Characteristics of and risk factors for compensated occupational injury and disease claims in dairy farmers: a case-control study.

Research indicates that dairy farmers have an elevated risk of work-related adverse health outcomes. This case-control study evaluated the characteristics of and risk factors for compensated occupational injury and disease claims among Finnish dairy farmers. The cases consisted of 19 farm couples in which both spouses had a history of multiple claims. There were 283 claims in total, a rate of 26.6 claims per 100 person-years. The controls consisted of 12 couples in which neither spouse had compensated or rejected claims during their work history as insured farmers. A combined mail/telephone survey charted potential risk factors for compensated claims. These claims frequently involved work tasks and causes related to animal husbandry. Cattle were the most common cause for injuries in general and for serious injuries in particular. Gender differences in farm work and claims were observed. Using logistic regression analyses, we identified personal and work-related risk factors including long work history, small-scale dairy farm operation, and conventional stanchion barn for dairy cattle. Outdated working conditions, while not statistically significant, were positively associated with claims as well. Declined current work ability and musculoskeletal or respiratory conditions were significantly associated with claims where each of these outcomes may contribute to the other. Identified factors could be used to select subgroups of dairy farmers with either elevated or reduced risk of claims. Prevention of adverse health outcomes could be most effective when targeted to farmers at highest risk of occupational injury and disease.

Risk factors for occupational injuries among full-time farmers in Finland.

The objectives of this study were to evaluate the frequency of and farm management-related risk factors for occupational injuries among full-time farmers. A computer-assisted telephone interview was conducted among randomly selected self-employed full-time farmers (n = 1182; 911 male and 271 female), The response rate was 86%. Two-thirds of the respondents raised dairy or beef cattle. Nearly 16% of the farmers had experienced one or more occupational injuries requiring medical consultation during the past 12 months; the total number of such injuries was 222. Injuries were more common among male (17 injuries/100 person-years) than female farmers (13 injuries/ 100 person-years). The injuries occurred most frequently in animal husbandry work (n = 97). Falling or slipping was the most common mechanism of injury. Poisson regression with a stepwise (forward) model selection procedure identified the following risk factors for occupational injuries: male gender, younger age, cooperation with other farmers, perceived high accident risk, and stress symptoms. The adjusted rate ratios for these risk factors ranged from 1.40 to 1.96. This study indicates that interventions are needed, particularly among male farmers in their early years of full-time farm operation. At this stage of life, heavy financial burden and stress while establishing and expanding production may contribute to injuries. To reduce stress and related injuries, we recommend guidance for farmers regarding the organization and management of farm work.

Barriers and enabling factors for safety improvements on farms in Finland.

Systematic reviews of agricultural safety and health interventions have shown little evidence of effectiveness. In this study, we used a self-documentation and collaborative interpretation method (cultural probes, n = 9) as well as farm interviews (n = 11) to identify factors affecting the adoption and implementation of safety information. The three main barrier groups found were (1) personal characteristics of the farmer, (2) limited resources to make safety improvements, and (3) the slow incremental evolution of the physical farm environment where old, hazardous environments remain along with new, safer improvements. The enabling factors included good examples or alarming (and thus activating) examples from peers, ease of implementation of the promoted safety measures, and enforcement of regulations. The findings suggest that a user-centered approach could facilitate the development of more effective safety and health interventions. A conceptual model of the safety intervention context created in this study can be used as a framework to examine specific barriers and enabling factors in planning and implementing safety and health interventions.

Safety and animal handling practices among women dairy operators.

This article presents suggestions toward safer animal handling utilizing the results of a qualitative study of women dairy farmers in Finland. A major proportion of injuries (43%) occur in livestock-related work in Finnish agriculture. An even greater proportion of women's farm injuries (77%) is related to animals. We investigated the working conditions often women dairy farmers. Data were collected by observing farm work and performing semi-structured interviews. The study farms represented different milk production technologies with an average farm size of 106 ha (262 acres) of cultivated land, 51 ha (126 acres) of forest, and 45 dairy cows. Farm-related injuries were frequent; eight respondents out often had suffered one or several injuries during the previous two years. The women considered farm animals as the greatest hazard, and unexpected animal behavior was viewed as the most significant work-related injury risk. Dangerous situations often resulted from stress in cows caused by unpleasant circumstances or making animals fearful of people. Experiences from some farms suggested that dairy farm work can be relatively safe and that improving the trust between the cows and their handlers plays a key role in safety. We synthesized our findings into four animal handling strategies that can potentially reduce the risk of injury among stockpersons. We developed practical guidelines on how to gradually build a good cow-handler relationship based on our findings and the literature on cattle handling strategies and animal welfare science.

Certified safe farm: identifying and removing hazards on the farm.

This article describes the development of the Certified Safe Farm (CSF) on-farm safety review tools, characterizes the safety improvements among participating farms during the study period, and evaluates differences in background variables between low and high scoring farms. Average farm review scores on 185 study farms improved from 82 to 96 during the five-year study (0-100 scale, 85 required for CSF certification). A total of 1292 safety improvements were reported at an estimated cost of $650 per farm. A wide range of improvements were made, including adding 9 rollover protective structures (ROPS), 59 power take-off (PTO) master shields, and 207 slow-moving vehicle (SMV) emblems; improving lighting on 72 machines: placing 171 warning decals on machinery; shielding 77 moving parts; locking up 17 chemical storage areas, adding 83 lockout/tagout improvements; and making general housekeeping upgrades in 62 farm buildings. The local, trained farm reviewers and the CSF review process overall were well received by participating farmers. In addition to our earlier findings where higher farm review scores were associated with lower self-reported health outcome costs, we found that those with higher farm work hours, younger age, pork production in confinement, beef production, poultry production, and reported exposure to agrichemicals had higher farm review scores than those who did not have these characteristics. Overall, the farm review process functioned as expected. encouraging physical improvements in the farm environment, and contributing to the multi-faceted CSF intervention program.

Trimethylsilyldiazomethane: a safe non-explosive, cost effective and less-toxic reagent for phenol derivatization in GC applications.

Diazomethane is a highly explosive and toxic gas routinely employed for the quantitative and clean derivatization of phenols. We investigated the commercially available trimethylsilyldiazomethane in the presence of diisopropylethylamine as a safe, non-explosive and less-toxic alternative using six phenolic polychlorinated biphenyls as model analytes and fluoro-tagged analogues as internal standards. We compared yields and derivatization times of each method employing a liver microsomal extract as a real matrix. Steric hindrance and electronic properties of the analytes were also investigated. The alternative method afforded equal to higher derivatization yields with increased reaction times, up to 100 min, while explosion and toxic exposure risks were minimized and cost efficiency was increased above 25%. These findings demonstrate that non-explosive trimethylsilyl diazomethane produces comparable derivatization results to the dangerous diazomethane under the conditions studied.

Work Ability Index among Finnish dairy farmers.

Full-time farmers and particularly dairy farmers who plan to expand their production have voiced concerns about their physical and mental work ability in recent studies. The objectives of this study were to characterize the work ability of dairy farmers and to identify demographic groups at risk of disability and in greatest need of interventions to promote work ability. We conducted a postal survey using the Work Ability Index (WAI) questionnaire. The WAI of 399 dairy farmers (245 female and 154 male) was analyzed (response rate 41.5%). The mean WAI score was 36.0 among female and 39.0 among male respondents (scale: 7 = worst to 49 = best). The WAI decreased with age. The WAI was systematically better among males compared to females in all age groups, and the difference was greatest among those over 45 years of age. About one-fourth of females and one-tenth of males over 45 years of age were at an imminent risk of disability (poor WAI). The WAI of farmers in our study was similar to farmers in previous studies where entrepreneurs and salaried workers had better WAI compared to farmers. This study indicates that interventions are needed among older dairy farmers, particularly females, to help them improve their work ability. The first question (of seven) in the WAI questionnaire correlated well with the complete questionnaire-based WAI. The first question could be used in surveys as a condensed version of the WAI, if the same correlation is found in future studies. Based on this study, we recommend using the Work Ability Index questionnaire for assessing the health of those working in agriculture.

Interventions for preventing injuries in the agricultural industry.

BACKGROUND: Agriculture is more hazardous than most other industries. Many strategies have been introduced to reduce injuries in the field, yet the effectiveness of different interventions on occupational injuries still remains unclear. OBJECTIVES: This review aims to determine the effectiveness of interventions to prevent occupational injuries among workers in the agricultural industry compared to no interventions or to alternative interventions. SEARCH STRATEGY: Cochrane Central Register of Controlled Trials, Cochrane Injuries Group's specialised register, MEDLINE, EMBASE, PsychINFO, OSH-ROM (including NIOSHTIC and HSELINE) databases were searched up to June 2006. Reference lists of selected articles, relevant reviews and additional topic related databases and web sites were also searched. The searches were not restricted by language or publication status. SELECTION CRITERIA: Randomised controlled trials, cluster-randomised controlled trials, prospective cohort studies with a concurrent control group, and interrupted time series studies assessing any type of intervention aiming to prevent fatal or non-fatal injuries among workers in agriculture. DATA COLLECTION AND ANALYSIS: Two reviewers conducted data extraction and study quality assessment independently. Rate ratios of randomised controlled trials were calculated and the effect sizes were combined in a meta-analysis. Interrupted time series studies were reanalysed and each of them studied for having an immediate and a progressive effect. MAIN RESULTS: Five randomised controlled trials (RCTs) with 11,565 participants and three interrupted time series studies (ITSs) with 26.3 data points on average met the criteria. For educational interventions aiming at reducing injury rates among adults the pooled rate ratio after recalculation from effect sizes in three RCTs was 1.02 (95% CI 0.87 to 1.20). For educational interventions aiming at children the pooled rate ratio for injury rates in two RCTs was 1.27 (95% CI 0.51 to 3.16). One ITS that evaluated the effect of an intervention that included financial incentives decreased the injury level immediately after the intervention with an effect size of -2.68 (95% CI -3.80 to -1.56) but did not have a significant effect on the injury trend over time with an effect size of -0.22 (95% CI -0.47 to 0.03). One ITS study that evaluated the effect of legislation to ban Endosulfan pesticide on fatal pesticide poisonings increased the level of poisonings immediately after the introduction with an effect size of 2.20 (95% CI 0.97 to 3.43) but led to decrease in the trend of poisonings over time with an effect size of -2.15 (95% CI -2.64 to -1.66). One ITS study documented four different regulations aiming to increase the use of rollover protective structures (ROPS) on tractors and their effect on injuries and fatal injuries. The introduction of two different pieces of legislation requiring ROPS on new tractors sold after a certain date was associated with a decrease of fatal injuries over the long term (effect size -0.93 95% CI -1.02 to -0.03) but they were also associated with an increase of injuries in general (fatal and non-fatal injuries combined). Introduction of legislation requiring ROPS on all tractors, old tractors included, was not associated with a decrease but with an increase of injuries and fatal injuries over the long term. AUTHORS' CONCLUSIONS: The selected studies provided no evidence that educational interventions are effective in decreasing injury rates among agricultural workers. Financial incentives could reduce injury rates. Legislation to ban pesticides could be effective. Legislation expanding the use of safety devices (ROPS) on new tractors was associated with a decrease in fatal injuries.

Safety performance of animal confinement floors: slip, trip, and fall injuries in Finland.

Slip, trip, and fall (STF) injuries are common in agriculture. The aims of this study were to characterize STF injuries and to identify floor-related safety problems that can be reduced or eliminated through building design. Our material consisted of Finnish agricultural injury claim records for the period 1992-2002. The material included 6,414 slip, trip, and fall injuries that occurred in dairy, beef and swine production and were caused by floor structures. We examined coded information and injury descriptions to identify causes and contributing factors. The performance approach (PA) was used as a framework for discussing findings and their application to building design. PA provides a logic model for building design that considers the needs of workers, animals, and production processes. Nearly half (42%) of agricultural injuries occurred in dairy, beef, and swine production work. Fourteen percent of these injuries were slips, trips, and falls (STF) related to floor structures. More than 450 work years were lost due to disability resulting from these injuries. Many STF injuries occurred in milking (n = 1135), moving feeds (n = 962), and animal transport and care (n = 880). More than half (59%) of STF injuries occurred while carrying or moving a load. STF injury causes included floors, door sills, gutters, curbs, steps, ramps, grates, and contaminants like water, ice, snow, manure, detergent, forage, and hay. Men had a lower STF injury risk compared to women (RR = 0.63, 95% CI: 0.61-0.67). The magnitude and nature of STF injuries suggest that there is a need for improving the safety performance of floors and related structures. Key areas include slip-resistant floorings, effective contamination control, macro structures (elevations, entrances, access ways), and logistics for materials handling and storage spaces.

Tractor overturn concerns in Iowa: perspectives from the Keokuk county rural health study.

Agriculture remains one of the most hazardous industries in the U.S., with tractor overturns producing the greatest number of agricultural machinery-related fatalities. Rollover protective structures (ROPS) and seatbelts effectively reduce tractor overturn deaths. However, a large proportion of tractors in use in American agriculture are older tractors without ROPS and seatbelts. This article describes the tractor-related responses from participants in a population-based study conducted in Keokuk County, Iowa. This study was designed to measure rural and agricultural adverse health and injury outcomes and their respective risk factors. Questionnaires were partially developed from well-documented national surveys. Questions about agricultural machinery use, presence of safety equipment on the machinery, work practices, and attitudes about farm safety were included. Study participants on farms who owned tractors had an average of 3.1 tractors with an average age of 27 years. Only 39% of the 665 tractors had ROPS. Tractor age was associated with the presence of ROPS; 84% of tractors manufactured after 1984 were ROPS-equipped, whereas only 3% of tractors manufactured before 1960 were ROPS-equipped. ROPS-equipped tractors were significantly more common on larger farms and households with higher income. Only 4% of the farmers reported that their tractors had seatbelts and they wore them when operating their tractors. The results of this study support the findings of other studies, which indicate that many older tractors without ROPS and seatbelts remain in use in American agriculture. Until a dramatic reduction in the number of tractors in the U.S. operated without ROPS and seatbelts is achieved, the annual incidence of 120 to 130 deaths associated with tractor overturns will persist.

Vegetable oil sprinkling as a dust reduction method in swine confinement.

The aim of this project was evaluate the effectiveness of an oil sprinkling system as a dust-reduction method for swine production facilities. This article presents the results of the second-year experiment of a multi-year study. The first-year experiment demonstrated that a 5% oil-water emulsion automatically applied at the rate of 3 and 5 g/pig/day achieved a 23% to 34% reduction in total dust. The modifications for the second year experiment included: (1) increasing oil application rate to 7 and 8 g/pig/day, (2) replacing sprinkler heads to achieve a smaller droplet size and a more direct spray pattern on pen-floor surfaces, and (3) more closely matching the treatment and control rooms by stage in the pig production cycle. Four swine finishing rooms were used for this study; two were treatment rooms (soybean oil at 7 g/pig/day, and canola oil 8 g/pig/day) and two were control rooms. The treatment rooms had a low-pressure oil-sprinkling system, which sprinkled 5% oil-to-water mixture 12 times per day, 12 s each time. Concentrations of several environmental contaminants were measured. The average total dust concentration in the control rooms was 1.39 mg/m3. The average total dust concentration in the treatment rooms was 0.65 mg/m3. The treatment reduced dust by an average of 52%, (p = 0.0001). There was no difference in the degree of dust control between soybean oil and canola oil. The respirable dust concentrations were very low in all rooms, and there were no significant differences between rooms in ammonia, carbon dioxide, temperature, or humidity.

Injuries in the Iowa Certified Safe Farm Study.

The aims of this article are to assess injury characteristics and risk factors in the Iowa Certified Safe Farm (CSF) program and to evaluate the effectiveness of CSF for reducing injuries. This intervention program includes a health screening, on-farm safety review, education, and monetary incentives. Cohorts of farmers in an intervention group (n = 152) and control group (n = 164) in northwestern Iowa were followed for a three-year period. During the follow-up, there were 318 injuries (42/100 person-years), of which 112 (15/100 person-years) required professional medical care. The monetary cost of injuries was $51,764 ($68 per farm per year). There were no differences in the self-reported injury rates and costs between the intervention and control groups. Raising livestock, poor general health, and exposures to dust and gas, noise, chemicals and pesticides, and lifting were among risk factors for injury. Most injuries in this study were related to animals, falls from elevation, slips/trips/falls, being struck by or struck against objects, lifting, and overexertion. Machinery was less prominent than generally reported in the literature. Hurry, fatigue, or stress were mentioned as the primary contributing factor in most injuries. These findings illustrate the need for new interventions to address a multitude of hazards in the farm work environment as well as management and organization of farm work.

Mortality and morbidity in agriculture in the United States.

This article summarizes the trends in agricultural injuries and illnesses in the past decade, as well as the needs for surveillance in the future. Agriculture is one of the most hazardous industries in the U.S. The fatality rate in agriculture remained high (about 22/100,000 workers) through the 1990s. and tractors remained the leading source of death, causing approximately 300 fatalities each year. Non-fatal injuries and illnesses decreased in the employed agricultural worker population. There are no adequate injury and illness data for self-employed farmers and family members to show trends over time. The reported injury rates have been 0.5 to 16.6/100 workers, based on the source of information. Many studies have shown high rates of respiratory and musculoskeletal symptoms, hearing loss, and skin disorders in agriculture. The overall cancer rate is lower; however, certain cancers are elevated in farmers. Surveillance information has not improved significantly in the past decade; however, many studies have provided more insight into the prevalence, incidence, and risk factors for injury and illness. Further efforts are needed to better define the populations at risk, including farmers and ranchers, family members, workers, migrant and seasonal workers, and others exposed to farm hazards. Fatalities are well documented, and it is important to continue existing surveillance in the future. Surveillance systems should be developed to collect information on agriculture-related non-fatal injuries and illnesses.

The Fatality Assessment and Control Evaluation program's role in the prevention of occupational fatalities.

OBJECTIVES: The objective of the Fatality Assessment and Control Evaluation (FACE) program is to prevent traumatic occupational fatalities in the United States by identifying and investigating work situations at high risk for injury and formulating and disseminating prevention strategies to those who can intervene in the workplace. SETTING: The FACE program is a research program located in the Division of Safety Research, a division of the National Institute for Occupational Safety and Health (NIOSH). NIOSH is an agency of the United States government and is part of the Centers for Disease Control and Prevention. NIOSH is responsible for conducting research and making recommendations for prevention of work related illnesses and injuries. FACE investigators conduct traumatic occupational fatality investigations throughout the United States and provide technical assistance to 15 state health or labor departments who have cooperative agreements with NIOSH to conduct traumatic fatality surveillance, targeted investigations, and prevention activities at the state level. METHODS: Investigations are conducted at the worksite using the FACE model, an approach derived from the research conducted by William Haddon Jr. This approach reflects the public health perspective that the etiology of injuries is multifactorial and largely preventable. FACE investigators gather information on multiple factors that may have contributed to traumatic occupational fatalities. Information on factors associated with the agent (energy exchange, for example, thermal energy, mechanical energy, electrical energy, chemical energy), host (worker who died), and the environment (the physical and social aspects of the workplace), during the pre-event, event, and post-event time phases of the fatal incident are collected and analyzed. Organizational, behavioral, and environmental factors contributing to the death are detailed and prevention recommendations formulated and disseminated to help prevent future incidents of a similar nature. RESULTS: Between 1982 and the present, more than 1,500 fatality investigations have been conducted and reports with prevention recommendations distributed. Findings have been published in scientific and trade journals; safety professionals and policy makers have used FACE findings for prevention efforts; and working partnerships have been formed to address newly emerging safety concerns. CONCLUSIONS: FACE investigations identify multiple factors contributing to fatal occupational injuries, which lead to the formulation and dissemination of diverse strategies for preventing deaths of a similar nature.

A systematic review of farm safety interventions.

OBJECTIVE: The main objective of this study was to systematically review the existing evidence for the effectiveness of farm injury prevention interventions. SEARCH STRATEGY: We used a systematic approach to search the following electronic databases: MEDLINE, EMBASE, ERIC, PsycInfo, Sociofile, NTIS, Agricola, Expanded Academic Index, Dissertation Abstracts, and Occupational Safety and Health (NIOSHTIC). Proceedings and technical papers of the National Institute for Farm Safety were reviewed. We also checked the references of potentially eligible studies and consulted with experts in the field to identify other relevant information sources. SELECTION CRITERIA: Papers had to involve a farm safety intervention to be included in the review. To best characterize the current state of farm safety research, all study designs were accepted, including those without comparison groups and those with absent or inadequate evaluation methods. RESULTS: We identified 25 studies for the review. Eleven of the studies involved farm safety education programs, five consisted of multifaceted interventions that included environmental revisions, a farm visit, or both; nine papers described farm safety interventions but did not report results from an evaluation. Farm safety education interventions included safety fairs, day camps; certification programs; workshops; and courses for farm families, youth, and agricultural workers. Multifaceted interventions were targeted to farm operators and generally involved farm safety audits, followed by environmental or equipment changes and/or safety education. Program evaluations assessed changes in safety attitudes, knowledge, and/or behaviors and generally involved pre- and post-test methodology. Only three studies examined changes in the incidence of farm injuries. Of the studies evaluated, most reported positive changes following the interventions. However, limitations in the design of evaluations make the results of many of the studies difficult to interpret. CONCLUSIONS: There is a need for more rigorous evaluations of farm safety intervention programs. Suggested study design improvements include randomization of study subjects when appropriate, use of control groups and the objective measurement of outcomes such as behavior change and injury incidence.

Dust in pig buildings.

It is well documented in the international scientific literature that airborne dust in pig houses can cause serious health problems for humans as well as for animals. Extensive research has been carried out in different countries during the last few decades to improve the scientific understanding of air quality issues related to intensive animal production. Research and review papers were presented at the international symposium on Dust Control in Animal Production Facilities, held in Denmark in 1999. Different techniques have been used in order to reduce dust burdens in pig confinement buildings, but up to date only the procedure of spraying oil or a mixture of oil and water has contributed to reducing the indoor dust concentrations significantly. This article summarizes the current level of understanding of dust issues in intensive animal production buildings, mainly on the basis of papers presented at the above-mentioned symposium.