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Robert (Chip) Petrea
Agricultural Safety and Health Network (ASH-NET)
A Summary of 15 Years in Agricultural Safety and Health, and Action Steps for Future Directions
Agricultural Safety and Health Network
Carle’s Center for Rural Health and Farm Safety
John Deere Foundation
Eastern Washington University, Center for Farm Health and Safety
The Farm Foundation
The Great Plains Center for Agricultural Health*
W.K. Kellogg Foundation
National Children’s Center for Rural and Agricultural Safety and Health
National Institute for Occupational Safety and Health of the Centers for Disease Control and Prevention (CDC Conference Grant Number R13/CCR518764-01 & PO#03DSR5-0012)**
New York Center for Agricultural Medicine and Health
The Occupational and Environmental Education and Outreach Center, Great Lakes Centers for Environmental and Occupational Safety and Health, University of Illinois at Chicago School of Public Health
Pioneer Hi-Bred International, Inc.
University of Illinois Extension
University of Illinois at Urbana-Champaign, Office of Continuing Education
University of Illinois at Urbana-Champaign, Department of Agricultural Engineering
Agricultural Safety and Health Network
Technical Editor: Dave Mason, Publication Services, Inc.
Graphic Production and Placement: Dorothy Evans, Publication Services, Inc.
Public Health Review and Content: Natalie Roy, AgriSafe Network
Subvening Camarilla: Mary Barrow and Barbara and Dave Opperman, YHWH Syndic
Petrea, R.E. (Ed.). (2003). 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. Urbana, IL: Agricultural Safety and Health Network.
Photo Credits: AgrAbility Unlimited: pp. 10, 29, 30, 57, 76, 77; Donna Acklin: pp. 4, 46; Bob Aherin: p. 11; Ted Funk: pp. 32, 52; Robert Hornbaker: p. 18; Ken Koelkebeck: pp. 6, 54; Steven Lacey: pp. 19, 34, 37, 38; Suzanne Mason: pp. 1, 5, 56; Chip Petrea: pp. 17, 33, 41, 48, 60.
*This publication was supported by the United States Department of Health and Human Services, Centers for Disease Control and Prevention and the University of Iowa under Grant No. 5 U50 OH07748-02. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of United States Department of Health and Human Services, Centers for Disease Control and Prevention or the University of Iowa.
**This publication was supported by the United States Department of Health and Human Services, National Institute for Occupational Safety and Health of the Centers for Disease Control and Prevention under Grant No. R13.CCR518764-01 and PO#03DSR5-0012. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of United States Department of Health and Human Services, National Institute for Occupational Safety and Health of the Centers for Disease Control and Prevention.
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.
Project Planning Committee
Bob Aherin, University of Illinois
Pam Elkind, Eastern Washington University
Sister Gail Grimes, Farmworker Association of Florida
Janet Ivory, New York Center for Agricultural Medicine and Health
Susan Jones, Western Kentucky University
Tracy Keninger, Easter Seals of Iowa
Bob McKnight, Southeast Center for Agricultural Health and Injury Prevention
Suzanne Mason, Emory University
John May, New York Center for Agricultural Medicine and Health
Marge Niedda, El Comité de Apoyo a los Trabajadores Agrícolas
Teresa Niedda, Farmworker Safety and Health Institute
Chip Petrea, University of Illinois at Urbana-Champaign
Kathy Pitts, Eastern Washington University
CJ Tyler-Watson, Eastern Washington University
Ad Hoc Advisory Participants
Kelley Donham, University of Iowa
Bill Field, Purdue University
Eric Hallman, National Institute for Farm Safety
David Hansen, Farm Safety 4 Just Kids
David Hard, National Institute for Occupational Safety and Health
Barbara Lee, Marshfield Clinic, Marshfield, Wisconsin
Shannon Lizer, University of Illinois Medical School–Rockford
Murray Madsen, Deere and Co., Retired
Dennis Murphy, Penn State University
Steve Olenchock, National Institute for Occupational Safety and Health
Risto Rautiainen, University of Iowa
Susan Reynolds, Progressive Foundation
Lorann Stallones, Colorado State University
Don Villarejo, Center for Rural Studies, Retired
Using History and Accomplishments to Plan for the Future
Entities Endorsing This Project and Its Activities
Center for Farm Health and Safety, Eastern Washington Univeristy
Community Health Partnership of Illinois
Farm Safety 4 Just Kids
Farmworker Health and Safety Institute
Kentucky Partnership for Farm Family Health and Safety, Inc.
Iowa’s Center for Agricultural Safety and Health
Migrant Clinicians Network
National Children’s Center for Rural and Agricultural Health and Safety
National Institute for Farm Safety
New York Center for Agricultural Medicine and Health
North American Agromedicine Consortium
Penn State Agricultural Safety and Health
Work Group Process Discussion Leaders
Dave Hansen and Leslie Nickels
Teresa Niedda, Marge Niedda, and Richard Mandelbaum
CJ Tyler-Watson and Bob Aherin
Work Group Process Participants
Jeff Anderson, WA
Lori Anderson, WA
Brad Baugh, WA
Karyl Baugh, WA
Ed Bell, IN
Gary Erisman, IL
Christine Freehill, IL
Mark Freehill, IL
Jennifer Felzien, CO
Paul Gunderson, ND
Anne Harder, WA
Lex Harder, WA
Dan Littrel, NE
Tammi Littrel NE
Beth Mauer, PA
Richard Mauer, PA
Cyndy Shinn, NE
Gary Shinn, NE
Bill Stutts, LA
Tammie Stutts, LA
Helen Tyler, WA
CJ Tyler-Watson, WA
Aspacio Alcántara, NY
Carolina Almanza, FL
Ramona Alvarado, IL
Herminia Arenas, CA
Alfredo Bahena, FL
Cecilia Barros, CA
Felipe Cabrera, NC
Marta Duarte, CA
José Manuel Guzmán, NJ
Richard Mandelbaum, NJ
Alicia Marentes, TX
Carlos Marentes, TX
Tirso Moreno, FL
Oscar Munoz, IL
Marge Niedda, NJ
Teresa Niedda, NJ
Eduardo Ortega, NJ
Paula Placencia, CA
Adan Jesus Quavez, NY
Angelita Rodriquez, FL
Salvador Rodriquez, WA
Salvador Villancana, NJ
Executive Summary: Recommendations and Strategies
Highlights of Progress in Agricultural Safety and Health
Current Status of Agricultural Safety and Health in the United States
Emergency and Medical Services
Fatalities and Injuries
Illnesses and Diseases
Agricultural Safety and Health Professionals
Recommendations and Strategies with Rationales
Conference Presentations and Papers
Healthy People 2010
National Occupational Research Agenda Priority Research Areas
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 initiative.
B Associated with Strategy A would be the development of an agriculture-specific National Occupational Research Agenda (NORA) within Centers for Disease Control and Prevention/NIOSH.
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 2003.
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 funding.
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 AgrAbility program.
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 communities.
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 community.
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 and disease.
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 pesticides.
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:
- "U.S. Department of Labor should exclude from OSHA protection all agricultural workers in agricultural operations employing 10 or fewer non-family workers within the past 12 months, and having no temporary labor camps in the last 12 months. The U.S. Department of Labor has interpreted this to mean that whenever a farm operation has more than 10 workers employed on any 1 day, the operation is subject to OSHA regulation" (Runyan).
- "Permit Required Confined Spaces (PRCS) and under OSHA's guidelines, can only be entered by developing and following a plan addressing the hazards found in that space. The characteristics of a PRCS, are found under OSHA's Confined Space Standard (29 CFR 1910.146) but family farms
are exempted from the PRCS standard" (Steffen).
Disclaimer and Reproduction Information: Information in NASD does not represent NIOSH policy. Information included in NASD appears by permission of the author and/or copyright holder. More
Reviewed for NASD: 01/2005