Compliance with NAGCAT work practices recommendations for youth cleaning service alleys in stall barns

Unintentional injury is the leading cause of death in the U.S. among persons 1 to 44 years of age. Over one million children and adolescents in the U.S. live, work, and/or play on farms, where injury risk is relatively high compared to other settings. In an attempt to reduce the number of childhood agricultural injuries occurring on farms, the North American Guidelines for Children's Agricultural Tasks (NAGCAT) was developed to assist parents or other caregivers in assigning developmentally appropriate chores to youth exposed to agricultural hazards. The results presented here are from a longitudinal study in which we obtained (self-reported) daily chore, injury, and safety behavior data from children and adolescents. We focused on one NAGCAT chore, cleaning a service alley in a stall barn, in order to estimate the extent of compliance with specific work practice recommendations contained in the NAGCAT. Our results indicated that among the four NAGCAT-recommended safety practices for cleaning service alleys in stall barns (wearing nonskid shoes, leather gloves, a respirator, and eye protection), wearing non-skid shoes was the only safety practice reported with any degree of regularity. Overall, boys were more likely to wear non-skid shoes compared to girls. In addition, older youth were generally more likely to report higher work practice compliance compared to younger youth.     

Agricultural employers' hiring and safety practices for adolescent workers

The goal of the "Safety Training for Employers and Supervisors of Adolescent Farmworkers" initiative is to improve the occupational health and safety knowledge and practices of agricultural employers and supervisors responsible for employees, ages 14 to 17 years. Surveys were sent to members of the National Council of Agricultural Employers and the Washington Growers League to measure attitudes regarding adolescent employees, current hiring and training practices, and future intentions. More than half of the respondents hire adolescents. Two-thirds were male, nearly three-quarters of the respondents had college or post-graduate degrees, and more than half were 50 years or older. The majority of respondents had positive perceptions of adolescents in terms of dependability, helpfulness, and work ethic. Among those who currently hire young workers, the most common reasons were to provide a job for children of friends and family and because they can work part-time to fill a labor demand. Among those not hiring adolescents, the most common reason was concern about child labor regulations and associated tasks (e.g., paperwork, monitoring hours). Respondents use a variety of safety training resources, especially posters and safety meetings. For the future, they expect to need more handout materials and training videos. Study results provide insights into barriers to the employment of young workers and suggest methods by which agricultural safety specialists can best assist those employers and producers who are willing to hire adolescents into agricultural work settings.     

BRAC initiative towards promoting gender and social equity in health: a longitudinal study of child growth in Matlab, Bangladesh

OBJECTIVE: To explore the effect of BRAC (formerly Bangladesh Rural Advancement Committee) initiatives towards promoting gender and social equity in health among children of poor mothers who are BRAC members. DESIGN: A cohort of 576 children from the prospective study of a BRAC- International Centre for Diarrhoeal Disease Research, Bangladesh joint research project was analysed. Data were collected three times during 1995-1996 with approximately 4-month intervals. Stunting, defined as height-for-age below minus two standard deviations from the reference median, was the outcome health measure. The study children were stratified into three groups according to their mother's social and BRAC membership status: poor and BRAC member (BM), poor non-member (TG) and non-poor non-member (NTG). SETTING: Matlab, rural area of Bangladesh. SUBJECTS: Children aged 6-72 months. RESULTS: The overall prevalence of stunting was 76%; the highest prevalence was found among TG (84.6%) children and no significant difference was observed between BM and NTG children (67.3% and 69.4%, respectively). In all groups, a significantly larger proportion of girls was stunted compared with boys in the first round. Group-level analysis showed that stunting decreased among all children except BM boys at the end of third round, with the largest decline among BM girls. In contrast, stunting prevalence increased among BM boys. A similar trend was found in the individual-level analysis, where a larger proportion of BM girls recovered from stunting compared with other groups and no recovery was observed among BM boys. At the end of the third round, the nutritional status of BM girls was almost equal to that of the BM boys, while gender inequity remained large among TG and NTG children. CONCLUSION: The BRAC initiative appeared to contribute to a significant equity gain in health for girls, as well as to decreased differences in ill health between the poor and the non-poor.     

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.     

Tractor overturn concerns in Iowa: perspectives from the Keokuk county rural health study

Agriculture remains one of the most hazardous industries in the U.S., with tractor overturns producing the greatest number of agricultural machinery-related fatalities. Rollover protective structures (ROPS) and seatbelts effectively reduce tractor overturn deaths. However, a large proportion of tractors in use in American agriculture are older tractors without ROPS and seatbelts. This article describes the tractor-related responses from participants in a population-based study conducted in Keokuk County, Iowa. This study was designed to measure rural and agricultural adverse health and injury outcomes and their respective risk factors. Questionnaires were partially developed from well-documented national surveys. Questions about agricultural machinery use, presence of safety equipment on the machinery, work practices, and attitudes about farm safety were included. Study participants on farms who owned tractors had an average of 3.1 tractors with an average age of 27 years. Only 39% of the 665 tractors had ROPS. Tractor age was associated with the presence of ROPS; 84% of tractors manufactured after 1984 were ROPS-equipped, whereas only 3% of tractors manufactured before 1960 were ROPS-equipped. ROPS-equipped tractors were significantly more common on larger farms and households with higher income. Only 4% of the farmers reported that their tractors had seatbelts and they wore them when operating their tractors. The results of this study support the findings of other studies, which indicate that many older tractors without ROPS and seatbelts remain in use in American agriculture. Until a dramatic reduction in the number of tractors in the U.S. operated without ROPS and seatbelts is achieved, the annual incidence of 120 to 130 deaths associated with tractor overturns will persist.     

Proposed performance standards for the Agricultural Hazardous Occupations Order certification training program

The performance standards that accompany Gearing Up for Safety, the agricultural production safety training curriculum for youth, were designed to meet the certification testing requirements of the Agricultural Hazardous Occupations Order (AgHOs) certification training program. The AgHOs requires that certain youth who are older than 13 and younger than 16 years of age complete a prescribed training program before being eligible for employment on farms to perform certain tasks considered hazardous. These training resources will be available for implementation and can be accessed by contacting the second author. To our knowledge, up until this time, few, if any, standardized testing procedures or instruments have had the necessary psychometric evidence to support use of the resulting scores to assess the readiness of youth to meet the basic certification requirements contained in the AgHOs. This article describes the rationale, methods, and key findings from a standard-setting session held to establish minimum passing scores for a proposed testing process. The test will be used as a component of the Gearing Up for Safety certification process for youth workers seeking employment to perform job functions as specified under the AgHOs. Readers may be able to apply this standardized testing process, or similarly accepted processes, to other or future testing and certification projects involving agricultural safety and health.     

Drivers of adoption of safety innovations on Australian cotton farms

The Australian cotton industry has been a leader in the adoption of farm health and safety approaches in the Australian agricultural sector. In order to analyze factors associated with occupational health and safety performance, a review of available information and key stakeholder interviews were conducted A recently defined model for adoption of farm safety, emphasizing individual behavioral, environmental, community, and governmental factors, was used as the framework for the assessment. This hazard-based examination of changes describes improvements that have positively impacted health and safety. Improvements include: reduction in vehicle and on-farm traffic systems, safer irrigation systems, changes in cultivation technology, changes in pesticides and application technology, changes in harvest technology, adoption of gene technology, adoption of occupational health and safety (OHS) management systems, and government regulation. The introduction of genetically modified cotton has directly reduced potential exposure to pesticides, and it has indirectly impacted safety by, for example, reducing traffic flow on farms. This study demonstrates the considerable innovation and positive safety enhancements across the Australian cotton industry with respect to the interaction of management and production systems. These lessons should be used develop effective interventions in other agricultural industries.     

Farm safety through the camera's eye

Farms and ranches constitute one of the most hazardous work environments in America, and perhaps in the world, yet farm scenes are often portrayed as tranquil, picture-perfect settings. A review of 293 photographs that included persons and tractors, livestock, powered equipment, all-terrain vehicles, or bodies of water was undertaken by two independent reviewers. Predetermined criteria that captured best safety practices in agriculture were applied to each photograph. A rating of 1 (best practices), 2 (unsafe practices) or 3 (mixed messages) was given to each photograph. Three popular farm periodicals with various geographic distribution areas across the U.S. were examined. Issues from June 2005 through October 2006 were included in the review. Results revealed that only 56.7% of the photographs illustrated best practices for safety. Of the 27 photographs that included children, only 18.5% depicted best practices. Photographs in advertisements, where the settings can be staged, illustrated best practices 56.5% of the time. Editors, photo-journalists, and advertisers should take every opportunity to promote safety in this high-risk industry through portrayal of safe work practices and safe work environments in photographs that are used in farm periodicals.     

An exploratory analysis of occupational skin disease among Latino migrant and seasonal farmworkers in North Carolina

Occupational skin disease is highly prevalent among all agricultural workers. However, few data exist on risk factors for occupational skin disease among migrant and seasonal farmworkers. The goal of this analysis was to further document the prevalence of occupational skin disease among Latino farmworkers and delineate risk factors. This exploratory analysis used data collected in repeated survey interviews with Latino farmworkers in North Carolina in June and July (early season) and in August and September (late season), 1999. Respondents were largely male (95%) and from Mexico (95%), with about one-third each age 18-24, 25-34, and 35 and older. About half were in the U.S. on work contracts. Independent variables included the physical environment (crops worked), the social environment (having received pesticide safety training, having a work contract), and behavior and individual characteristics (re-wearing work clothes, showering after work, age). The dependent measures were reporting having had itching or burning skin or a skin rash in the two months prior to each interview; 24% of the respondents in the early season, and 37% in the late season reported skin disease signs and symptoms during the previous two months. Those reporting signs and symptoms in the early season were more likely to report them in late season. Significant independent risk factors for skin signs and symptoms in early season were re-wearing work clothes, showering after work, and being age 35 or older. In late season, those who had not received pesticide safety training had lower odds of reporting skin disease signs and symptoms, after adjusting for other potential risk factors. This exploratory study indicates that Latino migrant and seasonal farmworkers experience a high incidence of occupational skin disease. Further research is required with improved measurement of skin disease signs and symptoms, diagnosis of specific skin disease, and improved measurement of risk factors.     

Evaluation of the Farm and Agricultural Injury Classification Code and follow-up questionnaire

The Farm and Agricultural Injury Classification (FAIC) code was developed specifically to identify and classify all agricultural injuries of interest to agricultural safety and health professionals. The FAIC code overcomes fundamental problems of classifying agricultural-related injuries by grouping incidents into categories describing actual exposures encountered on farms and in agricultural work. The successful application of the FAIC code depends largely on a researcher's ability to obtain appropriate information to correctly use the code. The purpose of this research project was to: (1) compare data obtained through a newly developed FAIC follow-up questionnaire (FQ) with data from the Penn State Agricultural Injury Database (AID); and (2) test FAIC Code utility, reliability, and construct validity with agricultural safety and health professionals. The FQ improved classification of 57% of cases in the Penn State AID. A majority of agricultural health and safety professionals understood and used the FAIC coding system, without training, to code an average of 75% of the test cases the same as the researcher. A large majority of the professionals that participated in this study judged the FAIC code and the accompanying materials to be very useful.     

Why do boys eat less fruit and vegetables than girls?

OBJECTIVE: To explore why boys eat less fruit and vegetables (F&V) than girls, using longitudinal data following pupils from the age of 12.5 to 15.5 years, including perceived accessibility, modelling, intention, preferences, self-efficacy and knowledge of recommendations as potential mediators. DESIGN/SETTING/SUBJECTS: A longitudinal study, based on data collected among the control schools within the intervention project 'Fruits and Vegetables Make the Marks'. This sample contains 896 6th and 7th graders from 20 randomly selected elementary schools within two Norwegian counties. Questionnaires were administered in May 2002 and May 2005 (when the participants were in 9th and 10th grade in 18 secondary elementary schools). RESULTS: In single mediation analyses all determinants mediated parts of the gender difference, but only preferences decreased the gender difference to a level below statistical significance. Preferences alone explained 81% of the gender difference. In the multiple mediation analyses, the six mediators together explained 91% of the gender difference, but only preferences and perceived accessibility contributed uniquely to the explanation, with 25% and 10% respectively. CONCLUSIONS: Preference appears as the strongest mediator of the difference in F&V intakes between boys and girls. Further research should explore why girls like F&V more than boys.     

Occupational health survey of farm workers by camp health aides

Little is known about the magnitude of occupational health problems among migrant farm workers. A community-based cross-sectional survey was conducted in two migrant farm worker communities: Homestead, Florida, and Kankakee, Illinois. Camp Health Aides (CHAs) interviewed 425 workers about job tasks, personal protective equipment (PPE), field sanitation, work exposures, and selected health conditions. Limited provision of personal protective equipment was reported among those reporting early re-entry tasks: 35% in Kankakee and 42% in Homestead were provided gloves, and 22% in Homestead and 0% in Kankakee were provided protective clothing. About two-thirds were provided toilet facilities and water for hand-washing. Workers reported high prevalences of health conditions consistent with exposure to ergonomic hazards and pesticides. The prevalence of back pain in the past 12 months was 39% in Homestead and 24% in Kankakee. Among Homestead participants, 35% experienced eye symptoms, while 31% reported skin symptoms. These symptoms were less prevalent among Kankakee participants (16% for both eye and skin symptoms). Specific areas of concern included back pain associated with heavy lifting and ladder work; eye and skin irritation associated with fertilizer application tasks and with working in fields during or after spraying of chemicals, especially early re-entry of sprayed fields; and skin irritation associated with a lack of access to hand-washing facilities. In both Kankakee and Homestead, better adherence to safety standards is needed, as well as greater efforts to implement solutions that are available to help prevent work-related musculoskeletal problems.     

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.     

Misperceptions, inactivity and maternal factors may drive obesity among Barbadian adolescents

OBJECTIVES: To describe (1) the prevalence of overweight and obesity and their association with physical activity; (2) the effect of different cut-off points for body mass index (BMI) on weight status categorisation; and (3) associations of weight status with perceptions of body size, health and diet quality. DESIGN: A cross-sectional study. SETTING: Secondary schools in Barbados. SUBJECTS: A cohort of 400 schoolchildren, 11-16 years old, selected to study physical education practices. RESULTS: Prevalence of overweight (15% boys; 17% girls) and obesity (7% boys; 12% girls) was high. Maternal obesity, as defined by the International Obesity Task Force (IOTF) BMI cut-off points, predicted weight status such that reporting an obese mother increased the odds of being overweight by 5.25 (95% confidence interval: 2.44, 11.31). Physical activity was inversely associated with weight status; however levels were low. Recreational physical activity was not associated with weight status in either category. Overweight subjects tended to misclassify themselves as normal weight and those who misclassified perceived themselves to be of similar health status to normal-weight subjects. The National Center for Health Statistics and IOTF BMI cut-off points produced different estimates of overweight and obesity. CONCLUSIONS: Our findings suggest that inadequate physical activity and ignorance related to food and appropriate body size are promoting high levels of adiposity with a strong contribution from maternal obesity, which may be explained by perinatal and other intergenerational effects acting on both sexes. Prevalence studies and local proxy tools for adiposity assessment are needed.     

Ethnic differences in body mass index and associated factors of adolescents from minorities in Oslo, Norway: a cross-sectional study

OBJECTIVES: To examine ethnic differences in body mass index (BMI), food habits and physical activity, and determine the factors contributing to differences in BMI. DESIGN AND METHOD: In 2000-2001, 7343 (response rate 88%) 15- and 16-year-old students, enrolled in lower secondary schools in Oslo, participated in the cross-sectional Oslo Health Study. Of these participants, 1719 were defined as ethnic minorities. RESULTS: Significant gender and ethnic differences in mean BMI were observed. Of the ethnic minority adolescents, 5.8% were underweight (<5th percentile of the US Centers for Disease Control and Prevention (CDC)/National Center for Health Statistics (NCHS) reference distribution) and 9.1% were overweight (>85th percentile of the US CDC/NCHS reference distribution). BMI was not significantly associated with either socio-economic factors or physical activity. Food habits and physical activity differed with ethnicity but not with socio-economic factors. An ordinal regression showed that girls from East Asia (odds ratio (OR) 0.4) and boys from sub-Saharan Africa (OR 0.4) had lower BMI than the Western group. Among girls, higher BMI was associated with less frequent consumption of chocolates and sweets, full-fat milk and breakfast (OR 2.4, 1.7 and 1.7, respectively). Higher BMI, for both boys and girls, was associated with current and past dieting (OR 3.7 and 4.2, respectively). CONCLUSIONS: Adolescent food habits and physical activity varied by gender and ethnicity but not with socio-economic factors. BMI was associated with ethnicity, gender and food habits, but no significant relationship was observed with socio-economic factors or physical activity. Ethnicity, in addition to gender, should be taken into consideration when studying BMI and associated factors among adolescents.     

Protecting young workers in agriculture: participation in tractor certification training

Tractor-related injuries among youth are an important public health problem. The major objectives of this study were to (1) provide a rigorous estimate of the number of youth operating tractors in Ohio and (2) assess the extent to which these youth are participating in federally mandated tractor safety training. A self-administered questionnaire was completed by approximately 4,000 students ages 14 or 15 years who were enrolled in a stratified cluster sample of 99 Ohio schools. Almost one-third of the youth (30%) reported having operated tractors, with 19% having operated a tractor on a farm not owned by a parent or guardian. More than half of the youth (52%) reported having operated a tractor and/or other hazardous machinery, with 25% having operated the machinery on a farm not owned or operated by a parent or guardian. Extrapolating from 4-H records and Ohio census data, fewer than 1% of the youth who are operating tractors or other hazardous machinery have participated in tractor certification training. Increasing participation in mandated training may be an important step in protecting the health of our nation's young agricultural workers.     

Low back disorders in agriculture and the role of stooped work: scope, potential interventions, and research needs

Low back disorders (LBDs) continue to be a major occupational health problem facing the agricultural workforce. Working in a flexed or stooped posture is one of several workplace factors associated with occupationally related LBDs and is highly prevalent in many agricultural tasks. The purpose of this article is to evaluate the role of stooped work in the problem of LBDs among agricultural workers by examining the epidemiological literature, evaluating the scope of stooped work in agriculture, and examining current and potential intervention approaches. The literature review indicates that the prevalence of LBDs in agriculture worldwide is considerably high and substantially reported. Workers who are exposed to stooped work in agriculture are estimated to be in the 100s of millions worldwide. However, stooped work has not been specifically investigated as an independent LBD risk factor. Plausible biomechanical and physiological mechanisms of how stooped work may lead to damage to the spinal structures are discussed, and this complements the epidemiological evidence of high prevalence of LBDs in agriculture. However, this study also identifies the need to conduct more thorough epidemiological studies that utilize accurate quantitative exposure and outcome assessment techniques for developing more appropriate dose-response relationships in agricultural stooped work. This will provide better means for evaluating current and future interventions for jobs involving stooped work. Various intervention approaches are summarized to control and abate stooped work in agriculture; however, it must be emphasized that any development of ergonomic interventions for stooped work in agriculture must incorporate a participatory ergonomics approach that integrates the opinions and concerns of workers, managers, and ergonomists.     

Is breakfast consumption related to mental distress and academic performance in adolescents?

OBJECTIVE: To examine the relationship between mental distress, academic performance and regular breakfast consumption across gender and immigration status. DESIGN: Cross-sectional population-based study. Two four-page questionnaires were filled in during two school sessions. SETTING: All junior high schools in Oslo, Norway using the classroom as the setting for the study. SUBJECTS: All 10th grade students 15-16 years olds in 2000 and 2001. Of 8316 eligible students, 7343 (88.3%) participated in the study. RESULTS: All immigrant groups, except the Western countries group, are skipping breakfast more often than Norwegian students, and girls more often than boys (27 versus 19%). After adjustment for possible confounding factors, the odds ratio (OR) for being mentally distressed when eating breakfast seldom/never compared with every day was 3.0 (2.0-4.5) for boys, 1.6 (1.2-2.1) for girls and 1.6 (1.5-2.6) for the immigrant group. The comparable OR for having low school grades was similar for boys and girls, 2.0 (1.3-3.0), and 1.6 (1.5-2.6) for the immigrant groups. CONCLUSIONS: Skipping breakfast is a common feature among 10th grade students. The implications of skipping breakfast on mental distress and academic performance are stronger for boys than girls and stronger for Norwegians compared with immigrants.     

Workers' safety in milking premises

Dairy cattle rearing techniques have evolved, and milking has moved from stalls to specialized premises. A survey was carried out on a representative sample of dairy farms in central Italy to investigate workers' safety in milking premises. Results indicated acceptable sound level and microclimatic conditions, whereas repetitive motion of the upper limbs should be carefully monitored for the possible effects it can induce on the milkers, who were devoid of adequate personal protective equipment (PPE). Floor antislipping characteristics represented a major deficiency in the building material, in spite of its strength and durability.