Safety on North Carolina and Kentucky trout farms.

The objective of this study was to identify and describe work-related safety hazards, injuries, and near-injury events (close calls) that occurred on trout farms in North Carolina and Kentucky. An interview instrument was used to collect information on occupational hazards, injuries, and near-injury events that resulted from work-related activities. Trout farmers reported occupational hazards including falling live tank lids, slippery surfaces on hauling trucks, lifting strains, falls from raceway walls and walkways, needlesticks while vaccinating fish, allergies, hypothermia/drowning, falls from cranes, chemical exposure, fire/explosions related to oxygen exposure, and electrical contact with overhead power lines. This study also reports solutions suggested by farm safety researchers or used by farmers to prevent the safety hazards found on trout farms.

Safety status of farm tractors that operate on public highways in four rural Kentucky counties.

Kentucky FFA students inspected 153 farm tractors for safety features that prevent operator injuries during tractor overturns, highway collisions, runovers, and power take-off (PTO) entanglements. Tractor mean age was 23.6 years (SD = 20.9). Rollover protective structures (ROPS) were present on 50.66% of tractors, but only 33.33% of these had functional seatbelts. Loose and damaged seats were found on 30.46% of tractors. In 38.99% of cases, tractor rear-wheel fenders exposed operators to moving tractor tires, and 48.67% of tractors had dangerously worn or damaged tires. Tractors with a narrow front-end stance comprised 16.11% of the total. Only 53.06% of the tractors had starters with secure hard cover by-pass starting shields that fully covered the starter terminals, and 37.37% had fully exposed terminals with no cover. PTO master shields with all parts present and undamaged were present on only 29.27% of the tractors, and in 39.02% of cases the entire shield was missing. Only 44.67% of the tractors had properly mounted and fully functional mounting and dismounting access steps and handholds. SMV emblems were missing on 53.64% of tractors and in the proper place and condition in only 25.83% of cases. Tractors with properly mounted and fully functional head and tail lights comprised 40.94% of the sample, and tractors with no functional lights comprised 24.16%. Properly mounted, clean, and functional rearview mirrors were present on only 19.87% of the tractors, and 69.54% had no rearview mirrors. The project increased farming and non-farming students' awareness of tractor safety issues, provided empirical data about the safety status of a sample of tractors that frequently travel public highways in four rural Kentucky farming counties, and promoted dialog about these issues with adult farmers and other community members with whom the students interacted.

Prevalence of ROPS-equipped tractors in U.S. aquaculture.

Aquaculture involves the production of plant and animal products that are cultured in water. The principal freshwater fishes raised in the U.S. are catfish (raised mainly in ponds) and trout (raised mostly in concrete raceways), and the principal crustaceans grown are shrimp, crayfish, oysters, and clams. Tractors are used on aquaculture farms mostly in pond culture. Ponds present overturn hazards because of the slopes of levees, slippery conditions, and nighttime driving. Protection is afforded to the tractor operator when a rollover protective structure (ROPS) is attached to the tractor. The purpose of this study was to analyze and describe the prevalence of ROPS-equipped tractors on farms engaged in aquaculture in the U.S. The analysis concluded that 78% of tractors used in aquaculture were equipped with a ROPS, in contrast with the prevalence of ROPS at 49% for all of agriculture. Moreover, 91% of the tractors in the South used for aquaculture were equipped with a ROPS. The national sample for aquaculture included 75 farms and 137 tractors, which is small, but nonetheless, several hypotheses can be generated as a result of this descriptive study.

Projected incidence and cost of tractor overturn-related injuries in the United States.

In 2004, the Agricultural Safety and Health Centers, supported by the National Institute for Occupational Safety and Health, launched an initiative to conduct research on the consequences of and approaches to control of agricultural tractor-related injuries. The most significant cause of fatal injuries is associated with tractor overturns, and a recognized intervention to control these injuries is equipping the tractor with a rollover protective structure (ROPS). The purpose of this study was to determine the incidence of tractor-related fatal and nonfatal injuries and their social costs. Based upon the annual average incidence of 125 tractor-overturn-related fatalities in the U.S. for the period 1992 to 2002, an analysis was conducted of injuries over the 25-year period 1997 to 2021. Using the number of fatalities as an index value, the analysis found that in 1997, there were a total of 2,412 tractor overturns. These overturns were associated with 125 deaths and 573 nonfatal injuries requiring at least outpatient treatment. Compared to ROPS-equipped tractors, 123 (98.6%) deaths and 543 (95%) of nonfatal injuries were associated with non-ROPS tractor overturns. The undiscounted social cost of these injuries totaled $1.5 billion in 2006 dollars for the 25-year period when using cost factors for the agricultural population. When discounted at 3%, this total was $1.1 billion, and when discounted at 5%, it was $0.9 billion. In an alternative analysis, when using cost factors for all occupations including agriculture, the undiscounted social cost totaled $2.9 billion, $2.1 billion when discounted at 3%, and $1.7 billion discounted at 5% for the 25-year period. Non-ROPS tractors as compared to ROPS-equipped tractors account for at least 97% of the costs, no matter the discount rate or cost factors used.

Frequency and severity of injuries to operators during overturns of farm tractors.

Previous estimates of operator death from farm tractor overturn events range from 0.03 to 0.68. This study provided population-based estimates of the denominator of total farm tractor overturns and the frequency of six classes of overturn injury outcomes for tractors with and without rollover protective structures (ROPS). A 40-item telephone survey collected information from a random sample of 6,063 (8.0%) Kentucky farms about each farm's most recent overturn. A total of 551 (9.1%) farms reported overturns, and 5,512 (90.1%) reported no overturns. Injury outcomes for 443 overturns of non-ROPS tractors and 89 ROPS tractors were distributed as follows: no or minor injury (non-ROPS: 70.43%; ROPS: 82.02%), outpatient treatment (non-ROPS: 21.90%; ROPS: 9.00%), hospital admission (non-ROPS: 15.35%; ROPS: 3.37%), temporary disability (non-ROPS: 13.54%; ROPS: 14.61%), permanent disability (non-ROPS: 3.16%; ROPS: 0.00%), and death (non-ROPS: 5.42%; ROPS: 1.12%). (Percents total to more than 100 because some operators treated as outpatients were subsequently hospitalized, disabled, or died.) The observed 0.054 probability of death from overturn of non-ROPS tractors in this sample was corrected for the proportion of farms that went out of business prior to the survey and thus were excluded from the sampling frame. The adjusted 0.08 probability of death from overturn of a non-ROPS tractor is five times smaller than the NIOSH estimate of 0.40. The discrepancy lies in the much larger denominator of all non-fatal and fatal overturns than assumed previously.

Seatbelt use during tractor overturns.

In 2002, the Kentucky Farm Tractor Overturn Survey was administered, in which 6,063 randomly selected farm operators responded to questions that addressed the presence and use of seatbelts in the event of a tractor overturn. Data were analyzed to determine the proportion of seatbelt presence and use on tractors that overturned differentiated by whether they were equipped or not equipped with a rollover protective structure (ROPS). In 537 overturns reported for which the ROPS status was known, 92 involved ROPS-equipped tractors, of which 60 had a functioning seatbelt, and 19 operators of these tractors used the seatbelt that was present during the overturn. However, of the 445 overturns of non-ROPS tractors, eight had a functioning seatbelt, and three of these operators wore the seatbelt. Two of the three operators that wore seatbelts on non-ROPS tractors suffered a permanent disability. In contrast, of the 19 operators who wore a seatbelt on ROPS-equipped tractors, 18 experienced no or minor injuries, and one required outpatient care. Seatbelts are known to save lives but are a secondary safety device to ROPS, for ROPS alone saves lives and is a necessary pre-condition for seatbelt presence and use.

Cost effectiveness of a dealer's intervention in retrofitting rollover protective structures.

OBJECTIVE: To evaluate the cost effectiveness of a 4.5 year education campaign that promoted farmers' adoption of rollover protective structures (ROPS) to prevent tractor overturn injuries. DESIGN: Randomized controlled trial, decision analysis, and cost effectiveness analysis. SETTING: One treatment county and one control county in the State of Kentucky. INTERVENTION: A campaign by a local tractor and equipment dealership to encourage farmers to purchase and install ROPS and seatbelt retrofit kits for older tractors. MAIN OUTCOME MEASURES: Number of injuries averted and cost per injury averted. RESULTS: The dealership's 4.5 year intervention was shown to potentially reduce both fatal (0.26) and non-fatal (1.50) injuries by 2.6% in its county over the intervention period using a 20 year analytic horizon. When extrapolated statewide, 6.7 lives would be saved and 39 non-fatal injuries would be averted over the combined 24.5 year combined intervention period and analytic horizon. The intervention for this period was cost effective with a "savings" of 35,713 dollars per injury (fatal plus non-fatal) averted at a 4% discount rate. CONCLUSIONS: Tractor manufacturer promotions can influence their dealerships to promote ROPS retrofits by their customers. A manufacturer backed dealer ROPS retrofit campaign was cost effective in reducing overturn related injuries.

Instructional practices at Farm Safety 4 Just Kids (FS4JK) safety day camps.

The instructional methods used with 1,347 youth in seven Farm Safety 4 Just Kids (FS4JK) day camp sessions conducted in five states during the summer and fall of 2002 were videotaped. The videotapes, instructor questionnaires, and day camp materials were analyzed using an observation protocol that focused on instructional practices and an interaction analysis of instructor-student talk during the sessions. Results showed that instruction focused on hazard recognition, a high level of participant attention during all the sessions observed, and safety day camp content relevant to rural participants regardless of whether they live or work on a farm. Recommendations for improving instructional practice include better use of print materials, more interactive, participatory activities for students, and reduction of instructor-centered, didactic approaches. Given the high level of students' attention, increased involvement of students in active, participatory approaches might enhance the effectiveness of the instruction by: (1) further engaging students through personalizing hazard recognition, (2) contextualizing reports of injuries, (3) examining the complexities of choosing safe behaviors, and (4) paying more attention to the consequences of injury events. Role-playing, narrative simulations, and other types of interactive and collaborative exercises are instructional approaches that support the inclusion of the pre-event contingencies and post-event consequences that are part of all injury events.

Cost-effectiveness of a ROPS retrofit education campaign.

A community educational campaign implemented in two Kentucky counties was effective in influencing farmers to retrofit their tractors with rollover protective structures (ROPS) to protect tractor operators from injury in the event of an overturn. This article reports on the cost-effectiveness of this program in the two counties when compared to no program in a control county. A decision analysis indicated that it would be effective at averting 0.27 fatal and 1.53 nonfatal injuries over a 20-year period, and when this analysis was extended statewide, 7.0 fatal and 40 nonfatal injuries would be averted in Kentucky. Over the 20-year period, the cost-per-injury averted was calculated to be $172,657 at a 4% annual discount rate. This cost compared favorably with a national cost of $489,373 per injury averted despite the additional program cost in Kentucky. The principle reason for the increased cost-effectiveness of the Kentucky program was the three-fold higher propensity for tractors to overturn in Kentucky. The cost-per-injury averted in one of the two counties was $112,535. This lower cost was attributed principally to incentive awards financed locally for farmers to retrofit their tractors with ROPS.

Cognitive-behavioral approaches to farm community safety education: a conceptual analysis.

For many years, farm health and safety education efforts have focused on the presentation of safety rules and guidelines. This method of instruction tends to ignore the contingencies that influence the actual behavior of farmers. Consequently, while most farmers understand the safety instruction messages they receive, they frequently continue to engage in risky behaviors. They do so even when they are aware of the injury consequences that can result from engaging in risky behaviors during farm work. Consequently, educational programs for the delivery of farm health and safety knowledge have been judged to be of questionable effectiveness. Yet, current political, social, and economic realities suggest that safety and health education will remain a favored methodology for the foreseeable future. These observations suggest that farm safety education efforts may need to be reconceptualized. This article examines the learning of safe and unsafe work practices from three historical learning theory perspectives: behaviorism, constructivism, and socioculturalism. The conceptual analysis is illustrated through case study examples. The analysis may provide insights into why transmission of knowledge by itself is not effective for replacing risky behaviors with safe work practices. It may also assist the design of farm health and safety education programs that impart knowledge, as well as change attitudes and behavior that support safe work practices.

Stories or statistics? Farmers' attitudes toward messages in an agricultural safety campaign.

Farming is the second most hazardous occupation in the U.S. The high mortality rate is due in large part to farm equipment hazards, particularly tractor overturns. Injuries and deaths associated with tractor overturns could be prevented with the use of a rollover protective structure (ROPS). In spite of the known dangers associated with overturn incidents, farmers are reluctant to retrofit ROPS on older tractors. Few agricultural safety campaigns target the issue of ROPS retrofits, and none have been evaluated systematically. This article reports a study that examines a set of messages that were central to the Community Partners for Healthy Farming project. This study indicates that narrative-based messages and messages incorporating fear appeals are more favorably evaluated by farmers than messages that simply inform farmers or messages that rely on statistics.

Equipment dealers' perceptions of a community-based rollover protective structures promotion campaign.

Farming is one of the most hazardous occupations, and tractor overturns are the leading cause of agricultural fatalities. This article examines a community-based injury intervention designed to increase the number of rollover protective structures (ROPS) and seat belts on tractors and to promote safe operation of farm tractors in two counties. Equipment dealers who sell retrofit ROPS kits to farmers were a critical component of the intervention. Interviews were conducted with dealers after the 31-month intervention period to understand their perceptions, any difficulties they experienced as a result of the project and how a similar project could be improved. Comments were analyzed in relation to theories of persuasion. Results indicated that dealers believed the intervention was successful in producing behavior change among some farmers. Dealers also provided important insights into why some farmers continued to resist retrofitting tractors with ROPS. Recommendations are offered for designers of community-based interventions beyond the ROPS project described here.

Sex differences in principal farm operators' tractor driving safety beliefs and behaviors.

OBJECTIVE: To examine the widely accepted hypothesis that farm women are more concerned with safety issues and behaviors than their male counterparts are. METHODS: A telephone survey was administered to a random sample of Kentucky principal farm operators, 90 of whom were women. Participants were questioned about their tractor safety beliefs and practices. RESULTS: No significant sex differences in tractor safety perceptions and behavior were observed. CONCLUSIONS: Socialization of women to the role of principal farm operator may override their typically greater sensitivity to safety issues, an important consideration when designing safety campaigns for this population.

Exophthalmometry: a comparative study of the Naugle and Hertel instruments.

Exophthalmometry is frequently used as a tool in the evaluation of proptosis. The purpose of this study was to compare the clinical usefulness of the newly developed Naugle superior and inferior orbital rim-based exophthalmometer with that of the Hertel exophthalmometer, as well as to obtain normal values and analysis of possible race and sex differences. In the first part of this study, we measured 135 patients in a double-blind study in order to evaluate the repeatability of serial measurements using each instrument. Comfort was also evaluated in this series of patients. In the second part, a single observer measured 205 patients in order to obtain information for a multifaceted analysis. In the first part of the study, we found the Hertel measurement to be more variable in terms of coefficients of variation. We further found the Hertel base measurements to vary more between observers than those of the Naugle instrument. In the second part, we found that the mean values of globe position were not statistically different (mean Naugle, 17.23; mean Hertel, 18.61; p = 0.909). A significant difference was noted between black and white patients when using the Naugle instrument. A difference between white and black women was noted with the Hertel instrument. The results of this analysis strongly suggest that the values obtained from the Naugle exophthalmometer are more repeatable in serial measurements compared with the Hertel values. However, single measurements of globe position from all patients were statistically similar. We conclude that the Naugle instrument is comparable in accuracy to the Hertel instrument for measuring ocular position, as well as being more comfortable for the patient. The Naugle instrument has the advantage of measuring hyperophthalmos and hypoophthalmos with a vertical gradient scale.

Brown recluse spider envenomation of the eyelid: an animal model.

The authors developed a rabbit model of the brown recluse (BR) spider envenomation of the human eyelid. The spider bite causes cutaneous necrosis and systemic toxicity in human eyelids, possibly leading to disseminated intravascular coagulation, hemolysis, and death. The treatment has been controversial. The animal model evaluated the effects of single- and combined-agent therapy in four phases: venom dose response, time course, therapeutic effectiveness (steroid vs. dapsone vs. antivenom), and optimal therapy (steroid and dapsone; steroid and antivenom; and dapsone and antivenom combination groups). The combination dapsone and antivenom treatment group was the optimal animal regimen, although not completely effective in eliminating microscopic necrosis. The authors also report dramatic clinical improvement in human inflammatory response with dapsone therapy and recommend immediate dapsone therapy combined with specific BR venom, if available, in humans.

Embedded performance measures as teaching and assessment devices.

Standard methods of testing trainees during courses on health and safety are time-consuming and, therefore, testing is rarely completed. Embedded performance measures, however, offer an alternative to traditional testing; they are completely integrated with instruction and require the learner to perform numerous short problem-solving tasks. The author focuses on the history of embedded performance measures and their effectiveness in health and safety training.

Harada's disease associated with fibrous dysplasia.

Harada's disease is a well-described entity consisting of bilateral serous retinal detachments and diffuse choroiditis. The etiology of Harada's disease is obscure. Fibrous dysplasia of the orbit is also a well-known entity associated with many orbital and ophthalmologic findings. The defect in fibrous dysplasia appears to be a congenital nonhereditary abnormality in bone-forming mesenchyme. We present a case of Harada's disease and fibrous dysplasia of the orbit. The clinical photographs, fluorescein angiograms, ultrasound study, and histologic specimens are presented.