Agriculture, Forestry, and Fishing Research at NIOSH Reviews of Research Programs of the National Institute for Occupational Safety and Health (2008) / Chapter Skim
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6 Review of Health Effects Research
6 Review of Health Effects Research
Pages 94-110
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From page 94... ...
Because of the historic funding placed in agriculture, the committee focused to a considerable extent on the agriculture sector and on the health effects research conducted intramurally by NIOSH scientists and extramurally through research development and support in university-based Centers for Agricultural Disease and Injury Research, Education, and Prevention (Ag Centers) and among researchers in the broader community; the committee also evaluated health effects research in forestry and fishing to the extent that the available information permitted.
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From page 95... ...
LOGIC SUBMODEL Information received from the NIOSH AFF Program (NIOSH, 2006a) related to inputs, activities, outputs, intermediate outcomes, and end outcomes in health effects research is summarized in the health effects research logic submodel (Figure 6-1)
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From page 96... ...
Time needed to build relationships with partners and constituents Current political climate Farms becoming larger with less reliance on child labor Lack of resources and interest in funding surveillance Seasonality of industries, weather, climate change Funding periods limit ability to evaluate long-term effects of intervention Negative effect of economic downturn Uncertainty regarding immigration issues Poor national/political understanding of scope and cost of occupational disease and public health External Factors FIGURE 6-1 Health effects research logic submodel. AMSEA = Alaska Marine Safety Education Association, CAFO = concentrated animal feeding operation, CES = Cooperative Extension Service, ERC = Education and Research Centers, FACE = Fatality Assessment and Control Evaluation , FOPS = falling object protective structure, HHE = Health Hazard Evaluation, MMWR = Morbidity and Mortality Weekly Report, NCI = National Cancer Institute, NPFVOA = North Pacific Fishing Vessel Owner's Association, NTOF = National Traumatic Occupational Fatality, OHNAC = Occupational Health Nurses in Agricultural Communities, PPE = personal protective equipment, ROPS = rollover protective structure, SENSOR = Sentinel Event Notification of Occupational Risk , USCG = U.S.
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From page 97... ...
For example, inputs from the Alaska fishing program were excellent. Other AFF projects had less adequate inputs, partially because of cultural, geographic, financial, and other types of barriers; the paucity of interventions aimed directly at farm workers is evidence of the limitation.
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From page 98... ...
For example, geographic dispersion of AFF worksites, rural isolation, non-English dialects, so cial dynamics, access to workers at occupational sites, the undocumented status of some exposed AFF workers, and patterns of worksite task organization may militate against effective penetration. Nevertheless, Congress's intent was clear: to safeguard and promote the safety and health of AFF worker populations in the nation's fundamental interest.
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From page 99... ...
For example, sleep deprivation and the effects of nightshift work have not been extensively explored, workplace violence has received little attention, the health impact of volatile organic chemicals and solvents that are ubiquitous in AFF worksites remains unknown, infectious disease has received little exploration, and reproductive health effects have received only sporadic support in both the intramural and extramural parts of the AFF Program. The study of gene-environment interactions is a nascent program; it has become clear that research in this field requires large numbers of subjects to generate useful results, so there is a need to conduct well-organized multicenter studies with careful exposure assessment and characterization of disease phenotypes.
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From page 100... ...
Department of Agriculture funding, numerous agricultural extension safety professionals were directly involved in research conducted by the extramurally funded Ag Centers. Organizations such as Farm Safety 4 Just Kids, the National Institute for Farm Safety, and the W
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From page 101... ...
Review of H e a lt h E f f e c t s R e s e a r c h 101 TABLE 6-1 Research Emphases of Some NIOSH Ag Centers Ag Center Research Strength or Emphasis Pacific Northwest Agricultural Safety Prevention of occupational disease and injury in farmers, and Health Center, Washington fishermen, forestry operators through occupational medicine, epidemiology, industrial hygiene Western Center for Agricultural Health promotion and disease prevention, injury and Health and Safety, California ergonomics, neurotoxicity and pesticides, respiratory diseases, industrial hygiene and exposure assessment, evaluation, biostatistics Southwest Center for Agricultural Farm-family health and injury control, hired farmworker Health, Injury Prevention, and health and safety, animal-handling injuries, stress, health Education, Texas and safety training and education Deep-South Center for Agricultural Asthma, ergonomic injuries, heat stress in farm workers; Disease and Injury Research, prostatic cancer in licensed pesticide applicators; health, Education, and Prevention, Florida exposure assessment of poultry producers; incidence of logging-related injuries; safety of farm children Southeast Center for Agricultural Special populations, community-based interventions, Health and Injury Prevention, engineering, ergonomics, green tobacco sickness, Kentucky environmental health Northeast Center for Agricultural Hearing loss, arthritis, skin cancer, allergies, mechanical and Occupational Health, New York injuries, migrant farm workers, older farmers, women, children Midwest Center for Agricultural Infectious pathogens, women, developing and evaluating Research, Education, and Disease health promotion and disease and injury prevention and Injury Prevention, Wisconsin programs, engineering control technologies, injuries in children High Plains Intermountain Center Engineering, industrial hygiene, education, toxicology, for Agricultural Health and Safety, social work, epidemiology, environmental health, Colorado agricultural sciences Great Plains Center for Agricultural Environmental health, health and safety of farmers, Health, Iowa occupational health, injury prevention, rural health National Children's Center for Rural Health and safety issues for farm children, guidelines for and Agricultural Health and Safety, acceptable agricultural tasks Wisconsin in response to an explicit directive of Congress, those surveillance efforts could have shaped the direction of the program for years to come. Instead, data remain unanalyzed in several of the states, and one state experienced such basic difficulty in planning, organizing, and directing the effort that little could be salvaged.
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From page 102... ...
OUTPUTS Major outputs of the AFF Program have been publications in scientific jour nals, fact sheets on the NIOSH Web site, summaries of disorder- or organ-system focused epidemiological projects (for example, the documents Epidemiology of Farm-Related Injuries: Bibliography with Abstracts and Injury and Asthma Among Youth Less Than 20 Years of Age on Minority Farm Operations in the United States, 2000) , and monographs (such as Simple Solutions: Ergonomics for Farm Workers, 2001; Guide to Evaluating the Effectiveness of Strategies for Preventing Work Injuries, 2001; and Childhood Agricultural Injury Prevention: Issues and Interventions from Multiple Perspectives, 1992)
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From page 103... ...
Cancer The AFF Program has not had a major focus on research in occupational cancer detection or prevention since the 1990s except through its partnership with NCI and NIEHS in the Agricultural Health Study (AHS)
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From page 104... ...
Research outputs -- which include published reports, scientific manuscripts, training materials, and dissemination of these products -- address hearing conservation, hearing loss as a risk factor for injury, comparisons of self reported hearing to audiometric testing, prevalence of noise-induced hearing loss, and task-based and animal-based exposure assessment. While the majority of activ
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From page 105... ...
Poisonings Poisoning from exposure to high concentrations of toxicants remains an important problem in AFF workers, primarily related to exposure to pesticides. NIOSH has funded extensive work in agricultural pesticide poisoning, including epidemiology, identifying clinically relevant biomarkers, and training workers to avoid causative pesticide exposure.
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From page 106... ...
Workplace violence occurs occasionally among hired farm laborers, but there is very little evidence in literature regarding prevalence and reports are anecdotal. In the California Agricultural Worker Health Survey, only 0.7 percent of male workers reported ever having been a victim of workplace violence (Brammeier et al., in press; Villarejo and McCurdy, in press)
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From page 107... ...
It is known that workers in specific industries in which long hours and shift work are common, including healthcare, are at increased risk for adverse health outcomes directly associated with sleep deprivation. NIOSH has not extensively addressed the issue in the AFF sector, even though accounts of long workdays and workweeks are noted in employee activity logs and are legion in the sector.
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From page 108... ...
NIOSH funding has been invested in AFF worksite interventions, such as de sign of a Certified Safe Farms initiative, tractor ROPS public policy development, rural cancer control intervention development, ergonomic tool design, develop ment of respiratory and hearing personal protective equipment, organic dust re duction in AFF worksites through animal housing engineering, injury prevention through redesign of worksite facilities and methods of work, design of safe play areas for children in agricultural worksites, design of helicopter logging injury countermeasures, and use of enhanced deck safety technologies for fishermen. Those initiatives have generally been scientifically robust and clinically relevant and have reflected input of AFF stakeholders whose perspective governed identification and priority-setting of interventions and the actual deployment process.
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From page 109... ...
The most robust activity occurred in the fishing sector, and activity was somewhat more limited in the logging sector, but in both instances the NIOSH intramural program led the way. Most AFF resources allocated by Congress were directed toward the agricultural sector; however, this sector has been the most timid in these matters.
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From page 110... ...
. The higher incidence of primary intracranial glioma among male farmers compared to the general population led to the design and implemen tation of a case-control study conducted jointly by NIOSH and two extramurally funded Ag Centers (Great Plains Center for Agricultural Health in Iowa and the National Farm Medicine Center in Wisconsin)
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