Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, U50-OH-008107, 2009 Dec; :1-45
The National Children's Center for Rural and Agricultural Health and Safety (NCCRAHS) serves as the only NIOSH funded agricultural center designated to focus on children (0 to 18 years). Formally established in 1997, the 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 professional and lay audiences. Children on our nation's 2 million farms and ranches continue to be injured and killed in agricultural settings where they visit, play, work and live. NIOSH (with USDA-NASS) data, released in late 2007, estimated 23,074 agricultural injuries among children and adolescents working, visiting and living on farms. The majority of events affect household (family farm) children; and about two-thirds of all injuries affect non-working children. Since the beginning of NIOSH's Childhood Agricultural Injury Prevention Initiative in late 1996, progress has been made on many fronts. Data from 1998, 2001, 2004 and 2006 reveal an overall 37% decline in childhood agricultural nonfatal injuries. On family farms, the rate of injuries per 1,000 household youth declined by 44% (from 18.8 to 10.5/1000 youth). During this same period while NIOSH was funding research and surveillance, there was a sizable investment in private sector funding dedicated to community-based educational programs. NCCRAHS staff members, with their external partners and scientific advisors, have been involved in many of the research, intervention, training and outreach activities that address childhood agricultural safety for this past decade. From 2003 to 2009 (the span of this grant report), NCCRAHS staff members planned, implemented and evaluated nearly all project activities as proposed in the Center application submitted in June 2003. The Center's theme was "building partnerships to protect children at work and children at play on our nation's farms and ranches." Projects were designed to support this theme and, indeed, numerous new partnerships were developed and sustained. The Administrative Core strived to provide a framework to support, guide and monitor the progress of the overall center and the specific components of each core. Administrative efforts were directed toward the key activities required to address national needs and project specific issues in a timely and efficient manner. The Administrative Core was comprised of the Center Principal Investigator, all Core leaders, the Migrant Clinicians Network liaison, the Center Manager and the Communications Specialist. Ten external advisors provided periodic input and review of activities. The mini-grant program funded up to $60,000 annually, reviewing 90 proposals and funding 26 different projects. The progress and quality of Center initiatives were evaluated for process and impact. A monthly staff meeting included updating a Benchmark Metrics document for process and status. An external evaluator assisted with impact evaluation of select aspects of the Center's work. Average annual NIOSH budget support for the full Children's Center was nearly $700,000. Considerable supplemental funds from the private sector and in-kind contributions extended the Center's work beyond the NIOSH funding limits. The Outreach Core, comprised of three projects, provided opportunities to address the Center's theme of "building partnerships." The Stakeholder Communications project aimed to provide technical assistance, disseminate newsletters and special reports, maintain dynamic websites, provide professional seminars/presentations, and support public awareness campaign efforts. With changing use of the Internet, project aims and websites were modified to meet public demands for more information readily downloadable from websites. The Childhood Agricultural Safety Network (CASN) aimed to enhance individual and organizational capacity to address childhood farm safety and to build and expand collaborations among child safety advocates in 2 the U.S. and Canada. The most visible product of the CASN group was the launching of a national public awareness campaign with the primary poster depicting a grandfather with child on tractor amid a message that it is "Easier to Bury a Tradition than a Child." The Best Practices Recommendations project allowed the Center to address a series of different small scale projects that meet needs of child safety advocates, including health and safety guidelines for agritourism operators, resources for employers who hire adolescent farm workers, and resources for assisting farm owners in constructing safe play areas on farms. The Prevention/Intervention Core included one funded project that addressed safety training for employers of adolescent farm workers. This project yielded information that led to a reshaping of resources and training approaches. A follow-up intervention was funded in the next grant cycle. The Education Core had two funded projects. First, an upgrade of the National Agricultural Safety Database (NASD) resources on children and agriculture was undertaken. Through a systematic approach, current resources were scored on various criteria and recommendations were submitted to the NASD administrator. Unfortunately, recommended upgrades were not adopted. This led to the NCCRAHS decision to use its own website for posting and promoting downloadable resources on topics of greatest concern and interest to safety advocates. The second project was the Journalists' Workshop intervention. Over the five year grant, five distinct workshops were convened in locations co-hosted by other NIOSH Agricultural Centers. Each event was modified based on feedback from previous workshops. Evaluation of the process and impact yielded very positive findings, including a measurable increase in appropriate reporting in the media of childhood agricultural issues. A "how to" conduct a journalist workshop was published to facilitate expansion of this concept on other topics, with other audiences. The Research Core included one project that addressed youth tractor crashes on public roads with respect to legislation that required tractor safety certification of young drivers. Results were informative and demonstrated the limited impact that legislation has when the training curriculum on injury prevention does not match the majority of injury events. In addition to the specific funded projects within the Center, staff members were engaged in childhood agricultural safety activities as part of their professional activities in organizations such as National Institute for Farm Safety and American Public Health Association. Further, advisory roles with other NIOSH Agricultural Centers and international colleagues extend the reach of staff beyond the Center's projects. Individual RO1 research grants furthered the efforts of the Center to build upon the knowledge base regarding children and farm safety. This synergy of activities has enabled NCCRAHS to make significant strides in enhancing the health and safety of all children exposed to hazards associated with agricultural work and rural environments.
Barbara Lee, Marshfield Clinic Research Foundation, Marshfield Clinic, 1000 North Oak Ave, Marshfield, WI 54449