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California Department of Health Services
The NURSE (Nurses Using Rural Sentinel Events) project is
conducted by the California Occupational Health Program of
the California Department of Health Services, in conjunction
with the National Institute for Occupational Safety and Health.
The program's goal is to prevent occupational injuries associated
with agriculture. Injuries are reported by hospitals, emergency
medical services, clinics, medical examiners, and coroners.
Selected cases are followed up by conducting interviews of
injured workers, co-workers, employers, and others involved
in the incident. An on-site safety investigation is also conducted.
These investigations provide detailed information on the worker,
the work environment, and the potential risk factors resulting
in the injury. Each investigation concludes with specific
recommendations designed to prevent injuries, for the use
of employers, workers, and others concerned about health and
safety in agriculture.
PROJECT ABSTRACT
The California
Occupational Health Program (COHP) has developed a model program
for active surveillance linked with work-site specific and
community-based prevention of occupational injuries in agricultural
workers. The model links the reporting of fatal and severe
injuries occurring in the agricultural workplace to investigations
identifying potential risk factors, making recommendations
for injury prevention, and facilitating on-site prevention
programs, which integrate safety training, epidemiologic surveillance
and research, and practical engineering solutions. Nurses
are based in Fresno and Monterey counties which are the major
agricultural counties in California. Nurses facilitate reporting,
coordinate workplace follow-up, and assist or conduct workplace
specific and broad-based education and training programs.
The ultimate goal of the project is to prevent work-related
injuries to agricultural workers and others exposed to hazards
associated with agriculture.
The
basic approach used was to identify, select, and recruit the
key emergency medical care providers, including emergency
departments in hospitals and emergency medical services in
each county to report injuries related to agriculture. Injured
workers, coworkers, and employers are confidentially contacted
and interviewed by nurses and other project staff. Nurses
arrange workplace visits, conduct workplace investigations
in conjunction with a safety engineer, and coordinate and
conduct workplace safety programs in collaboration with the
California Agricultural Health and Safety Promotion System
(University of California at Davis Cooperative Extension).
Workplace specific recommendations for preventive interventions
are developed and disseminated. Demographic, health and risk
factor/exposure data is maintained in an automated database
which used for case management, descriptive epidemiology,
prioritizing workplaces for interventions, statistical analysis,
and report generation.
Nurses
maintain ongoing contact with reporters in the surveillance
system to give feedback on reporting and case follow-up and
to conduct long-term follow up with workers and employers.
As part of an evaluation component, a plan is being developed
to determine whether the recommendations or workplace interventions
have been implemented, and/or to document the barriers for
their implementation. To implement the NURSE project and to
disseminate the findings and recommendations, we continue
outreach and liaison to medical, agribusiness, labor, governmental
and community service organizations in each county and state-wide
coalitions as well as other groups involved in agricultural
safety.
The
proposal continues to be linked to the Farm Family Health
and Hazard Surveillance (FFHHS) project. As source data from
FFHHS project becomes available, these will be used to help
develop and target materials which can be distributed to injured
workers and others through the NURSE project. Activities in
year three will expand upon progress made in previous years
and concentrate on implementing a dissemination plan and developing
an evaluation plan.
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and Reproduction Information: Information in NASD does not
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NASD Review: 04/2002
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