"Safety for agricultural educators": evaluation of an intervention to enhance awareness of agricultural hazards

Safety for Agricultural Educators (SAGE) is a two-sided fact sheet on agricultural hazards that has been distributed by the New York Center for Agricultural Medicine and Health (NYCAMH) to Northeastern high school agriculture educators over the past six years. It was intended to supplement and stimulate the teaching of safety principles in agricultural education classes and thus enhance the awareness and knowledge of young people working on farms. This paper describes an evaluation of SAGE's success at achieving these goals. Postal surveys from 29 teachers who had not previously received SAGE gathered data on class demographics and the amount of class time devoted to a variety of agricultural topics including tractor operation and agricultural health and safety. Teachers were asked to assess their students' awareness of safety and health issues and also to estimate the number of students working in the farm environment. Following a year of SAGE mailings, the same information was gathered from the 24/29 post-SAGE responders. Comparison of pre-post responses from the 24 matched responding educators showed: limited increase in the teachers' knowledge of basic agricultural safety information; a decline in the amount of class time devoted to health and safety; a marginal increase in estimated student awareness of health and safety and very little evidence of teacher awareness of SAGE as a safety resource. Most notable was the fact that only 8% of all students were currently working on a farm and teachers estimated that only 6% would be working on farms in five years.

Noise and chemical induced hearing loss: special considerations for farm youth

Farm youth face multiple risks for injury and illness in agriculture. Reviewed here is evidence from current literature illustrating the noise and chemical exposure hearing risks that farm youth potentially face. Sources of noise (e.g., machinery) and potentially toxic chemical exposures (e.g. solvents and pesticides) common in the farm environment are reviewed, illustrating the need for heightened research attention to a problem that may affect up to 2 million children in the United States alone and that requires both public and occupational health solutions. As existing studies have not sufficiently explored potential ototoxic effects of these exposures on children and adolescents, recommendations are outlined for research characterizing both chemical and noise exposures to farm youth and their combined effects on hearing.

Laboratory evaluation of belt usage with apple buckets

BACKGROUND

Migrant and seasonal orchard harvest workers experience musculoskeletal strain caused by carrying heavy loads and holding awkward postures. An ergonomic hip belt designed to redistribute weight from the upper back, neck, and shoulders to the hips was evaluated.

METHODS

A comparison of muscle exertion (using electromyography [EMG]) of four key back and shoulder muscles and shoulder surface pressure (using a surface pressure sensor [PS]) was made among 10 laboratory volunteers under intervention and control conditions, in two postures (standing erect [0 degrees ]) and flexed [45 degrees ]).

RESULTS

All but one measure showed a significant reduction in the flexed posture with the intervention. Two of eight measures showed a significant reduction in the erect posture. Correlations with shoulder discomfort were found for deep shoulder EMG (r=0.71, P=0.021) and shoulder surface pressure (r=0.58, P=0.082).

CONCLUSIONS

The hip belt intervention produces significant reductions in muscle activity while in a posture commonly assumed during orchard work.

Risk Perceptions, Barriers, and Motivators to Tractor ROPS Retrofitting in the New York State Farm Community

The prevalence of tractor rollovers among agricultural workers has made the retrofitting of tractors with rollover protective structures (ROPS) and seat belts a public health priority for agricultural health and safety specialists. To address this concern, the New York Center for Agricultural Medicine and Health (NYCAMH) developed a seven-question survey, designed to assess perceptions of risk as well as potential motivators and barriers to retrofitting. Data from 465 phone surveys were gathered from New York State farmers representing various commodities and farm sizes. Analysis of responses to three qualitative questions contained in the survey indicated that most farmers in New York understand the importance of ROPS but lack the proper motivation to consider retrofitting. It appears that more convenient safety strategies, cost, and age of the tractor compete with a farmer's initiative to retrofit. In addition, survey responses illustrate that although many farmers believe ROPS are important in a general sense, many believe that this safety measure is not necessary for them in particular. Frequent motivators to retrofitting are concerns about safety, although the authors conclude that a more thorough analysis of these "general safety concerns" in qualitative interviews is important.

Estimating farmworker population size in New York State using a minimum labor demand method

Assessment of health needs and services for hand-harvest farmworkers requires reliable population estimates. In New York State, the only publicly available source for these is the Department of Labor (DOL). However, published production data exist that may enable estimation of minimum labor demand (MLD) for hand-harvest labor. Our objective was to develop an estimation process for minimum labor demand (MLD) for hand-harvested crops in NYS and contrast the results with DOL estimates. Four crop strata (below ground, ground, bush/vine, and orchard) were identified. MLD (measured in worker-seasons) was estimated by dividing the total annual harvest hours required for each crop stratum by the total hours worked by one worker in a season for that crop stratum. The MLD estimate of the total number of worker seasons combined for all strata (14,121) was higher than that of the DOL (8,230). Harvest acreage was unavailable for 21% of the 991 county-crop combinations studied; therefore, data were imputed from other sources. Within these strata, the greatest difference was found for ground crops, where the DOL count was 28% of the size of the MLD estimate. DOL and MLD estimates were closest in orchard crops (DOL 109% of MLD). Publicly available data provide a potentially valuable source of informationfor estimation of the MLD. Use of these methods implies that the DOL may substantially underestimate the size of this population. Differences seen between the two methods were sensitive to the crop type. County-level farm surveys to verify MLD estimation factors would enhance the method's accuracy.

Chronic disease risk in central New York dairy farmers: results from a large health survey 1989-1999

BACKGROUND

The agricultural workplace presents a variety of health and safety hazards; it is unknown whether farm work may be a risk factor for certain chronic diseases.

METHODS

The health survey data from a large rural population in central New York were used from two studies (1989, 1999) to assess both 1999 prevalence and 10-year incidence of self-reported diabetes, heart disease, hypercholesterolemia, and hypertension among farm (predominantly dairy) and non-farm residents. The 1999 asthma prevalence was also assessed.

RESULTS

Multiple logistic regression models for 1999 prevalence found statistically significant protective effects of farming for hypertension (OR=0.83, P=0.0105) and hypercholesterolemia (OR=0.853, P=0.0522). Non-significant results were seen for heart disease (OR=0.67, P=0.128) and diabetes (OR=0.856, P=0.1358). The model for 1999 asthma prevalence showed a significantly elevated risk for farming (OR=1.542, P=0.0004). Logistic models created for the 10-year incidence of hypertension, hypercholesterolemia, diabetes, and heart disease did not show a significant effect for farming.

CONCLUSIONS

The protective effect of farming observed for the 1999 prevalence of hypertension and hypercholesterolemia was not seen for the 10-year incidence of these diseases.

The Disease-Modifying Effects of Twice-Weekly Oral Azithromycin in Patients with Bronchiectasis

INTRODUCTION

Bronchiectasis is a chronic pulmonary process characterized by recurrent respiratory infections leading to destruction of airways secondary to inflammation. We investigated whether the addition of 6-months' twice-weekly azithromycin to the existing treatment regimen in patients with pulmonary bronchiectasis decreased the number of exacerbations and improved pulmonary function compared with a similar period of time without concurrent azithromycin.

METHODS

Thirty patients with high-resolution computed tomography scan-confirmed bronchiectasis were to be recruited. In random order, patients received usual medications for 6 months, and usual medications plus oral azithromycin 500mg twice weekly for 6 months. Patients receiving azithromycin first had a 1-month washout period prior to entering the second phase. Patients recorded weekly peak flow (PF) measurements. Pulmonary function tests (PFTs), 24-hour sputum volume, and needs for intervention with medication or ancillary support were collected at baseline and every 3 months. Exacerbation incidence and sputum volume measurements were compared from baseline to the end of each study phase.

RESULTS

Twelve patients were enrolled; 11 were included in the analysis. Owing to randomization, most patients received the azithromycin first, which was fairly well tolerated. PFTs did not change significantly during either study phase and PFs appeared to remain stable during azithromycin therapy and throughout the subsequent control phase. Azithromycin significantly decreased the incidence of exacerbations compared with usual medications (5 vs 16; p = 0.019). Mean 24-hour sputum volume significantly decreased (15% [p = 0.005]) during the active treatment phase, and remained decreased during the control phase (p = 0.028). Subjectively, patients reported increased energy and quality of life while receiving treatment with azithromycin.

CONCLUSIONS

The addition of twice-weekly azithromycin significantly decreased the incidence of exacerbation and 24-hour sputum volume and may have stabilized the PFTs and PFs in this 11-patient pilot study. The results of this study justify further investigation of adding azithromycin to the treatment regimens of patients with bronchiectasis for its disease-modifying effects.

Prevalence and predictors of respiratory symptoms among New York farmers and farm residents

BACKGROUND

Data from telephone interviews with New York farmers and farm residents were used to study the prevalence and risk factors of symptoms that could be related to asthma and allergies.

METHODS

Participants were asked if they had wheezing or whistling in the chest in the past year and about the occurrence of stuffy, itchy, runny nose or watery, itchy eyes in the past year.

RESULTS

The prevalence of wheeze was 18.2% and of stuffy nose/watery eyes was 57.4% (N = 1,620). Significant risk factors for wheeze were cigarette smoking, a systemic reaction to allergy skin testing, immunotherapy, or insect sting, reactivity to a pet, having goats, and more acreage in corn for silage. Significant risk factors of stuffy nose/watery eyes were younger age, having more than a high school education, being a worker on the farm, and having done spraying.

CONCLUSIONS

Wheeze may be indicative of existing or latent asthma, a potentially limiting respiratory illness. Stuffy, itchy, runny nose or watery, itchy eyes, which may cause irritation and discomfort, may also indicate an increased sensitivity to respirable dusts and chemicals. This cohort of New York farmers had significant farm-related risk factors for wheeze and stuffy nose/watery eyes.

Occupational injury and illness among migrant and seasonal farmworkers in New York State and Pennsylvania, 1997-1999: pilot study of a new surveillance method

BACKGROUND

Traditional worksite injury surveillance methods are often ineffective for Northeastern farms employing seasonal harvest labor. Many are small farms, exempt from mandatory injury reporting. The high proportion of foreign workers and the temporary nature of the work further discourages reporting. Therefore, an alternative migrant health center-based occupational injury and illness surveillance system was piloted during 1997-1999.

METHODS

Anonymous medical chart data from nine migrant health centers and four regional hospital emergency rooms was collected during 1997-1999.

RESULTS

There were 516 injury/illness cases over two seasons. Joint/muscle straining (31%), falling (18%), poison ivy contact (10%), and object strikes (8%) were most common injurious events. The participation rate of health care was 75%; 130 cases were reported by hospital emergency rooms; and optimal health center participation was associated with: being a farmworker-dedicated program, and including the chart reviewer in the health center's decision to participate.

CONCLUSIONS

Further development of a medical records-based surveillance system should include hospital emergency rooms and focus on identified health center performance factors.

An analysis of self-reported joint pain among New York farmers

Data from the telephone interview portion of the New York State Farm Family Health and Hazard Surveillance Project were used to study the prevalence and predictors of joint pain in a cohort of farmers and farm residents. The participants were owner/operators, workers, and residents from a representative sample of farms from 12 New York counties. A total of 1706 participants completed a telephone interview on musculoskeletal conditions. Joint trouble was defined as self-reported aches, pain, or discomfort in the past year in each of five different joint areas. The 12-month prevalence of joint trouble was: lower back 41%, neck/shoulders 35%, knees 29%, hands/wrists 28%, and hips 15%. Using logistic regression modeling, significant risk factors for joint trouble were identified (p < 0.05). Older age and being female increased the risk of aches, pain, or discomfort in most joints. Being the owner/operator increased the risk of neck/shoulder and lower back trouble, and being a worker increased the risk of neck/shoulder trouble. Doing tractor work was associated with trouble in all five joint areas, and milking was associated with knee trouble. These findings indicate that personal risk factors and the intensity and nature of the farm work contribute to joint trouble. Ergonomic improvements to tractors and milking facilities should be a high priority.

A comparison of self-reported hearing loss and audiometry in a cohort of New York farmers

The New York State Farm Family Health and Hazard Surveillance was conducted to assess the health status and safety practices among year-round adult farmers and farm residents in New York State and included a telephone interview survey of 1,727 persons from 552 farms. To determine the extent to which self-reported hearing loss is in agreement with audiometry, a subset of 376 participants who completed a hearing loss interview and pure-tone audiometry was analyzed. Thirty-six percent of the participants had self-reported hearing loss, defined as at least some difficulty hearing in one or both ears. The prevalence of audiometric hearing impairment, defined as a threshold average greater than 25 dB hearing level, was 9% for the binaural low-frequency average (500, 1000, and 2000 Hz), 29% for the binaural mid-frequency average (1000, 2000, 3000, and 4000 Hz), and 47% for the binaural high-frequency average (3000, 4000, 6000, and 8000 Hz). Agreement between self-report and audiometry was highest for the binaural mid-frequency average (kappa statistic 55%, sensitivity 77%, and specificity 82%). Self-reported hearing loss was found to be a moderately good measure of hearing impairment. We conclude that a simple questionnaire focusing on hearing difficulty is a useful and valid tool for conducting epidemiologic studies of farmers. Whenever possible, a substudy using audiometry should be conducted.

Acetylcholine receptor-reactive antibody induces nitric oxide production by a rat skeletal muscle cell line: influence of cytokine environment

The monoclonal Lewis rat skeletal muscle cell line, LE1, responded to the acetylcholine receptor (AChR)-reactive antibody mAb35 by up-regulating levels of mRNA for inducible nitric oxide synthase (iNOS/NOS-II), followed by levels of NO. Interferon-gamma (IFN-gamma) and interleukin-1 (IL-1) were also each capable of inducing iNOS message, and synergistically with mAb35. Finally, myocyte-derived NO was implicated as a possible source of immunomodulation in experimental autoimmune myasthenia gravis (EAMG), as shown by the ability of the culture fluids from IFN-gamma-activated LE1 cells to inhibit the proliferation of AChR-reactive T cells.

Predictors of hearing loss in New York farmers

BACKGROUND

Data from the telephone interview portion of the New York Farm Family Health and Hazard Surveillance were used to study self-reported hearing loss in New York farmers.

METHODS

One thousand six hundred and twenty-two persons completed the hearing loss and noise exposure interview. Hearing loss was defined as at least some trouble hearing in one or both ears. Predictors of hearing loss were determined using logistic regression.

RESULTS

Twenty-two percent of participants reported hearing loss. From the logistic regression, significant confounders are age (P = 0.0001), gender (P = 0.0001), being from a livestock farm (P = 0.012), and loss of consciousness due to head trauma (P = 0.04). Significant noise exposures are more hours of lifetime exposure to noisy farm equipment (P = 0.001) and having had a noisy non-farm job (with some hearing protection P = 0.002, without any hearing protection P = 0.0001).

CONCLUSIONS

Farm noise exposure is a serious risk to the hearing of this population. Although use of hearing protection should be encouraged, replacing and modifying farm equipment to decrease noise at the source should be the first priority.

Severe farm injuries among New York farmers

BACKGROUND

Data from the telephone interview portion of the New York State Farm Family Health and Hazard Surveillance were used to study the incidence and predictors of severe farm injury.

METHODS

One thousand seven hundred and six participants completed two telephone interviews in which they reported all injuries over a 12-month period.

RESULTS

Nine percent of participants reported at least one severe farm injury. Using logistic regression the significant risk factors for sustaining at least one severe farm injury are younger age, the presence of hearing loss or joint trouble, working more hours per day, being the owner/operator of the farm, and being from a farm with higher gross sales.

CONCLUSIONS

There needs to be continuing education of all farmers as to the risks of injury. However, when resources are limited, we recommend that injury education and interventions in this farming population should target younger farmers, those who work longer hours, owner/operators, farmers from higher grossing farms, with special attention to farmers who have physical impairments.

The dhb operon of Bacillus subtilis encodes the biosynthetic template for the catecholic siderophore 2,3-dihydroxybenzoate-glycine-threonine trimeric ester bacillibactin

Bacillus subtilis was reported to produce the catecholic siderophore itoic acid (2,3-dihydroxybenzoate (DHB)-glycine) in response to iron deprivation. However, by inspecting the DNA sequences of the genes dhbE, dhbB, and dhbF as annotated by the B. subtilis genome project to encode the synthetase complex for the siderophore assembly, various sequence errors within the dhbF gene were predicted and confirmed by re-sequencing. According to the corrected sequence, dhbF encodes a dimodular instead of a monomodular nonribosomal peptide synthetase. We have heterologously expressed, purified, and assayed the substrate selectivity of the recombinant proteins DhbB, DhbE, and DhbF. DhbE, a stand-alone adenylation domain of 59.9 kDa, activates, in an ATP-dependent reaction, DHB, which is subsequently transferred to the free thiol group of the cofactor phosphopantetheine of the bifunctional isochorismate lyase/aryl carrier protein DhbB. The third synthetase, DhbF, is a dimodular nonribosomal peptide synthetase of 264 kDa that specifically adenylates threonine and, to a lesser extent, glycine and that covalently loads both amino acids onto their corresponding peptidyl carrier domains. To functionally link the dhb gene cluster to siderophore synthesis, we have disrupted the dhbF gene. Comparative mass spectrometric analysis of culture extracts from both the wild type and the dhbF mutant led to the identification of a mass peak at m/z 881 ([M-H](1-)) that corresponds to a cyclic trimeric ester of DHB-glycine-threonine.

Safety awareness among New York farmers

BACKGROUND

This study was conducted to assess the health status and safety practices among year-round adult farm workers and residents and included a telephone interview survey of 1,727 persons from 552 farms.

METHODS

Logistic regression was used to analyze four safety questions.

RESULTS

Among 541 farm owner/operators significant predictors of making substitutions in the use of chemicals and major changes to equipment include younger age, more persons assisting on the farm, and higher gross sales. Having training is associated with having more than a high school education. Among all participants the perception that personal protective equipment are useful is associated with being younger, male, an owner/operator or worker, and having at least a high school education.

CONCLUSIONS

These findings suggest that older and less educated farmers should be targeted for health and safety programs.

Occupational hearing loss

Hearing loss is a significant and unfortunately common occupational malady. Over the past several decades both the Occupational Safety and Health Administration (OSHA) and the National Institute for Occupational Safety and Health (NIOSH) have initiated efforts to better understand and to limit the occurrence of occupational hearing loss, particularly as it relates to excessive noise exposure. This paper briefly addresses the pathophysiology of noise-induced hearing loss and then describes the occupational and non-occupational factors which influence a worker's risk of hearing loss. The primary foci of this discussion are the clinical evaluation, diagnosis, and management of occupational hearing loss. Issues of prevention, OSHA-mandated hearing conservation efforts and compensation are reviewed.

Farm tractors, and the use of seat belts and roll-over protective structures

Roll-over protective structures (ROPS) on farm tractors could significantly reduce the rate of fatal occupational injury on farms, but comparatively few tractors have them. Many of the policy discussions have focused on trying to identify the percentage of tractors that do not have ROPS, even though such a focus probably does not accurately represent effective protection by ROPS. This study investigates whether including differences in hours of usage, tractor activities, and seat belt use affects estimates of farm operators' protection by ROPS. In general, tractors used more hours a year were more likely to have ROPS. ROPS status also varied by tractor activity. When adjusting for seat belt use, effective ROPS protection is much less than when considering just ROPS status. Measures of the effective coverage of ROPS and policy responses should reflect these differences in hours, activities, and seat belt use.

Developmentally regulated expression of a mouse germ cell nuclear antigen examined from embryonic day 11 to adult in male and female mice

A rat IgM monoclonal antibody has been developed which recognized a mouse germ cell nuclear antigen (GCNA1). GCNA1 is present in prospermatogonia (gonocytes) in males and in oogonia and oocytes of females within the gonadal ridge from Embryonic Day 11.5 onward, but rarely in primordial germ cells prior to their arrival at the gonadal ridge. Immunolocalization demonstrates that GCNA1 is abundant in nuclei of spermatogonia and early spermatocytes, but decreases during subsequent spermatocyte and round spermatid development, and is not detected beyond step 10 elongating spermatids. The antigen is approximately 80-110 kDa on immunoblots of isolated pachytene spermatocytes and round spermatids. However, GCNA1 appears to be absent from sperm in the epididymis and vas deferens, Sertoli cells, TM3 cells (Leydig-like) and TM4 cells (Sertoli-like), lung, liver, kidney, spleen, heart, skin, brain, epididymis, and ovary. GCNA1 is present in prepuberal male mice (Days 2-14) in all stages of prespermatogonial and spermatogonial development. It is also present in prepuberal male mice (Days 2-14) in all stages of prespermatogonial and spermatogonial development. It is also present in oocytes of neonatal females until Postpartum Day 12. GCNA1 is first lost from oocytes in the medulla of the ovary as they arrest at the dictyate stage and gain a layer of granulosa cells. In addition, antigen is present in moderate amounts in F9 embryonal carcinoma cells and SCC-PSA1 pluripotent terato-carcinoma cells. Thus, GCNA1 serves as a common marker of the germ cell lineage in male and female mice after primordial germ cells arrive in the gonadal ridge until they reach the diplotene/dictyate stage of the first meiotic division.

Silo filler's disease in New York State

Twenty new cases of Silo filler's disease (SFD) have been collected, documenting the incidence and clinical features of exposure to nitrogen oxides present in freshly filled silos. Cases of SFD were identified using a statewide computerized discharge diagnosis system. Fifteen of these were identified in the index period, allowing us to calculate an approximate annual incidence of 5.0 cases/100,000 silo-associated farm workers/yr in New York State. All cases occurred during harvest periods, with 80% in September and October. Corn silage was the gas source in 18 (90%). All cases involved young white men (mean age, 31.5 yr). The most common presenting feature was dyspnea. All victims entered a silo during the peak danger period, and only one used recommended ventilation techniques. Four cases ended in death (20% mortality). Silo filler's disease, although rare, is a potentially devastating disease involving otherwise young, healthy farm workers. It is readily prevented.

The dangers of dairy farming: the injury experience of 600 workers followed for two years

In order to better understand the work-related injuries sustained on central New York dairy farms, we undertook a two-year population-based study of 600 farmers and farm workers on 201 dairy farms. During the observation period, 1984-1986, 151 persons had 200 injuries, giving an injury rate of 16.6%/year (166 injuries/1,000 workers/year). Men were injured more often than women (p less than or equal to 0.01). Injured workers were older (p less than or equal to 0.01), worked more hours (p less than or equal to 0.001), and had heavier workloads than noninjured workers (p less than or equal to 0.001). The growing and harvest seasons had the most injuries; winter the fewest. More than 2/3 of the injuries occurred in the afternoon. Owners/operators, often the most experienced, knowledgeable people on the farms, were most often hurt. Those working more than 60 hours/week, with greater than 30 acres under tillage/worker, had a relative risk of 2.76 compared with all other workers. The attributable risk for this group was 51%. There were two fatalities, both involved owner/operators. Our findings suggest that previous studies may have underestimated the risks faced by farmers. Dairy farming in central New York is very dangerous work. Those who own and operate these dairy farms are most often hurt and killed. Analysis of events on individual farms will be reported separately.