NOTE: This document is provided for historical purposes only.

C1.1 Overview of the NIOSH Childhood Agricultural Injury Prevention Initiative-Hard DL, Castillo DN, Myers JR, Pizatella TJ, Olenchock SA

In 1996 the report Children in Agriculture: Opportunities for Safety and Health-A National Action Plan was released by the National Committee for Childhood Agricultural Injury Prevention. The National Action Plan (NAP) generated "specific, targeted recommendations for research, education, policy, and evaluation, with the goal of reducing unintentional agricultural injuries to children younger than 18 years." The plan specifically recommended that NIOSH assume leadership for coordinating efforts to implement this action plan at the federal level. Due in large part to the awareness and concern raised by this report about the childhood agricultural injury issue, NIOSH received a congressional appropriation of $5 million in fiscal year (FY) 1997 and through the present year for implementing this Initiative.

The NIOSH Childhood Agricultural Injury Prevention Initiative builds upon previous NIOSH research and objectives, as well as recommended action steps in the NAP. In implementing the Childhood Agricultural Injury Prevention Initiative, NIOSH has assumed a leadership role by identifying, funding and developing quality childhood agricultural injury prevention activities. Due to efforts by NIOSH and its extramural partners, progress is being achieved. Thirteen extramural research proposals specific to childhood agricultural safety and health research have been completed and new grants were solicited in FY 2000 to conduct additional research in this area. A national surveillance plan for childhood agricultural injuries is being developed and implemented by NIOSH. An extramural partner has also developed a model for training professionals in childhood agricultural injury prevention approaches. Finally, the important issue of being able to turn research findings into action and serve as a resource for injury professionals working with this specific target population is addressed by another extramural partner, the National Children's Center for Rural and Agricultural Health and Safety (NCCRAHS), located at the Marshfield Medical Research and Education Foundation in Marshfield, Wisconsin.

C1.2 NIOSH Approach to Childhood Agricultural Injury Surveillance-Myers JR

NIOSH began the Childhood Agricultural Injury Prevention initiative in the fall of 1997 to implement the recommendations developed by the National Committee for Childhood Agricultural Injury Prevention (NCCAIP). One NCCAIP recommendation is for surveillance specific to childhood agricultural injuries. A major issue for childhood farm injuries is the number of special populations (e.g., youth workers, minority children, youth visiting farms). Because of these special populations, no single surveillance method provides adequate information for all youth. NIOSH is evaluating different surveillance approaches for these special populations. Farm operator surveys are proposed for the surveillance of youth living on, or visiting farms, and youth directly hired by the farmer. A general farm operator survey has been completed, and a second survey targeting minority farmers is planned. A personal interview survey is ongoing to assess injuries to young minority farm workers, and the children of minority farm workers. A national hospital emergency department surveillance system is also being evaluated for assessing youth farm injuries. The Census of Fatal Occupational Injuries and death certificates will be used to assess fatal injuries. These methods will be used by NIOSH to develop an ongoing periodic surveillance approach for childhood agricultural injuries.

C1.3 Agricultural Disability Awareness and Risk Education (AgDARE)-Reed DB, Kidd PS, Rayens MK, Westneat SC

Introduction: Adolescent farm workers continue to be at high risk for work-related injury and death. An agricultural safety curriculum using narrative and physical simulations was developed and tested in this three year NIOSH sponsored intervention project.

Method: Using a quasi-experimental crossover design, 22 high schools in Kentucky, Iowa, and Mississippi were assigned to a treatment or control group. All enlisted agriculture students (n=1,127) completed surveys that included questions about farm residency, farm work, and occupational exposures to machinery, noise, and dust. Each student received pre and post tests on safety attitude and safety behavior. The treatment schools received two days of class instruction using the developed curriculum. Instruction was delivered by the research team at two separate times of the school year. Control schools received no intervention. A select number of students who completed the treatment are participating in farm safety audits to observe the students' work habits (results forthcoming).

Results: Of the full sample, 861 reported working on farms. Of these, 74% were male and 76% were in the ninth or tenth grade. Only 53% had ever driven a ROPS equipped tractor, 4.9% had overturned a tractor, and 42% had used PTO powered equipment with missing or damaged shields. 72% worked in dusty environments; 85% in noisy surroundings. There were significant differences (p<.05) in safety attitude and safety behaviors between the treatment group and control groups. There were no significant differences between order of treatment (narrative or physical) and control groups on the dependent variables.

Conclusions: Farm youth continue to be at risk for serious injury. Adolescents' safety attitudes and behaviors can be influenced by an interactive school curriculum that requires little class time. Formal evaluation of the curriculum needs to be conducted to assess the real utility of this project in the classroom.

C1.4 Health Professional Education to Promote Use of Childhood Agricultural Injury Prevention Guidelines-Shutske JM, Schermann M

A one-hour educational module was developed in cooperation with the National Children's Center for Rural and Agricultural Health and Safety. This module was designed to educate parents, other care providers, and health professionals about the appropriate use and application of the North American Guidelines for Children's Agricultural Tasks. Initial pilot surveys of a small group of central Minnesota workshop participants (n=12) early in the year 2000 showed a significant change before and after the workshop in attitudes related to the age at which participants believed it was appropriate for children in their county to perform five different farm tasks. These tasks were: operating a tractor and towed tillage implement (p=.003); hitching a towed implement to a tractor (p=.002); operating a combine (p=.006); feeding milk to calves (p=.007); and operating a PTO-driven stationary machine (p=.008). The mean increase in appropriate age, according to participants before and after the workshop, ranged from +1.46 to +2.30 years for the various tasks. Additional results will be reported that will include a larger group of health professionals from Minnesota, Wisconsin, North Dakota, South Dakota, and Iowa. In addition, a continuing education credit-bearing website for nurses is being developed and will be summarized.

C1.5 National Children's Center for Rural and Agricultural Health and Safety-Lee BC

In 1997 the National Children's Center for Rural and Agricultural Health and Safety was formally established with a mission to enhance the health and safety of all children exposed to hazards associated with agricultural work and rural environments. The Center is based at the Marshfield Clinic, Marshfield, WI, one of the largest rural healthcare facilities in the U.S. with over 550 physicians. Funding is provided by the National Institute for Occupational Safety and Health (NIOSH), federal Maternal and Child Health Bureau, Marshfield Clinic, and private donations. Staff members have advanced training in injury prevention, health promotion, agricultural safety, and related topics. The team works in cooperation with nine formal collaborating agencies that enable the Center and collaborators to maximize their capacity to address complex issues related to children and agricultural injury prevention. A 23-member external Steering Committee guides the Center's program planning. The Center's work is based on objectives and recommendations of the 1996 National Action Plan for Childhood Agricultural Injury Prevention.

Major activities of the Center include: a) provide technical assistance for childhood agricultural injury prevention programs; b) convene consensus development sessions to address controversial issues; c) enhance communications between researchers, safety specialists, and the farming community; and d) provide professional training, including an annual Rural Youth Safety Summer Seminar. A recent accomplishment was the development and dissemination of the North American Guidelines for Children's Agricultural Tasks. Currently, a major initiative is underway to address the occupational health and safety needs of migrant farmworker youth.

The Center's primary audience is professionals involved in agricultural safety and health. An Internet site provides ready access to injury facts, prevention program tactics, and links to relevant web-sites for rapid referrals. A toll-free phone line (888-924-7233) provides opportunities to access staff for in-depth technical assistance inquiries.

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