Occupational Research Agenda for Northwest Farming

RESEARCH TOOLS & APPROACHES



THE FINAL CATEGORY INCLUDES FOUR SUBTOPICS that address how occupational health and safety research can have a positive impact on farming. New production techniques require novel methods for controlling exposure to physical and chemical agents, and for reducing risk of injuries. The ability to provide accurate and timely diagnosis plays an important role in the prevention of agricultural-related occupational illnesses, and can help properly classify disease as work-related. Evaluation of the strengths and weaknesses of interventions can provide valuable information for those working in and serving the farming community. Finally, surveillance programs are a cornerstone of public health practice in areas such as infectious disease control, but have yet to be established systematically for diseases related to agriculture. Basic demographic, incidence, and prevalence data are needed to inform research and intervention programs. Creative effort will be needed to make such programs successful and cost-effective for Northwest farming.

HAZARD CONTROL TECHNOLOGY



A variety of engineering, administrative, and worker protection techniques can be used to manage health and safety hazards. These may include design changes to equipment, modifications to training efforts, or the design and proper use of personal protective equipment. Important concerns in Northwest farming include tractor rollover protection, mitigation of pesticide drift and applicator exposure, chemical product substitution, and improved techniques for livestock management. Basic and applied research is needed to identify, evaluate, and develop both health-effective and cost-effective control strategies for specific hazards, and to assure their wide dissemination in the farming community.

[NIOSH NORA: Control Technology and Personal Protective Equipment

IMPORTANCE

Workplace health and safety hazards are normally mitigated by a hierarchy of control techniques, with engineering controls, administrative controls, and personal protection employed where appropriate. Engineering controls offer an opportunity to design a hazard out of the production process. The replacement of a hazardous insecticide with a less hazardous product, for example, can reduce risk for many workers across an entire industry. Technologies that reduce equipment noise or minimize human contact with hazardous chemicals can have an immediate impact on illness rates. Guard devices on equipment can prevent injuries and save lives. Administrative controls focus on proper management of the workplace. For instance, some Farm Summit participants felt that emphasis on wage-based labor rather than piecework could prevent many serious injuries. Finally, personal protective equipment, and training in its proper maintenance and use, is often the last resort for reducing hazardous exposures. The use of chemical protective gloves during pesticide handling is known to be an effective means of reducing skin exposure, but care must be taken to ensure that the glove material is chemical-resistant and that the gloves do not interfere with efficient work practices.

Opportunities for research cited at the Farm Summit and during telephone interviews included personal protective equipment, bioengineering, machinery design, livestock management, and labor activities. Several Farm Summit participants noted the high number of accidents due to machinery, particularly with respect to tractor rollovers. The need for improved machinery design, proper maintenance, and safe use of machinery and equipment was emphasized during discussions. Recommended solutions included installing rollover protection (ROPs) devices, collaborating with manufacturers to develop innovative designs, developing feedback loops to manufacturers, and improving readability of warning stickers.

Participants also noted the importance of new training methods. Specific topics included financial management for farmers, stress management, consistent safety materials, hazard recognition, translation of rules and requirements into action, proper ways to handle accident victims, and a safety and health resource catalog for the Northwest.

A public agency official suggested a new form of training for medical professionals. He recommended using telemedicine for one-on-one consultations with rural physicians. New computer technologies could provide valuable tools for rural medical practice and increased occupational health and safety training of primary care providers.

A private health and safety consultant also suggested standardized training for farm workers and managers. He said that uniform training, similar to other industries, should be available. This training should focus on good practices and bring information to those working in the agricultural field. He noted that basic safety training that could apply to various jobs would be a useful foundation. Employers would know that workers had some fundamental health and safety training. Another training recommendation was to bring the information directly to workers in the field. One example was employing a school bus equipped with audiovisual aids and encouraging hands-on instruction.

RESEARCH OPPORTUNITIES

• Use computer simulations to design safer agricultural machinery
• Develop design standards
• Assess existing solutions
• Identify methods that encourage adoption of existing agricultural safety solutions by industry
• Document hazards specific to commodity groups

ADDITIONAL INFORMATION

Duncan JR, Wilkinson RH, Purschwitz MA, Murphy DJ, Anterson KC, Baker LD. Agricultural Safety and Health for Engineers. St. Joseph: American Society of Agricultural Engineers, 1994.

Liu J, Ayers P. Application of tractor stability index for protective structure development. J of Ag Safety and Health 1:171– 181 (1998).

American Society of Agriculture Engineers homepage: http://asabe.org/

A Guide to Agricultural Tractor Rollover Protective Structures: http://www.marshfieldclinic.org/nfmc/default.aspx?page=nfmc_rops_guide

DIAGNOSTIC APPROACHES



Accurate and timely diagnosis of work-related illness and injury is essential for proper treatment. Many diseases can be caused by a combination of workplace exposures, nonworkplace exposures, and preexisting conditions. Research is needed to develop new methods of diagnosis, and to link diagnoses with specific workplace exposures. Rural health care professionals need further training in this area, particularly in the identification and treatment of dermatitis, heat stress, and pesticide exposure.

[NIOSH NORA: Not included in the NIOSH NORA document]

IMPORTANCE

Proper diagnosis of work-related illness and injury in agriculture can be difficult for the clinician. Many patients present with nonspecific symptoms, such that a specific cause is difficult to pinpoint. A disease may be the result of preexisting conditions and of recent exposure. Workers who have recently arrived to the Northwest may not have medical records for the clinician to review. And it is often not possible for a diagnosis to be informed by a detailed understanding of work processes and workplace conditions. All of these factors make accurate diagnosis extremely challenging. Many Farm Summit and telephone interview participants recommended further advancement in diagnostic approaches in the field of agricultural health and safety and the need for new methods to identify agricultural-related occupational illnesses. Health care providers also need to be better informed and motivated to learn diagnostic methods specific to agricultural work.

Specific areas for improved diagnostic approaches were identified as heat stress, pesticide exposure, and dermatitis.

RESEARCH OPPORTUNITIES

• Improve the means for identifying agricultural-related disease and injury for the Northwest medical community
• Provide cross-cultural training to health care professionals performing diagnoses

ADDITIONAL INFORMATION

Schuman SH, Simpson WM. Ag-Med: The Rural Practitioner's Guide to Agromedicine. American Academy of Family Physicians, 1997.

US EPA. Pesticides and National Strategies for Health Care Providers: Workshop Proceedings. Washington DC: Environmental Protection Agency, 1998.

INTERVENTION EFFECTIVENESS



Various health and safety interventions can prevent workplace illnesses and injury. These methods can include control technologies, guidelines and regulations, worker participation programs, and training. Interventions in current use could be improved by research evaluating their effectiveness. Such interventions include government regulations, enforcement procedures, improved chemicals, and educational programs for children.

[NIOSH NORA: Intervention Effectiveness Research]

IMPORTANCE

Changes are often introduced into agricultural production with the intent of preventing or reducing illness and injury. Yet in many cases, the effectiveness of these changes remains unknown. Evaluation of interventions is a relatively new area of research in occupational health and safety. Such investigations can be expensive, and may seem unnecessary, particularly in cases where the intervention is relatively straightforward. In many other cases, however, there may be several intervention options, and their relative impact is an open question. Intervention effectiveness prompted much discussion among Farm Summit and telephone interview participants. Topics included a range of issues that could be subject to evaluation.

Participants frequently questioned the effectiveness of enforcement agencies. Suggested areas for change included:

• Improve communication between agencies.
• Make regulations more relevant.
• Provide better training to inspectors and agents that would address differences in languages and cultures.
• Include technical assistance and training to induce compliance, and use punitive measures, e.g., public list, if compliance is not met.
• Write rules in an understandable format.

Participants also suggested improved health and safety training methods for various audiences, including farmers, physicians, legislators, farm workers, and child laborers.

Farm Summit attendees and telephone interview participants recommended assessing the effectiveness of agricultural equipment and techniques. An extension agent said that personal protective equipment and respirators are not comfortable to wear during the summer months. He suggested a project to improve the comfort and ease of personal protective equipment and measure the subsequent change in workers’ use of these devices.

RESEARCH OPPORTUNITIES

• Improve enforcement processes
• Measure the effectiveness of voluntary protection programs
• Review and identify factors affecting enforcement effectiveness, e.g., agency resources, politics, bilingual/cultural investigators
• Evaluate safety and health information dissemination
• Assess the validity of cholinesterase field measurements kits
• Investigate the impact of safety interventions
• Evaluate personal protective equipment
• Explore the effectiveness of safety equipment
• Evaluate Farm Safety Day Camps
• Evaluate the ability of material safety data sheets to convey information to agricultural workers

ADDITIONAL INFORMATION

McDonald MC, McDivitt JA. Evaluation challenges in agricultural health and safety centers. J of Ag Safety and Hlth 1:139–147 (1998).

Tinker TL, Silberberg PG. An evaluation primer on health risk communication programs and outcomes. Washington DC: Department of Health and Human Services, 1997.

Miller M, Keifer M. Cholinesterase Monitoring in Washington State: Report from the Technical Advisory Group, 1995.

Scharf T, Kidd P, Cole H, Bean T, Chapman L, Donham K, Baker D. Intervention tools for farmers—safe and productive work practices in a safer work environment. J of Ag Safety and Health 1:193–203 (1998).

SURVEILLANCE RESEARCH METHODS



Surveillance systems are an important foundation for setting research priorities as they find answers to the questions, “who, what, why, where, and how.” The public health community relies on surveillance information to set research and prevention priorities, but gaps in many existing systems limit their usefulness. Surveillance systems in farming need to be updated and expanded, and new methodologies for data collection and evaluation need to be developed.

[NIOSH NORA: Surveillance Research Methods]

IMPORTANCE

Public health surveillance is central to the process of disease prevention. Modern disease prevention and health promotion programs are based on meaningful data systems. Repeated surveys using common definitions of illness or injury can lead to an understanding of trends in communities or worker groups. Data from such a surveillance system can be used to identify unusual patterns of disease, or can serve to evaluate the effectiveness of interventions. Few surveillance systems exist for illness and injury related to agricultural production. New methods are need to address the unique characteristics of rural populations and agricultural workers.

RESEARCH OPPORTUNITIES

• Develop a number of different database systems. Examples included a database tracking the use of chemicals used in agriculture and prevalence of occupational skin disease
• Identify the location and trends of injuries and fatalities
• Study health and safety attitudes prevalent in farming communities

ADDITIONAL INFORMATION

Purschwitz MA. Epidemiology of agricultural injuries and illnesses. In: Safety and Health in Agriculture, Forestry, and Fisheries. (Langley RL, McLymore RL , Meggs WJ, Roberson GT, eds). Rockville, MD: Government Institutes, 1997.

Halperin W, Baker EL, eds. Public Health Surveillance. New York: Van Nostrand Reinhold, 1992.

Murphy DJ, Yoder, AM. Census of fatal occupational injury in the agriculture, forestry, and fishing industry. J of Ag Safety and Health 1:55–66 (1998).

Vallarejo D. Occupational injury rates among hired farmworkers. J of Ag Safety and Health 1:39–46 (1998).

ENDNOTES

¹ Agriculture, forestry, and fishing employment in Washington State. Olympia, WA: Washington State Department of Employment Security, 1991.

² Idaho Census of Fatal Occupational Injuries: 1997. [Cited 28 June 1999].

³ Research and Analysis Section, Department of Consumer and Business Services. Oregon Workers’ Compensation Claims Characteristics CY 1997 (1997). Available: http://www.cbs.state.or.us/external/imd/rasums/2055/2055.html [Cited 28 June 1999].

⁴ Roggenburg L: Characteristics of work injuries and illnesses for 1997: agriculture, forestry and fishing. Salem, OR: Oregon State Department of Consumer and Business Services, 1999.

⁵ Census of fatal and occupational injuries, Oregon, 1997. Salem, OR: Oregon Department of Consumer and Business Services, 1999.

⁶ Wahlers R. Agricultural workforce in Washington state 1997. Olympia, WA: Washington State Employment Security, 1998.

⁷ Heyer N, Franklin G, Rivara FP, Parker P, Haug JA. Occupational injuries among minors doing farm work in Washington State: 1986–1989. Am J Public Health 82:557-560 (1992).

⁸ Matter A: Oregon industrial report on 1986–1995 compensable claims and fatalities for workers aged 17 and under. Salem, OR: Oregon Department of Consumer and Business Services, 1998.

⁹ Oregon Department of Consumer and Business Services (1999).

¹⁰ Roggenburg L (1999).

¹¹ Oregon Workers’ Compensation Claim Characteristics, Calendar Year 1996. Salem, OR: Oregon Department of Consumer and Business Services, 1998.

¹² Roberts C, Mayer JD, Henderson WR Jr. Asthma deaths in Washington State 1980–1989: geographic and demographic distributions [see comments]. Ann Allergy Asthma Immunol 76:20–6 (1996).

¹³ Ertle AR, London MR. Insights into asthma prevalence in Oregon. J of Asthma 35: 281–289 (1998).

¹⁴ Sama S, Bushley A, Cohen M, Cotey M, Park B, Kaufman J. Work-related skin disorders in Washington State, 1993–1997. Olympia, WA: Washington State Department of Labor and Industries, 1998.

¹⁵ Oregon Department of Consumer and Business Services (1998).

¹⁶ Karsky T. Ag Safety and Health Statistics. Available: http://www.uidaho.edu/bae/agsafety/ stats.htm [Cited 29 June 1999].

¹⁷ Heyer N (1992).

¹⁸ Matter A. Oregon Industrial Report on 1986–1995 Compensable Claims and Fatalities for Workers Ages 17 and Under. Salem, OR: Oregon Department of Consumer and Business Services, 1998.

¹⁹ Bugarin A, Lopez E. Farmworkers in California. Sacramento, CA: California State Legislature, California Research Bureau, 1998.

APPENDIX 1

PLANNING COMMITTEE

Richard Fenske
Director
Pacific Northwest Agricultural Safety and Health Center
Dept. of Environmental Health
University of Washington

Matthew Keifer
Co-Director
Pacific Northwest Agricultural Safety and Health Center
Dept. of Environmental Health
University of Washington

Sharon Morris
Associate Director
Pacific Northwest Agricultural Safety and Health Center
Dept. of Environmental Health
University of Washington

Adrienne Hidy
Program Manager
Pacific Northwest Agricultural Safety and Health Center
Dept. of Environmental Health
University of Washington

Marcy Harrington
Program Coordinator
Pacific Northwest Agricultural Safety and Health Center
Dept. of Environmental Health
University of Washington

Norman Herdrich
Outreach Coordinator
Pacific Northwest Agricultural Safety and Health Center
Dept. of Environmental Health
University of Washington

Amy Hagopian
Associate Director
Programs for Healthy Communities
School of Medicine
University of Washington

Appendix 2

PHONE INTERVIEW PARTICI PANTS*

Larry Albin Washington State Director US Department of Agriculture	Dyvon Havens President Western Washington Horticultural Association	Pedro Serrano Safety and Health Specialist Washington State Department of Labor & Industries, Policy and Technical Services
Susan Aldrich-Markham Extension Agent Oregon State University Extension Service	Michael Heumann Epidemiologist Oregon Health Division, Environmental, Occupational and Injury Epidemiology	Myron Shenk Assistant Professor Interim Farm Safety Specialist Oregon State University Integrated Plant Protection Center
Bob Arrington Assistant Director Pesticide Management Division Washington State Dept. of Agriculture	Dennis Hoffman Safety and Health Consultant Washington State Department of Labor & Industries	Timothy Smith Extension Agent Washington State University Extension Service
James Baker Environmental Toxicologist Idaho State Dept. of Agriculture	Clint Jacks Extension Staff Chair Oregon State University Extension Service	Tim Stock Farmworker Education Specialist Washington State Department of Agriculture Pesticide Management Division
Lyden Baum Manager Pesticide and Surveillance Section Washington State Department of Health	Jeffrey Jenkins Associate Professor Agricultural Chemistry Extension Department of Environmental & Molecular Toxicology Oregon State University	Frances Storrs Professor of Dermatology Emerita Oregon Health Sciences University
Varon Blackburn Vice President AgriNorthwest	Jeff Johnson Research Director Washington State Labor Council	William Symons Associate Professor Extension Safety Specialist Washington State University Extension Service Department of Biological Systems Engineering
Michael Bondi Extension Agent Oregon State University Extension Service	Tom Karsky Extension Safety Specialist University of Idaho	Mike Taylor Washington State Migrant Health Supervisor Title I Educational Service District
Evelyn Brookhyser Extension Agent Oregon State University Extension Service	Alice Larson Coordinator Workgroup on Pesticide Health and Safety Larson Assistance Services, Washington	Sherman Takatori Pesticide Training Specialist Idaho Department of Agriculture
Gus Bryngelson Farmer and Board Member Magic Valley SAFE KIDS Coalition, Idaho	Fred Lundin Extension Agent Oregon State University Extension Service	Tumac Machinery Washington
Chip Bubl Extension Agent Oregon State University Extension Service	Bill Mason Public Health Advisor Washington State Department of Health Environmental Health & Safety, Pesticide Section	Luis Urias Agricultural Program Specialist Idaho State Department of Agriculture
Jay Carr Extension Agent Oregon State University Extension Service	Blossom Mathews Director Magic Valley SAFE KIDS Coalition, Idaho	Sheldon Wagner Professor of Clinical Toxicology Oregon State University National Pesticide Telecommunication Network
Tina Castanares Medical Director La Clinica del Carino, Oregon	Tom McCoy Chair Safety Committee Oregon Wheat Growers League	Kent Waliser Operations Manager Wells & Wade Fruit Company/Dole Northwest, Washington
Burton Chestnut Safety Director Washington State Farm Bureau	Joe McDonald Agronomy Division Manager Pendleton Grain Growers	Marty Weis Industrial Hygiene Compliance Supervisor Washington State Department of Labor & Industries
Hartzell Cobbs Executive Director Idaho Rural Health Education Center Mountain States Group	John McFadden Safety and Health Consultation Supervisor Washington State Dept. of Labor & Industries	Kevin Whitehall Assistant Manager Central Washington Grain Growers, Inc.
John Cornell Owner Farm Safety Services, Washington	Gary Melchior Field Development Representative Gowan Company, Washington	Ann Wick Program Manager Washington State Department of Agriculture
Michael Craigen General Manager Farmer-Stockman Insurance Service	Mary Miller Occupational Health Nurse Practitioner Washington State Dept. of Labor & Industries, Policy and Technical Services	James Willis Director, Articulation & School Partnerships Director, Distance Learning Walla Walla Community College Washington
Elaine Cullen Chief, Extramural Coordination/ Communication Spokane Research Laboratory National Institute for Occupational Safety and Health	Lorinda Moholt Director of Communications Oregon Dairy Products Commission	Christy Witzke Loss Control Consultant SAIF Corporation, Oregon
Charlie de La Chapelle, Jr Farmer 7C Orchards, Washington	Brenden Monahan Attorney Velaconge, Moore, and Shore	Vickie Ybarra Director Community Health Services Yakima Valley Farm Workers Clinic, Washington
Greg Doering Former President Interstate Professional Applicators Association, Oregon	Barbara Morrissey Toxicologist Pesticide Section Washington State Department of Health Office of Toxic Substances	Lorna Youngs Assistant Director Oregon Department of Agriculture
Lewis Eilers Idaho Dairymen’s Association	Verena Neal President Washington Chapter of the Interstate Professional Applicators Association
Tim Ennis Public Information Officer Oregon State University Office of Rural Health	Jeff Olsen Extension Horticulturalist Oregon State University Extension Service
Allan Felsot Professor and Extension Specialist Washington State University Food & Environmental Quality Laboratory	Sean Phelan Attorney Columbia Legal Services, Washington
Dennis Fiess Executive Director Ag Bureau, Spokane Chamber of Commerce	Patrick Pleas Attorney Northwest Justice Project, Washington
Daniel Ford Advocacy Coordinator Columbia Legal Services, Washington	Fred Rios Bureau Chief Field Operations Division of Agricultural Resources Idaho State Department of Agriculture
Bob Goyt Owner Lake Orchards, Inc., Washington	David Rountry Pesticide Risk Reduction Specialist Washington State Department of Ecology
Ginny Hamilton Industrial Hygienist Washington State Department of Labor & Industries WISHA Training & Outreach Services	Marilyn Schuster Manager Standards and Technical Resources Oregon OSHA
Mike Harker Manager Washington/Oregon Asparagus Growers Association	Tomas Schwabe Trainer Oregon Occupational Safety and Health Administration

APPENDIX 3

FARM SUMMIT ATTENDEES*

Bob Arrington Assistant Director Pesticide Management Division Washington State Department of Agriculture	Dyvon Havens President Western Washington Horticultural Association	David Rountry Pesticide Risk Reduction Specialist Washington State Department of Ecology
Margot Barnett Strategic Options Consulting, Oregon	Michael Heumann Epidemiologist Oregon Health Division, Environmental, Occupational and Injury Epidemiology	Tomas Schwabe Trainer Oregon Occupational Safety and Health Administration
Gus Bryngelson Farmer and Board Member Magic Valley SAFE KIDS Coalition, Idaho	Tom Karsky Extension Safety Specialist University of Idaho	Myron Shenk Assistant Professor Interim Farm Safety Specialist Oregon State University Integrated Plant Protection Center
Maggie Bryngelson Farmer and Board Member Magic Valley SAFE KIDS Coalition, Idaho	Alice Larson Coordinator Workgroup on Pesticide Health and Safety Larson Assistance Services, Washington	Pedro Serrano Safety and Health Specialist Washington State Department of Labor & Industries Policy and Technical Services
Burton Chestnut Safety Director Washington State Farm Bureau	Blossom Mathews Director Magic Valley SAFE KIDS Coalition, Idaho	Tom Sjostrom Safety Engineer Washington State Department of Labor & Industries, Safety and Health Assessment and Research for Prevention (SHARP)
John Cornell Owner Farm Safety Services, Washington	Linda McCauley Associate Professor Oregon Health Sciences University Center for Research on Occupational and Environmental Toxicology	CJ Tyler-Watson Outreach Coordinator Center for Farm Health and Safety/PNASH Eastern Washington University
Pamela Elkind Professor of Sociology and Director Center for Farm Health and Safety/PNASH Eastern Washington University	Joe McDonald Agronomy Division Manager Pendleton Grain Growers	Sheldon Wagner Professor of Clinical Toxicology Oregon State University National Pesticide Telecommunication Network
Daniel Ford Advocacy Coordinator Columbia Legal Services, Washington	Steven Neufeld Research Coordinator Center for Farm Health and Safety/PNASH Eastern Washington University
Ginny Hamilton Industrial Hygienist Washington State Department of Labor & Industries, WISHA Training & Outreach Services	Patrick Pleas Attorney Northwest Justice Project, Washington

PHOTO CREDITS

Harley Soltes, The Seattle Times

Earl Dotter

Richard Fenske, UW PNASH Center

Norman Herdrich, UW PNASH Center

Harley Soltes, The Seattle Times

Dean Rutz, The Seattle Times

Norman Herdrich, UW PNASH Center

Richard Fenske, UW PNASH Center

Nancy Simcox, UW Field Research & Consultation Group

Gloria Coronado, Fred Hutchinson Cancer Research Center

Earl Dotter

Matthew Keifer, UW PNASH Center

Richard Fenske, UW PNASH Center

Matthew Keifer, UW PNASH Center

Nancy Simcox, UW Field Research & Consultation Group

Adrienne Hidy, UW PNASH Center

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