Summary of Known U.S. Injuries and Fatalities Involving Livestock Waste Storage, Handling, and Transport Operations: 1975-2019.

HIGHLIGHTS: Approximately ten cases were documented annually over the 44-year period; 48% were in the last decade and 28% were in the last three years, primarily due to more aggressive surveillance and on-line access to incident reports. A total of 389 incidents involving 459 individuals were documented, of which 59% were fatal; >85% of the victims were male, with an average age of 37. 49 rescue incidents involved a total of 119 secondary victims, indicating that approximately 26% of the victims were secondary victims, including first responders. 20% of all victims, when age was known, were children or youth under the age of 21. ABSTRACT: There is limited published research exploring the frequency and causes of livestock waste-related fatalities and injuries among farm operators and workers. While there has been ongoing surveillance of mortality and morbidity involving agricultural confined space-related incidents, such as grain storage facilities, few resources have been invested in estimating the frequency of livestock waste-related incidents, which are often reported as primarily involving confined spaces. Existing surveillance efforts have historically underreported fatal cases, injuries, and near misses and misclassified these incidents as non-farm related. For nearly 40 years, the Purdue Agricultural Confined Spaces Incident Database (PACSID) has been used to document agricultural confined space-related incidents, of which manure storage and handling activities have accounted for 22% of the cases documented. The specific goal of this study was to address the gap in the current understanding of the frequency and severity of injuries associated with livestock waste storage, handling, and transport by: (1) developing a consistent way to identify, document, and code these cases; (2) summarizing all known U.S. cases, both fatal and non-fatal, currently documented in the PACSID; (3) identifying the most significant risks contributing to livestock waste storage, handling, and transport-related incidents; and (4) providing evidence-based recommendations and mitigation strategies to enhance the effectiveness of current injury prevention measures. The PACSID and other sources were mined for relevant data, and an aggressive effort was made to document additional cases through a variety of surveillance methods. A total of 459 individual U.S. cases from the study period (1975 to 2019) were identified, coded using a uniform coding system, and summarized. Overall, cases were documented in 43 states, with 66% (302 cases) documented in heavily agricultural and, more specifically, historically strong dairy production states. Of the cases reviewed, 59% were fatal, males ages 21 to 30 and dairy farm workers were identified as high-risk populations, 20% were identified as under the age of 21, and 49 incidents involved multiple victims. Farm injury data limitations and underreporting were problematic, especially during the early years of the study period. However, the findings provide a foundation for recommending safer workplace safety and health practices, evaluating existing engineering and regulatory standards, assessing the impacts of current injury prevention efforts, and redesigning farm safety programs, especially those targeting livestock workers, to reduce the frequency and severity of these incidents.

Summary of Injuries and Fatalities Involving Livestock Manure Storage, Handling, and Transport Operations in Seven Central States: 1976-2019.

HIGHLIGHTS A total of 133 cases were documented in a seven-state region, with Iowa reporting 43% of the cases and asphyxiations accounting for 42% of all cases. Most victims were male (>79%) with an average age of 38 years. The overall fatality rate was 57%, and 16% of the victims were under the age of 21. Thirteen incidents involved secondary victims, including eleven incidents involving two, one incident involving three, and one incident involving four. ABSTRACT. Research was conducted to document, classify, analyze, and summarize available injury and fatality data involving facilities and equipment for livestock manure storage, handling, and transport in the seven-state region (Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, and South Dakota) served by the Central States Center for Agricultural Safety and Health (CS-CASH). Data were initially drawn from the Purdue Agricultural Confined Space Incident Database (PACSID), which contained over 2,400 individual U.S. cases of agricultural confined space related entrapment, engulfment, entanglement, asphyxiation, and falls that were documented between 1975 and 2019. Data from these cases have been partially summarized and published, but the findings did not include in-depth analysis of manure-related incidents. Approximately one in five (460) of the 2,400+ cases that were documented over 44 years involved storage, handling, or transport of livestock wastes, including exposure to toxic gases. Of these, 133 cases were documented as having occurred in the targeted seven-state region. Each case was identified and coded according to a protocol developed previously to classify incidents related to livestock manure handling, storage, and transport. Iowa and Minnesota accounted for 79% of the total, with swine operations accounting for 33% of cases when livestock type was known. Of the victims, 79% were male. Ages ranged from 1 to 85, with an average age of 38, and 15% of the victims were age 21 and under. There were 13 incidents for which two or more victims were identified, including one incident involving four victims. It is believed that historical under-reporting of incidents, especially non-fatal incidents, continues to be a barrier to achieving a more comprehensive understanding of the scope and magnitude of the problem. However, the findings are sufficient to be used in cooperation with stakeholders to enhance the content and delivery of evidence-based agricultural safety and health programs, promote safer work practices, and contribute to the development of engineering design standards. The desired outcomes of this research include more effective strategies to protect farmers and farm workers who are at high risk of manure-related injuries. The findings also provide a sufficient baseline to gauge the effectiveness of future injury prevention measures.

A 25-Year Overview of AgrAbility Demographics.

The U.S. Department of Agriculture's (USDA) National Institute of Food and Agriculture (NIFA) AgrAbility Program was established as part of the 1990 Farm Bill. It functions through partnerships between land grant universities and nonprofit disability organizations to improve the independence and quality of life of ranchers and farmers with disabilities. This article reports on analyses of the first 25 years of demographic data from clients served by funded state AgrAbility projects.Between 1991 and 2016, State or Regional AgrAbility Projects (SRAPs) provided information, education, and service annually to an estimated average of 490 new clients for a total of 11,754 new clients. New clients' average age was 52.1 with 75.1% male. Primary causes of reported disabilities were chronic nonincident-related disabilities (41.7%), non-agricultural incidents (32.2%), and agricultural incidents (19.5%). Typically AgrAbility served clients for one to 74 months (M = 14.85 months), because of the severity of their disabilities, the deterioration of their situation, and the years it sometimes took to assist them in reaching their goals. Combining new, ongoing, reopened, and closed case reports, SRAPs served approximately 1,190 clients annually on average. The average age of new, ongoing, reopened, and closed case reports was 52.7 with 78.0% male.Data collection, analyses, and reporting of client data presented a means of providing program accountability and of helping guide future programming efforts. Findings were used by stakeholders, policymakers, and decision-makers to justify the continued inclusion of the AgrAbility Program in the 2018 USDA Farm Bill.

Indiana Farm Occasional Wood Cutter Fatalities Involving Individuals 55 Years and Older.

Forestry activities, such as tree cutting and harvesting of forest resources, have been documented as dangerous tasks with increased risk of injuries and fatalities. These hazards are well known in the professional logging community, but less attention is given to farmers who perform occasional tree trimming and cutting activities, especially for the older farmer population. This study examined Indiana farm work-related fatalities from 1988 to 2017 involving farmers 55 years and older who performed occasional wood cutting activities. Fatality cases were mined from the Purdue University Agricultural Safety and Health Program's fatality database. A total of 40 fatality cases were reported, representing 10.3% of all reported farm fatalities of farmers 55 years and older over the time period. The average age of the victims was 67.4, with 65% of cases involving victims 65 years or older. All victims were males. Wood cutting fatalities increased over the observation period. The most frequently reported fatal injury type was being crushed by tree or tree limbs, with 16 cases (40%), and the most common cause of fatality was due to cutting and trimming of trees, with 27 cases (67.5%). It was determined that the incidents were largely preventable and that future injury prevention strategies should address the risks associated with aging, the added risk of being struck by limbs or trees due to unsafe felling practices, the need for appropriate personal protective equipment, and the hazards involved in operating agricultural tractors in wooded areas.

Accessing and operating agricultural machinery: Advancements in assistive technology for users with impaired mobility.

This research focused on the advancements made in enabling agricultural workers with impaired mobility to access and operate off-road agricultural machinery. Although not a new concept, technological advancements in remote-controlled lifts, electronic actuators, electric over hydraulic controllers, and various modes of hand controls have advanced significantly, allowing operators with limited mobility to resume a high level of productivity in agricultural-related enterprises. In the United States, approximately 1.7% of the population is living with some form of paralysis or significant mobility impairment. When paired with the 2012 USDA Agriculture Census of 3.2 million farmers, it can be extrapolated that these technologies could impact 54,000 agricultural workers who have encountered disabling injuries or disease, which inhibit their ability to access and operate tractors, combines, and other self-propelled agricultural machines. Advancements in agricultural-specific technologies can allow for many of these individuals to regain the ability to effectively operate machinery once more.

Development of methodology to document and code farm-related injuries and fatalities involving manure storage, handling and transport - with summary of 2017 incidents.

As part of ongoing surveillance of fatalities and injuries involving agricultural confined spaces by Purdue University's Agricultural Safety and Health Program, nearly 300 cases involving manure storage, handling, and transport equipment and facilities have been documented over the past 30 years. With the exception of a summary of 77 fatalities published by Beaver and Field1, these cases have not been previously analysed or published due to a lack of resources and the limitations of the Purdue Agricultural Confined Spaces Incident Database (PACSID) which was designed primarily for analysis of grain-related cases. These limitations included differences in terminology used to code case information in the PACSID and dissimilar causative and contributing factors. To develop a consistent and more useful approach to process and analyze data, 28 U.S. manure-related incidents involving 39 victims documented as having occurred in 2017 were examined for type of incident, victim characteristics, primary contributing factors, and nature of injuries. A review of literature was conducted to identify previously reported contributing factors, and a coding rubric was developed and reviewed by a panel of experts. It was determined that the rubric provided a consistent way to code and analyze descriptive information available on each case. A pilot analysis was completed of the 39 cases using the new tool, and results were summarized. The final methodology will be used to analyze all historically documented incidents, as well as future incidents. Findings presented include a review of relevant literature, discussion of the methods used in case documentation, classifications developed from sample data, and a summary of incidents in 2017. Anticipated outcomes include: 1) consistent strategy to document, code, and summarize manure-related incidents; 2) means of classification of key contributing factors; 3) identification of new or emerging trends; and 4) completion of previously documented incidents.

Editorial: ROPS Are Not Homemade.

Safety professionals should speak up when secondary school teachers and FFA advisors consider fabricating and installing low-cost rollover protective structures (ROPS) as service learning projects for ag education students or as a service to the farm community. These projects are often motivated by the desire to address the continued occurrence of tractor rollovers, which are the most frequent cause of farm-related fatalities (NIOSH, 2018). These projects have also been made feasible by the availability of online plans for ROPS fabrication, including plans from the National Institute for Occupational Safety and Health (NIOSH) that are designed for specific makes and models of tractors. Because of the large number of older tractors that were not originally equipped with ROPS, and the cost and lack of easily accessible ROPS retrofits, fabricating a structure to provide operator protection in the event of an overturn can be attractive as a service learning project. In addition, several of the NIOSH Agricultural Injury Prevention Centers have promoted these projects as a means of reducing the frequency of rollover-related injuries. However, in light of the liability risk involved, such projects should be weighed carefully. Fabricating a ROPS is not the same as building a chicken house, fabricating a welding table, or welding together a hay feeder. ROPS are life-saving devices that must meet specific design and installation standards that exceed the expertise available in most secondary school ag education shops, and even most local machine shops. In fact, "ROPS" is a technical term defined by OSHA standards and the Society of Automotive Engineers (SAE). It does not apply-nor should it be applied-to untested, homemade structures that are installed on tractors with the intent of protecting the operator.

Utilization and Effectiveness of Harnesses and Lifelines in Grain Entrapment Incidents: Preliminary Analysis.

No previous studies have been found that document the level of use or validate the effectiveness of safety harnesses and lifelines in the prevention of or extrication from grain entrapments or engulfments. This article addresses that void via analysis of the data contained in the Purdue Agricultural Confined Space Incident Database. A total of 1,147 cases involving entrapments or engulfments in grain masses were mined for terms that might indicate the use of a safety harness, lifeline, fall restraint system, rope, or outside observer. Case information ranged from brief news accounts to comprehensive investigation results. The review turned up 38 incidents (< 5%) in which these safety devices were identified as having been used by either workers or rescuers during access to a storage structure. In 26 of the 38 cases (68%) where safety devices were identified, the entrapment or engulfment resulted in a fatality. The two most common reasons cited for failure of these devices were (1) that the lifeline or rope was too long (17 incidents) and (2) that the worker had removed the harness with the attached lifeline while in the structure (6 incidents). It was also determined that these devices, if used improperly, can lead to secondary injuries of the victim. The preliminary evidence suggests that use of these devices alone does not ensure the user's safety and may even provide a false sense of security if used without proper training. It was further found that an approved body harness and safety line provided little or no protection from either entrapment or falls if used in the presence of vertically crusted grain surfaces, without proper anchors, or not in conjunction with outside observers. The presented results are important for safety professionals to consider as they endeavor to reduce the risk of grain entrapment and engulfment incidents through training, education, selection of personal protective equipment, etc., and should contribute to the development of new structural standards for grain bins. It is the intent of this article to elucidate the importance of training and proper use of these safety devices.

Summary of U.S. Injuries and Fatalities Involving Entrapment and Suffocation in Grain Transport Vehicles.

Since 1978, the Purdue University Agricultural Safety and Health Program has managed a surveillance effort and database to collect information on documented injuries and fatalities in all forms of U.S. agricultural confined spaces. The database currently contains 1,968 cases documented in the U.S. between 1964 and 2016. Of these cases, 174 (8.8%) involved entrapment or suffocation in grain transport vehicles (GTVs), including gravity-flow wagons, semi-truck trailers, and other agricultural transport vehicles that have limited access and are not considered normal work spaces or are classified as confined spaces. These GTV cases represent the overwhelming majority of documented cases involving all forms of agricultural transport vehicles, including forage and manure transport vehicles. Of the incidents documented, 64.3% resulted in fatalities and 71.8% involved children and youth age 20 years and under, when the age was determined. For the GTV cases, the typical victim was male (88.5%), and the average age of the victim was 19.9 (median 12), with over 63.5% of the cases involving children under the age of 15. In numerous incidents, more than one victim became entrapped, including one incident involving five victims. The number of documented cases decreased sharply from a peak of approximately 7 cases per year in the early 1990s to an average of 3.1 cases per year over the past two decades, with no cases documented in 1998 and 2013. However, there is a linear increase in the frequency of incidents since the first case was documented in 1964. This trend is partially due to peaks in 2011 and 2014, when 10 and 9 cases, respectively, were documented, along with more vigilant surveillance methods due to online search capabilities. The general decline, more recently, in the annual number of cases is attributed to increased awareness of the hazards to youth during transport in GTVs, increased use of warnings on GTVs, and the increased size of GTVs, which makes human access more difficult and less practical. Efforts over the past decade to bring attention to the risk of entrapment in GTVs should be recognized as a success of the educational and technological strategies initiated due to earlier high-profile incidents. However, with 6, 10, 9, and 4 cases documented in 2010, 2011, 2014, and 2016, respectively, continued efforts to address the problem are justified. Recommendations for future actions include development of a safety standard for GTVs that includes placement of safety messages on all new GTVs, use of windows above outlets, retrofitting older GTVs with appropriate warnings, and continuing to address the hazard with safety resources targeting all workers exposed to grain handling and transport.

Determining the Effectiveness of Mirrors and Camera Systems in Monitoring the Rearward Visibility of Self-Propelled Agricultural Machinery.

This study concerned the ability of operators of tractors and other self-propelled agricultural machinery to visually recognize objects and/or hazards within close proximity to the rear of those machines and/or any implements in tow, especially when backing up. It was hypothesized that the data collected would identify the factors affecting rearward visibility and help determine the effectiveness of two backup-assisting devices (i.e., mirrors and camera systems) in enhancing the operator's ability to observe objects or hazards. The study's experimental design involved the following: (1) selecting nine self-propelled machines for testing (five tractors of varying sizes, a combine, a sprayer, a skid steer loader, and a UTV); (2) laying out a five cell by five cell test grid behind each machine, with an indicator pole centered in each cell; (3) positioning the mirrors (exterior/interior) and camera system (camera and display monitor) for maximum visibility; and (4) collecting images from a 50th percentile male operator's eye midpoint position. The findings were recorded graphically onto a master grid for the backup-assisting devices (both individually and in combination) on each machine. Analysis of the results confirmed that various issues related to the machines impact the effectiveness of mirrors and camera systems in enhancing rearward visibility. Among them are the operator station's design and configuration, seat adjustability, optional accessories, exterior lighting, type of implement in tow, hitching method, and highway transport mode. These findings led to recommendations relative to each of the mirrors and camera systems, as well as observations of operator interactions with accessories and perceived effects on the operator's ability to view obstructed areas in close proximity to the machinery.

Methods of Collecting and Analyzing Rearward Visibility Data for Agricultural Machinery: Hazard and/or Object Detectability.

Recent interest in rearward visibility for private, construction, and commercial vehicles and documentation of rearward runovers involving bystanders outside the field of vision of the vehicle operator led to an investigation into the need for enhanced methods of rearward visibility for large, off-highway, agricultural equipment. A review of the literature found limited relevant research and minimal data on incidents involving rearward runovers of bystanders and co-workers. This article reviews the findings regarding the methods identified and tested to collect and analyze rearward visibility data, from the operator's perspective, for large self-propelled agricultural equipment, including the four-wheel drive tractors, combines, agricultural sprayers, and skid-steer loaders that are increasingly found on agricultural production sites. The methods identified, largely drawn from research conducted on private and commercial vehicles, were tested to determine their application in identifying rearward blind spots. These methods are described, and the findings from field-testing of specific machines are provided. Recommendations include establishing an appropriate engineering standard regarding rearward visibility of agricultural equipment with limited rearward vision and the use of rearward alarm systems for warning bystanders of rearward movement.

Utilizing Secondary Agricultural Education Programs to Deliver Evidence-Based Grain Safety Training for Young and Beginning Workers.

Purdue University's Agricultural Safety and Health Program (PUASHP) has collaborated with secondary agricultural education programs, including FFA Chapters, for over 70 years to deliver and promote agricultural safety and health programming. With support from a U.S. Department of Labor Susan Harwood Program grant, PUASHP utilized a Developing a Curriculum (DACUM) process to develop, implement, and evaluate an evidence-based curriculum for use with young and beginning workers, ages 16-20, exposed to hazards associated with grain storage and handling. The primary audience was students enrolled in secondary agricultural education programs. A review of the literature identified a gap in educational resources that specifically addresses this target population. The curriculum developed was based on fatality and injury incident data mined from Purdue's Agricultural Confined Space Incident Database and input from a panel of experts. The process identified 27 learning outcomes and finalized a pool of test questions, supported by empirical evidence and confirmed by a panel of experts. An alignment process was then completed with the current national standards for secondary agricultural education programs. Seventy-two youth, ages 16-20, enrolled in secondary-school agricultural education programs, and a smaller group of post-secondary students under the age of 21 interested in working in the grain industry pilot tested the curriculum. Based on student and instructor feedback, the curriculum was refined and submitted to OSHA for approval as part of OSHA's online training resources. The curriculum was delivered to 3,665 students, ages 16-20. A total of 346 pre- and post-tests were analyzed, and the results used to confirm content validity and assess knowledge gain. Findings led to additional modifications to curriculum content, affirmed knowledge gain, and confirmed appropriateness for use with secondary agricultural education programs. The curriculum has been promoted nationally and made available for free download from www.agconfinedspaces.org . Findings further confirmed the value of delivering safety programming through established programs such as secondary agricultural education programs and FFA Chapters serving youth.

Comparisons of Agricultural Seating for Paraplegia.

People with spinal cord injury/paraplegia are operating agricultural machinery despite the lack of research evidence to support seating interventions. These operators represent a vulnerable population in the agricultural workforce, and information to support their health in the workplace is urgently warranted. This research compared a group of subjects with paraplegia on different intervention cushion conditions during a simulated tractor driving task. Numerical data acquired from a pressure-mapping instrument were explored for statistical relationships within a small cohort of people with paraplegia participating in a feasibility study that was previously reported for clinical results. Relationships reaching statistical significance were found to support the primary hypothesis, while other hypotheses did not reach the threshold of significance. The primary hypothesis, that a contour tractor seat intervention condition would be inferior to other intervention conditions, was supported. For this cohort of heterogeneous users with paraplegia, a contour tractor seat of foam and cloth fabric manufacture was not an appropriate intervention selection versus other aftermarket wheelchair cushions.

Contributing Causes of Injury or Death in Grain Entrapment, Engulfment, and Extrication.

OBJECTIVES: Grain entrapments and engulfments are one of most common hazards associated with grain storage facilities, with over 1,140 such entrapments/engulfments documented since the 1970s. The objective of the study was to determine the factors that contribute to injury or death in grain entrapment, engulfment, and extrication cases. METHODS: A literature review, including data contained in the Purdue Agricultural Confined Spaces Incident Database (PACSID), was conducted to determine the conditions that the body experiences during an entrapment or engulfment in grains and during extrication efforts. RESULTS: Based on the review, the conditions a human body faces during an entrapment, engulfment, or extraction can be split into two broad categories-environmental and physiological/psychological. The environmental factors depend on the grain's properties, depth of entrapment or engulfment, position of the victim's body, and characteristics of the storage unit, which include the grain's lateral pressure, vertical pressure, and weight, as well as friction, oxygen availability and diffusion rate, and grain temperature. The physiological and psychological factors are related to the individual's age and physical and psychological conditions, and manifest themselves in terms of oxygen consumption, asphyxiation (including aspiration, lack of oxygen, compression or splinting of the thorax), blood flow, and heart rate. CONCLUSION: Of all the above factors, a review of fatality data contained in the PACSID indicate that aspiration, asphyxiation, grain weight, and lateral pressure are most likely the primary cause of death for most entrapment victims. Research gaps found by this study include an understanding of the impact of lateral pressure on lung expansion and oxygen availability and consumption rate, and the need for more case studies to accurately determine cause of death.

Risk assessment of cattle handling on pasture using work environment screening tool.

Working with beef cattle in an open area or while on pasture has been shown to expose workers to a high risk of work-related injury. Prior research on this problem has been conducted using mail surveys, interviews, self-reporting of work practices and injury experiences, and summaries of published injury data, including media reports. Prior research on injury prevention has largely focused on worker education in a specific cultural or geographical setting. A pilot study was conducted to test the cross-cultural usability of the Working Environment Screening Tool in Agriculture (WEST-AG), a modification of the WEST, developed for Swedish industrial applications, to assess risk factors associated with farmers working with cattle being raised largely on pasture as compared with cattle raised in confined feeding operations. Swedish and English language versions of WEST-AG were developed and pilot-tested on a convenient sample of eight Swedish and eight Indiana farms that raise beef cattle primarily on pasture. On-site observations were conducted independently by Swedish and US agricultural safety professionals and documented using photography and a 15-risk-of-injury component on an 11-degree linear scale. Comparisons were made between independent observations documented from the Swedish and Indiana application of the WEST, including collective assessment of photographic record, and the results reported. Key findings included (a) a higher level of observed risks on Indiana farms studied as compared with their Swedish counterparts; (b) high levels of worker exposure to cattle, especially mature breeding bulls, on both sets of farms; (c) a higher frequency of self-reported farm-related injuries than anticipated on both Swedish and Indiana farms; (d) substantially different economic, social, cultural, and regulatory forces that influence small-operation Swedish and Indiana beef producers' decisions regarding adoption of safer work practices, including use of new and safer technology; and (e) differences between the interpretations of the levels or severity of risks observed between the Swedish and US researchers conducting the assessments based upon regulatory and cultural context. Recommendations for enhancing the methodology of applying the WEST-AG to beef production are discussed, along with utilizing the findings to recommend steps to enhance worker safety on small beef farms, regardless of cultural setting. The most significant contribution of this study was to explore the viability of an assessment tool for agricultural workplaces that could be used internationally to enhance worker safety and health regardless of cultural and political differences.

Hazards for farmers with disabilities: working in cold environments.

In consequence of working in cold environments, agricultural workers may be exposed to higher risk of cold-related injuries, compared with the general population. These injuries can include tissue damage due to the exposure to subfreezing temperatures, more generalized symptoms caused by hypothermia, and secondary injuries caused by impaired performance. Risk of cold injury is increased for older workers and for those with disabling health conditions, both of which occur in above-average numbers in agriculture. Based on a selective review of the literature and case studies assembled by Purdue's Breaking New Ground Resource Center, an overview is presented of the mechanisms and symptoms of cold injuries, together with practical suggestions to help reduce risks of cold injuries for workers in agricultural settings. Special attention is given to potential risks to individuals with physical disabilities.

Twenty years of AgrAbility: a retrospective forum.

In 1990, the Farm Bill included authorization for the Education and Training Assistance Program for Farmers with Disabilities with the goal of enabling a high-quality lifestyle for farmers, ranchers, and other agricultural workers with disabilities. Twenty years later, AgrAbility is a developed national program with 25 state projects and affiliates throughout the United States and strong recognition with the rural and disability communities. A special forum was held in Washington, DC, last September to celebrate AgrAbility's achievements. Clients, staff members, advisory team members, government officials, and guests joined to discuss future plans for the program. Recommendations were considered to broaden the effect of the program and to enhance access to program services, especially in states without funded programs. This article summarizes key outcomes from this event.

Proceedings of the "Arthritis, Agriculture, and Rural Life: state of the art research, practices, and applications" conference, West Lafayette, Indiana, May 11-13, 2011.

This article presents proceedings of the first national conference to assemble professionals to address the issue of arthritis in agriculture. The "Arthritis, Agriculture, and Rural Life: State of the Art Research, Practices, and Applications" conference, May 11-13, 2011, at the Purdue University Beck Agricultural Center in West Lafayette, Indiana, focused on increasing awareness and education in the prevention, effects, care, and treatment of arthritis specific to farmers. Presentations included a contextualizing keynote and sessions addressing the prevention and treatment of arthritis in agriculture, including topics such as traditional arthritis therapies, alternative treatments, assistive technology, and ergonomic techniques and modifications. Participants discussed particular issues on a field trip to several Purdue University research farms addressing ergonomics. The conference concluded with a farmer panel, where attendees heard personal stories from farmers suffering from the effects of arthritis.

Secondary injury potential of assistive technologies used by farmers with disabilities: findings from case studies.

In order to complete essential tasks, farmers with disabilities often make and use assistive technology (AT), which itself may cause further injuries known as secondary injuries. A set of 19 case studies was used to investigate the potential for injury on home-fabricated assistive technologies (ATs) used by farmers with disabilities. The case studies consisted of close-ended and open-ended interviews that were designed to help understand the farmers' perception of potential for injuries and safety measures implemented or not implemented. The qualitative study used grounded theory principles and the collected data were analyzed to arrive at a list of features on ATs that have substantial potential to cause injury to the user. Based on the case study results, AT user characteristics and environmental factors were also considered as factors that contribute to potential injuries. Findings were used to develop an instrument for use by rehabilitation professionals to evaluate ATs for potential injury causing hazards.

AgrAbility mental/behavioral health for farm/ranch families with disabilities.

Farmers and their families are at high risk for work-related stressors and incidents that may result in physically disabling conditions. Coping with the acute and chronic results of disability has been documented to contribute to mental and behavioral health issues. Improvements in the ability to cope with the impact of stressors and adjustment to living with a severe disability can enhance quality of life and well-being and decrease long-term emotional complications. Due to the unique characteristics of many rural or agricultural communities (including isolation, low population density, and lack of transportation services), residents with disabilities are at significant risk for mental/behavioral health issues complicated by the lack of mental/behavioral health services and resources. The United States Department of Agriculture (USDA) AgrAbility Program was authorized by Congress as part of the 1990 Farm Bill to assist farmers, ranchers, their workers, and families who are impacted by disability. Initially AgrAbility services targeted physical disabilities; but as the need has become more apparent, efforts are being made to expand mental/behavioral health-related services, including referrals to appropriate sources of treatment. A survey was conducted in 2009 by the National AgrAbility Project (NAP) to identify the types of mental/behavioral health services and resources that the 21 USDA-funded State and Regional AgrAbility Projects (SRAPs) provide for their clients. Resources were also identified from three other experts in the rural mental/behavioral health field who are associated with the AgrAbility Program. The purpose of this article is to report a summary of those services and resources that are currently available through the AgrAbility network. Recommendations for the NAP concerning mental/behavioral health initiatives and implementation strategies for the SRAPs are also presented.