Cattle-related injuries and farm management practices on Kentucky beef cattle farms.

While working on farms with livestock increases the risk of injury among farm workers in comparison to other commodity farms, few studies have examined the role offarm management practices in association with the risk of cattle-related injury. We examined the farm management practices of Kentucky beef cattle farms in association with self-reported rates of cattle-related injuries among workers. We conducted a mail survey of a random sample of 2,500 members of the Kentucky Cattlemen's Association. Results from 1,149 farm operators who were currently raising beef cattle and provided complete survey response are reported. During the busy season, the principal operator worked 20 hours per week on the beef operation, and among all farm employees, the beef operation required 35 hours per week (median cumulative hours). There were 157 farms that reported a cattle-related injury in the past year among the principal operator or a family member, yielding an annual cattle-related injury rate of 13.7 beef cattle farms per 100 reporting at least one cattle-related injury. The majority of these injuries were associated with transporting cattle, using cattle-related equipment (head gates, chutes, etc.), and performing medical or herd health tasks on the animal. A multivariable logistic regression analysis of cattle-related injuries indicated that the risk of injury increased with increasing herd size, increasing hours devoted to the cattle operation per week by all workers, and the number of different medical tasks or treatments performed on cattle without the presence of a veterinarian. Farms that performed 9 to 13 tasks/treatments without a veterinarian had a two-fold increased risk of a cattle-related injury (OR = 1.98; 95% Cl: 1.08-3.62) in comparison to farms that performed 0 to 4 tasks without a veterinarian. In adjusted analyses, the use of an ATV or Gator for cattle herding was associated with a significantly reduced risk of cattle-related injury (OR = 0.51; 95% CI: 0.30-0.86) in comparison to other herding methods. This study indicates that a substantial proportion of cattle-related injuries are associated with work activities related to handling practices and cattle restraining equipment.

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.

Suicides among farmers in three southeastern states, 1990-1998.

Several studies have documented higher rates of suicide among farmers in comparison to other occupational groups, both in the U.S. and internationally. The purpose of this study is to describe the epidemiology of farmer suicides in three southeastern states (Kentucky, North Carolina, and South Carolina) during the nine-year period 1990-1998. Electronic death certificate data were obtained from the National Center for Health Statistics. Over the nine-year period, there were 590 deaths related to suicide (E-codes: 950-959) among farmers (occupation codes: 473, 474, 475, 477, and 479) in the states of Kentucky, North Carolina, and South Carolina. The results of this study confirm the increased rate of suicide mortality among white male farmers in comparison to the total white male population in these three southern states. The increased rate of suicide was significantly elevated among farmers age 25-34 years (RR: 2.07; 95% CI: 1.61-2.67) and among those age 75-84 (RR: 2.04; 95% CI: 1.70-2.45) and age 85 years and older (RR: 2.67; 95% CI: 2.02-3.54) in comparison to the total white male population.The use of a firearm was the primary mechanism of death for the majority (86%) of the cases. Farmer suicide mortality rates in the southeastern U.S. are higher than in Midwestern states. The elevated rate of white male farmer suicides in North Carolina over this time period (35% higher age-adjusted suicide rate in comparison to South Carolina) suggests a need for further investigation to assess the individual, social, and economic factors that may explain this elevated rate. Interventions for the prevention of suicide need to be directed to older male farmers who consistently have higher suicide rates than similar males in other occupations.

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.

Using U.S. Poison Control Center records to identify bystander pesticide exposures: a one-year surveillance of four southeastern states.

The extent to which bystanders are exposed to pesticide applications is unknown. Systematic monitoring around spray areas is not routine. Quantifying exposures is extremely difficult. Persons inadvertently exposed to pesticides often do not know the chemical or quantity, and persons living near areas of frequent field spraying may receive multiple exposures. In the U.S., concerns about health consequences from these exposures may prompt calls to poison control centers. The goal of this study was to determine what surveillance poison control centers can provide on environmental pesticide exposures to bystanders. We searched the American Association of Poison Control Centers' 2001 electronic medical records for exposure reports involving persons from 129 agriculturally intensive counties in Kentucky, Tennessee, Louisiana, and Arkansas that implicated at least one of 54 generic classifications of agricultural chemicals. We abstracted 980 pesticide-related records. Narrative sections were reviewed to determine bystander status of the exposed person. Forty-six bystander exposures were identified from 32 events. Bystander ages ranged from 2 to 81 (median: 45; 16 females, 13 males). All pertinent information for bystander classification came from narrative sections of the record. 28% identified aircraft crop dusters as the pesticide source. The most implicated substance was malathion (30.4%), while 19.6% did not know the exposure substance. 73.9% of cases were symptomatic; 65.2% of the exposed persons were seen in or referred to a healthcare facility. No hospitalizations or deaths were reported. Although they may underestimate the true numbers, U.S. poison control center data can provide valuable information about bystander environmental pesticide exposures.

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.

Observation study of students who completed a high school agricultural safety education program.

The Agricultural Disability Awareness and Risk Education Project (AgDARE) is a research-based curriculum of agricultural safety instruction based on Prochaska and DiClemente's Transtheroetical Model of Change. The program uses eight reality-based psychomotor and narrative modules to teach safe farm work behaviors. In addition to in-class pencil and paper assessments on safety attitudes and behavior intention, farm visits were made to assess the longer term influence of AgDARE. Visits were made between 11 and 20 months (mean = 14.24 months) after completion of the classroom instruction to 29 students who worked on farms and completed at least one-half of the AgDARE instruction. All but one of the visited students exhibited safe work behaviors addressed by the AgDARE instruction. In addition, 76% of the visited students had made positive changes in their farm work behavior since participating in AgDARE. Changes extended beyond the instruction that students received in class to include other aspects of farm work and other family members. The use of farm visits to evaluate students' safety behaviors was tempered by the challenge of contacting students and obstacles associated with observing work in an environment where little is routine or regular.

Tractor driving among kentucky farm youth: results from the farm family health and hazard surveillance project.

This article documents the extent of children's involvement in tractor operations among a representative sample of Kentucky children living and working on family farms. Specifically, we describe children's exposures to tractor-related work activities, profile their use of the tractor (number of days worked), and assess compliance with generally recommended safety measures, such as using tractors equipped with ROPS (rollover protective structures), avoiding riding as passengers on tractors, and operating tractors on public roadways. Data for this study were collected in 1994 and 1995 as part of the NIOSH-sponsored Farm Family Health and Hazard Surveillance Project (FFHHSP). Despite recognition in the health and safety community of the hazards associated with operating tractors without ROPS on public roadways and with extra riders, these practices remain common among youth on Kentucky farms. Farms with annual incomes greater than $10,000, particularly with livestock commodities, appear to use youth for a greater number of days of tractor operation than other farms. Such farms may be an appropriate target for intervention.

Agricultural Disability Awareness and Risk Education (AgDARE) for high school students.

OBJECTIVE: Develop and test a farm health and injury prevention educational intervention for high school agriculture students. SETTING: Twenty one high schools in Kentucky, Iowa, and Mississippi. METHODS: A quasiexperimental crossover design was used to test the effectiveness of two sets of instructional materials designed through participatory action research with agriculture teachers and students. Narrative simulations based on farm work stories and simulations of farm work while students pretended to have a disability were completed in 14 schools (n = 373) over the academic year. Students in seven control schools (n = 417) received no intervention but completed, in the same time frame as students in the treatment schools, demographic surveys and premeasures and post-measures of farm safety attitudes and intent to change safety behaviors. One year after the intervention, 29 students from the treatment group received farm visits to measure their farm safety behaviors. RESULTS: Students engaged in hazardous work on farms. Thirty two were involved in tractor overturns and 11 had received injuries from rotating power take-off mechanisms. One fourth reported hearing problems, and 21% had respiratory symptoms after working in dusty farm surroundings. Students who completed at least two physical and two narrative simulations of the Agricultural Disability Awareness and Risk Education (AgDARE) curriculum showed statistically significant positive changes in farm safety attitude and intent to change behaviors. CONCLUSIONS: Adolescents engage in farm work that places them at risk for injury and illness. The AgDARE curriculum may be an effective and efficient method of teaching farm safety in high school agriculture classes.

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.

Farm tractor safety in Kentucky, 1995.

OBJECTIVE: Tractor rollovers are a major cause of farm injuries and fatalities. The authors used data from a statewide surveillance study to estimate the prevalence of safety features such as rollover protective structures, seat belts, and power take-off shields on farm tractors in Kentucky. METHODS: Using data from the Farm Family Health and Hazard Surveillance Project, the authors report on the prevalence of farm tractor safety features by size of farm, by region of the state, by number of tractors per farm, and by tractor age and estimate the prevalence of tractors equipped with rollover protection by region and for the state as a whole. RESULTS: Of the estimated 85,446 family-owned farms in Kentucky with at least one tractor, an estimated 55.6%, or 47,515 farms, do not have a tractor equipped with a rollover protective structure. Few tractors that are 10 years old or older were found to be equipped with seat belts; no tractors that were more than 20 years old were equipped with seat belts. CONCLUSIONS: Kentucky, with an estimated 25 to 30 tractor-related fatalities each year, may contribute up to 20% of the total number of farm tractor fatalities in the nation. The overall prevalence of rollover protective structures on tractors in Kentucky is lower than estimates for other states as reported in national survey data. The study's findings suggest the need to target smaller farms with one or two tractors for retrofitting of rollover protective structures and for tractor safety programs.

Delay among the general public in telephoning a poison center.

Delay in seeking treatment for poisonings can hinder patient recovery. Our study examined delay in notifying a poison center about green tobacco sickness (GTS), a form of nicotine poisoning resulting from dermal contact with tobacco leaves. We conducted a follow-up survey of 55 cases of GTS reported by telephone to the kentucky Regional Poison Center in 1993. The "delay" group (38.2% of the cases) was defined as those callers who stated in the follow-up report that they should have phoned the poison center sooner than they did. Characteristics of the callers who delayed and the GTS patients they reported were compared with characteristics of the "non-delay" group. Delay was associated with callers' awareness of the poison center's expertise in agricultural poisonings and with age and sex of the patient. Our findings point to the need to target groups such as farmers with an educational campaign to make them more aware of the extent of the poison center's services and to encourage timely reporting of occupational poisonings.