communications (newsletter, list server) have expanded educational efforts of the center internationally.
Individual Western Center Projects
Rapid Assays for Human and Environmental Exposure Assessment
This project is developing rapid, sensitive, and cost effective immunoassays that will provide high quality analytical data for use in exposure assessment, model development, and mechanistic research. Objectives of the study are to: develop technologies to improve the speed, sensitivity, and robustness of existing immunoassays for biomarkers; develop immunoassays for new analytes of both exposure and effect that have been identified as useful to other WCAHS investigators; and provide analytical support to other WCAHS investigators with existing pesticide immunoassays. The major impact of this research on public health will be the development of sensitive, rapid, cost effective analysis tools for biomarkers of the pesticides, permethrin, imidacloprid, thiomethoxam and fipronil and a more general marker of inflammation.
- Farm Worker Family Health Cohort Study
Specific aims are to: 1) Conduct two questionnaire follow-ups of the MICASA study population (from the previous funding period) and to conduct spirometry, measure vital signs and anthropometry, and collect biologic samples; 2) Assess the relationship of exposure to dusts and other toxicants from agricultural activities to respiratory health; 3) Assess the contribution of agricultural work to musculoskeletal problems and injuries; 4) Assess the relationship between lifestyle factors (i.e. diet, obesity and smoking) with chronic health outcomes; 5) Disseminate results to individuals, the farm worker community and policy makers to increase awareness of factors affecting health among farm worker families and to suggest approaches to improve health. This research has direct relevance to public health in that it will aid our understanding of the diverse causes of disease in this population and assist in developing strategies to prevent complications from acute and chronic diseases. It would also provide a natural progression from research to intervention and prevention efforts.
- Respiratory Health and Exposures on Large Californian Dairies
The aims of this study are to define the concentrations of airborne pollutants highly associated with respiratory problems, and examine the respiratory health of the dairy workers compared to a control group of creamery employees and grain storage workers in a collaborator's study in Colorado. This cross-sectional study is monitoring personal exposure to particulate matter, endotoxins, and ammonia over a work shift in 200 dairy workers (from dairies with over 1,000 lactating cows) and 50 creamery workers. Outreach is also being extended to those individuals who deal with health, safety and other regulations pertaining to the dairy industry.
- Health Effects of Airborne Agricultural Particles from the Sacramento/San Joaquin Valley
This project is addressing the following questions: (1) Do differences in particle concentration, size distribution, and composition that occur as a function of agricultural activity result in different health outcomes that can be detected during inhalation exposure experiments? (2) Is exposure to agricultural particles associated with measurable pulmonary responses following short-term to sub-acute exposure intervals? (3) Does the season of the year have a significant bearing on respiratory responses observed?, and (4) Are specific components of agricultural-based particles more toxic than others? Each question is being addressed using real-time, inhalation exposure experiments.
- Dairy Safety Training Program
This program was developed by the WCAHS as part of the Worker Occupational Safety and Health Training and Education Program (WOSHTEP). WOSHTEP is administered by the Commission on Health and Safety and Workers’ Compensation in the Department of Industrial Relations through interagency agreements with the Labor Occupational Health Program at UC Berkeley, WCAHS and the Labor Occupational Safety and Health Program at UCLA. Products of this program can be found at: http://agcenter.ucdavis.edu/Announce/dairy_guide.php.
- National Institute for Occupational Safety and Health (NIOSH)
- Centers for Disease Control and Prevention
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