Limitations in fields of vision for simulated young farm tractor operators.

Farm tractors account for the majority of deaths and injuries among youths working on North American farms. A vehicle operator's field of vision is an important operational aspect for safe driving. However, very little is known about visual limitations of young tractor operators compared to adult operators. The main purpose of this study was to quantify limitations in fields of vision of children with different anthropometry. The study was based on assessment of 42 farm tractors in popular use in the USA. The results showed that youth operators typically had diminished fields of vision compared to the average adult operator. The degree of visual limitation is greatest for objects at close distances and when objects are straight in front of the operator/tractor. This has serious implications in terms of risks for runovers, rollovers and collisions. Study findings may help illuminate the development of policies and guidelines in tractor-related jobs for children. STATEMENT OF RELEVANCE: This study provides an ergonomic approach for evaluation of children's visual limitations in tractor operations. This approach could be used in other related cases, where children are allowed to operate vehicles.

Ability of youth operators to reach farm tractor controls.

Farm tractor work is commonly assigned to young people on North American farms, where tractors account for the majority of deaths and major portions of non-fatal trauma to working youths. However, little is known about the potential mismatch between the anthropometric and physical characteristics of children and tractor characteristics. The purpose of this study was to evaluate the ability of children of varying ages and percentiles to reach major controls on 45 tractors in common use in the US. The main study finding was that many tractor controls, especially those that are hand-operated, may not be effectively reached by the majority of youth operators aged 12 to 16 years. The study raises further serious questions about the ability of children to safely operate tractors in common use on US farms and calls for reconsideration of age guidelines for the assignment of children to tractor work on farms. This study provides novel ergonomic evidence about the ability of children to reach controls inside agricultural tractor cabins. The approach could be applied in similar situations where youths may operate other vehicles or machines. Study findings support the establishment and refinement of policies and guidelines related to youth tractor operation.

Prevention of agricultural injuries: an evaluation of an education-based intervention.

OBJECTIVE: To evaluate the effectiveness of an agricultural health and safety program in reducing risks of injury. DESIGN: Cross-sectional survey. SETTING: 50 rural municipalities in the Province of Saskatchewan, Canada. INTERVENTION: The Agricultural Health and Safety Network (AHSN), a mainly educational program that administered 112 farm safety interventions over 19 years. SUBJECTS: 5292 farm people associated with 2392 Saskatchewan farms. Farms and associated farm people were categorized into three groups according to years of participation in the AHSN. IMPACT: self-reported prevalence of: (1) farm safety practices; (2) physical farm hazards. OUTCOME: (1) self-reported agricultural injuries. RESULTS: After adjustment for group imbalances and clustering at the rural municipality level, the prevalence of all impact and outcome measures was not significantly different on farms grouped according to years of AHSN participation. To illustrate, the adjusted relative risk of reporting no rollover protection on tractors among farms with none (0 years) versus high (>8 years) levels of AHSN participation was 0.95 (95% CI 0.69 to 1.30). The adjusted relative risk for agricultural injuries (all types) reported for the year before the survey was 0.99 (95% CI 0.74 to 1.32). CONCLUSIONS: Educational interventions delivered via the AHSN program were not associated with observable differences in farm safety practices, physical farm hazards, or farm-related injury outcomes. There is a need for the agricultural sector to extend the scope of its injury prevention initiatives to include the full public health model of education, engineering, and regulation.

Forces required to operate controls on farm tractors: implications for young operators.

Farm tractors account for the majority of fatal injuries to adolescents working in agriculture and therefore remain a leading occupational priority. The question of whether these injuries occur because adolescents are assigned tractor jobs beyond their physical capabilities has not been answered. The purpose of this study was to estimate the activation forces required to operate controls on 40 tractors in common use in the US and compare them with existing estimates of physical strength for children of varying ages and with recommended ergonomic force limits for repeatedly engaging controls. Activation forces for steering, brakes and clutch were measured on each tractor. The main study finding was that the activation forces required to operate tractors typically exceeded the physical abilities of most children aged 13 to 17 years. This raises serious questions about the ability of children to safely operate tractors in common use on US farms. This study provides an ergonomic approach for evaluating the potential mismatch between young people's strength capabilities and forces required in operating farm tractors. This approach could be used in similar situations where adolescents may operate vehicles (e.g. all-terrain vehicles), machinery or other mechanical devices requiring activation of levers and controls. Study findings potentially inform the establishment of occupational policies surrounding tractor operation by young people.

A summary of state laws regulating youth operating farm tractors on highways.

Driving farm tractors on highways is hazardous for youth due to the large speed differential between motor vehicles and agricultural vehicles, as well as recent increases in traffic volume on many rural roads. In 1994, the state of Wisconsin enacted legislation requiring youth who operate farm tractors on highways to complete a tractor and machinery certification course. We were interested in finding out whether other states have similar requirements. The purpose of this project was to collect and summarize state laws regulating youth who operate farm tractors on highways in the U.S. A systematic method was used that included an initial Lexis-Nexis database search followed by internet searches in combination with follow-up email and telephone communications when missing or unclear results were obtained. The findings show that 14 states have legislation addressing youth who operate farm tractors on highways. The content of these statutes varies, but includes driver's license or educational requirements, as well as regulations concerning the ages, locations, and/or times of day when youth may drive farm machinery on highways. This compilation of state laws will be useful information for agricultural safety professionals in designing effective outreach programs. A synthesis of the findings may also lead to the development of model legislation or inform future research efforts aimed at preventing youth farm tractor crashes on highways.

Evaluation of a policy to reduce youth tractor crashes on public roads.

OBJECTIVE: Evaluate the effectiveness of a United States state law, Wisconsin Act 455, in reducing highway tractor crashes involving youth operators. DESIGN: Policy outcome evaluation involving review of a retrospective case series. SETTING: Youth highway tractor crashes from Wisconsin for the years 1994-2003 that resulted in a fatality, injury, and/or property damage. SUBJECTS: One hundred and forty six tractor crash cases involving operators younger than 16 years. METHODS: Describe and model the tractor crash patterns before and after enactment of the law, and examine the relation between the contributing circumstances identified in the crash reports and the content covered in the mandated tractor certification course. RESULTS: There was neither a significant change in the number of youth tractor crashes after the law was passed, nor any reduction in the proportion of crashes where the youth operator was designated at fault. The tractor certification course did not cover the major factors contributing to youth tractor crashes on public roads. CONCLUSIONS: No significant effect of the law was detected and crash rates at the end of the study period were similar to those before Wisconsin Act 455. The authors'findings should not be construed to suggest that public policy, in general, is an ineffective strategy for the prevention of pediatric agricultural injuries. Negotiating a balance in public policy debates will be a challenge, but it is clear that future policy initiatives need to identify and implement the right policy for the right problem.

Farm health surveillance in the Marshfield Epidemiologic Study Area: a pilot study.

Surveillance of agricultural work-related illness and non-fatal injuries is limited and considered to be a major gap in prevention and policy-making capacity. This pilot study evaluated the utility of the Marshfield Epidemiologic Study Area (MESA) and its farm residency cohort to identify and monitor potential priorities for prevention and control. MESA is a defined geographic region that serves as a resource for conducting population-based health research. Nearly all of the residents receive their health care from the Marshfield Clinic and affiliated hospitals, providing archived electronic medical information to characterize past and present diagnoses. Based on scientific literature and national research priorities, five broad health issues (injuries, back problems, hearing loss, respiratory conditions, and dermatologic conditions) were selected. To estimate age-specific and age-adjusted incidence and prevalence, we followed a fixed cohort of 1995 MESA residents through 2002. Standardized incidence ratios and standardized prevalence ratios were also estimated to quantify the potential impact of farm residency. Linking MESA, its farm residency cohort, and the clinic's data archives allowed successful identification of significant associations with agricultural exposure for a few conditions and subconditions related to consensus priorities in agricultural health, particularly among men. These included extrinsic alveolitis, organic dust toxic syndrome, back pain, osteoarthrosis, and certain injuries. However, the system was generally not able to demonstrate strong influence of farm residency on disease occurrence for many conditions specifically selected for their likely capacity to show such influence. Future surveillance systems should supplement clinical data with other sources of information on health events and should be adequately powered to focus on narrower ranges of health conditions.

Pediatric farm injuries involving non-working children injured by a farm work hazard: five priorities for primary prevention.

OBJECTIVES: To describe pediatric farm injuries experienced by children who were not engaged in farm work, but were injured by a farm work hazard and to identify priorities for primary prevention. DESIGN: Secondary analysis of data from a novel evaluation of an injury control resource using a retrospective case series. DATA SOURCES: Fatal, hospitalized, and restricted activity farm injuries from Canada and the United States. SUBJECTS: Three hundred and seventy known non-work childhood injuries from a larger case series of 934 injury events covering the full spectrum of pediatric farm injuries. METHODS: Recurrent injury patterns were described by child demographics, external cause of injury, and associated child activities. Factors contributing to pediatric farm injury were described. New priorities for primary prevention were identified. RESULTS: The children involved were mainly resident members of farm families and 233/370 (63.0%) of the children were under the age of 7 years. Leading mechanisms of injury varied by data source but included: bystander and passenger runovers (fatalities); drowning (fatalities); machinery entanglements (hospitalizations); falls from heights (hospitalizations); and animal trauma (hospitalizations, restricted activity injuries). Common activities leading to injury included playing in the worksite (all data sources); being a bystander to or extra rider on farm machinery (all data sources); recreational horseback riding (restricted activity injuries). Five priorities for prevention programs are proposed. CONCLUSIONS: Substantial proportions of pediatric farm injuries are experienced by children who are not engaged in farm work. These injuries occur because farm children are often exposed to an occupational worksite with known hazards. Study findings could lead to more refined and focused pediatric farm injury prevention initiatives.

Evaluation of the North American Guidelines for Children's Agricultural Tasks using a case series of injuries.

OBJECTIVE: To evaluate the potential for the North American Guidelines for Children's Agricultural Tasks (NAGCAT) to prevent the occurrence of pediatric farm injuries. This evaluation focuses upon farm injuries experienced when children were engaged in farm work. DESIGN: Novel outcome evaluation involving primary review of three retrospective case series. SETTING: Fatal, hospitalized, and restricted activity injuries from the United States and Canada. SUBJECTS: Nine hundred and thirty four pediatric farm injury cases. METHODS: The applicability of NAGCAT to each case was rated. For injuries where NAGCAT were applicable, recurrent injury patterns were described and the potential for NAGCAT to prevent their occurrence was assessed. RESULTS: A total of 283 (30.3%) cases involved children engaged in farm work. There was an applicable NAGCAT guideline in 64.9% of the work related cases. Leading individual guidelines applicable to the injury events were: (1) working with large animals; (2) driving a farm tractor; and (3) farm work with an all-terrain vehicle. In the judgment of the research team, 59.6% of these injuries were totally preventable if the principles espoused by NAGCAT had been applied. CONCLUSIONS: NAGCAT are a set of consensus guidelines aimed at the prevention of pediatric farm injuries. The findings suggest that NAGCAT, if applied, would be efficacious in preventing many of the most serious injuries experienced by children engaged in farm work. However, work related injuries represent only a modest portion of pediatric farm injuries. This new information assists in the refinement of NAGCAT as an injury control resource and puts its potential efficacy into context.

Operational characteristics of tractors driven by children on farms in the United States and Canada.

Farm tractors are an important source of traumatic injury for children on farms. There is, however, no documentation about the age and size of tractors that children are operating and little information about the frequency with which rollover protective structures (ROPS) are used. This study described tractors that children on farms in the U.S. and Canada were operating by age, horsepower, and the presence of ROPS, according to the age and gender of the farm children involved. As a sub-analysis of data compiled during a randomized controlled trial, a descriptive analysis was completed on work exposure data collected by telephone interview. Of the 1,113 children involved in the trial, 522 (47%) were reported to perform at least one job that involved the operation of a farm tractor, and 408 (36.7%) were operating tractors of at least 20 horsepower. The majority of these children were male. There was a wide range of ages and sizes of tractors operated. However, the majority of tractors were between 20 and 70 horsepower and manufactured after 1970. Nearly one-half of the tractors were equipped with ROPS, and these tended to be newer and larger tractors. This analysis provides new data about the broad range of tractors driven by farm children in the U.S. and Canada. The findings point to a need to re-examine the reliance on a single voluntary standard to mitigate the hazard of tractor rollovers and the need for an enhanced safety policy requiring all tractors operated by children be equipped with ROPS.

Assignment of work involving farm tractors to children on North American farms.

BACKGROUND: Children are at high risk for tractor-related injury. The North American Guidelines for Children's Agricultural Tasks (NAGCAT) provide recommendations for the assignment of tractor work. This analysis describes tractor-related jobs assigned to farm children and compares them to NAGCAT. METHODS: A descriptive analysis was conducted of baseline data collected by telephone interview during a randomized, controlled trial. RESULTS: The study population consisted of 1,138 children who worked on 498 North American farms. A total of 2,389 farm jobs were reported and 456 (19.1%) involved operation of farm tractors. Leading types of tractor jobs were identified. Modest, yet important, percentages of children were assigned tractor work before the minimum ages recommended by NAGCAT. CONCLUSIONS: Children on farms are involved in tractor work at a young age and some are involved in jobs that they are unlikely to have the developmental abilities to perform. NAGCAT is a new parental resource that can be applied to these work situations.

Agricultural work activities reported for children and youth on 498 North American farms.

Children are at high risk for agricultural injury, yet there is little documentation about the range of farm work that children perform or the ages at which children experience these work exposures. The purpose of this study was to identify the scope of agricultural jobs performed by farm children and to describe variations in work involvement within demographic subgroups. A descriptive analysis was conducted of baseline data collected by telephone interview during a multi-site randomized controlled trial. The study population consisted of 1,138 children from 498 North American farms. A total of 2,389 jobs were reported for the 1,138 children. The leading categories of work were animal care, crop management, and tractor with implement operation. Regional differences were observed, consistent with variations in commodities. Substantial proportions of children were assigned to farm work even in the youngest age group of 7-9 years. Males were differentially assigned to tractor with implement operations, while females were more often assigned to animal care. This study provides one of the first systematic accounts of farm work performed by North American children. This analysis of work exposures provides information from which known prevention priorities can be reinforced and new opportunities for prevention identified.

The health beliefs and skin cancer prevention practices of Wisconsin dairy farmers.

PURPOSE/OBJECTIVES: To assess and describe health beliefs, level of knowledge about skin cancer, current skin cancer prevention practices, and cues to preventive action of Wisconsin dairy farmers. DESIGN: Descriptive survey. SETTING: Rural Wisconsin. SAMPLE: A stratified random sample of 535 male dairy farmers from the Wisconsin Department of Agriculture mailing list; 202 farmers (38%) returned the survey. METHODS: A survey instrument developed by the researcher was mailed to the farmers. Descriptive statistics were used to analyze data. MAIN RESEARCH VARIABLES: Susceptibility, seriousness, benefits, barriers, current practices, knowledge, and cues to preventive action in regard to skin cancer. FINDINGS: Farmers were knowledgeable about skin cancer and felt that they were susceptible, that it was a serious disease, and that protective actions were beneficial; however, they did not practice sun protection. "Too hot to wear" was the most frequent reason given for not wearing protective clothing, and "I forget to wear it" was the most common reason for not using sunscreen. CONCLUSIONS: Barriers to the use of sunscreen may be the most amenable to intervention. The utility of the Health Belief Model with this population is questioned and may require additional research. IMPLICATIONS FOR NURSING PRACTICE: Farming-related magazines and newspapers can be used to provide health information. Skin cancer education should be provided at schools, work sites, outpatient clinics, hospitals, and community screening events to remind farmers to practice sun protection.

Knowledge of occupational hazards in photography: a pilot study.

1. Artists use many materials composed of the same chemicals that cause major occupational health problems in industry. 2. The majority of artists are unaware of the potential hazards in the materials and processes they use. 3. The pilot study revealed that greater than 90% of the amateur photographers did not use safety precautions in the darkroom. 4. The most common perceived barrier to the use of safety precautions was the lack of knowledge about chemical safety.