Disparities in COVID-19 vaccine uptake, attitudes, and experiences between food system and non-food system essential workers.

The COVID-19 pandemic has disproportionately affected the health of food system (FS) essential workers compared with other essential and non-essential workers. Even greater disparity exists for workers in certain FS work settings and for certain FS worker subpopulations. We analyzed essential worker respondents (n = 151,789) in May-November 2021 data from the National Immunization Survey Adult COVID Module (NIS-ACM) to assess and characterize COVID-19 vaccination uptake (≥1 dose) and intent (reachable, reluctant), attitudes about COVID-19 and the vaccine, and experiences and difficulties getting the vaccine. We compared rates, overall and by certain characteristics, between workers of the same group, and between FS (n = 17,414) and non-food system (NFS) worker groups (n = 134,375), to determine if differences exist. FS worker groups were classified as "agriculture, forestry, fishing, or hunting" (AFFH; n = 2,730); "food manufacturing facility" (FMF; n = 3,495); and "food and beverage store" (FBS; n = 11,189). Compared with NFS workers, significantly lower percentages of FS workers reported ≥1 dose of COVID-19 vaccine or vaccine requirements at work or school, but overall vaccine experiences and difficulties among vaccinated FS workers were statistically similar to NFS workers. When we examined intent regarding COVID-19 vaccination among unvaccinated FS workers compared with NFS counterparts, we found a higher percentage of FMF and FBS workers were reachable whereas a higher percentage of AFFH workers were reluctant about vaccination, with differences by sociodemographic characteristics. Overall, results showed differences in uptake, intent, and attitudes between worker groups and by some sociodemographic characteristics. The findings reflect the diversity of FS workers and underscore the importance of collecting occupational data to assess health inequalities and of tailoring efforts to worker groups to improve confidence and uptake of vaccinations for infectious diseases such as COVID-19. The findings can inform future research, adult infectious disease interventions, and emergency management planning.

Emerging technology in agriculture: Opportunities and considerations for occupational safety and health researchers.

INTRODUCTION: A variety of factors are driving the development of robotics and automation in the agriculture industry including the nature of work, workforce shortages, and a variety of economic, climatic, technologic, political, and social factors. While some new robotics and automated machines are available commercially, most are still being developed. This provides occupational safety and health researchers an unprecedented opportunity to mitigate risks and benefit the health and safety of agriculture workers. METHOD: The NIOSH Office of Agriculture Safety and Health (OASH) is working to better understand how the advancements in automation and robotics is affecting workers. OASH is coordinating with the NIOSH Center of Occupational Robotics Research (CORR) to help to increase the understanding of human/machine interactions; improve the ability to identify injuries and fatalities involving automation/ robotics; and provide guidance on working safely with automation/ robotics. OASH also joined a small team of academics and industry to organize the SAfety For Emerging Robotics and Autonomous aGriculture or (SAFER AG) Workshop to identify gaps in knowledge and research needs that connect to issues related to risks and regulations/standards, occupational safety research, and impacts on workforce and society. This workshop was sponsored by USDA NIFA. PRACTICAL APPLICATIONS: Occupational safety and health experts need to engage and collaborate with developers of technology. It is also increasingly important for occupational safety and health researchers and practitioners to not only become familiar with existing manufacturing safety standards, but also the lengthy standards development process. Joining consensus standards groups to help shape new standards for emerging technologies may help to mitigate adverse worker impacts. NIOSH's Office of Agriculture Safety and Health will continue to identify research gaps, support new research projects, education, outreach efforts and the development of best practices with our partners.

CDC-Supported National Network of Farmworker-Serving Organizations to Mitigate COVID-19.

The Centers for Disease Control and Prevention has partnered with the National Center for Farmworker Health to respond to the impact of COVID-19 on US farmworker communities. Immigrant farmworkers are often isolated from public health infrastructure. This partnership built the capacity of a national network of organizations to connect farmworkers to COVID-19 education and vaccinations in 20 states through training and resource sharing. The partnership funded 194 network member staff, trained 1130 individuals, and supported COVID-19 outreach to more than 600 000 farmworkers. (Am J Public Health. 2023;113(2):166-169. https://doi.org/10.2105/AJPH.2022.307159).

Have you met Angus? Development and evaluation of a social marketing intervention to improve personal flotation device use in commercial fishing.

INTRODUCTION: Drowning is the leading cause of death among commercial fishermen in the United States. Approximately 30% of all commercial fishing fatalities are attributed to falls overboard. One of the simplest and most affordable ways to prevent these fatalities is for crewmembers to wear personal flotation devices (PFDs) while on deck. An examination of over 200 fatal falls overboard in the U.S. fishing industry revealed that none of the victims were wearing PFDs when they died. PFDs are not required to be worn by commercial fishermen in the United States, so this study was designed to encourage behavior change using targeted health communication and social marketing. METHODS: This study developed, implemented, and evaluated a multi-media social marketing campaign featuring a fictitious, culturally-relevant spokesman designed to look, talk, and act like the target audience. The messages were crafted to address common barriers to PFD adoption and misconceptions about fleet-specific risks for fatalities from falls overboard. The campaign was evaluated over two seasons of fishing to look at message retention and intent toward action following exposure to the campaign materials. RESULTS: Survey respondents indicated overall positive opinions about the spokesman and the messages. Results also show a reported change in behavior related to using PFDs while working on deck. DISCUSSION: Targeted multi-media messaging can influence behavior of workers in high-risk occupations in remote locations. Safety message development should focus on occupational culture to create valid and authentic communication products for workers in high-risk industries.

Occupational Safety and Health with Technological Developments in Livestock Farms: A Literature Review.

In recent decades, there have been considerable technological developments in the agriculture sector to automate manual processes for many factors, including increased production demand and in response to labor shortages/costs. We conducted a review of the literature to summarize the key advances from installing emerging technology and studies on robotics and automation to improve agricultural practices. The main objective of this review was to survey the scientific literature to identify the uses of these new technologies in agricultural practices focusing on new or reduced occupational safety risks affecting agriculture workers. We screened 3248 articles with the following criteria: (1) relevance of the title and abstract with occupational safety and health; (2) agriculture technologies/applications that were available in the United States; (3) written in English; and (4) published 2015-2020. We found 624 articles on crops and harvesting and 80 articles on livestock farming related to robotics and automated systems. Within livestock farming, most (78%) articles identified were related to dairy farms, and 56% of the articles indicated these farms were using robotics routinely. However, our review revealed gaps in how the technology has been evaluated to show the benefits or potential hazards to the safety and well-being of livestock owners/operators and workers.

Working hours, sleep, and fatigue in the agriculture, forestry, and fishing sector: A scoping review.

INTRODUCTION: Agriculture, forestry, and fishing industry (AgFF) workers often work extremely long hours during peak production seasons, resulting in sleep deprivation and fatigue. The National Occupational Research Agenda has classified fatigue as a "significant safety issue" and area of concern for many industry sectors, including AgFF. This review explores current research and practice in AgFF and proposes next steps. METHODS: We conducted a scoping literature review to examine the extent and nature of research in this area. Article inclusion criteria included peer-reviewed journal articles written in English; published after 1989; covering AgFF workers in high-income countries; with data on working hours/schedules and sleep related to safety and health. RESULTS: Limited research has addressed long hours and sleep deprivation among AgFF workers. We identified 8350 articles for title and abstract review. Among those, 407 underwent full-text review and 96 met all inclusion criteria (67% agriculture, 25% fishing/seafood processing, 8% forestry). The literature provided some evidence fatigue contributes to fatalities, injuries, and illnesses in AgFF. Older, new, young, foreign-born, and female workers, as well as those who work in small organizations or longer hours (40+) may be at higher risk for fatigue-related injury and illness. Few studies have developed or evaluated interventions to control risks. DISCUSSION: Given that fatigue is a factor in injury and illness for this sector, future AgFF surveillance and research should increase efforts to capture fatigue and sleep data, directly investigate the role of long hours and nonstandard work schedules in the sector, and most importantly, create practical interventions to manage fatigue.

Factors associated with crewmember survival of commercial fishing vessel sinkings in Alaska.

Occupational fatality surveillance has identified that fishing vessel disasters, such as sinkings and capsizings, continue to contribute to the most deaths among crewmembers in the US fishing industry. When a fishing vessel sinks at sea, crewmembers are at risk of immersion in water and subsequent drowning. This study examined survival factors for crewmembers following cold water immersion after the sinking of decked commercial fishing vessels in Alaskan waters during 2000-2014. Two immersion scenarios were considered separately: immersion for any length of time, and long-term immersion defined as immersion lasting over 30 minutes. Logistic regression was used to predict the odds of crewmember survival. Of the 617 crewmembers onboard 187 fishing vessels that sank in Alaska during 2000-2014, 557 (90.3%) survived and 60 died. For crewmembers immersed for any length of time, the significant adjusted predictors of survival were: entering a life-raft, sinking within three miles of shore, the sinking not being weather-related, and working as a deckhand. For crewmembers immersed for over 30 minutes, the significant adjusted predictors of survival were: wearing an immersion suit, entering a life-raft, working as a deckhand, and the sinking not being weather-related. The results of this analysis demonstrate that in situations where cold water immersion becomes inevitable, having access to well-maintained, serviceable lifesaving equipment and the knowledge and skills to use it properly are critical.

Fatal Falls Overboard in Commercial Fishing - United States, 2000-2016.

Commercial fishing is one of the most dangerous jobs in the United States, with a 2016 work-related fatality rate (86.0 deaths per 100,000 full-time equivalent workers) 23 times higher than that for all U.S. workers (3.6) (1). Sinking vessels cause the most fatalities in the industry; however, falling from a fishing vessel is a serious hazard responsible for the second highest number of commercial fishing-associated fatalities (2,3). CDC's National Institute for Occupational Safety and Health (NIOSH) analyzed data on unintentional fatal falls overboard in the U.S. commercial fishing industry to identify gaps in the use of primary, secondary, and tertiary prevention strategies. During 2000-2016, a total of 204 commercial fishermen died after unintentionally falling overboard. The majority of falls (121; 59.3%) were not witnessed, and 108 (89.3%) of these victims were not found. Among 83 witnessed falls overboard, 56 rescue attempts were made; 22 victims were recovered but were not successfully resuscitated. The circumstances, rescue attempts, and limited use of lifesaving and recovery equipment indicate that efforts to reduce these preventable fatalities are needed during pre-event, event, and post-event sequences of falls overboard. Vessel owners could consider strategies to prevent future fatalities, including lifeline tethers, line management, personal flotation devices (PFDs), man-overboard alarms, recovery devices, and rescue training.

Occupational Fatalities Resulting from Falls in the Oil and Gas Extraction Industry, United States, 2005-2014.

During 2003-2013, fatality rates for oil and gas extraction workers decreased for all causes of death except those associated with fall events, which increased 2% annually during 2003-2013 (1). To better understand risk factors for these events, CDC examined fatal fall events in the oil and gas extraction industry during 2005-2014 using data from case investigations conducted by the Occupational Safety and Health Administration (OSHA). Sixty-three fatal falls were identified, accounting for 15% of all fatal events. Among fatal falls, 33 (52%) workers fell from a height of >30 feet (9 meters), and 22 (35%) fell from the derrick board, the elevated work platform located in the derrick (structure used to support machinery on a drilling rig). Fall fatalities occurred most frequently when drilling rigs were being assembled or disassembled at the well site (rigging up or rigging down) (14; 22%) or when workers were removing or inserting drill pipe into the wellbore (14; 22%). Measures that target derrickmen and workers engaged in assembling and disassembling drilling rigs (rigging up and down) could reduce falls in this industry. Companies should annually update their fall protection plans and ensure effective fall prevention programs are in place for workers at highest risk for falls, including providing trainings on proper use, fit, and inspection of personal protective equipment.

Preventing fatal winch entanglements in the US southern shrimp fleet: A research to practice approach.

INTRODUCTION: During 2000-2011, 35 injuries (8 fatal) involving winches were reported to the Coast Guard in the Southern shrimp fleet. Injuries involving the main winch drums had a higher risk for fatal outcomes compared to injuries involving the winch cathead (RR=7.5; 1.1-53.7). The objective of this study was to design effective solutions to protect deckhands from entanglement hazards posed by winches found on the vessels in the Southern shrimp fleet. METHODS: Based on injury characteristics, site visit observations, and input from vessel owners, NIOSH determined that the design and implementation of effective main-winch guarding was a feasible first-step in mitigating the entanglement hazard. Design considerations for stationary guards favor systems that are simple, affordable, durable, unobtrusive, and will not interfere with normal fishing operations. In addition, an auxiliary-stop method was tested to prevent entanglements in try-net winches. RESULTS: Standardized passive guards were designed for three commonly found main winch models. Initial prototype guards have been sea-tested. The design of six additional guards is underway, for a total of three iterations for each winch model identified. These will incorporate features found to be valued by fishermen, will be more efficient, and will reduce the overall cost of fabrication and maintenance. Sea testing of these iterations continues. The auxiliary-stop circuit control prototype system was designed to prevent entanglements in the try-net winch and is currently being sea tested. DISCUSSION: NIOSH has completed initial designs for stationary-winch guards. Through collaborations with shrimper associations and safety groups, the successfully tested winch guard and auxiliary stop designs will be made available to qualified welders and craftsmen to use. This approach has proven effective in preventing other types of winch injuries. PRACTICAL APPLICATIONS: Injury epidemiologic methods and industry input are an effective way to identify workplace hazards and to design effective safety interventions to control hazards.

Aviation-Related Wildland Firefighter Fatalities--United States, 2000-2013.

Airplanes and helicopters are integral to the management and suppression of wildfires, often operating in high-risk, low-altitude environments. To update data on aviation-related wildland firefighting fatalities, identify risk factors, and make recommendations for improved safety, CDC's National Institute for Occupational Safety and Health (NIOSH) analyzed reports from multiple data sources for the period 2000-2013. Among 298 wildland firefighter fatalities identified during 2000-2013, 78 (26.2%) were aviation-related occupational fatalities that occurred during 41 separate events involving 42 aircraft. Aircraft crashes accounted for 38 events. Pilots, copilots, and flight engineers represented 53 (68%) of the aviation-related fatalities. The leading causes of fatal aircraft crashes were engine, structure, or component failure (24%); pilot loss of control (24%); failure to maintain clearance from terrain, water, or objects (20%); and hazardous weather (15%). To reduce fatalities from aviation-related wildland firefighting activities, stringent safety guidelines need to be followed during all phases of firefighting, including training exercises. Crew resource management techniques, which use all available resources, information, equipment, and personnel to achieve safe and efficient flight operations, can be applied to firefighting operations.

Occupational fatalities during the oil and gas boom--United States, 2003-2013.

During 2003-2013, the U.S. oil and gas extraction industry experienced unprecedented growth, doubling the size of its workforce and increasing the number of drilling rigs by 71%. To describe fatal events among oil and gas workers during this period, CDC analyzed data from the Bureau of Labor Statistics (BLS) Census of Fatal Occupational Injuries (CFOI), a comprehensive database of fatal work injuries. During 2003-2013, the number of work-related fatalities in the oil and gas extraction industry increased 27.6%, with a total of 1,189 deaths; however, the annual occupational fatality rate significantly decreased 36.3% (p<0.05) during this 11-year period. Two-thirds of all worker fatalities were attributed to transportation incidents (479, [40.3%]) and contact with objects/equipment (308 [25.9%]). More than 50% of persons fatally injured were employed by companies that service wells (615 [51.7%]). It is important for employers to consider measures such as land transportation safety policies and engineering controls (e.g., automated technologies) that would address these leading causes of death and reduce workers' exposure to hazards.

Work-related traumatic injuries onboard freezer-trawlers and freezer-longliners operating in Alaskan waters during 2001-2012.

BACKGROUND: Workers onboard freezer-trawl (FT) and freezer-longline (FL) vessels in Alaska may be at high risk for fatal and non-fatal injuries. METHODS: Traumatic occupational injuries onboard vessels in the FT and FL fleets were identified through two government data sources. RESULTS: The annual risk of fatal injuries was 125 per 100,000 FTEs in the FT fleet, and 63 per 100,000 FTEs in the FL fleet. The annual risk of non-fatal injuries was 43 per 1,000 FTEs in the FT fleet and 35 per 1,000 FTEs in the FL fleet. The majority of injuries in the FT fleet occurred in the factories and freezer holds, whereas the most common injuries in the FL fleet occurred on deck while working the fishing gear. CONCLUSIONS: The findings confirmed that workers in those fleets were at high risk for work-related injuries. Injury prevention should focus on removing hazards in the work processes injuring the most workers.

Occupational fatalities in Alaska: two decades of progress, 1990-1999 and 2000-2009.

INTRODUCTION: Alaska had the highest work-related fatality rate of any state during 1980-1989. The National Institute for Occupational Safety and Health established the Alaska Field Station (AFS) to address this problem. METHODS: AFS established surveillance systems to provide scientific assessments of occupational hazards. Interventions were developed in collaboration with partners and evaluated. RESULTS: During 2000-2009, Alaska experienced a 42.5% decline in work-related fatalities over the previous decade of 1990-1999. In 2009, the workplace fatality rate for Alaska was 5.6/100,000 workers. Commercial pilot deaths were reduced by 50% and Bering Sea crab fishing death rates were reduced by 60%. Building on this success, AFS established national programs to improve safety in the commercial fishing and oil and gas extraction industries. IMPACT ON INDUSTRY: A focused, epidemiological approach to reducing fatalities in high-risk occupations is effective. Ongoing commitment to this type of approach will assist in continued success in Alaska and elsewhere.

Occupational fatalities in the United States commercial fishing industry, 2000-2009.

The occupational fatality rate among commercial fishermen decreased in the United States during 1992-2008; however, commercial fishing continues to be one of the most dangerous occupations in the United States, with an average annual fatality rate of 129 deaths per 100,000 fishermen in 2008. By contrast, the average annual occupational fatality rate among all US workers during the same period was four deaths per 100,000 workers. During the 1990s, numerous safety interventions were developed for Alaska fisheries that resulted in a significant decline in the state's commercial fishing fatality rate. In 2007, the National Institute for Occupational Safety and Health (NIOSH) expanded surveillance of commercial fishing fatalities to the rest of the United States. The purpose of this report is to identify the hazards and risk factors for all causes of occupational mortality in the US commercial fishing industry, and to explore how those hazards and risk factors differ among fisheries and locations. During 2000-2009, 504 commercial fishing fatalities occurred in the United States. Most (261, 52%) occurred following a vessel disaster (defined as a sinking, capsizing, or other event in which the crew was forced to abandon ship) or a fall overboard (155, 31%). Fatalities occurred in Alaska (133, 26%), Northeast (124, 25%), Gulf of Mexico (116, 23%), West Coast (83, 16%), and the Mid- and South Atlantic (41, 8%) regions. Fatalities occurred most commonly while fishing for shellfish (226, 47%), groundfish (144, 30%) and pelagic fish (97, 20%). Average annual fatality rates were calculated for selected fisheries. The Northeast multispecies groundfish fleet had the highest average annual fatality rate (600 deaths per 100,000 full-time equivalent [FTE] fishermen) followed by the Atlantic scallop fleet (425 deaths per 100,000 FTE fishermen) and the West Coast Dungeness crab fleet (310 deaths per 100,000 FTE fishermen). To reduce fatalities among fishermen at greatest risk, additional prevention measures tailored to specific high-risk fisheries should be considered.

Drowning in Alaska: progress and persistent problems.

OBJECTIVES: The purpose of this study is to evaluate and describe the current problem of drowning in Alaska, measure changes in the rates since earlier studies have been done and compare occupational and non-occupational drowning characteristics. STUDY DESIGN: This is a descriptive observational study, using existing records obtained from several sources to describe and compare drowning victims and event characteristics. METHODS: Drowning fatality data were collected from death certificates, law-enforcement reports and news articles. Descriptive statistics and risk ratios were calculated to compare levels of risk based on incident and victim characteristics. RESULTS: During 2000-2006, 402 unintentional drowning deaths, 108 of them occupational, occurred in Alaska, with an average annual fatality rate of 8.9 deaths per 100,000 Alaskans. The victim population was 86% male and 44% Alaska Native; 40% drowned in the south-west region of Alaska. For non-occupational cases with alcohol use documented, 33% were associated with alcohol consumption, as were 78% of those involved with all-terrain vehicle crashes. Only 17% of non-occupational victims who drowned while boating wore a Personal Flotation Device (PFD). CONCLUSIONS: The drowning rate in Alaska during 2000-2006 was 8.9 drowning deaths per 100,000 population. This shows a decrease from the rate reported in a 1996 study, but several problems persist. Males and Alaska Natives had elevated risks for drowning. A substantial portion of fatalities were associated with alcohol consumption. PFD use remains low, and child drowning rates were unchanged from earlier studies. Increased data on water temperature and immersion time may help demonstrate the benefits of PFD use to those at risk. Social marketing efforts should be adapted for at-risk populations.

Reducing commercial fishing deck hazards with engineering solutions for winch design.

INTRODUCTION: The majority (67%) of hospitalized injuries among Alaska commercial fishermen are associated with deck machinery. This paper describes the "Prevention Through Design" process to mitigate one serious machinery entanglement hazard posed by a capstan deck winch. METHODS: After observing that the capstan winch provides no entanglement protection and the hydraulic controls are usually out of reach of the entangled person, NIOSH personnel met with fishermen and winch manufacturers to discuss various design solutions to mitigate these hazards. RESULTS: An emergency-stop ("e-stop") system was developed that incorporated a momentary contact button that when pushed, switches a safety-relay that de-energizes the solenoid of an electro-hydraulic valve stopping the rotating winch. The vessel owners that had the e-stop installed enthusiastically recommend it to other fishermen. NIOSH entered into a Proprietary Technology Licensing Agreement with a company to develop the system for commercial use. CONCLUSIONS: This is an example of a practical engineering control that effectively protects workers from a hazardous piece of equipment by preventing injuries due to entanglement. This solution could reduce these types of debilitating injuries and fatalities in this industry.

Fatal falls overboard on commercial fishing vessels in Alaska.

BACKGROUND: Falls overboard are a major contributor to commercial fishing fatalities in Alaska. The National Institute for Occupational Safety and Health has repeatedly identified falls overboard as a critical issue in commercial fishing safety. This article describes the problem of falls overboard and discusses possible ways to reduce the risk factors. METHODS: Data from the Alaska Occupational Injury Surveillance System on fatal falls overboard in Alaska between 1990 and 2005 were used. An in-depth descriptive analysis of these fatalities was performed to identify areas for intervention. RESULTS: There were 71 fatal falls overboard on commercial fishing vessels in Alaska during the 16-year time period. Falls overboard did not decline significantly during those years. The most common circumstances associated with falling overboard were working with fishing gear, being alone on deck, losing balance or slipping, heavy weather, gear entanglement, and alcohol. The level of involvement of those circumstances varied by region and gear type. SUMMARY: Many fatal falls overboard may be prevented by understanding the circumstances involved and targeting interventions at those specific risk factors. Interventions include creating more enclosed work spaces, managing lines, avoiding fishing alone, wearing personal flotation devices and man overboard alarms, and reducing alcohol use. Subsequent research should identify further interventions for each circumstance and evaluate the effectiveness of these interventions with the fishing industry.