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Hansen-Ruiz CS, Luschen K, Huber J, Scott E. Understanding Stakeholder Dissemination Preferences for an Agriculture, Forestry, and Fishing Injury Surveillance System. J Agromedicine 2024; 29:235-245. [PMID: 38100079 DOI: 10.1080/1059924x.2023.2293832] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
Researchers and epidemiologists are working to improve the capture of agriculture, forestry, and fishing (AgFF) injuries in a variety of ways. A critical component of any surveillance system is the dissemination of information. The purpose of this paper is to report on a survey conducted with AgFF injury surveillance stakeholders to understand preferred dissemination strategies. The survey was distributed using REDCap via web link to organizational stakeholders, which included advisory board members, safety trainers, industry managers and workers, and research collaborators. In total, there were 75 respondents (21% response rate). Occupation and industry influenced preference in update methods. Regarding the length and breadth of updates, 63% of respondents prefer reports (one to five pages), followed by 57% desiring a summary (less than one page), while only 24% wanted a detailed analysis. Social media and news preferences were also different among stakeholders. Surveillance data were desired for 1) trend analysis, 2) tailoring activities and solutions for education, training, outreach and interventions and 3) for research purposes such as grant proposals and evaluation. The dissemination of injury surveillance data should be tailored to the intended audience. Greater attention needs to be paid to the ways in which we share our findings.
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Affiliation(s)
- Cristina S Hansen-Ruiz
- Northeast Center for Occupational Health and Safety in Agriculture, Forestry, and Fishing, Bassett Medical Center, Cooperstown, NY, USA
| | - Kevin Luschen
- Northeast Center for Occupational Health and Safety in Agriculture, Forestry, and Fishing, Bassett Medical Center, Cooperstown, NY, USA
| | - John Huber
- Northeast Center for Occupational Health and Safety in Agriculture, Forestry, and Fishing, Bassett Medical Center, Cooperstown, NY, USA
| | - Erika Scott
- Northeast Center for Occupational Health and Safety in Agriculture, Forestry, and Fishing, Bassett Medical Center, Cooperstown, NY, USA
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Harduar Morano L, Rosenman KD. Non-Fatal Work-Related Farm Injuries Occurring to Michigan Adults and Youths. J Agromedicine 2024; 29:155-161. [PMID: 37953628 DOI: 10.1080/1059924x.2023.2281530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 10/03/2023] [Indexed: 11/14/2023]
Abstract
Farming is one of the top industries in Michigan and has the highest fatality rate. National sources of non-fatal farm injuries underestimate the burden, especially among children. In this paper, we provide a more accurate estimate of non-fatal farm injuries in Michigan by using an ongoing multi-source surveillance system. Michigan's farm-injury surveillance system includes abstractions of hospital-based medical records, poison control center calls, ambulance runs, and workers' compensation claims for individuals with a farm-related injury. For this analysis, injury onset occurred in 2015 to 2021 and included all injuries regardless of age or occupation. We identified 4,306 injuries in adults and 336 injuries in youth. For those 0-13 years of age all but two were family members. For those 14-15 and 16-17 years of age, 19% and 45%, respectively were hired hands. For adults, 51% were owner/operators, 43% were hired hands, and 5% were family members. For all ages, the most frequent injury source was cattle. Lacerations/cuts/punctures were the most common type of injury for those < 14 years of age while for older individuals it was contusions/bruises. The plurality of injuries occurred in the summer months. Children working on a farm are in unique situation and tracking injuries and identifying injury sources provide necessary information to protect their health and well-being. Michigan's farm-injury surveillance system will continue to provide a comprehensive count of work-related injuries among Michigan's farming population. The information is used to direct public health intervention both at the individual and population level.
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Affiliation(s)
- Laurel Harduar Morano
- College of Human Medicine, Department of Medicine, Division of Occupational and Environmental Medicine, Michigan State University, East Lansing, MI, USA
| | - Kenneth D Rosenman
- College of Human Medicine, Department of Medicine, Division of Occupational and Environmental Medicine, Michigan State University, East Lansing, MI, USA
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Walker J, Madigan D, Friedman LS, Forst L. Injuries Among Hispanic/Latinx Agricultural Workers Seen in Illinois Hospitals. J Agromedicine 2024; 29:246-256. [PMID: 38108302 DOI: 10.1080/1059924x.2023.2293826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
OBJECTIVE Agriculture is a dangerous industry, with evidence indicating a disproportionate burden among Hispanic/Latinx workers. There is a need to expand the utilization of different data systems to improve the surveillance of precarious workers within agriculture. This analysis describes inclusion criteria to identify farm-related injuries and illnesses in hospital data utilizing ICD-10 codes to better assess health equity issues involving Hispanic/Latinx workers and their associated costs. METHODS Discharge data of agriculture-related injuries and illnesses treated in Illinois hospitals and emergency departments from 2018 to 2021 were extracted using ICD-10 diagnosis and location of injury codes. Injury cause, nature, severity, and course of clinical care are stratified by ethnicity. Multivariable models were developed to assess differences in injury severity, level of care required, and cost of care. RESULTS We identified 3,745 farm-related injuries and illnesses treated in Illinois hospitals between 2018 and 2021, of which 196 involved Hispanic/Latinx individuals. Hispanic/Latinx patients were substantially younger and disproportionately covered by workers' compensation insurance or uninsured. Compared to non-Hispanic/Latinx individuals, Hispanic/Latinx patients suffered injuries from different mechanisms, particularly involving animals and cutting/piercing instruments. While non-Hispanic/Latinx individuals demonstrated more severe injuries based on the descriptive statistics, after controlling for confounding (particularly age), we did not observe ethnic disparities in injury severity or level of care required. However, the cost of care was equivalent to or higher among Hispanic/Latinx persons. CONCLUSION The case definition used for this analysis identified agriculture-related cases and provided insights on the course of clinical care by ethnicity. This strategy would likely yield valuable information in states with larger and more diverse agricultural workforces. More targeted research to appropriately scope the issue and inform interventions is needed to understand differential exposure and reduce agricultural workplace hazards and address the financial burden resulting from farm-related injuries.
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Affiliation(s)
- Jared Walker
- Environmental and Occupational Health Sciences, School of Public Health, University of Illinois, Chicago, IL, USA
| | - Dana Madigan
- Environmental and Occupational Health Sciences, School of Public Health, University of Illinois, Chicago, IL, USA
| | - Lee S Friedman
- Environmental and Occupational Health Sciences, School of Public Health, University of Illinois, Chicago, IL, USA
| | - Linda Forst
- Environmental and Occupational Health Sciences, School of Public Health, University of Illinois, Chicago, IL, USA
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Soto Mas F, Sebastian R, Rosero D, Nervi L, Casanova V, Guldan S. Safety and Injury of US-Certified Organic Crop Producers in the Southwest Region. J Agromedicine 2024; 29:168-178. [PMID: 37940850 DOI: 10.1080/1059924x.2023.2281526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 10/24/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVES Literature on occupational risks among organic farmers is scarce. This study explored safety practices and non-fatal injuries among organic producers, and the role of sociodemographic, work, and farm characteristics on safety and injury. METHODS Cross sectional survey of certified organic crop producers in the Southwest (SW) region of the United States (US). The Organic Integrity Database was used for recruitment. Data were collected through an electronic and paper survey. RESULTS Analyses were conducted on 115 cases; response rate was estimated at 25%. A high majority of respondents owned their operation and were younger than 65 years, male, educated beyond high-school, and non-Hispanic whites. Less than half had more than 10 years of experience in organic farming; one-third worked off the farm year-round. Safety practices were very basic despite the widespread use of equipment and machinery, and limited to wearing normal clothing and apparel such hats and glasses. About half of respondents (52.6%) reported non-fatal injuries in the past year; and one-third (32.7%) time lost due to injuries. The overall cumulative incidence rate was estimated at 5.3 injuries per 10 workers within the last year. The injury rate decreased with hours worked. Significant differences were found on gender and education level and safety practices, with female respondents and the more educated being more proactive in practicing safety. Those working less than 40 h/week, in farms smaller than 50 acres, using light machinery or compact utility tractors, and tractors without roll-over protection reported significantly higher injury frequency compared to their counterparts. CONCLUSION This study contributes unique data on an essential workforce not captured by current occupational injury and illness surveillance systems. It identifies important personal and contextual factors that may contribute to safety and injury in this population. The findings indicate the need to promote safety and prevent injuries that result in work time lost. This study may also inform future occupational safety and health research and practice, including surveillance, injury prevention programs that target certain workers and production practices, and policies that support and protect the organic farmer.
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Affiliation(s)
- Francisco Soto Mas
- College of Population Health, 1 University of New Mexico, Albuquerque, NM, USA
| | - Rachel Sebastian
- Pacific Institute for Research and Evaluation - Southwest Center, Albuquerque, NM, USA
| | - Daisy Rosero
- Transdisciplinary Research, Equity and Engagement (TREE) Center for Advancing Behavioral Health, College of Population Health, 1 University of New Mexico, Albuquerque, NM, USA
| | - Laura Nervi
- College of Population Health, 1 University of New Mexico, Albuquerque, NM, USA
| | - Vanessa Casanova
- SW Ag Center and School of Medicine, University of Texas at Tyler, Tyler, TX, USA
| | - Steve Guldan
- Department of Plant and Environmental Sciences, and Superintendent, Alcalde Sustainable Agriculture Science Center, New Mexico State University, Alcalde, NM, USA
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Kang JY, Song SW, Hong H, Kim WJ, Kang Y, Kang JH, Lee SK, Bu J, Ko SY, Lee SH. Clinical characteristics and outcomes of injuries in agricultural and nonagricultural workers visiting the emergency department: a propensity-matched analysis. Clin Exp Emerg Med 2024; 11:68-78. [PMID: 37439139 PMCID: PMC11009704 DOI: 10.15441/ceem.23.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 06/29/2023] [Accepted: 06/30/2023] [Indexed: 07/14/2023] Open
Abstract
OBJECTIVE Agriculture is a hazardous industry. However, previous studies have focused on injuries to agricultural workers without comparison with injuries to nonagricultural workers. Therefore, we compared the clinical characteristics and outcomes of injuries reported at an emergency department (ED) between agricultural workers and nonagricultural workers. METHODS We established a prospective ED-based agricultural injury surveillance system at a tertiary university hospital. Adult patients visiting the ED for an injury were divided into farmer and non-farmer groups depending on their engagement with agriculture. Using an adjusted multivariate analysis and propensity score matching (age, sex, inhabitant, and insurance type), we compared the clinical characteristics and outcomes of injuries between the farmer and non-farmer groups. RESULTS In total, 38,556 injured adult patients (37,746 in the non-farmer group and 810 in the farmer group) were available for the unmatched sample analysis. The 1,620 matched subjects were equally classified after one-to-one nearest-neighbor propensity score matching. A multivariate logistic regression analysis of the unmatched sample revealed higher adjusted odds ratios (ORs) for intensive care unit admission (adjusted OR, 1.752; P=0.003) and overall surgery (adjusted OR, 1.870; P<0.001) in the farmer group. In contrast, univariate logistic regression analyses of the propensity score-matched sample found a higher OR in the farmer group only for overall surgery (OR, 1.786; P<0.001). CONCLUSION Injuries of agricultural workers had higher odds only of requiring surgery; differences in injury-related mortality between groups were not statistically significant in either the matched or unmatched sample analyses.
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Affiliation(s)
- Jong Yeon Kang
- Department of Emergency Medicine, Jeju National University Hospital, Jeju, Korea
| | - Sung Wook Song
- Department of Emergency Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Hansol Hong
- Department of Emergency Medicine, Jeju National University Hospital, Jeju, Korea
| | - Woo Jeong Kim
- Department of Emergency Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Youngjoon Kang
- Department of Medical Education, Jeju National University School of Medicine, Jeju, Korea
| | - Jeong Ho Kang
- Department of Emergency Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Sung Kgun Lee
- Department of Emergency Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Jihwan Bu
- Department of Emergency Medicine, Jeju National University Hospital, Jeju, Korea
| | - Seo Young Ko
- Department of Emergency Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Soo Hoon Lee
- Department of Emergency Medicine, Jeju National University Hospital, Jeju, Korea
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Adibellİ D, Sümen A. Non-Fatal Agricultural Injuries and First Aid Self-Efficacy Among Greenhouse Workers in Turkey. J Agromedicine 2024; 29:1-9. [PMID: 37715707 DOI: 10.1080/1059924x.2023.2259379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/18/2023]
Abstract
OBJECTIVE This study aimed to see if there was a link between first aid self-efficacy and the frequency of occupational accidents and non-fatal agricultural injuries in greenhouse agriculture workers. METHODS This cross-sectional study was conducted with 251 people in a district center. Sociodemographic, occupational accident, and injury questionnaires prepared by the researchers and the First Aid Self-Efficacy Scale were used to collect the data. SPSS 25.0 software was used to evaluate the data and descriptive statistics; the Mann-Whitney U test and Kruskal Wallis analysis of variance were applied in the analysis. RESULTS 71.4% of the participants experienced an occupational accident by falling and slipping; 41.7% were slightly injured after the accident, and 63.2% experienced injuries in fractures, sprains, and crushes. We found that most injuries were in the lower extremities (33.2%), and 66.4% were admitted to the hospital. We ascertained that male workers' median first-aid self-efficacy scores were significantly higher than those of female workers (p < .05). We determined there was no significant difference between first-aid self-efficacy scores according to other sociodemographic variables, occupational accidents, or injury data (p > .05). CONCLUSION Occupational accidents and non-fatal agricultural injuries are common in greenhouse agriculture, and male workers have higher first-aid self-efficacy than female workers. Since greenhouse work is a hazardous line of work, providing simple medical first-aid training would be useful for those working in this field.
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Affiliation(s)
- Derya Adibellİ
- Department of Nursing, Health Science Faculty, Antalya Bilim University, Antalya, Turkey
| | - Adem Sümen
- Department of Public Health Nursing, Kumluca Health Science Faculty, Akdeniz University, Antalya, Turkey
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Becklinger N. Animal-Related Injuries and Fatalities in the AgInjurynews Collection. J Agromedicine 2023; 28:714-725. [PMID: 37016477 DOI: 10.1080/1059924x.2023.2198525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
OBJECTIVES This research had three objectives. The first was to characterize reports of animal-related injuries found in the AgInjuryNews Dataset. The second objective was to compare the results of the AgInjuryNews reports to that of the Regional Rural Injury study. The third objective was to qualitatively and quantitatively assess the utility of using the AgInjuryNews database. METHODS A total of 104 reports on animal-related incidents representing 112 victims were sourced from AgInjuryNews. Chi square tests were performed comparing fatal and non-fatal injuries across age, gender, role in incident, animal, and activity. Additional chi square tests were performed to compare AgInjuryNews data with the results of Regional Rural Injury Study II across age, gender, animal, and activity. Utility of the dataset was assessed by examining the distribution of reports across states, the availability of articles, and qualitative observations. RESULTS Chi square results comparing fatal and nonfatal injuries were significant for victim gender. Results of the comparison of the two studies were significant for age and activity. A mismatch between the states with the highest populations of large animals and the states with the most reports in the AgInjryNews.org database was detected. Approximately 42% of reports the original articles were not accessible. Media bias plays a role in which cases are reported, but the size and accessibility of the dataset increases its utility. CONCLUSION Despite the limitations inherent to the dataset, the amount of freely accessible information and the level of insight provided make AgInjuryNews a valuable resource for agricultural injury research.
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Affiliation(s)
- Nicole Becklinger
- University of Southern Indiana - Engineering, Pott College of Science, Engineering, and Education, Evansville, IN, USA
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Michael JH, Gorucu S. Severe injuries from product movement in the U.S. food supply chain. JOURNAL OF SAFETY RESEARCH 2023; 85:234-241. [PMID: 37330873 DOI: 10.1016/j.jsr.2023.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 11/14/2022] [Accepted: 02/08/2023] [Indexed: 06/19/2023]
Abstract
INTRODUCTION The modern food supply chain presents unique hazards to employees that result in higher morbidity and mortality rates versus other industries. Employees in food manufacturing, wholesaling, and even retailing experience relatively high numbers of occupational injuries and fatalities. One reason for the high hazard rates may be the reliance on a synergistic packaging system designed to load and transport food products within and between manufacturers, wholesalers, and retailers. Packaged food products are often aggregated using palletizers before they can be transported by forklifts and pallet jacks. Materials handling within facilities is critical to the efficient functioning of all members of the food-related supply chain, but product movement can be a source of occupational injuries. No previous research has examined the cause and result of such hazards. METHOD This paper aims to examine severe injuries related to the packaging and movement of food products in segments of the food and beverage supply chain from manufacturing to retailing. An OSHA database was used to investigate all severe injuries in the six years from 2015 to 2020. The focus was on the food supply chain for the period since OSHA began mandating new reporting procedures for severe injuries. RESULTS Results show there were 1,084 severe injuries and 47 fatalities during the six-year period. Fractures of the lower extremities were most prevalent, with the most frequent event type being transportation-related such as pedestrian-vehicle incidents. Significant differences were seen in the three parts of the food supply chain. PRACTICAL APPLICATIONS Implications are drawn for key sectors of the food-related supply chain to reduce packaging- and product movement-related hazards.
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Affiliation(s)
- Judd H Michael
- Dept of Agricultural & Biological Engineering, The Pennsylvania State University, University Park, PA 16802, United States.
| | - Serap Gorucu
- Dept of Agricultural & Biological Engineering, The University of Florida, United States
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Ouattara BS, Beseler CL, Rautiainen RH. Agricultural Injuries: Risk Factors and Severity by Affected Body Part among US (Midwest) Farmers. J Agromedicine 2023; 28:214-223. [PMID: 35703065 DOI: 10.1080/1059924x.2022.2089421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Statistics from the United States Bureau of Labor Statistics indicate that agriculture consistently ranks as the most hazardous industry in the US. To identify specific targets for prevention, we investigated injury risk factor profiles separately for each injured body site. We also characterized the severity of agricultural injuries by injured body site using the type of medical care and lost work time due to injury. METHODS We used the Central States Center for Agricultural Safety and Health (CS-CASH) surveillance data for 2018 to perform descriptive statistics and regression modeling. RESULTS We found that 12% (513/4351) of the participants experienced one or more injuries in the previous 12 months. Compared to female operators, male operators had 3.53 (95% CI: 1.17-10.68) times higher odds of back injury. Operators in livestock production had 2.77 times (95% CI:1.12-6.82), 2.28 times (95% CI:1.25-4.14), and 1.69 times (95% CI:1.10-2.59) higher odds of injury to the chest/trunk, finger, and leg/knee/hip, respectively, compared to operators in crop or mixed production. After adjusting for age and gender, operators who worked full time (vs. part-time) on the farm/ranch had 2.11 times (95% CI:1.03-4.34) higher odds of back injury. Arm/shoulder and leg/knee/hip injuries were more frequent in older age groups. CONCLUSIONS Prevention measures should be tailored considering specifically livestock producers with emphasis on trainings on proper livestock handling, such as being gentle, establishing routine, keeping distance, and avoiding sudden and loud noise when handling animals. Applying these techniques avoid startling the animals and reduce the risk of injuries.
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Affiliation(s)
- Balkissa S Ouattara
- Department of Environmental, Agricultural and Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Cheryl L Beseler
- Department of Environmental, Agricultural and Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Risto H Rautiainen
- Department of Environmental, Agricultural and Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
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Schuelke SA, Ellermeier ME. Agricultural Safety and Health Curriculum: Preparing the Next Generation of Rural Nurses. J Agromedicine 2023; 28:208-213. [PMID: 35341477 DOI: 10.1080/1059924x.2022.2058665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The purpose of this study is to examine the impact of including/expanding agricultural health and safety curriculum in a prelicensure baccalaureate of nursing program on the nursing students' knowledge of agricultural health and safety. A convenience sample of baccalaureate nursing students in their first year of nursing school on two different campuses of a Midwestern college of nursing. Agricultural health and safety content was introduced with pre- and post-surveys completed after delivery of the agricultural health and safety education unit. Independent T-test (p < .05) performed on pre (n = 135) and post surveys (n = 109). There were no significant differences between baseline data on the two campus sites or between genders. There were statistically significant differences between baseline and post levels of knowledge, with an increase in perceived knowledge. Students "raised on a farm" or "that worked on a farm" and students "not raised on a farm" or "didn't work on a farm" had significantly different knowledge levels at baseline, and all groups had a statistically significant change in knowledge, but no significant posttest difference between groups. Incorporation of agricultural health and safety into a Bachelor of Science Nursing program can lead to significant knowledge increase and better prepare student nurses to provide care to patients with agricultural-related injuries and health concerns.
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Affiliation(s)
- Sue A Schuelke
- University of Nebraska Medical Center College of Nursing, Lincoln, NE, USA
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Larkins MC, Khanchandani A, Tumin D, Greene E, Ledoux M, Longshore S. Outcomes of farm compared to nonfarm pediatric injuries: A propensity-matched analysis. J Rural Health 2023; 39:383-391. [PMID: 36076339 DOI: 10.1111/jrh.12711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Pediatric farm-related injuries are rare but tend to be severe relative to other types of pediatric injury and may result in worse clinical outcomes. However, the comparison of farm and nonfarm injuries is confounded by different injury mechanisms, patient characteristics, and treating facilities. Therefore, we used propensity score matching to compare outcomes of pediatric farm and nonfarm injuries in the United States. METHODS Data were obtained from the 2017-2019 Trauma Quality Program database. Farm as compared to nonfarm injury was defined as the location of an injury and served as the independent variable analyzed in this study. The outcome variables analyzed were in-hospital mortality, hospital length of stay (LOS), and admission to the intensive care unit (ICU). RESULTS We identified 2,040 farm injuries and 201,865 nonfarm injuries meeting inclusion criteria. In this cohort, the mortality rate was 1%, median LOS was 2 days, and 14% of patients were admitted to the ICU. In the propensity-matched analysis (including 2,039 farm cases matched to 2,039 nonfarm controls), farm as compared to nonfarm injuries were associated with 5% longer LOS (95% CI: 1%, 8%; P = .01), but not mortality or ICU admission. CONCLUSIONS In a propensity-matched analysis, pediatric farm injuries resulted in prolonged hospital stay compared to nonfarm injuries. Identifying patient- and health care system-level factors contributing to prolonged LOS may help optimize the care of children injured on farms.
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Affiliation(s)
- Michael C Larkins
- Brody School of Medicine at East Carolina University, Greenville, North Carolina, USA
| | - Ashish Khanchandani
- Brody School of Medicine at East Carolina University, Greenville, North Carolina, USA
| | - Dmitry Tumin
- Department of Pediatrics, Brody School of Medicine at East Carolina University, Greenville, North Carolina, USA
| | - Erika Greene
- ECU Health Medical Center, Greenville, North Carolina, USA
| | - Matthew Ledoux
- Department of Pediatrics, Brody School of Medicine at East Carolina University, Greenville, North Carolina, USA
| | - Shannon Longshore
- Department of Surgery, Brody School of Medicine at East Carolina University, Greenville, North Carolina, USA
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VanWormer JJ, Berg RL, Burke RR, Barnes KL, Weichelt BP. Regional surveillance of medically-attended farm-related injuries in children and adolescents. Front Public Health 2022; 10:1031618. [PMID: 36589945 PMCID: PMC9795044 DOI: 10.3389/fpubh.2022.1031618] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 11/25/2022] [Indexed: 12/15/2022] Open
Abstract
Purpose Due to numerous environmental hazards such as heavy machinery and large livestock, youth who live and work on farms are at high risk of injury, disability, and death. This study described a regional surveillance system for monitoring farm-related injuries in children and adolescents. As the risk of farm-related injuries are not exclusive to farm residents, trends in farm-related injuries over the previous 5 years were reported and compared between children/adolescents who did and did not live on farms in north-central Wisconsin. Methods A retrospective cohort of child and adolescent patients of the Marshfield Clinic Health System was assembled. Incident farm-related injuries, including from agricultural work or other activities in a farm environment, were extracted from medical records from 2017 through 2021. Generalized linear models were created to compare age- and sex-adjusted farm-related injury rates by year. Results There were 4,730 (5%) in-farm and 93,420 (95%) out-farm children and adolescents in the cohort. There were 65 incident farm-related injury cases in the in-farm group and 412 in the out-farm group. The annual incidence rate of farm-related injuries was higher in the in-farm group, but changes during the 5-year timeframe were not significant in either group. In the in-farm group, rates ranged from a high of 61.8 [95% confidence interval (CI): 38.3, 94.5] incident farm-related injuries per 10,000 children/adolescents in 2017 to a low of 28.2 (13.5, 51.9) injuries per 10,000 children/adolescents in 2018. In the out-farm group, rates ranged from 10.7 (8.3, 13.6) to 16.8 (13.7, 20.5) incident farm-related injuries per 10,000 children/adolescents per year between 2017 and 2021. The in-farm group had a higher proportion of injured males and heavy machinery injuries, while the out-farm group had more all-terrain vehicle injuries and pesticide poisonings. Conclusion Farm residency remains hazardous for children and adolescents, as injury rates were three times higher in the in-farm group and remained stable over 5 years. All-terrain vehicle injuries were high in both groups, and should be a priority in rural safety interventions. With additional adaptations to other states, this surveillance model could be scaled across other healthcare systems.
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Affiliation(s)
- Jeffrey J. VanWormer
- Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Institute, Marshfield, WI, United States,*Correspondence: Jeffrey J. VanWormer
| | - Richard L. Berg
- Office of Research Support Services, Marshfield Clinic Research Institute, Marshfield, WI, United States
| | - Richard R. Burke
- National Farm Medicine Center, Marshfield Clinic Research Institute, Marshfield, WI, United States
| | - Kathrine L. Barnes
- National Farm Medicine Center, Marshfield Clinic Research Institute, Marshfield, WI, United States
| | - Bryan P. Weichelt
- National Farm Medicine Center, Marshfield Clinic Research Institute, Marshfield, WI, United States
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Oliveira JCAXD, Corrêa ÁCDP, Rocha RM, Santos EC, Beltrame RCT, Borges AP. Implications of health conditions on rural soybean workers' quality of life. Rev Bras Enferm 2022; 75Suppl 2:e20210983. [PMID: 36134784 DOI: 10.1590/0034-7167-2021-0983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 04/24/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to analyze the implications of health conditions on rural workers' quality of life in the context of soybean production. METHOD a cross-sectional study, with an intentional sample of 299 male rural workers. Data collection took place between October and December 2019. The following instruments were used: World Health Organization Quality Life-bref; Rural Workers' Living & Health Conditions questionnaire; International Physical Activity Questionnaire; Cut down, Annoyed, Guilty, and Eye-opener. They were analyzed via descriptive and inferential statistics, using bivariate (Mann-Whitney; Kruskal-Wallis) and multivariate tests (generalized additive models for location, scale and shape). RESULTS the presence of a diagnosis of morbidity, alcohol dependence, occupational accidents and absenteeism implied a decrease in workers' quality of life scores. CONCLUSION the existence of unfavorable health conditions has a negative impact on rural soybean workers' quality of life.
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Oliveira JCAXD, Corrêa ÁCDP, Rocha RM, Santos EC, Beltrame RCT, Borges AP. Implicações das condições de saúde na qualidade de vida de trabalhadores rurais da soja. Rev Bras Enferm 2022. [DOI: 10.1590/0034-7167-2021-0983pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: analisar as implicações das condições de saúde na qualidade de vida dos trabalhadores rurais inseridos no contexto de produção da soja. Método: pesquisa transversal a partir de uma amostra por conveniência de 299 homens trabalhadores rurais. A coleta ocorreu entre os meses de outubro e dezembro de 2019. Utilizaram-se os instrumentos: World Health Organization Quality Life-bref; questionário Condições de Vida & Saúde dos Trabalhadores Rurais; International Physical Activity Questionnaire; Cut down, Annoyed, Guilty, and Eye-opener. Foram analisados via estatística descritiva e inferencial, com aplicação de testes bivariados (Mann-Whitney; Kruskal-Wallis) e multivariados (modelos aditivos generalizados para locação, escala e forma). Resultados: a presença de diagnóstico de morbidade, dependência de álcool, acidente no trabalho e absenteísmo implicaram diminuição dos escores de qualidade de vida dos trabalhadores estudados. Conclusão: a existência de condições de saúde desfavorável repercute negativamente na qualidade de vida dos trabalhadores rurais atuantes no contexto da soja.
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Stakeholders’ Consumption of Agricultural Injury Reports from News Media: A Six-Year Analysis of Website Usage and Visitor Analytics. SAFETY 2021. [DOI: 10.3390/safety7020048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
AgInjuryNews.org is a news report-based, online sentinel surveillance dataset that has provided publicly available news and media reports of agricultural injuries since early 2015. In the 6 years since its inception, AgInjuryNews.org has hosted 12,897 unique visitors and has collected 997 user account registrations. New users from geographic areas home to NIOSH-funded agricultural research centres were most prominent, with these centres returning in larger numbers, comparatively. Users were acquired mostly through web searches, collaborations with other agencies, and paid Facebook.com advertisements. Paid advertisements recruited 3792 visitors; however, retention, registrations, and on-site engagement from this source was low. This analysis shows that data consumption on AgInjuryNews.org is steadily growing. Similar self-hosted programs that provide data or digital resources to agricultural safety and health stakeholders should consider the integration of auditing and analytics tracking, including user registrations.
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Gorucu S, Michael J, Chege K. Nonfatal Agricultural Injuries Treated in Emergency Departments: 2015-2019. J Agromedicine 2021; 27:41-50. [PMID: 33830887 DOI: 10.1080/1059924x.2021.1913271] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Utilizing emergency department admissions to estimate and describe agricultural injuries in the United States (U.S.) provides a unique view of one of the country's most dangerous occupations. This study characterizes and provides nationally representative estimates of persons with non-fatal agricultural-related injuries treated in emergency departments in the U.S.We conducted a cross-sectional study using U.S. Consumer Product Safety Commission, National Electronic Injury Surveillance System (NEISS) data for patients treated in emergency departments from January 1, 2015 to December 31, 2019. We queried all cases in the NEISS database using the location code "farm" and with a narrative search using relevant key words.An estimated 62,079 people were treated in an emergency department for agricultural related injuries. The mean age estimate in this population was 39 years-old, with ages ranging from 1 to 95. Almost two-thirds of patients were male, and almost 80% were white. Approximately 30% and 22% of those injured were youth and elderly patients, respectively. The majority of injuries occurred from April through September. The most common injury was fracture, followed by open wound or amputation. There were significant differences between the body parts injured in youth versus adult patients. The primary source of injury was in the vehicles category, with tractors being the dominant vehicle type.Agricultural vehicles remain a major source of injuries that require treatment in emergency departments. Previous methods of quantifying severe ag-related injuries were limited; our research utilized NEISS data to portray injury statistics more accurately.
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Affiliation(s)
- Serap Gorucu
- Agricultural and Biological Engineering Department, University of Florida, Gainesville, Florida, USA
| | - Judd Michael
- Department of Agricultural and Biological Engineering, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Kelly Chege
- Department of Agricultural and Biological Engineering, Pennsylvania State University, University Park, Pennsylvania, USA
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Simpkins J, Sturdevant D, Timmerman G. An initial analysis of agricultural trauma in South Dakota with an emphasis on work-related injuries. AESCULAPIUS (SIOUX FALLS, S.D.) 2021; 1:2. [PMID: 34423334 PMCID: PMC8375630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
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Scott E, Hirabayashi L, Graham J, Krupa N, Jenkins P. Using hospitalization data for injury surveillance in agriculture, forestry and fishing: a crosswalk between ICD10CM external cause of injury coding and The Occupational Injury and Illness Classification System. Inj Epidemiol 2021; 8:6. [PMID: 33583430 PMCID: PMC7883573 DOI: 10.1186/s40621-021-00300-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 01/05/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND While statistics related to occupational injuries exist at state and national levels, there are notable difficulties with using these to understand non-fatal injuries trends in agriculture, forestry, and commercial fishing. This paper describes the development and testing of a crosswalk between ICD-10-CM external cause of injury codes (E-codes) for agriculture, forestry, and fishing (AFF) and the Occupational Injury and Illness Classification System (OIICS). By using this crosswalk, researchers can efficiently process hospitalization data and quickly assemble relevant cases of AFF injuries useful for epidemiological tracking. METHODS All 6810 ICD-10-CM E- codes were double-reviewed and tagged for AFF- relatedness. Those related to AFF were then coded into a crosswalk to OIICS. The crosswalk was tested on hospital data (inpatient, outpatient, and emergency department) from New York, Massachusetts, and Vermont using SAS9.3. Injury records were characterized by type of event, source of injury, and by general demographics using descriptive epidemiology. RESULTS Of the 6810 E-codes available in the ICD-10-CM scheme, 263 different E-codes were ultimately classified as 1 = true case, 2 = traumatic/acute and suspected AFF, or 3 = AFF and suspected traumatic/acute. The crosswalk mapping identified 9969 patient records either confirmed to be or suspected to be an AFF injury out of a total of 38,412,241 records in the datasets, combined. Of these, 963 were true cases of agricultural injury. The remaining 9006 were suspected AFF cases, where the E-code was not specific enough to assign certainty to the record's work-relatedness. For the true agricultural cases, the most frequent combinations presented were contact with agricultural/garden equipment (301), non-roadway incident involving off-road vehicle (222), and struck by cow or other bovine (150). For suspected agricultural cases, the majority (68.2%) represent animal-related injuries. CONCLUSIONS The crosswalk provides a reproducible, low-cost, rapid means to identify and code AFF injuries from hospital data. The use of this crosswalk is best suited to identifying true agricultural cases; however, capturing suspected cases of agriculture, forestry, and fishing injury also provides valuable data.
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Affiliation(s)
- Erika Scott
- Northeast Center for Occupational Health and Safety in Agriculture, Forestry, and Fishing, Bassett Medical Center, One Atwell Road, Cooperstown, NY, 13326, USA.
| | - Liane Hirabayashi
- Northeast Center for Occupational Health and Safety in Agriculture, Forestry, and Fishing, Bassett Medical Center, One Atwell Road, Cooperstown, NY, 13326, USA
| | - Judy Graham
- Northeast Center for Occupational Health and Safety in Agriculture, Forestry, and Fishing, Bassett Medical Center, One Atwell Road, Cooperstown, NY, 13326, USA
| | - Nicole Krupa
- Bassett Research Institute, Bassett Medical Center, Cooperstown, NY, USA
| | - Paul Jenkins
- Bassett Research Institute, Bassett Medical Center, Cooperstown, NY, USA
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Driscoll M, Dalton D, Jenkins P, Tinc P, Murphy D, Douphrate DI, Lundqvist P, Pate M, Lindahl C, Meyerhoff A, Scott E, Carrabba J, Hagevoort GR, Sorensen J. A Scoping Review of Safety and Health Interventions in the High-Risk Dairy Industry: Gaps in Evidence Point to Future Directions in Research. J Agromedicine 2020; 27:51-63. [PMID: 33191879 DOI: 10.1080/1059924x.2020.1837703] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The occupational injury rate of the dairy industry (6.6 per 100 full-time workers) is twice that of the national average across all industries (3.3 per 100 full-time workers). While dairy farms are becoming larger in size and fewer in number, this rate has not changed. A scoping review was conducted to identify published reports of occupational safety interventions in the dairy industry. An additional criterion was that the study included an evaluation of the intervention. Out of 22 articles that met the first criterion (discussion of interventions specific to the dairy industry), 19 met the second of having an evaluative component. These 19 articles corresponded to 16 unique studies, because 4 articles corresponded to the same study. Of the 16 unique studies, only 3 had a comparison of treatment vs. control effects, and none measured the impact of the intervention on injuries and fatalities. Of the 16 interventions, 6 were focused on training or informational campaigns in which the evaluations primarily measured knowledge acquisition. Additionally, none of these studies had a sufficient sample size to compare injury rates as an outcome. Our study demonstrates that the literature lacks any rigorous evaluation of whether dairy safety interventions are making an impact on injury prevention. Given this, it is not possible to determine how work-related injuries and deaths can be prevented in the dairy industry. Recommendations for future research include incorporating rigorous evaluation into research designs and attempting to develop low-cost, unobtrusive methods for collecting data on intermediate and final outcomes.
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Affiliation(s)
- Maryellen Driscoll
- Agriculture, Forestry, and Fishing, The Northeast Center for Occupational Health and Safety, Cooperstown, NY, USA
| | - Deborah Dalton
- Agriculture, Forestry, and Fishing, The Northeast Center for Occupational Health and Safety, Cooperstown, NY, USA
| | - Paul Jenkins
- Agriculture, Forestry, and Fishing, The Northeast Center for Occupational Health and Safety, Cooperstown, NY, USA
| | - Pamela Tinc
- Agriculture, Forestry, and Fishing, The Northeast Center for Occupational Health and Safety, Cooperstown, NY, USA
| | - Dennis Murphy
- Department of Agricultural & Biological Engineering, Penn State University, University Park, PA, USA
| | - David I Douphrate
- Southwest Center for Occupational and Environmental Health, Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health in San Antonio, the University of Texas Health Science Center at Houston, San Antonio, TX, USA
| | - Peter Lundqvist
- Department of Work Science, Business Economics and Environmental Psychology, Swedish University of Agricultural Sciences, Alnarp, Sweden
| | - Michael Pate
- Department of Agricultural & Biological Engineering, Penn State University, University Park, PA, USA
| | - Cecilia Lindahl
- Department of Work Science, Business Economics and Environmental Psychology, Swedish University of Agricultural Sciences, Alnarp, Sweden
| | - Anna Meyerhoff
- Agriculture, Forestry, and Fishing, The Northeast Center for Occupational Health and Safety, Cooperstown, NY, USA
| | - Erika Scott
- Agriculture, Forestry, and Fishing, The Northeast Center for Occupational Health and Safety, Cooperstown, NY, USA
| | - James Carrabba
- Agriculture, Forestry, and Fishing, The Northeast Center for Occupational Health and Safety, Cooperstown, NY, USA
| | - G Robert Hagevoort
- Extension Animal Sciences and Natural Resources Department, College of Consumer and Environmental Sciences, New Mexico State University, Dairy Extension, Clovis, NM, USA
| | - Julie Sorensen
- Agriculture, Forestry, and Fishing, The Northeast Center for Occupational Health and Safety, Cooperstown, NY, USA
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Yang L, Weston C, Cude C, Kincl L. Evaluating Oregon's occupational public health surveillance system based on the CDC updated guidelines. Am J Ind Med 2020; 63:713-725. [PMID: 32483871 PMCID: PMC7383881 DOI: 10.1002/ajim.23139] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 04/06/2020] [Accepted: 05/14/2020] [Indexed: 11/28/2022]
Abstract
Background The Oregon Occupational Public Health Program (OOPHP) monitors occupational health indicators (OHIs) to inform occupational safety and health (OSH) surveillance. In 2018, OOPHP evaluated the performance of the OSH surveillance system and identified areas for future improvement. Methods Following the Centers for Disease Control and Prevention (CDC) updated guidelines for evaluating public health surveillance systems, the OOPHP evaluation team engaged internal and external stakeholders using a mixed‐methods approach. Operational measures for ten surveillance attributes were developed. Multiple data collection methods resulted in credible evidence for evaluation conclusions. Analyses included summary statistics and qualitative analysis of interviews, a focus group, and online surveys. Results Twenty stakeholders took part in this evaluation, with an average participation rate of 55%. Results showed the Oregon OSH surveillance system was simple, flexible, and highly accepted by its stakeholders. Funding security presents challenges for stability. A lack of timeliness of OHIs, low relevance of OHIs to local OSH issues, and the system's ineffectual data dissemination all limit the usefulness of the OSH surveillance system. A review of key data sources for the system showed good data quality and predictive value positive, but relatively poor sensitivity and representativeness. Conclusions The evaluation team successfully adapted attributes and examples in the CDC guidelines to this Oregon OSH surveillance evaluation. The evaluation findings have informed the development of recommendations for improvements to OOPHP's OSH surveillance. Future research is needed to develop guidance specific to OSH surveillance evaluation.
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Affiliation(s)
- Liu Yang
- School of Biological and Population Health Sciences, College of Public Health and Human SciencesOregon State UniversityCorvallisOregon
| | - Crystal Weston
- Public Health DivisionOregon Health AuthorityPortlandOregon
| | - Curtis Cude
- Public Health DivisionOregon Health AuthorityPortlandOregon
| | - Laurel Kincl
- School of Biological and Population Health Sciences, College of Public Health and Human SciencesOregon State UniversityCorvallisOregon
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Weichelt B, Heimonen T, Gorucu S, Redmond E, Vechinski J, Pflughoeft K, Bendixsen C, Salzwedel M, Scott E, Namkoong K, Purschwitz M, Rautiainen R, Murphy DJ. Redesigning a Sentinel Surveillance System for Collecting and Disseminating Near Real-Time Agricultural Injury Reports: System Usability Study. JMIR Form Res 2019; 3:e13621. [PMID: 31376278 PMCID: PMC6696853 DOI: 10.2196/13621] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 05/23/2019] [Accepted: 05/25/2019] [Indexed: 11/26/2022] Open
Abstract
Background Injury data and reports provide valuable information for both public and private organizations to guide programming, policy, and prevention, but in the increasingly complex and dangerous industry of US agriculture, the injury surveillance needed to produce this data is lacking. To address the gap, AgInjuryNews was established in 2015. The system includes fatal and nonfatal injury cases derived from publicly available reports, including occupational and nonoccupational injuries, occurring in the agricultural, forestry, and fishing (AFF) industry. Objective The study aimed to develop a stakeholder-engaged redesign of the interactive, up-to-date, and publicly available dataset of US AFF injury and fatality reports. Methods Instructor-led heuristic evaluations within a 15-student undergraduate course, data from 8 student participants of laboratory-based usability testing and 2016 and 2017 AgInjuryNews-registered user surveys, coupled with input from the National Steering Committee informed the development priorities for 2018. An interdisciplinary team employed an agile methodology of 2-week sprints developing in ASP.NET and Structured Query Language to deliver an intuitive frontend and a flexible, yet structured, backend, including a case report input form for capturing more than 50 data points on each injury report. Results AgInjuryNews produced 17,714 page views from 43 countries in 2018 captured via Google Analytics, whereas 623 injury reports were coded and loaded, totaling more than 31,000 data points. Newly designed features include customizable email alerts, an interactive map, and expanded search and filter options. User groups such as the Bureau of Labor Statistics and the Agricultural Safety and Health Council of America have endorsed the system within their networks. News media have cited or referenced the system in national outlets such as the New York Times, Politico, and the Washington Post. Conclusions The new system’s features, functions, and improved data granularity have sparked innovative lines of research and increased collaborative interest domestically and abroad. It is anticipated that this nontraditional sentinel surveillance system and its dataset will continue to serve many purposes for public and private agricultural safety and health stakeholders in the years to come.
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Affiliation(s)
- Bryan Weichelt
- National Farm Medicine Center, Marshfield Clinic Research Institute, Marshfield, WI, United States
| | - Tomi Heimonen
- Department of Computing and New Media Technologies, University of Wisconsin-Stevens Point, Stevens Point, WI, United States
| | - Serap Gorucu
- Department of Agricultural and Biological Engineering, Penn State University, University Park, PA, United States
| | - Emily Redmond
- National Farm Medicine Center, Marshfield Clinic Research Institute, Marshfield, WI, United States
| | - Josef Vechinski
- Marshfield Clinic Information Services, Marshfield Clinic Health System, Marshfield, WI, United States
| | - Kurt Pflughoeft
- Department of Computing and New Media Technologies, University of Wisconsin-Stevens Point, Stevens Point, WI, United States
| | - Casper Bendixsen
- National Farm Medicine Center, Marshfield Clinic Research Institute, Marshfield, WI, United States
| | - Marsha Salzwedel
- National Farm Medicine Center, Marshfield Clinic Research Institute, Marshfield, WI, United States
| | - Erika Scott
- Northeast Center for Occupational Health and Safety, Bassett Medical Center, Cooperstown, NY, United States
| | - Kang Namkoong
- Department of Communication, University of Maryland, College Park, MD, United States
| | - Mark Purschwitz
- Department of Biosystems and Agricultural Engineering, University of Kentucky, Lexington, KY, United States
| | - Risto Rautiainen
- Central States Center for Agricultural Safety and Health, University of Nebraska Medical Center, Omaha, NE, United States
| | - Dennis J Murphy
- Department of Agricultural and Biological Engineering, Penn State University, University Park, PA, United States
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