The Great Plains Center for Agricultural Health will host Agricultural Medicine: Occupational and Environmental Health for Rural Health Professionals, June 8-12, 2015, at the University of Iowa. The course is designed to provide the information and skills needed to enable safety and health professionals to anticipate, recognize, and prevent occupational illnesses and injuries among members of the agricultural community.
There will also be an open house to meet leaders in rural and agricultural health on Monday, June 8, from 4-6 p.m. at the College of Public Health.
The course is appropriate for safety and health managers, physicians, nurses, veterinarians, graduate students, and anyone interested in the unique safety and health needs of rural and agricultural communities. The course includes classroom instruction, farm tours, safety and rescue demonstrations, and a networking reception. Topics to be discussed include agricultural injury, pesticide exposures and associated health effects, occupational diseases of the lungs in agricultural settings, livestock production, transportation hazards, behavioral and emotional health, zoonotic disease, ergonomics, cancer among agricultural workers, and many others. Continuing education and academic credits are available.
The Iowa Department of Public Health – State Office of Rural Health is providing scholarships to pay the registration fees for two Iowa health care providers to attend the training.
A new report by UI College of Public Health investigators sheds light on the more than 200 agriculture-related deaths per year that occur in Midwestern states, confirming that farming remains one of the nation’s most dangerous industries and poses particular risks to vulnerable populations such as elderly workers.
Researchers Amanda Swanton, Tracy Young, Corinne Peek-Asa, Marizen Ramirez, and Fred Gerr studied 1,858 agriculture-related deaths that occurred between 2005 and 2012 in 12 Midwestern states, including Iowa, Illinois, Indiana, Kansas, Michigan, Minnesota, Missouri, North Dakota, Nebraska, Ohio, South Dakota, and Wisconsin.
“Numerous hazards threaten farm workers including exposure to machinery, livestock, chemicals, noise, and physical stress, which can be compounded by the fact that agricultural activities are often performed in rural environments with limited access to medical services,” the authors explain.
Over the period reviewed, there were on average 232 agriculture-related fatalities per year in the Midwest region, an annual rate of 19.94 agriculture-related deaths per 100,000 farm operators. This compares with an overall rate of 3.4 fatal work injuries per 100,000 full-time equivalent workers across all industries in 2012.
The researchers also report that agriculture-related fatalities increase with age. Over three-quarters (77%) of agriculture-related deaths occurred among persons 45 years or older, and 41% occurred in individuals 65 and older. Less than 3% of agriculture-related fatalities occurred among minors less than 16 years old.
Other findings include:
Agriculture-related fatality is much more commonly experienced by males than females. Of the 1,858 total agriculture-related deaths studied, 95% occurred in males while only 5% occurred in females.
More than half (51.6%) of individuals who died due to an agriculture-related injury were performing a vehicle- or transportation-related task at the time of the incident. Of these 958 fatalities, 315, or 33%, were due to farm vehicle (e.g. tractor) rollovers.
Agriculture-related fatalities are most frequent from late spring to early fall. The greatest number of deaths occurred in July (13%), while the lowest number of deaths occurred in December (4%).
Fatalities most often occurred within 24 hours of the inciting injury, however deaths occurring after 24 hours were more frequent with increasing age. The fact that some older individuals do not die immediately of their injuries suggests that there may be an opportunity for medical intervention to potentially save these lives, however further research is needed.
The Great Plains Center for Agricultural Health hosted the workshop “Building Capacity: A National Resource of Agricultural Medicine Professionals” Jan. 14-15 at the UI College of Public Health. The attendees included six partners from Iowa, Nebraska, North Carolina, Texas, and Vermont who teach the agricultural health and safety course called Agricultural Medicine: The Core Course.
“The development of the course was supported by the Great Plains Center through a consensus process with our partners and other leaders in agricultural safety and health,” says Diane Rohlman, associate professor of occupational and environmental health and one of the center’s project leaders. “The University of Iowa has long been recognized as a global leader in agricultural safety and health education.”
Since 2007 the course has been offered 26 times in eight states, as well as in Australia and Turkey. More than 600 students have completed the course, primarily health care providers (physicians, nurses/nurse practitioners, physician assistants), veterinarians, medical students and public health graduate students, and health and safety professionals including Extension, safety managers, producers, and county public health workers.
Agricultural medicine is a specialty of the broader field of occupational safety and health that is targeted towards an interdisciplinary audience of rural health and safety professionals. While those professionals are a key link in delivering occupational health and safety services to the agricultural community, they generally do not receive adequate training, a need this course addresses.
The workshop was held to discuss course revisions and identify approaches to ensure sustainability. Based on a review in 2012, the center revised the curriculum to:
meet the needs of the center’s current and target population: people who engage with and protect agricultural populations;
emphasize safety and injury prevention in the curriculum and provide practical approaches for controlling hazards;
add greater cultural relevance (both national and global perspectives);
include new/emerging issues and topics (such as rural roadway safety, ATVs, mechanization); and
incorporate more active learning – case studies, field trips, hands on activities.
According to the U.S Department of Agriculture, Iowa farmers are expected to bring in by far the largest harvest ever in 2014. The bumper crop means farmers will be working more days and longer hours, and amplifies the need for awareness around farm safety.
“This week is National Farm Safety Week, and with harvest right around the corner, highlighting farm safety could not come at a better time,” says Fred Gerr, director of the University of Iowa’s Great Plains Center for Agricultural Health based in the UI College of Public Health. “Farming is still one of the country’s most dangerous professions, and we must do everything we can to help farmers in Iowa and throughout the U.S. have a successful and safe harvest season.”
The 2014 Farm Safety and Health Week runs from Sept. 21-27. This year’s theme, “Safety Counts: Protecting What Matters,” underscores the importance of all Iowans working together to build a safer and healthier agricultural work place.
The UI College of Public Health is one of the pre-eminent academic institutions conducting research, education, and outreach on rural health and safety. The college’s activities in the area encompass a wide range of topics that directly affect the health of Iowans. For more information on agricultural safety, visit the following resources:
Great Plains Center for Agricultural Health: The University of Iowa’s Great Plains Center for Agricultural Health, one of 10 U.S. Agricultural Centers funded by the National Institute for Occupational Safety and Health (NIOSH), is committed to partnering with agricultural producers, agricultural safety and health professionals, agricultural businesses, and government agencies to deliver the most effective agricultural safety and health programs possible. The center has a wide range of educational materials available and offers in-person training and small grant opportunities.
Iowa’s Center for Agricultural Safety and Health (I-CASH): The vision of I-CASH is to make Iowa the world’s healthiest and safest agricultural environment in which to live and work. The center is a state-wide organization created in 1990 by the Iowa State Legislature in partnership with Iowa State University, the Iowa Department of Health, the Iowa Department of Agriculture and Land Stewardship, and a diverse group of private and public agricultural health and safety organizations.
For more information on National Farm Safety and Health Week, and safety resources, visit the website of the National Education Center for Agricultural Safety, www.necasag.org/.
Additional agricultural safety and health resources can be found on the NIOSH Agricultural Centers’ YouTube channel, www.youtube.com/USagCenters. The channel features more than 40 videos available for Extension agents/educators, agricultural science teachers, producers/owner/operators, first responders and agricultural families.
The research analyzed agricultural equipment crashes collected from nine Midwest Departments of Transportation from 2005–2008. Crash zip code was assigned as urban or rural (large, small, and isolated) using Rural–Urban Commuting Areas. Crash proximity to a town was estimated with geographic information system technology. The researchers estimated the odds of crashing in urban versus rural zip codes and across rural gradients, and estimated mean distance (miles) from a crash site to a town.
“Although approximately one-third of agricultural equipment-related crashes occur near town, these crashes are thought to be a rural problem,” says Karisa Harland, study author and researcher in the Department of Occupational and Environmental Health. “This research further illustrates the need for education among all roadway users, increased visibility of agricultural equipment, and the development of complete rural roads to increase road safety and prevent agricultural equipment-related crashes.”
The National Education Center for Agricultural Safety (NECAS) conducted a grain bin rescue demonstration at the UI College of Public Health as part of the UI’s Great Plains Center Core Course in Agricultural Safety and Health. Professionals in agriculture, medicine, health, nursing, veterinary science, and other fields attended the course this month.
On July 28, 2010, Catherine Rylatt was in her back yard on a sweltering Texas afternoon when she got a frantic phone call.
“He’s dead,” Rylatt’s mother sobbed across the line from Illinois. “Alex is dead.”
That day, Rylatt’s nephew, Alejandro “Alex” Pacas, and three other teenaged workers had been assigned to clear out a 500,000-bushel grain bin in Mount Carroll, Ill. The teens entered the half-full bin with directions to break up any corn clinging to the walls and walk on top of the corn to loosen the grain.
Although this task was intended to release a controlled flow of corn at the bottom of the bin, their movements unexpectedly set off a rapid cascade of grain that pulled the young men downward into the bin, entrapping them.
One teen escaped and notified a manager; another was rescued hours later. But Pacas, 19, and Wyatt Whitebread, 14, were engulfed and suffocated to death. After a federal investigation, the employer was fined for numerous safety violations and has since gone out of business.
Concentrating on Confined Spaces
Rylatt shares her nephew’s story to raise awareness about the dangers of working in and around grain bins and to advocate for greater safety. She spoke at the Midwest Rural Agricultural Safety and Health Conference, hosted last November by Iowa’s Center for Agricultural Safety and Health (I-CASH), Great Plains Center for Agricultural Health, and other organizations.
“There has been a rash of fatalities in grain bins the past several years, many of which have been people under 18,” says conference director Kelley Donham, professor in the Department of Occupational and Environmental Health, where he holds an endowed chair in rural safety and health. “We had the opportunity to work with our colleagues from the universities of Nebraska, Illinois, Ohio State, Purdue, and Pennsylvania State to feature this important issue.”
The conference focused on the hazards of confined spaces in agriculture, such as grain bins, silos, and manure pits, with an emphasis on grain handling safety. The meeting brought together a variety of stakeholders, including farmers, health professionals, the agricultural industry, government agencies, and researchers.
Confined spaces have been identified as a high priority by the Committee on Agricultural Safety and Health, formed by the U.S. Department of Agriculture. The committee, which includes Donham, plans to issue a white paper on agricultural confined spaces in early 2013.
“Our goal is to translate the information, energy, and advocacy into renewed health and safety practices on our commercial grain and farming operations,” says Donham.
Entrapments on the Rise
In 2010, the number of grain-related entrapments hit a record high of 51. Of those, 26 were fatal, according to Purdue University researchers who track grain entrapment cases. Because there is no comprehensive reporting system, researchers estimate the number of cases could be 20-30 percent higher.
Grain entrapment incidents have been rising for the past 10 years, “probably because there has been so much more storage of grain as a result of the ethanol boom, and to allow the ability to hold it and sell it at favorable market prices,” says Donham, who also directs I-CASH.
Commercial grain handling facilities fall under the jurisdiction of the state or the federal Occupational Safety and Health Administration (OSHA). OSHA has numerous regulations governing worker safety around confined spaces. But smaller commercial grain handling facilities may not enforce the rules, Donham notes, which can increase the danger for workers. Moreover, grain and feed storage structures located on farms or feedlots with fewer than 11 employees are exempt from OSHA rules.
For most small farmers, it is costly to comply with the federal standards, Donham says, adding the regulations may be impractical.
Risks, Regulations, and Responsibility
Doug Heinichen, who farms 800 acres in Iowa, told conference attendees that while safety is good business and safety education is important, “I’m glad I’m exempt from regulations.”
“It’s my responsibility to postpone my own death,” he added.
Plus, habits are hard to break, pointed out panel member Brian Hammer, risk management consultant with Nationwide Insurance.
“Many employees are willing to take risks they shouldn’t because they grew up in a culture where ‘Dad never did this, and he’s fine,’” Hammer said, referring to a tendency to take safety short cuts. “We have to try to change the safety culture [of farms and agricultural businesses]. Good supervisors are key.”
Another way to lower risk is to reduce the need to enter bins to check the condition of grain through the use of moisture sensors and other technologies, said panel member Dirk Maier, professor and head of the department of grain science and industry at Kansas State University.
“In the U.S., we harvest over 20 billion bushels of grain every year,” Maier said. “Our goal is to eliminate the need to enter bins. Technologies and best management practices exist to successfully store grain.”
A Focus on Prevention
When things do go wrong, time is crucial. Once caught in flowing grain, it takes only seconds until it becomes impossible to climb out.
A grain bin rescue is complicated.
A common technique demonstrated at the conference involved placing a tube or panels around the victim to displace the grain pressure. It takes on average three and a half hours for a rescue, according to Dan Neenan, manager of the National Education Center for Agricultural Safety.
Regrettably, there wasn’t time to save Alex Pacas and Wyatt Whitebread.
“Use our stories, use the pain, use the heartbreak to prevent these deaths,” Rylatt said.
Grain engulfment can occur when a worker:
Stands on moving or flowing grain, which acts like quicksand and can bury the worker in seconds.
Stands on or below “bridged” grain, which occurs when grain clumps together because of moisture or mold, creating an empty space beneath the grain as it is unloaded. If a worker stands on or below the bridged grain, it can collapse.
Stands next to an accumulated pile of grain on the side of the bin, which can collapse onto the worker unexpectedly or when the worker attempts to dislodge it.