Summary of recommendations from the National Institute for Occupational Safety and Health Fire Fighter Fatality Investigation and Prevention Program, 2006-2014.

INTRODUCTION: The NIOSH Fire Fighter Fatality Investigation and Prevention Program (FFFIPP) conducts independent investigations of selected fire fighter line-of-duty deaths (LODD) and offers recommendations to prevent similar deaths. The purpose of the current study was to provide information on more recent FFFIPP recommendations and to determine if recommendations have changed over time. METHODS: Fatality investigations completed from 2006 to 2014 were selected for this study with recommendations being assigned into twelve major categories when possible. The most frequently occurring recommendations were then rank ordered overall and then by medical and traumatic fire fighter LODD. RESULTS: There were 1,067 total recommendations made in the published fire fighter investigative reports for both medical and trauma-related fire fighter fatalities for the period 2006-2014. Of these, 784 (73%) could be placed within one of the 12 categories noted previously. The top 10 recommendation categories overall were: 1. Medical screening, 2. Fitness and wellness program, 3. Training, 4. Medical clearance, 5. Standard Operating Procedures/Standard Operating Guidelines (SOPs/SOGs), 6. Incident command, 7. Strategy and tactics, 8. Communications, 9. Personal protective equipment and 10. Staffing. CONCLUSIONS: The leading recommendations from the NIOSH FFFIPP medical investigations between 2006 and 2014 did not change compared to those made between 1998 and 2005, with the exception of the addition of "medical clearance for duty". There were changes for the traumatic injury leading recommendations for 2006-2014, with the major change being "training", which was the leading FFFIPP recommendation for traumatic injuries for this time period. Practical applications: The intent of the FFFIPP is to influence fire departments and fire fighters to critically assess and evaluate situations/circumstances similar to those identified by NIOSH investigations and implement the recommendations offered to prevent additional fire fighter fatalities.

The NIOSH CROPS Demonstration Project: A Study in New York and Virginia with an Emphasis on Youth.

The agriculture, forestry, and fishing (AgFF) industry sector has had the highest rate of work-related deaths over the past several years. Tractors are the single largest source of occupational fatalities in this industry sector, and tractor rollovers are the largest category of tractor fatalities. The risk of death due to tractor rollovers has been found to be reduced considerably when rollover protective structures (ROPS) are used in conjunction with seatbelts. Increasing the number of tractors with ROPS and seatbelts is one way in which tractor rollover fatalities can be mitigated. The NIOSH cost-effective rollover protective structure (CROPS) project was designed as a demonstration project to determine if CROPS, a type of ROPS, could be retrofitted in the field and were acceptable to farmers. To this end, the CROPS project was successful, with 50 tractors being retrofitted with CROPS in the field. All study participants were asked to complete a pretest, test, and posttest regarding the CROPS retrofit demonstration and their knowledge and attitudes toward ROPS. CROPS demonstrators were the participants who retrofitted their tractors with CROPS. Demonstrators were asked to recruit three to five other participants, known as observers, to watch the demonstration. The rationale was to generate interest in ROPS/CROPS among other farmers and community leaders. Overall, 16% of the participants had youth operating tractors on their farms. Participants reported that 44 youth operated tractors on their farms, more than 25% of these young tractor operators were 4 to 10 years old, and half of the youth operating tractors on participant farms were 13 years old or younger. Only one participant group (demonstrators) included individuals who had all of their tractors protected with ROPS/CROPS for young tractor operators (28%), but they accounted for only one farm each among the New York and Virginia demonstrators. The survey question on ROPS importance did not show an overall increase after respondents participated in the CROPS demonstration project. However, one Virginia observer asked to become a Virginia demonstrator and installed a CROPS on his tractor. Additionally, the questions on attitude toward ROPS showed a general increase in mean scores, with the some of the lowest response categories on the follow-up survey not being selected by respondents, indicating a potentially positive impact on participants' safety attitudes toward ROPS. For the safety attitude questions, the majority remained the same. This study indicates there is still much work to be done to reduce the number of deaths in production agriculture due to tractor rollovers. CROPS could be a valuable addition to the efforts of retrofitting ROPS on tractors in order to reduce the number of deaths due to tractor rollovers.

Prevalence of carpal tunnel syndrome among employees at a poultry processing plant.

OBJECTIVE: To determine prevalence of carpal tunnel syndrome (CTS) among poultry processing employees while taking into account non-occupational factors and assess any association between CTS prevalence and exposure groups. METHODS: Performed a cross-sectional survey to assess CTS (n = 318). A CTS case was defined as an employee with self-reported CTS symptoms, an abnormal hand symptom diagram, and an abnormal nerve conduction study (NCS). Log-binomial regression was used to estimate prevalence ratios. RESULTS: Three hundred and one participants had sufficient symptom information or NCS data to be classified. 126 (42%) of 301 participants had evidence of CTS. In the adjusted analysis, the highest exposure group had CTS prevalence that was significantly higher than that for the lower exposure group [PR: 1.61; 95% CI = (1.20, 2.17)]. CONCLUSIONS: Increasing levels of hand activity and force were associated with increased CTS prevalence among participants. Recommendations were provided to reduce exposure to these risk factors.

Partnering strategies for childhood agricultural safety and health.

The National Institute for Occupational Safety and Health (NIOSH) has been the lead federal agency of the national Childhood Agricultural Injury Prevention Initiative (CAIPI) since the program's inception in 1996 and in this role, collaborated with numerous partners in childhood agricultural injury prevention activities. This collaboration has likely helped achieve the current reduction in childhood agricultural injury. The paper looks at existing groups with past and current childhood agricultural injury prevention activities for partnering strategies that could contribute to reducing the morbidity and mortality of childhood agricultural injuries. Based upon the review, suggestions are made for future partnering strategies to continue progress in this area.

Fatal work-related injuries in the agriculture production sector among youth in the United States, 1992-2002.

Youth working on farms face unique risks that are not present for many other young workers, including machinery, large animals, electrical hazards, chemical hazards and excessive noise. This research identified the number and rate of occupational fatalities for youth working in the agriculture production industry, which is most closely affiliated with farming, for the years 1992-2002. The Census of Fatal Occupational Injuries (CFOI), developed by the Bureau of Labor Statistics (BLS), was the database used for the analysis. There were 310 work-related deaths to youth less than 20 years of age from 1992 through 2002 in the agriculture production sector. This compares to 1,958 total fatalities for all workers less than 20 years of age for the same time period. The number of agricultural production fatalities to youth has shown a general downward trend over this time period. The rates were higher for young workers in agriculture production than for young workers in all industries by a factor of 3.6. Fifteen year olds had the highest fatality rates with the crop production sector having a rate six times that of all 15 year old workers. The objective of this descriptive research was to identify, prioritize and publicize the risks to children and youth who work on farms in order to provide public health and safety professionals relevant information upon which to base decisions for interventions or other prevention activities for this priority population. This research also has direct applications for farm parents and safety and health professionals who work with the priority population of young agricultural workers.