Cost Analysis of a PTO Driveline Shielding Program: Are Effective Programs Cost-Effective?

HIGHLIGHTS: This article describes a cost assessment of a PTO driveline shielding intervention. Considerations for effective occupational safety interventions beyond reductions in injuries or fatalities are described. The financial viability of combining various on-farm services to reduce intervention costs is discussed. ABSTRACT: PTO entanglements are a primary injury concern on U.S. farms, affecting adults and children. These events often lead to severe injury and permanent disability but can be prevented with proper use of PTO shielding. A promising strategy for increasing PTO shielding on farms has been the introduction of user-friendly shielding options by qualified safety specialists. This study looks at the cost-effectiveness of this approach. The cost-effectiveness of this PTO shielding strategy was calculated based on program-related costs, the PTO shield cost, the lifespan of PTO shields, and the number of PTO shields needed to prevent an entanglement. The cost per entanglement prevented was then calculated by dividing the total costs by the number of entanglements prevented in several cost-estimate scenarios. Costs were adjusted for inflation to 2019 dollars. Costs per entanglement prevented ranged from a low of $921,544 (assuming a 10-year PTO lifespan and using 12,487 as the number needed to treat, i.e., to prevent a PTO entanglement, referred to as the NNT) to a high of $18,583,492 (assuming a three-year PTO lifespan and 67,119 as the NNT). The cost per entanglement prevented at the median PTO lifespan of five years and median NNT of 39,802 was $6,612,244. Based on our estimates, the cost-efficacy of increasing PTO shielding using qualified safety specialists differs widely based on the shield lifespan and the number of shields needed to avoid one entanglement. However, if the cost of introducing PTO shields in on-farm visits is coupled with other on-farm services that defray these costs, then the cost-efficacy increases considerably.

Rollover Protective Structures, Worker Safety, and Cost-Effectiveness: New York, 2011-2017.

OBJECTIVES: To measure cost-effectiveness of an intervention to increase retrofitting of rollover protective structures (ROPS) on tractors. METHODS: Tractor overturns are the leading cause of farm fatalities. ROPS prevent these deaths. This study updates a 2011 cost-effectiveness assessment of a New York State intervention to increase use of ROPS. We subtracted intervention cost from the cost of injuries averted, then divided this figure by the number of averted injuries. We used related probabilities and costs of fatalities and injuries from published literature to calculate the program's cost-effectiveness. RESULTS: The total cost of the injuries averted from 2007 to 2017 was $6 018 742 versus a total program cost of $1 776 608. The one-time retrofit costs will continue to prevent injuries as long as the tractors are used, generating additional (projected) future savings of $12 136 512, $15 781 027, and $18 924 818 if retrofitted tractors remain in operation 15, 20, or 25 years after their retrofit. CONCLUSIONS: Social marketing was cost-effective for reducing injuries from tractor overturns. Public Health Implications. These results indicate that the intervention model is effective from both a public health and economic standpoint and should be expanded into other states.

Outcomes and Economic Benefits of Penn State Extension's Dining With Diabetes Program.

INTRODUCTION: Many diabetes education programs address the problem of diabetes, but little attention is given to the economic impact of such programs. Our objective was to assess the effectiveness of a community-based education program in improving diabetes-related lifestyle behaviors and biomarkers and ascertain the economic benefits of the program for adults aged 18 years or older with type 2 diabetes, prediabetes, or no diagnosis of diabetes in Pennsylvania. METHODS: From October 2012 through June 2015, Pennsylvania State University Extension's Dining with Diabetes program collected data on 2,738 adults with type 2 diabetes or prediabetes and adult family members without diabetes. The program consisted of 4 weekly 2-hour classes and a follow-up class conducted 3 months after the fourth 2-hour class. In the initial class and the follow-up class, participants completed a lifestyle questionnaire and their hemoglobin A1c and blood pressure were measured. Economic benefit was calculated as the medical expenditure cost savings resulting from program participation. RESULTS: At 3-month follow-up, a significant number of participants had improved their lifestyle behaviors (diet and physical activity), had reductions in hemoglobin A1c and blood pressure, and improved their diabetes status. The Dining with Diabetes program had a 5-year benefit-cost ratio of 2.49 to 3.35. CONCLUSION: Participants who completed the Dining with Diabetes program had significant improvements in diabetes-related biomarkers and lifestyle behaviors. If the Dining with Diabetes program were extended to half of the 1.3 million people living with diabetes in Pennsylvania and if they had similar improvements, the 1-year benefit to the state would be approximately $195 million, assuming a conservative 15% decrease in direct medical costs.

Impact of preparing for OSHA local emphasis program inspections of New York dairy farms: Case studies and financial cost analysis.

BACKGROUND: OSHA inspection of dairy farms began in July 1, 2014 in New York State. As of September 2014, a total of eight farms were randomly selected for inspection. This case study addresses how dairy farm managers prepared for these inspections, and identifies farm level costs preparing for inspection and/or being inspected. METHODS: Four farms that were OSHA inspected and 12 farms that were not inspected were included in this mixed method evaluation using a multimodal (telephone, email, or mail) survey. Descriptive analysis was carried out using frequencies, proportions, means, and medians. RESULTS: Overall, the impact of OSHA inspections was positive, leading to improved safety management and physical changes on the farm and worker trainings, although the farmers' perspectives about OSHA inspection were mixed. CONCLUSIONS: The cost of compliance was low relative to estimated overall production costs. Clarifications and engineering solutions for specific dairy farm hazard exposures are needed to facilitate compliance with OSHA regulations.