Surgeon General's Conference on Agricultural Safety and Health, 1991

On April 30-May 3, 1991, CDC's National Institute for Occupational Safety and Health (NIOSH) convened the Surgeon General's Conference on Agricultural Safety and Health in Des Moines, Iowa. The theme for this conference was ``FarmSafe 2000: A National Coalition for Local Action.'' Agricultural safety and health professionals, equipment manufacturers, farmer and migrant health organizations, rural health-care professionals, and agricultural youth organizations met to deliberate on methods to reduce health and safety risks in agriculture. More than 700 persons attended and represented 41 states and Puerto Rico. Through small-group interactive discussions, the conference addressed surveillance, research, and intervention--three public health activities necessary to meet year 2000 national health objectives (1). This report summarizes the issues considered at the conference and recommendations proposed by attendees. Surveillance

• Government, industry, communities, and individuals should

collaborate to develop agricultural surveillance programs to both recognize problems and delineate their scope.

• Potential initial targets for surveillance include fatal

injury, amputation, eye injury, skin cancer, repetitive trauma, acute pesticide poisoning, hearing loss, and respiratory conditions.

• Surveillance efforts should include use of compiled data to

set priorities for intervention efforts (e.g., installation of roll-over-protective-structures (ROPS) to prevent fatalities from tractor roll-overs), followed by rapid evaluation of the efficacy of these interventions.

• Approaches warranting further assessment include

surveillance by local health and safety practitioners, promulgation of surveillance case definitions by health and safety experts, and coding of death certificates for industry and occupation. Research

• To improve understanding of the etiology of

agriculture-related disease and injury, risk factors should be better characterized, and specific physical, chemical, and biologic health hazards should be identified.

• Research efforts are needed to address the effects of

combined exposures and repeated acute exposures on chronic diseases, inadvertent injection of biologic or infectious agents through needlestick injuries, and immunosuppression associated with exposures to chemical and biologic agents.

• The safety and health problems of special populations

(e.g., migrant workers, children, and women) and regional patterns of injury and disease should be studied epidemiologically.

• Research efforts should focus on intervention strategy

alternatives (e.g., education, regulation, and engineering controls), protective technology, the efficacy of standards, and the role of personal actions. Intervention

• Preventive interventions exist to reduce risks for many

vectorborne diseases (e.g., equine encephalitides and Lyme disease), exposures to agrichemicals and other potentially toxic agents, and acute trauma or chronic musculoskeletal disorders associated with agricultural equipment.

• Feasible approaches exist in three intervention categories:

hazard elimination, passive controls, and behavioral changes.

1. Hazard elimination approaches include equipment redesign (e.g., increasing tractor-seat flexibility to allow 360-degree observation of agricultural operations), job redesign (e.g., reducing repetitive lifting in dairy operations through use of overhead tracks to assist workers in moving bulky equipment during cow milking), and product substitutions (e.g., using smaller amounts and less toxic pesticides for pest management on farms).

2. Passive controls eliminate the need for specific decisions or actions by workers. These include the use of ROPS on tractors, kill switches that shut off chain saws automatically when they recoil toward the operator, or closed pesticide-loading systems, which reduce exposures to potentially toxic substances.

3. Behavioral changes (e.g., wearing personal protective equipment, applying insect repellents, or reading and heeding warning signs) can be promoted among workers and others in the farm community through education efforts. Successful adoption of behavioral changes depends on a variety of factors, including the characteristics of the target audiences (e.g., age, education level, and culture); the media and people used to reach target audiences; and linkages between local, state, and national coalitions. Reported by: Div of Respiratory Disease Studies; Div of Safety Research; Div of Surveillance, Hazard Evaluations, and Field Studies; Office of the Director, National Institute for Occupational Safety and Health, CDC.

   Editorial Note

Editorial Note: The terms "agricultural population" and "agricultural worker" encompass several groups, including farm owners and their families; migrant and seasonal workers; agricultural service workers; and persons working in the forestry, logging, and commercial fishing sectors (2). Based on U.S. Department of Agriculture estimates, approximately 13.1 million persons in the United States derive some income from farming; in addition, 6 million persons are considered to be members of farm families. In 1989, approximately 3.4 million persons were full-time workers in agriculture (3).

Injury and disease associated with physical, chemical, and biologic hazards occur disproportionately among agricultural workers and their families. Although the agricultural industry employs only 2% of U.S. workers, it ranks fourth in both the number of work-related traumatic fatalities (accounting for 742 deaths annually) and the rate for occupational fatalities (20.7 fatalities per 100,000 workers) (4). Agricultural machinery, especially farm tractors, is a major cause of work-related death among agricultural workers; of the estimated 1500 machinery-related deaths occurring annually among all workers, more than half involve farm equipment (5). Surveillance data for 1985 indicate that racial/ethnic minorities were at particular risk for agricultural work-related fatal injury: the risk for work-related death among Hispanic and black agricultural workers was 20%-30% greater than among non-Hispanic whites; in addition, for all other minorities, the risk was twice as great as for non-Hispanic whites (5).

In addition to work-related injury, agricultural workers are at substantial risk for occupational illness. In 1988, the agricultural sector had the second highest rate of occupational illnesses among the 10 industrial sectors (6). Moreover, agricultural workers are at increased risk for a variety of malignant and nonmalignant chronic diseases (7). For example, in 1988, agricultural workers ranked first in incidence of occupational skin disorders and sixth in work-related respiratory illnesses (6). Finally, work-related exposure to antibiotics, which may create selective pressures for development of more resistant strains of bacteria (8), and exposure of agricultural workers and farm family members to potentially hazardous noise levels (7) have been identified as problems in the agricultural sector.

The Surgeon General's conference identified prevention actions to reduce agriculture-related diseases and injuries and issues that must be addressed to assure actions can be implemented. Papers and proceedings from this conference will be published as will a Surgeon General's report on agricultural safety and health, which will propose prevention actions for reducing agriculture-related diseases and injuries and review current federal policies for protecting agricultural workers. The proceedings and the Surgeon General's report are available from The Agricultural Safety and Health Program, NIOSH, CDC, Mailstop D-26, 1600 Clifton Road, N.E., Atlanta, GA 30333 (fax (404) 639-2196).

References

1. Public Health Service. Healthy people 2000: national health promotion and disease prevention objectives--full report, with commentary. Washington, DC: US Department of Health and Human Services, Public Health Service, 1991; DHHS publication no. (PHS)91-50212.

2. Bureau of the Census. 1980 census of population: alphabetical index of industries and occupations. Washington, DC: US Department of Commerce, Bureau of the Census, 1982; document no. PHC80-R3.

3. Bureau of Labor Statistics. Employment and earnings annual averages. Washington, DC: US Department of Labor, Bureau of Labor Statistics, January 1990, vol 37, no. 1.

4. Bell CA, Stout NA, Bender TR, Conroy CS, Crouse WE, Myers JR. Fatal occupational injuries in the United States, 1980 through 1985. JAMA 1990;263:3047-50.

5. Myers JR. National traumatic occupational fatalities: a surveillance tool for agricultural work-related deaths. In: Proceedings of the National Institute for Farm Safety Summer Conference. Columbia, Missouri: National Institute for Farm Safety, 1989; paper no. 89-9.

6. Bureau of Labor Statistics. Occupational injuries and illnesses in the United States by industry, 1987. Washington, DC: US Department of Labor, Bureau of Labor Statistics, 1990; bulletin 2366.

7. National Coalition for Agricultural Safety and Health. Agricultural safety and health: the issues. In: Agriculture at risk: a report to the nation. 3rd ed. Iowa City, Iowa: National Coalition for Agricultural Safety and Health, 1989.

8. Haze VW, Black CA. Antibiotics for animals: the antibiotics issue. In: Comments from the CAST. Washington, DC: US Council on Agricultural Science and Technology, 1989.

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