Retrospective Risk Assessment of Injuries and Fatalities in the Forestry and Logging Workforce in the United States, 2003-2019.

OBJECTIVES: The objectives of this study on the forestry and logging workforce are to: 1) Analyze causes of injuries/fatalities to inform future intervention studies focused on risk mitigation, 2) determine whether there are any trends or associations between work-related risk factors and workplace injuries/fatalities over a 16-year period (2003-2019), and 3) identify knowledge gaps related to injuries and fatalities for future studies to address. METHODS: Data on fatalities, injuries, and illnesses of the forestry and logging workforce from the United States Bureau of Labor Statistics were analyzed. Correlation analysis (p < .05) was conducted to assess the relationship between causes of forestry and logging workforce fatalities by cause of fatality in the United States. Injury and fatality rates were calculated for each year (fatalities: 2003-2018; injuries: 2005-2019) and time span-specific incidence rates were calculated by cause. RESULTS: Contact with objects and equipment was the primary cause of injuries and fatalities in the forestry and logging workforce during the study period. Transportation-related incidents ranked second as the cause of fatalities, while the category of falls, slips, and trips was the second leading cause of injuries. CONCLUSION: Gaps in occupational health and safety identified by this study should be collaboratively addressed by researchers and the forestry industry.

Evaluation of surface versus total permethrin content in permethrin-treated clothing: Implications for protection against mosquitoes.

Permethrin is a synthetic pyrethroid insecticide used to treat uniforms (e.g. military, foresters) and other clothing to protect people against pests (e.g., mosquitoes, ticks). Pests contacting the surface of permethrin-treated clothing (PTC) are repelled and/or killed, depending on the dose and duration of exposure. Hence, it is important to assess the amount of permethrin on the surface of clothing. Fabric swatches prepared using two commercially available permethrin treatments (Insect Shield® & Sawyer Repellant) and one laboratory created treatment (4g permethrin/L) were tested. A Martindale Abrasion and Pilling Tester (MAPT) and gas chromatography were used to assess surface permethrin content (SPC) and total permethrin content (TPC). Sawyer PTC had the highest SPC (mean ± standard error) (32.68±14.55µg/g), followed by Insect Shield® (23.35±2.71µg/g) and lab-created 4g/L permethrin (8.7±0.78µg/g). SPC (after 1000 rubs on MAPT) for Insect Shield®, Sawyer, and 4g/L permethrin groups was significantly lower than TPC (P=0.011, P<0.001, and P=0.001, respectively). The SPC/TPC relationship varied widely between permethrin treatment methods and practical implications for this are discussed. Mosquito repellency tests indicate that Insect Shield®, Sawyer, and lab-created (4g/L) permethrin-treated fabrics showed a significantly higher repellency rate than control (untreated) fabrics (P=0.001, P<0.0001, P<0.0001, respectively). While Insect Shield® had the highest repellency rate against susceptible (53%) and exposed (48%) mosquitoes, differences between groups were not significant. Repellency rates indicate SPC plus other factors (e.g. treatment method) may contribute to mosquito repellency and should be considered in risk assessments for protection against pests.

Working along the Continuum: North Carolina's Collaborative Response to COVID-19 for Migrant & Seasonal Farmworkers.

North Carolina employs 78,000+ migrant/seasonal farmworkers (MSFWs) annually. Arrival/departure dates are crop and weather dependent. MSFWs may be employed by a grower or a farm labor contractor (FLC). Like farmworker housing, FLCs may be registered or unregistered. Primary care or enabling services are provided by the NC Farmworker Health Program or community health centers that receive dedicated federal funding for MSFWs. The arrival of NC's growing season, MSFWs, and COVID-19 brought unforeseen challenges even to those experienced in caring for MSFWs. Challenges include congregate activities, consistency/accuracy of COVID-19 related communications, availability of alternate housing, barriers to testing and contact tracing, lack of internet connectivity in farmworker housing and insufficient personal protective equipment. Challenges are discussed in no order of occurrence or level of importance as many are inter-related. To meet these challenges, a migrant health and housing workgroup was convened. Members include the NC Department of Labor-Agricultural Safety and Health Bureau, NC Department of Health and Human Services - Communicable Disease Branch and NC Farmworker Health Program, NC Community Health Center Association and NC Agromedicine Institute. Members work collaboratively along the continuum from local to state levels and across agencies and communities to facilitate strategies to address COVID-19 challenges. Implications exist for practice, research and policy including testing of MSFWs on arrival with a 14-day quarantine before moving to assigned farm, a "strike team" to do on-farm tests for workers in the event of a positive case or exposure; and, research on COVID-19 outbreaks and impact of telehealth on MSFWs wellbeing.

Adapting Certified Safe Farm to North Carolina Agriculture: An Implementation Study.

Certified Safe Farm (CSF) is a multimodal safety and health program developed and assessed through multiple controlled intervention studies in Iowa. Although developed with the intent to be broadly applicable to agriculture, CSF has not been widely implemented outside the midwestern United States. This article describes the CSF implementation process in North Carolina (NC), as piloted on a large-scale in three agriculturally diverse and productive counties of NC, and reports its effectiveness using the Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework. Implementation involved (1) capacity building through safety and health training, (2) adaptation of components of Iowa's CSF model to NC agriculture, (3) marketing and recruitment, and (4) formative evaluation, including an online survey and focus group discussion. From 2009 to 2012, 113 farms participated in at least one component of the CSF intervention, representing a NC farm participation rate of 3.1% in the study area. A major adaptation of NC implementation was the utilization of NC Cooperative Extension as the local driver of implementation in contrast to local AgriSafe clinics in Iowa. The most innovative adaptation to CSF components was the development of a defined economic incentive in the form of a cost-share program. The RE-AIM framework was found to be useful and relevant to the field of agricultural health and safety translational research. This study provides effectiveness measures and implementation alternatives useful for those considering implementing CSF. It informs current efforts to move CSF from research to practice through the National Sustainable Model CSF Program initiative.

A cross-sectional study of stressors among farmers in Eastern North Carolina.

BACKGROUND: Agriculture is a hazardous, stressful occupation that can adversely affect farmers' health. Identifying stressors among farmers may help health professionals improve health outcomes by developing targeted intervention strategies and services. METHODS: Over a 4-month period, we conducted a cross-sectional study of 128 farmers in an economically disadvantaged, 29-county region of Eastern North Carolina. We used a modified version of the Farm Ranch Stress Inventory to measure farmers' self-reported reactions to potential stressors. RESULTS: The majority of farmers surveyed were aged 40-59 years, had farmed for more than 20 years, and worked more than 40 hours per week on the farm. Large proportions of respondents identified the following factors as 'very stressful': concern about the weather (60.2%), concern over the future of the farm (29.7%), outsiders not understanding the nature of farming (25.2%), problems with machinery (23.4%), market prices for crops/livestock (45.3%), taxes (38.3%), health care costs (32.5%), and not having enough time to spend with family in recreation (13.3%). Experiencing 8 or more factors as "very stressful" was found to be positively associated with working more than 40 hours per week on the farm (P = .008) and with being a farm manager or a farm worker who does not operate equipment (P = .001). CONCLUSIONS: Information about perceived stressors among farmers may help health professionals develop targeted interventions for reducing stress. More research is needed to better evaluate health outcomes, to reduce farm-related injuries, and to improve psychosocial well-being.

Evaluation of respiratory symptoms and respiratory protection behavior among poultry workers in small farming operations.

Agricultural workers who work in enclosed poultry operations are at increased risk of respiratory exposure to atmospheric contaminants, including dusts, endotoxins, particulate from feathers, ammonia, and hydrogen sulfide from animal excrement. Given the relatively large number of small, family-run poultry farms in North Carolina, there has been relatively little research in the area documenting human lung function and perception of using respiratory protection among poultry workers. This study assesses respiratory health, knowledge, and perception of wearing respiratory protection among a sample of poultry workers attending a regional farm show in North Carolina. Lung function (spirometry), airway inflammation (exhaled nitric oxide), self-reported respiratory symptoms, and behavior of wearing respiratory protection were evaluated. Overall, mean lung function values were slightly lower than normal predicted values. The majority of participants ranked using respiratory protection as very important (51.9%); however, actual self-reported behavior was low (16.7%). In bivariate analysis, associations between the importance of wearing respiratory protection and the number of poultry houses (P=.04), as well as using a respirator and the number of poultry houses (P=.01) were statistically significant. Improved educational opportunities, including fit-testing and proper respiratory selection, should be emphasized for workers at small, poultry farm operations.

North Carolina farm women: opportunities for support and farm-related education.

The stress that farming visits upon male farmers has been acknowledged for decades. Stress- and work-related injuries among nonmigrant farm women is well documented from 1980 through the mid-1990s. A void of literature concerning nonmigrant farm women exists since that time. One possible explanation for this deficit is that United States Department of Agriculture Census of Agriculture data only consider the contributions of women on the farm if they are reported as farm operators. From 2002 to 2007, the number of women farm operators in North Carolina (NC) increased by 3%, and currently 13% of the state's farms are operated by women. These numbers emphasize the importance of understanding the self-perceived needs of women farmers. A qualitative research project was conducted to investigate the social-emotional needs of NC farm women. Semistructured interviews were conducted with 15 women with whom the NC Agromedicine Institute had previously worked in collaboration on farm health and safety. Key themes from interviews were (1) chameleonic, (2) inseparable connectedness, (3) farm sword, (4) women of a feather, and (5) one size doesn't fit all. Participants reported multiple roles, difficulty separating from the farm, preferring the farm over any other place, and viewing themselves as misperceived farm professionals. Participants need opportunities to interact with other farm women for support and sharing farm-management techniques. Future study recommendations include (1) inventory existing programs for farm women; (2) further investigate the support and educational needs of farm women; and (3) examine how farm women are perceived by nonfarm individuals.

Qualitative assessment of agritourism safety guidelines: a demonstration project.

In 2007, the National Children's Center for Rural and Agricultural Health and Safety (NCCRAHS) published Agritourism Health and Safety Guidelines for Children to provide helpful recommendations for protecting the health and safety of children visiting agritourism farms. Supplement A: Policies and Procedures Guide and Supplement B: Worksite Guide were subsequently published in 2009 and provided agritourism farms with checklists to use in reviewing, planning, and implementing their own health and safety practices. In order to better understand what would be required of a farm wishing to implement the guidelines using Supplements A and B, the North Carolina Agromedicine Institute conducted a single-family farm demonstration project with support from the NCCRAHS. The aims of the project were to (1) determine child health and safety risks associated with an existing agritourism farm; (2) determine the cost of making improvements necessary to reduce risks; and (3) use project findings to motivate other agritourism farms, Cooperative Extension agents, and agritourism insurers to adopt or recommend Agritourism Health and Safety Guidelines for Children for their own farms or farms with which they work. At the conclusion of the study, the target farm was in compliance with an average of 86.9% of items in Supplements A and B. Furthermore, 89% of individuals self-identifying as farmers or farm workers and 100% of Cooperative Extension agents and agritourism insurers attending an end-of-project workshop indicated their intent to adopt or recommend Agritourism Health and Safety Guidelines for Children for their own farms or farms with which they work.

Assessment of sun safety behavior among farmers attending a regional farm show in North Carolina.

BACKGROUND: Due to the nature of working outdoors, many farmers experience high levels of exposure to ultraviolet radiation (UVR) whereby, increasing their risk for skin cancer. The primary goal of this study was to evaluate personal behavior and perception on sun protection among farmers attending a regional farm show in North Carolina. METHODS: Farmers (n = 397) were asked to complete a self-administered questionnaire regarding behavior and importance of using personal sun protection (i.e., sunblock, etc.,) when working outdoors. RESULTS: There were 285 (71.8%) male farmers and 79 (19.9%) female farmers with a mean age of 54 years. Overall, the majority of farmers recognized the importance of protecting themselves from the sun, however, actual personal behavior for using proper protection methods ranked low. Farmers with lighter, fairer skin tended to use more sun protection and ranked the importance of sun protection higher when compared to those with skin that was less likely to burn in the sun. CONCLUSION: The importance of personal sun protection should continue to be stressed to farmers at every available opportunity including farm shows, trainings and through health care providers.

Harvest of need: addressing health and safety challenges on North Carolina's farms.

Agriculture is North Carolina's leading source of revenue and its most dangerous industry. This issue brief, along with the commentaries and sidebars in the associated policy forum, addresses the complexity of agricultural health and safety in North Carolina and concludes that the following activities are crucial to reducing the incidence of agricultural illness, injury, and death in the state: (1) positive promotion of safe and healthy farms, (2) increased funding for existing programs, (3) creation of a task force to develop a dedicated, comprehensive surveillance system for agricultural illness, injury, and fatality, (4) increased emphasis on and funding for training of health care professionals and emergency response personnel in agricultural health and safety, (5) funding to expand farm health and safety programs to all 100 counties, and (6) strong collaborations to further develop and strengthen a seamless, holistic system for addressing the state's agricultural health and safety needs.