A Summary of 15 Years in Agricultural Safety and Health, and Action Steps for Future Directions
- Executive Summary: Recommendations and Strategies
- Highlights of Progress in Agricultural Safety and Health
- Current Status of Agricultural Safety and Health in the United States
Public Health Perspectives
The inspiration for this document arose out of general conversations among various individuals, specifically in discussions occurring at the annual meeting of the Agricultural Safety and Health Network (ASH-NET) in 1998. This discussion centered on the process and efforts a decade earlier that led to the publication of Agriculture at Risk: A Report to the Nation (Merchant et al. 1989) and the contribution that document made in increasing investments and national efforts related to the safety and health of the nation's family farms.
Discussions soon focused on the notable absence of a similar but current comprehensive document that looked at production agriculture and farmers, farmworkers, and their families. The passage of time and the changes within agriculture, and agricultural safety and health, since the publication of Agriculture at Risk called for another effort. Individuals' thoughts then turned to the possible uses to which a document relating current overall perceptions of the status of agricultural safety and health, and concrete recommendations on future research and program needs, could be put. Such a document could provide policymakers, public and private funding agencies, and the general public with a convenient and realistic summary of recent progress in, the current status of, and informed projections on issues of concern within agricultural safety and health.
With these discussions and thoughts fresh in their minds, the participants in ASH-NET undertook to serve as the coordinating body for a proposed project. This three-year project "Using History and Accomplishments to Plan for the Future: A Summary of 15 Years in Agricultural Safety and Health, and Action Steps for Future Directions" would pull together the different elements and technical expertise needed to produce a document aimed at refocusing attention on agricultural safety and health concerns.
These elements and expertise included agricultural safety and health researchers, educators, and program personnel; agriculture manufacturer and insurance association representatives; federal, state, and local government agency personnel; local medical, health, and emergency service providers; and practicing farmworkers and farmers. Although considerable research to access and better understand the views of farmers and farmworkers toward specific agricultural safety and health topics has occurred, it was equally important to access these viewpoints in real time.
I am profoundly grateful to all those whose contributions made this document a reality. Their expertise, time, energy, and forgone work opportunities all contributed to the fundamental roles they served. All of us sincerely hope that this endeavor will make a meaningful contribution in furthering the safety and health needs of the farmers, farmworkers, and their families involved in production agriculture, upon whom we are critically dependent.
Executive Summary: Recommendations and Strategies
The U.S. Congress should provide funding to the several federal agencies referenced-through reallocation, redistribution, or additional, and as needed-for implementing both the research and nonresearch components of this report.
The impact of the many local, regional, state, and national private-sector contributions are recognized and most significant to the cause of agricultural safety and health, and those will continue. The magnitude and importance of the recommendations and strategies identified are mostly national in scope and require national resource assistance, the better to serve as a foundation and partner to those private sector contributions.
Develop a specific federal research and surveillance agenda with measurable goals and objectives to reduce agriculture-related injuries, illness, and disease.
A NIOSH should fund the development of goals and measurable objectives for agriculture
producers, workers, and their families. Following a model similar to Healthy People 2010, a
task force representing various agricultural health and safety disciplines would direct this
B Associated with Strategy A would be the development of an agriculture-specific National
Occupational Research Agenda (NORA) within Centers for Disease Control and
C Federal agencies and the land grant universities should develop strategies to implement the
National Land Grant Research and Extension Agenda for Agricultural Safety and Health
D Include occupational injury and illness reporting, with location of injury, as a supplement to
the annual National Health Interview Survey as an interim step until a mechanism to offset
data omissions within current Bureau of Labor Statistics-based surveys can be implemented.
E DOL and NIOSH should coordinate the development, a comprehensive national nonfatal injury surveillance system comparable to the Census of Fatal Occupational Injuries (CFOI) that would be directed at women, older farmers, immigrant and minority workers (by race/ethnicity), the disabled, adult full- and part-time workers (both paid and unpaid), and cultural minorities for delineation of the extent of specific problems related to each of these populations.
Current funding for research and programming for special populations at risk within agriculture
should be continued.
A USDA should continue funding through its Cooperative State Research, Education, and
Extension Service (CSREES) for National AgrAbility and associated state programs as a
conduit to collect and disseminate information on injury, illness, and disease effects within
agriculture and successful accommodation of those disabling conditions.
B Implement the specific recommendations relating to childhood agriculture injury prevention
as produced by the National Children's Center for Rural and Agricultural Health and Safety (Lee et al. 2002).
C Implement the specific recommendations relating to improving the working conditions of migrant and seasonal adolescent farmworkers as produced by the National Adolescent Farmworker Occupational Health and Safety Advisory Committee (Vela Acosta & Lee 2001).
Strategies to improve the living and working environment of migrant and seasonal farmworkers
should be implemented.
A Federal funding for migrant health clinics should be maintained with expanded assistance to
those clinics to assist in compiling surveillance data on diagnosis and treatment.
B Increase enforcement of current regulations relating to the current EPA Worker Protection
Standard (WPS) and the Certification of Pesticide Applicators Standard (CAS).
C Evaluate components of the current EPA Worker Protection Standard (WPS) and the
Certification of Pesticide Applicators Standard (CAS), in conjunction with local/regional
farmworkers, to ensure that such training adequately reflects the actual conditions
experienced by the workers.
D Evaluate the current protocols related to reporting agricultural chemicals, in conjunction
with local/regional farmworkers, to ensure that the procedures are readily available to
farmworkers and conducted in a manner that farmworkers find effective.
E Federal agencies funding research and services for migrant and seasonal farmworkers should
require that those workers, both men and women or their designated representatives, be
actively engaged in the planning and implementation of proposal objectives as a criterion for
Model agricultural safety and health programs related to health care services, professional
training, educating, and conducting applied research in community settings should be replicated
and evaluated to determine their effectiveness in other agricultural communities.
A USDA should target the development of information, assessment, and assistance programs
that address underserved populations in ways that are culturally sensitive to the differences
among populations and base such programs on the successes learned with the National
B NIOSH should revitalize the Agricultural Health Promotion System (AHPS) funding stream.
Such funding could focus on combining lessons learned from previous (AHPS) funding with
new findings from successful models of community-directed interventions.
C NIOSH should target specific funding within the Centers for Agricultural Disease and Injury
Research, Education, and Prevention (Ag Research Centers) to form advisory committees of
farmers and farmworkers to develop protocols for using community assets to collaboratively
conduct technical, anthropological, and social science research within the agricultural
Enhance collaborative efforts between professionals working in agricultural safety and health and
professionals working in primary health care.
A USDA should be allocated additional funds to designate a full-time national program leader
for agricultural safety and health within the Cooperative State Research, Education, and
Extension Service. Such a designation is not intended to supersede or replace currently
delegated DOL, EPA, or OSHA oversight.
B In each state, USDA should fund a full-time state extension specialist in agricultural safety
and health with matching operating funds from the state. This position would collaborate
with the health specialist identified in strategy C below.
C In each state, NIOSH, HHS, or USDA should fund a full-time faculty position at a
corresponding state university providing health professionals with matching operating funds
from the state. Utilizing the agromedicine model, this position would deal primarily with
rural primary care and would work in collaboration with the state extension specialist in
agricultural safety and health.
D USDA through the university-based extension system should facilitate collaboration of
professional organizations to provide for the continuing professional development of
agricultural safety and health professionals and primary care providers and other health care
providers on current issues related to the agricultural environment.
Increase the capacity to provide rural emergency medical services, agricultural occupational
health services, mental health care, rehabilitation services, and education to the agricultural
A An interagency agreement between Department of Transportation/National Highway Traffic
Safety Administration, Department of Homeland Security, Department of Health and
Human Services, and United States Department of Agriculture should be developed to
designate a single site with specific authority for administration and funding to ensure that
rural emergency services remain an integral part of national emergency service capabilities.
B The Rural Emergency Medical Service Training and Equipment Assistance Program,
authorized in the Health Care Safety Net Amendments of 2001 (P.L. 107-251), should
receive funding appropriations as designated through the U.S. Department of Health and
Human Services and administered by the Health Services Resources Administration.
C The National Institute of Mental Health/Office of Rural Mental Health Research and the
National Advisory Committee on Rural Health and Human Services/Office of Rural Health
Policy/Health Resources and Services Administration should work collaboratively in
developing a National Center for Agricultural Behavioral Health to facilitate the interface of
research and service delivery relating to addictions, mental health, and social psychological
distress found in the agricultural setting.
D Target musculoskeletal disorders for CDC/NIOSH funding and support for expanded field
intervention and prevention in cooperative partnerships with farmers and farmworkers.
E State university-based Cooperative Extension offices should establish formal relationships with state Public Health Departments and state Environmental Protection Agency offices to facilitate the formation of a task force to provide pesticide prevention programs for farmers, migrant/seasonal farmworkers, and their families, as well as rural residents.
F Recruitment and retention of rural emergency volunteers should be the topic of in-depth research at the community/squad level in order to understand the problem. Subsequent planning and action should be based on the findings of that research.
Enhance determinant research that examines how various risks and protective factors affect the
health of the agricultural community.
A NIOSH, NIEHS, and EPA should continue funding investigations related to improved
assessments of indoor air exposure for confinement workers and better define
Recommended Exposure Limits (RELs, NIOSH) and associated Permissible Exposure Limits
(PELs, OSHA) to reflect any dose-response relationship found.
B The EPA should target additional technical, epidemiological, and exposure assessments to
define the emission elements responsible for specific community effects found with large
confinement animal production.
C BLS and NIOSH should collaborate to allocate funding, similar to NIOSH Sentinel Event
Notification System for Occupational Risks (SENSOR) projects, toward protocols to
improve the delivery of standard medical surveillance to agricultural workers, including
improved reporting and tracking of occupational injury and illness.
D NIOSH and privately and publicly owned corporations should increase efforts toward the
standardization and improvement of biomarker assessments relating to agricultural illness
E EPA and privately and publicly owned corporations should target funding for research to
establish causal linkages or dose-response relationships between chronic illness and pesticide
exposure; critically important is research into potential endocrine disruptor effects of
F The National Cancer Institute should target funding for long-term research on the possible
association of nitrate in drinking water with cancer risks that addresses the inherent
weaknesses of currently available case-control and ecological studies.
Apply to the fullest extent current advances in engineering and application technology to reduce
fatalities, injuries, illness, and disease in the agricultural community.
A Continue dissemination and evaluation of the recommendations to reduce tractor-related
injuries and deaths produced at the Tractor Risk Abatement and Control policy conference
(Donham et al. 1997), particularly with those audiences whose collaboration will be needed
to enact said recommendations.
B USDA, through the Cooperative State Research, Education, and Extension Service (CSREES)
and the university-based extension system, should take the lead in facilitating the application
of industry-wide, low-cost ergonomic interventions and commodity-specific standardization
of improved ergonomic tools, using successes such as those in the NIOSH publication
Simple Solutions: Ergonomics for Farm Workers as a model.
C American Society of Agricultural Engineers and Society of Automotive Engineers, through
voluntary standards, should facilitate the use of universal design concepts to foster the
development of high-quality and task-specific materials for use in safety and health
equipment for the disabled.
Investigate the safety and health impacts of the annual exemptions from federal agency
enforcement of regulations applied to agriculture.
A Form a task force composed of individuals representing farm organizations, farm employer
organizations, farmers, farmworkers, appropriate researchers in pertinent fields, agricultural
health care providers, and applicable governmental agencies to evaluate the overall impact
of two important exemptions now applied to agriculture. NIOSH funds channeled through
the Ag Research Centers would cover the travel and lodging of task force representatives.
The two exemptions to be evaluated include: