Evaluating the Evolution of Social Networks: A Ten-Year Longitudinal Analysis of an Agricultural, Fishing and Forestry Occupational Health Research Center.

As part of our evaluation of the NIOSH-funded Northeast Center for Occupational Health and Safety: Agriculture, Forestry and Fishing (NEC), we present methodology, findings and the potential implications of a sequential social network analysis (SNA) conducted over ten years. Assessing the effectiveness of the center's scientific projects was our overarching evaluation goal. The evaluation design employed SNA to (a) look at changes to the center's network over time by visualizing relationships between center collaborators annually, (b) document collaborative ties and (c) identify particularly strong or weak areas of the network. Transdisciplinary social network criteria were applied to the SNA to examine the collaboration between center personnel, their partners and the industry groups they serve. SNA participants' perspectives on the utility of the SNA were also summarized to assess their interest in ongoing SNA measures. Annual installments of the SNA (2011-2020) showed an expansion of the network with a 30% increase in membership from baseline, as well as an increase in total relational ties (any type of contact). SNA measures also indicated significant increases in co-publication, cross-sector and transdisciplinary ties. Overall, SNA is an effective tool in visualizing and sustaining an occupational safety and health research and outreach network. Its utility is limited by how ties are characterized, grant cycle timeframes and how SNA metrics relate to productivity.

Agricultural Fatalities in New York State from 2009-2018: Trends from the past Decade Gathered from Media Reports.

OBJECTIVES: Agriculture remains one of the most dangerous industries in the United States. Fatal injury reports influence outreach and education training topics and assist in prioritizing research efforts and federal funding priorities. News stories of agricultural fatalities are routinely collected and cataloged by the New York Center for Agricultural Medicine and Health (NYCAMH). METHODS: The database was queried for agricultural fatalities in New York State between January 1, 2009 and December 31, 2018. Descriptive statistics were calculated based on a variety of factors including age, gender, geographic location, type of event, and source of injury. The 2017 Census of Agriculture data was used to calculate denominator data for persons at risk. RESULTS: Over the ten-year period from 2009 to 2018, one hundred sixty-nine (169) people were killed in agricultural injury events in New York. The most frequent cause of fatality was tractor related incidents, comprising nearly half of all fatalities (44%). There were 14 deaths of children nine and younger and an additional 11 deaths of adolescents between 10-19 years old. Steuben County had the highest rate of fatal injury at 20.9/100,000 FTE, followed by Jefferson County at 19.4/100,000 FTE. CONCLUSIONS: While the rates of workers killed on the job have dramatically dropped in many industries, agricultural fatalities remain stubbornly elevated above the all-worker fatality rate of 3.5/100,000 FTE. These data, along with non-fatal injury data, should be used to guide prevention and intervention activities. Such loss of life should underscore the tremendous stress the agricultural community is under, and serve to funnel resources to strengthen these communities, businesses and workers.

ESTIMATING THE COST OF AGRICULTURAL MORBIDITY IN MAINE AND NEW HAMPSHIRE.

This article provides an estimate for the economic costs of agricultural injuries sustained in the states of Maine and New Hampshire between the years 2008 and 2010. The authors used a novel dataset of 562 agriculturally related occupational injuries, and cost estimates were generated using the CDC's Web-based Injury Statistics Query and Reporting System (WISQARS). Individual cases from the dataset that did not match the query options for WISQARS were excluded. Of the 562 agricultural injuries identified in the dataset, 361 met the WISQARS criteria. The remaining 201 cases were judged to be incompatible with the WISQARS query criteria. Significant differences (p 0.0001) were found between the median costs of eight types of injury. Amputations (median = $70,077) and fractures (median = $13,365) were found to be the most expensive types of injury. The total cost of the 361 injuries for which estimates were available was $6,342,270. Injuries that reportedly involved machinery were found to be more expensive than injuries caused by animals. This article highlights the difference in the total cost of injury between types of injuries and demonstrates that agricultural injuries were a significant economic burden for Maine and New Hampshire for the years 2008-2010. These data can be used to direct future preventive efforts. Finally, this article suggests that WISQARS is a powerful tool for estimating injury costs without requiring access to treatment or billing records.

A Comparison of Interventional Approaches for Increasing Power Take-off Shielding on New York Farms.

OBJECTIVE: Power take-off (PTO) driveline entanglements are a primary source of injury on US farms. As with many farm injury concerns, hazard control technology is widely available for mitigating the risk of these entanglements. Despite the availability of hazard control technology, PTO shields are damaged or missing on approximately 57% of PTO driveline implements in New York. Given the catastrophic nature of entanglements and the ready access to safety technology, a better understanding of what motivates farmers to install or replace PTO shields is warranted. METHODS: To examine this question, agricultural health and safety researchers in New York State conducted an initial comparison of PTO shield sales on farms receiving one of three different interventional approaches. These included PTO shield audits, a social marketing campaign, and on-farm safety services. PTO shield purchases were tracked from January 2011 through June 2016 on farms receiving these interventions and on other farms that were not exposed to interventional strategies. RESULTS: Results indicate that a significantly higher number of PTO shields were purchased on farms that requested and received on-farm safety services versus farms that were exposed to PTO shield audits, the social marketing campaign, or the control group. PTO shield sales were slightly elevated on farms receiving driveline audits, as compared with control farms (although these differences were not significant). CONCLUSIONS: No marked differences in sales were noted between control farms and farms exposed to the social marketing campaign. Only one of the three interventional strategies (on-farm safety services) approached the number of PTO shield sales necessary to prevent an entanglement.

Development and Evaluation of a Basic First Aid Curriculum for Spanish-Speaking Dairy Workers.

. Over the past decade, the New York State dairy industry has grown substantially, resulting in an increase in immigrant workers who speak languages other than English. Estimates suggest that over 50% of workers on large New York dairies are Spanish-speaking individuals who immigrated to the U.S. from Guatemala, Mexico, and other Latin American countries. With a growing population of Spanish-speaking workers, safety concerns on farms have become a prominent issue. This article reviews the development and evaluation of a basic dairy first aid curriculum, which is intended to educate Spanish-speaking immigrant dairy workers on emergency response and first aid. The materials developed are culturally relevant and can be easily understood by low-literacy, non-English-speaking workers. In evaluation of the materials using pre- and post-testing, a significant knowledge gain was identified in workers who participated in the training.

Developing Surveillance Methodology for Agricultural and Logging Injury in New Hampshire Using Electronic Administrative Data Sets.

OBJECTIVE: Agriculture and logging rank among industries with the highest rates of occupational fatality and injury. Establishing a nonfatal injury surveillance system is a top priority in the National Occupational Research Agenda. Sources of data such as patient care reports (PCRs) and hospitalization data have recently transitioned to electronic databases. METHODS: Using narrative and location codes from PCRs, along with International Classification of Diseases, 9th Revision, external cause of injury codes (E-codes) in hospital data, researchers are designing a surveillance system to track farm and logging injury. RESULTS: A total of 357 true agricultural or logging cases were identified. CONCLUSIONS: These data indicate that it is possible to identify agricultural and logging injury events in PCR and hospital data. Multiple data sources increase catchment; nevertheless, limitations in methods of identification of agricultural and logging injury contribute to the likely undercount of injury events.

Estimation of agricultural and logging injury incidence in Maine using electronic administrative data sets.

Agriculture and forestry rank among industries with the highest rates of occupational fatality and injury. Establishing a nonfatal injury surveillance system is a top priority in the National Occupational Research Agenda. Recently, new sources of data such as Pre-Hospital Care Reports (PCRs) and hospitalization data have transitioned to electronic databases. Using narrative free text and location codes from Maine PCRs, along with International Classification of Diseases (ICD)-9 External Cause of Injury Codes (E-codes) in Maine hospital data, researchers are designing a surveillance system to track farm and forestry injury that utilizes electronic match-merging of the two data sources. For 2008, PCR records produced a total of 104 true agricultural cases. Of these, 66 (63%) were identified from the keyword/visual inspection process alone, 25 (24%) were identified by the farm checkbox only, and the remaining 13 (13%) by both methods. For the 150 unique injury events found in hospitalization data, 146 had the initial episode of care documented in only one of the three hospital files. The emergency department (ED) file had the largest number of these (123/146 = 84.2%), followed by the outpatient file (12/146 = 8.2%) and the inpatient file (11/146 = 7.5%). Of the 250 unique agricultural injuries identified (100 PCR only + 146 hospital only + 4 from both), 66 (26%) would not have been identified without free text review of PCR narrative. The false-positive rate (97.14%) keyword searches underscores that without visual inspection, it is not an effective strategy. Both sources of data (PCR and hospital data) need to be used in a continued surveillance system.

Electronic merger of large health care data sets: cautionary notes from a study of agricultural morbidity in New York State.

Agriculture ranks among industries with the highest rates of occupational injury and fatality. Administrative medical data sets have long been thought to have potential for occupational injury surveillance. This research explores the feasibility of establishing an agricultural injury surveillance system in New York State that combines data from existing electronic sources. Prehospital Care Report (PCR) data containing the nature of the accident, type of injury, time and date, and patient disposition were received. Researchers also obtained both hospital inpatient and emergency department (ED) records for 2007 through 2009 from the Statewide Planning and Research Cooperative System (SPARCS). For SPARCS data, a computer algorithm identified all potential cases of agricultural injury using International Classification of Diseases (ICD)-9 codes. An attempt was then made to match PCR and SPARCS data using accident date, gender, age, and admitting hospital. Of the PCR records that were matched to SPARCS, 46.8% were found on subsequent inspection to not actually relate to the same incident. Total PCR counts for 2007 and 2008 showed considerable fluctuation, at 2,512,828 and 2,948,841, respectively. A total of 1275, 1336, and 1393 farm injuries were identified in the SPARCS records for 2007, 2008, and 2009, respectively. This study demonstrates that accurate matching of PCR and SPARCS records requires the use of unique personal identifiers. Further, annual fluctuations in PCR counts preclude their current use in a surveillance system. An electronic data set consisting of SPARCS data could be used for surveillance, but would benefit from the addition of PCR data as these become more consistent.

A correction factor for estimating statewide agricultural injuries from ambulance reports.

PURPOSE: Agriculture ranks as one of the most hazardous industries in the nation. Agricultural injury surveillance is critical to identifying and reducing major injury hazards. Currently, there is no comprehensive system of identifying and characterizing fatal and serious non-fatal agricultural injuries. Researchers sought to calculate a multiplier for estimating the number of agricultural injury cases based on the number of times the farm box indicator was checked on the ambulance report. METHODS: Farm injuries from 2007 that used ambulance transport were ascertained for 10 New York counties using two methods: (1) ambulance reports including hand-entered free text; and (2) community surveillance. The resulting multiplier that was developed from contrasting these two methods was then applied to the statewide Emergency Medical Services database to estimate the total number of agricultural injuries for New York state. RESULTS: There were 25,735 unique ambulance runs due to injuries in the 10 counties in 2007. Among these, the farm box was checked a total of 90 times. Of these 90, 63 (70%) were determined to be agricultural. Among injury runs where the farm box was not checked, an additional 59 cases were identified from the free text. Among these 122 cases (63 + 59), four were duplicates. Twenty-four additional unique cases were identified from the community surveillance for a total of 142. This yielded a multiplier of 142/90 = 1.578 for estimating all agricultural injuries from the farm box indicator. Sensitivity and specificity of the ambulance report method were 53.4% and 99.9%, respectively. CONCLUSIONS: This method provides a cost-effective way to estimate the total number of agricultural injuries for the state. However, it would not eliminate the more labor intensive methods that are required to identify of the actual individual case records. Incorporating an independent source of case ascertainment (community surveillance) increased the multiplier by 17%.

Improving agricultural injury surveillance: a comparison of incidence and type of injury event among three data sources.

BACKGROUND: Agriculture ranks as one of the most hazardous industries in the nation. Ongoing injury surveillance is key to identifying and preventing major sources of injury. OBJECTIVE: The objective of this study was to compare the total number and types of injuries identified from community reporting versus two newly available medical data systems. These new systems are important because they are less time consuming and expensive to maintain. METHOD: Farm injury case records from 2007 were collected for 10 NY counties from the following sources: ambulance reports, hospital data, and community surveillance data. RESULTS: For the 107 ambulance report cases, horses (35%), tractors (15%), and livestock (10%) were the three leading injury sources. For the 261 hospital cases, the leading sources were hand tools (24%), farmstead machinery (23%), and buildings/structures/surfaces (22%). Tractor injuries (37%) were the most common source of injuries identified by the 44 community surveillance cases. Struck by object was the most frequent injury event type for hospital and surveillance data (34%, 30%). Falls were the highest category for ambulance reports (36%) and were also common for hospital data (29%). Nine of the 11 fatal cases were found through community surveillance. CONCLUSION: Ambulance reports and hospital data contribute a large number of additional farm injury cases to existing surveillance data. From these cases, horse injuries, falls, and hand tool injuries appear to play a larger role in farm injuries. Future research should explore how to best use these electronic resources for agricultural injury surveillance.