Future Directions for the Surveillance of Agricultural Injuries

Public Meeting (webinar)

National Institute for Occupational Safety and Health

March 30, 2015

PLEASE STAND BY FOR REALTIME CAPTIONS. 

 >> Good morning or afternoon depending on your location. Welcome to the Agricultural Injury 

Surveillance public meeting hosted by the National Institute for Occupational Safety and Health

(NIOSH). My name is Kara Perritt. I work for NIOSH and am located in Morgantown West Virginia. 

I will be serving as the facilitator for the public meeting which begins now. At this time, I request 

that you mute your phone and keep it muted unless you are recognized to speak. Additionally, 

please do not put this call on hold as that sometimes results in music that can be heard by all 

conference participants. Please be advised that this meeting is being recorded and will be 

transcribed in its entirety. All presentations and comments will be posted without change to the

NIOSH docket associated with this effort. If you do not agree with these procedures you may 

disconnect now. Today's schedule of events will begin with opening remarks from the NIOSH 

director followed by two NIOSH presentations. After these presentations, I will make administrative

announcements and set the ground rules for the participant presentations and the comment portion

of the meeting that will immediately follow. And now without further ado it is my pleasure to 

introduce the director of NIOSH, Dr. John Howard. Dr. Howard. 

Thank you, Kara. I just want to check and make sure you can hear me. 

Yes we can. Thank you. >> Thanks. Good morning and good afternoon to everybody. Thank you 

very much for taking time out of your busy schedules to attend our public meeting on surveillance 

of ag injuries. I think we are in a very important transition time right now and so your ideas about 

ag injury surveillance are very important to us as we struggle, along with everyone else, with 

decreasing budgets and other constraints that we have on our surveillance efforts. We want to 

probe, you and us and anybody who is interested, on new ways of doing surveillance. 

I have adopted this term of smarter surveillance; people have said what exactly does that mean? 

Certainly it means surveillance that is more cost effective than some of these very large, very 

expensive national surveillance programs that we have had. I think we were very advantaged in 

other era of budgets where we were able to do that. One of the things, the value the national 

surveillance has, is in sort of comparing your country with another country. There is nothing wrong 

with that, but I wonder if local or regional surveillance, especially in ag, because it differs so much

across the United States. I’m from California originally, and California agriculture is extremely 

different than Midwestern agriculture. So, that type of shifting surveillance, from national to regional 

and local approaches, is something that I would like to hear some comments on. And what is the 

role of our partners? We are very happy that we have ten agricultural safety and health research

centers. What is the role that those partners and others can take on to address the needs in

agricultural injury surveillance? 

Clearly, we want to do our surveillance so that we know what is going on with ag injuries in various 

parts of the United States. More than that, we want to be able to take action to prevent them. I 

think that is the last point I would make. How we can do our surveillance so it is action oriented to 

the prevention side. 

Again, thank you all for attending and I look forward to hearing all of your comments. Thank you, 

Kara. 
Thank you very much, Dr. Howard. Now we will hear from Captain. Brad Husberg, director of the 

NIOSH Office of Agricultural Safety and Health. 

Thanks, Kara. As Kara mentioned, my name is Brad Husberg. I’m the director of the NIOSH Office 

of Agricultural Safety and Health, also referred to as OASH. 

The NIOSH Office of Agricultural Safety and Health was created in 2012 and sets the research 

priorities and coordinates safety and health research for the NIOSH Agriculture, Forestry and 

Fishing sector program. Duties also include: responsibility for the NIOSH Agriculture, Forestry and 

Fishing research budget; strategic directions on research priorities; assisting in the evaluation of 

program outputs and outcomes; leading the Agriculture, Forestry and Fishing sector council of the 

National Occupational Research Agenda, also referred to as NORA, and responding to requests for 

information about agriculture, forestry and fishing research at NIOSH. 

The NIOSH Agriculture, Forestry and Fishing program can be divided into the intramural program, 

which includes work done by NIOSH researchers, and the extramural programs, which include

research that is funded by NIOSH and done by other organizations and agencies. 

The intramural work includes providing guidance and direction of projects and coordination of the 

NIOSH Agriculture, Forestry and Fishing steering committee. Extramural efforts include working 

with the NIOSH funded agricultural safety and health centers and other groups doing research 

with NIOSH dollars, through contracts, grants and cooperative agreements. 

NIOSH also helps to guide the Ag Center’s work with the Agriculture, Forestry and Fishing Sector 

Council of the National Occupational Research Agenda where long-term priorities and goals are set 

for agricultural, forestry and fishing safety and health research. The NORA sector council includes 

representatives from business, safety and health organizations, and academia. NORA also 

includes members from NIOSH. The research priorities set by the NORA sector council and our

coordination are not just for NIOSH. I would like to thank you for taking the time to help us learn 

more about potential options for future surveillance in the Agriculture, Forestry and Fishing sector. 

Thank you. >> Thank you very much Brad. The final NIOSH presentation will be made by Kitty 

Hendricks, project officer of the NIOSH Agricultural Injury Surveillance Program. Kitty. 

Good afternoon. I'm going to begin by providing some background information on the NIOSH 

agricultural injury surveillance program. NIOSH has had an emphasis on agricultural safety and 

health for more than 20 years. 

NIOSH began its focus on agriculture in 1990 when Congress in part in response to the 1988 

National Coalition for Agricultural Safety and Health report designated NIOSH to lead a national 

effort in the prevention of occupational injury and illness in agriculture. 

In the following years NIOSH began two agricultural programs, first, in 1993 the Agricultural Health

and Safety Initiative; and later in 1996 the Childhood Agricultural Injury Prevention Initiative. >> The 

Agricultural Health and Safety Initiative was initiated to reduce the occurrence of occupational 

injuries and illnesses on farms in the United States. 

NIOSH began working with the US Department of Agriculture’s National Agricultural Statistics 

Service to track occupational injuries and the presence of tractor safety devices on farms. >> The 

Childhood Agricultural Injury Prevention Initiative was introduced to reduce injuries to youth on US 

farms. 

Tracking injuries has been a major part of this initiative. In addition to focusing solely on youth it 

also differs from previous efforts by including both work and nonwork injuries. >> NIOSH began 
their surveillance efforts with two surveys in 1993 - The Farm Family Health and Hazard Survey 

and the Traumatic Injury Surveillance of Farmers. In 1999, the first Childhood Agricultural Injury 

Survey, also known as CAIS, was conducted; and in 2001 the first Occupational Injury Surveillance 

of Production Agriculture, or OISPA survey, began. 

Overtime NIOSH has collected multiple years of data for these surveys, and also expanded our 

efforts to include surveys for both adults and youth which focused on minority operated farms, as 

well as the Farm and Ranch Safety Survey, which examined common hazards on farms. >> In an

effort to collect the most comprehensive data possible, NIOSH also collaborated with the 

Department of Labor to fund an injury supplement to the National Agricultural Workers survey. This

surveys supplement is conducted through personal interviews and collect injury data for hired crop 

workers. To date, data collection has been completed for two study periods. 

These different surveys have provided valuable data that have shown that between 1998 and 2012: 

injuries to all youth on farms have decreased by 63%, work-related youth farm injuries have 

decreased 82%, and injury rates for household youth have decreased 51%. Between 2001 and 

2012, adult occupational farm injuries declined by 30%, and injuries to working adult household 

members declined by 22%. Data from the NAWS injury supplement have shown that injury rates for 

hired crop workers decreased by 33% during the data collection periods. >> Data collection is 

ongoing for CAIS and OISPA which are currently collecting data for the 2014 calendar year. NAWS 

injury supplement data are also being collected for the 2014/2015 data cycle. >> Static data tables 

from each of our USDA farm operator surveys are available on the CDC website. NIOSH is 

currently working on similar tables to provide public access to the NAWS injury supplement data. 

And NAWS data are also publicly available through special request of the US Department of Labor. 

Beginning in 2015, NIOSH will not reestablish interagency agreements with USDA and the 

Department of Labor to collect survey data for the agricultural injury surveillance system. This 

includes the NAWS supplement and all farm operator surveys. 

Therefore, the following data will be discontinued after our current data collection efforts end: the 

numbers of youth living on, visiting, and working on farms; the numbers and rates of injury to youth 

who live and work on farms; the numbers and rates of injury to adults who work on farms; the 

number of tractors not equipped with ROPS; injury information for hired crop workers; and data on 

farm hazards, such as silos and manure storage. 

One of the challenges we have encountered, is that due to the decline in the number of injuries 

occurring on farms a much larger sample size is needed in order to provide stable injury estimates. 

NIOSH does not have the resources to support the cost of the necessary increase in sample size. 

However, NIOSH will continue to explore ways to improve agricultural surveillance for the future,

and stakeholder input will be an essential part of this process. 

I encourage anyone who is interested to submit any comments regarding the NIOSH agricultural 

surveillance program to the public docket. All comments should reference the docket number, they

can be submitted either electronically or by mail, and must be submitted by May 27, 2015. >> 

Additionally, if anyone has any questions or would like additional information you can contact me at 

any time. Thank you. >> Thank you. Before we get into the participants’ presentation and the

comment portion of the meeting, I wanted to take a moment to introduce those of us from the 

NIOSH Agricultural Injury Surveillance Program who are in attendance today. We have Kitty 

Hendricks, who just heard from, the project officer; team members Michael Goldcamp and Larry

Layne; me, as a team leader, and Dawn Castillo, who is our division director. In attendance from 

the NIOSH Office of Agricultural Safety and Health, we have director, Brad Husberg, who we heard 

from, and Deputy Director, Pietra Check. We have now come to the participant presentations and 

comment portions of the meeting. The primary objective of this public meeting is for NIOSH to 
receive comments, suggestions and questions that will be considered as we plan for the future of 

agricultural injury surveillance. We will begin with the three scheduled participant presentations. If 

you did not request to make a presentation and you want to speak you may use the question and 

answer panel to make that request. You may make your request at any time starting right now. 

Just click on the Q& A in the command menu and indicate you wish to speak by clicking on the

raise your hand icon, which is a small picture of a hand. The hand icon is located in the upper right 

corner of the Q&A panel. The hand icon is a toggle switch; do not click on it more than once unless 

you wish to withdraw your request to speak. After the last scheduled presentation, we will call on 

participants who request to speak in the order in which those requests were received. These 

participants will be allowed up to five minutes of speaking time. 

Our first of three scheduled presenters is Dr. Barb Marlenga. Dr. Marlenga, you have 10 minutes 

for your presentation. The timer will start when you begin speaking. Please unmute your phone to 

begin. >> Thank you. Dr. Howard and NIOSH colleagues, thank you for the opportunity to 

comment on future directions for the surveillance of agricultural injury. The National Children's 

Center for Rural and Agricultural Health and Safety has been integrally involved with the NIOSH led 

national initiative for protecting children on farms since its inception in 1996. We commend 

NIOSH’s efforts to collect, analyze and disseminate data specific to injuries among children who 

live on, visit, and work on farms and ranches in the US. Data from six points in time have been

extremely valuable for understanding the scope of the problem and guiding priorities for research 

and interventions. We credit the Childhood Agricultural Injury Survey data for motivating action in 

the public and private sectors that has yielded significant impact. Our center used injury data and 

fatality reports to update the 1996 National Action Plan for Protecting Children in Agriculture in both 

2001 and 2012. We have used the data to publish an annual child ag injury fact sheet that is 

frequently accessed by the media, by researchers and by the general public. It is especially 

valuable as a teaching tool in conjunction with new injury or fatality events. We have also used the 

data to assess implications for changing trends, for example, there is a higher priority on children 

younger than 10 years, and we have guided agricultural employers with a model policy for hired 

adolescent workers. 

We understand NIOSH’s rationale for discontinuing the child agricultural injury survey and the 

importance of making wise investments with limited budgets. We acknowledge the shortcomings of

surveillance efforts to date, and appreciate the fact that there is no perfect system for occupational 

injury data collection. Moreover, there are compounded challenges when garnering information on 

injuries, among children who are injured in the agricultural worksite as bystanders, or when 

incidents occur within unique population such as foreign born workers and beginning farmers and 

ranchers. The Blueprint for Protecting Children in Agriculture, the 2012 National Action Plan was 

developed through a consensus process of more than 100 child safety advocates. In the plan, 

specific attention was given to improving injury, disease and exposure data, and we base our 

comments, in large part, on this document which includes recommendations for agricultural injury 

data collection and dissemination pertaining to children younger than 18 years. There are many 

ideal components of a future agricultural injury surveillance system. In addition to the data 

collected on demographics and agents of injuries and exposure, there are specific elements 

desired for guiding interventions to protect youth. Critical factors include at minimum: 1) a child 

specific data set with clear definitions and inclusion/exclusion criteria; 2) data secured from multiple 

sources, including nontraditional agricultural data sources, for example, child death reviews, with

potential for merging or cross-referencing; 3) data collected from parents and farmers via methods 

other than landline telephone; 4) data collected from hard-to-reach populations, such as migrating 

workers, Anabaptists, beginning farmers, and urban agricultural producers; 5) variables regarding 

work versus nonwork, farm residency status, and the relationship of the injured child to the 

responsible adults; 6) public access to regional and national data; and 7) timely reports and 

postings of updated data. 
Presently there are several injury surveillance activities underway at various NIOSH Ag centers. 

Here at our NIOSH funded center, Doctor Barbara Marlenga is conducting a study on filling the 

gaps in child agricultural injury data. We anticipate that results from this exploration of some 

promising, existing public health surveillance systems will provide insights into options that may be 

considered for agricultural injury data collection for adults, as well as children. Our recommendation 

for the next step is to convene a multidisciplinary advisory group that includes the public and 

private sector, is bipartisan, and includes the agricultural industry. We propose options for building 

childhood agricultural injury and disease data into existing public health surveillance systems, and 

identify systems that could potentially be linked or merged, including private sector data sources, 

for example, tractor manufacturers or insurance companies to create a more complete and robust 

picture of child agricultural injury and disease. An option for this advisory group could be a 

commissioned project for the National Academies Board on agricultural and natural resources. 

Thank you for considering our comments and our recommendations. 

Thank you. Your presentation will be transcribed and posted to the NIOSH docket. At this time I 

would like to remind all participants to please mute your phones. Our second scheduled presenter 

is Dr. Thomas Arcury. You have 10 minutes for your presentation. The timer will begin when you 

start speaking. Please unmute your phone to begin. >> Thank you for allowing me the opportunity 

to speak. Let me start by saying something about my background and expertise. I am professor 

and vice chair of research for the Department of family and community medicine and the director of 

the Center for Worker Health at the Wake Forest School of Medicine. For the last 20 years I have 

been conducting research on the Occupational Health & Safety of agricultural workers, both 

farmers and hired farm workers. My group has written over 150 peer-reviewed scientific papers on 

the Occupational Health & Safety of agricultural workers. I'm happy to share a list of those 

publications with anyone. We have also written book chapters and developed educational materials 

to address occupational safety problems in agriculture. My major interests are migrant and 

seasonal farmworkers, these are largely immigrant workers; and hired youth farmworkers; these 

are largely US citizens who are often the children of migrant workers. 

The focus of my remarks is on hired migrant and seasonal farmworkers, adults and children. My 

position is that we do not have accurate knowledge of occupational injuries and illnesses 

experienced by hired agricultural workers and therefore we should not abandon collecting 

surveillance data. 

NIOSH needs to institute an active surveillance system that collects data directly from the hired 

agricultural workers so that accurate data on occupational injuries and illnesses can direct policy 

and programs. >> Agriculture, as we all know is a hazardous industry with high rates of injury, 

illness and mortality. Research projects focused on adult agricultural workers routinely report high 

rates of injury and illness. In our own research with adult workers our research on Green Tobacco 

illness found that 25% of workers experience occupational illness, that farmworkers experience two 

days of the sickness for every 100 days of work. Our research based on clinical examinations of 

adult farmworkers found that 16% of these workers had rotator cuff syndrome, 19% had 

epicondylitis, and 14% had lower back injury. Our research on pesticide exposure documented high 

levels of pesticides in urinary metabolites, and depressed cholinesterase among hired agricultural 

workers. 

Our research on hired youth farmworkers age 10 to 17 found that over a 12 month period while 

doing farm work, 54% reported any musculoskeletal injury, 61% reported any trauma and 72% 

reported any dermatological injury, which was mostly sunburn. Our research is not unique. 

Comparable results have been reported among adults and youth workers by investigators at the 

Western Center for Ag health and safety at UC Davis for musculoskeletal injuries, by investigators 

at the Northeast center of agricultural and occupational health for youth workers, and investigators 

at the Southwest Center for Agricultural Health, Injury Prevention and Education. In most states 
agricultural injuries are not reportable events. >> Agriculture does not have the same safety

requirements as other industries. Agriculture is exempt from many federal regulations and many 

states have not implemented laws to address these gaps. For example, many states farmworkers 

are not eligible for workers compensation. 

When safety regulations are present, research shows that these regulations are often not followed 

or enforced; including enforcement of pesticide safety through the US EPA worker protection 

standard, field sanitation requirements, and migrant housing. >> 

Passive surveillance based on the reporting of injuries and illness is not sufficient. Many workers 

do not seek healthcare or report injuries. 

They often fear losing their jobs, fear interaction with government officials, do not have health 

insurance to help pay for care, and do not have Workmen's Compensation. Because they do not 

have workers comp, agricultural workers are unlikely to report an injury or illness as work-related. 

Because migrant clinics are not reimbursed for care, they do not ask if an injury or illness is workrelated. >> Reporting systems often do not accurately capture occupational injuries of agricultural 

workers. This is detailed in research by investigators at the Northeast Center for agricultural and 

occupational health. >> Reporting systems greatly under calculate injuries of agricultural workers. 

This is detailed in research by investigators at the Western Center for agricultural health and safety. 

>> It is not appropriate for employers to report injuries and illnesses of their workers. They often do 

not know a worker has been injured or is ill. Remember, workers do not tell them because they 

fear losing their jobs. 

It is often in the best interest of the employers not to report employee injuries or illnesses. 

In that situation, we need an active surveillance system that asks workers directly about their workrelated injuries and illnesses. Given the breadth of the problem and a wide geographic distribution 

of workers, creative approaches to surveillance need to be considered. 

It would be appropriate to have a working group of occupational health experts and worker 

advocates with some input from industry to meet and develop creative approaches. This could be 

managed by representatives of the NIOSH funded Ag health and safety centers. Ideas could 

include an area cluster design reflecting differences in farm systems across the US. However, 

direct interviews and examinations of workers should be included. Thank you. 

Thank you very much Dr. Arcury. Your presentation will be transcribed and posted along with your 

slides to the NIOSH docket. Our final scheduled presenter is Dr. Risto Rautiainen. Sir, you have 10 

minutes for your presentation. The timer will start when you begin speaking. Please unmute your 

phone to start speaking. 

Thank you very much for the opportunity to provide my comments. I am a professor at the 

University of Nebraska Medical Center. I direct the central states Center for agricultural safety and 

health and chair the NORA agriculture forestry and fishing sector working group. >> NIOSH has 

really provided valuable information in the agricultural health and safety field by doing surveillance. 

The surveillance has provided information, especially on populations that are not covered by the 

Bureau of Labor Statistics or other surveillance mechanisms. Some of the good features of the 

NIOSH injury surveillance are that it has been national; it has included some regional data, has 

used fairly large samples, had good response rates, covered the key populations, and has provided 

estimates and information on injury characteristics. 

Some of the limitations have been that the reports have been fairly irregular, and not very local. 

There has not been enough information on the cost and lost time from injuries. Not really much

information on how the injuries actually happened. The analyses of these data have been mainly 
descriptive tables and not utilizing more advanced analytical statistics. Reports have been fairly 

slow in coming and the data is not very easy to locate. >> The current position that NIOSH has 

been considering or has decided to discontinue surveillance activities and this really leaves an 

unmet need in the field. We do need surveillance to document the burden, need and impact of 

agricultural health and safety and to track progress and detect emerging issues and even to justify 

the existence of the entire NIOSH agricultural forestry and fishing program. 

NORA strategic goals calls for surveillance and they are to improve surveillance within the sector. 

There are goals, intermediate goals and action steps. I will not read them all but some of them 

include maintaining and expanding the existing surveillance systems, which is now not going to 

happen. So, I think this puts the NIOSH surveillance group in a new situation where we really have

to look at new ways of addressing the issue. 

One of the things already mentioned is that there might be a good reason to hold a national 

meeting of surveillance experts to really explore the possibilities of developing an effective 

surveillance activity in the future. The NIOSH implementation of National Academy’s 

recommendations also recognizes the need for a comprehensive surveillance system. Conducting 

research on surveillance systems and creating a panel of experts to develop new approaches. And 

also, there is a mention of implementing pilot surveillance systems and we do have one such 

system going on at our center based out of Omaha. I would be happy to discuss that at a different 

time when there is more time. So, what types of information would be useful? Optimally, we need 

information on the populations, numbers, and demographics. We would really like to have 

information on working hours and even by task if possible. 

We need information on the injuries, counts, rates, by personal and farm characteristics. Also, cost 

and lost time information would be helpful. >> With the injuries, it might make sense to also collect 

information on illnesses and symptoms of work related illnesses which are not very well known 

currently. 

Also, it might be useful for information that producers are interested in - to collect information on 

material damage related to it injury incidents, and possibly information on exposures such as noise, 

dust, pesticides and other exposures. It would be also helpful to learn about the adoption of 

preventive measures including ROPS, PPE and other interventions to see if we are making 

progress. 

The new system should be regular, either one, two, or five-year interval and using standardized 

collection instruments. Covering key populations using established industry and occupation coding

and hopefully also be comparable internationally. At least be comparable within the US with other 

industries and occupations. We would need information on incident characteristics such as time, 

location, task, cause/source, type of incident. And injury characteristics including ICD-9 or ICD-10 

codes, body part, lost time, cost and possibly severity index. 

How could this kind of information be collected? 

We could continue similar collection mechanisms that NIOSH has conducted and maybe looking at 

if there is a way to modify it so that it could be more cost effective. We could possibly cooperate 

with the National Safety Council that also collects information on injuries or possibly a new 

mechanism of conducting online surveys -- for instance Farm Market iD has a fairly extensive data 

set for all US producers, agricultural producers which could be utilized for doing surveillance online 

but the response rate, in such a case, most likely would be lower than in the current surveys. 

There might be some possibilities of unifying the state trauma systems and developing a more 

comprehensive national database out of state -based systems. We also have ongoing press 
clipping services that provide valuable information. FACE investigations have been very helpful in 

providing information on specific cause and source or injury and providing recommendations to 

help prevent injuries. Also, currently available and past available information that NIOSH has 

already collected should be analyzed with advanced epidemiological methods and that would 

provide more detailed information from the data that has already been collected. And, finally, there 

should be a national clearinghouse for pulling all of these are data together and reporting it 

effectively to the public and to the farmers and to those working in the field. 

We need to keep the ultimate purpose in mind which is prevention. We need population information 

to know who is at risk. We need injury information to know what should be prevented, where, when, 

how and why. And putting those together we should learn more about the risk and protective 

factors for injury. 

We need ongoing systems so that we know if we are making progress. 

On the national level, we also need to look at the size of the population and the size of the injury 

problem, and evaluate that against other occupations and industries, to see if the current level of 

investment in the United States into agricultural health and safety is at the right level when we are 

comparing agricultural forestry and fishing to other occupations and industries. 

That is all. I think you all for hearing my comments and recommendations. Thank you. 

Thank you Dr. Rautiainen. Your presentation will be transcribed and posted along with your slides 

to the NIOSH docket. We will now hear from participants who requested an impromptu speaking 

opportunity through the Q&A feature. The speakers will be allowed five minutes. When you are 

recognized to speak please unmute your phone and identify yourselves. At that point your timer will 

begin. Michael Goldcamp has been monitoring requests to speak and he will recognize the

requesters in turn. Michael, who is our first speaker? 

We don't have one yet. 

Alright. Is there anybody who wishes to speak? If so please identify yourself. 

This is Mary Miller from Washington State. I tried to raise my hand online but I may not have 

succeeded, obviously. Can you hear me? 

Yes we can. 

Thank you. Sorry. So, I really appreciate this opportunity, particularly for the information provided 

by the presenters. I have a couple questions about this. I want reiterate all the recommendations 

by the speakers, I think they really provide us a huge foundation for going forward. What I'm 

concerned about, if there is not funding to do the basics that have been done all this time, where 

will the funding come from for these new opportunities if we developed regional and pilot programs 

that need to be at least coordinated and developed so they are consistent to be able to compare 

across regions and countries, that would take some funding and coordinating presumably or 

hopefully by NIOSH. So, that is one question that I have. And, the other question is, I'm just curious 

how would go about selecting a body that would be involved in providing some guidance and 

feedback in a working group? 

This is Dawn Castillo. So, I can try to it address the question regarding funding. One of the things 

that Kitty Hendricks had presented is that the methods that we have been using to-date have now 

become more expensive because of our progress in reducing injuries. So, we would have to 

expand our sample size. We are not facing a situation of no funds what we are facing is a situation 
where we need to look at these existing funds and how we can stretch it further. That addresses 

the first question. The second question is we very much welcome the suggestions that we have 

had and one of the comments to date is to have some type of the advisory committee work. When 

we opened up this meeting and we opened up the docket, it was with the sincere interest in having 

suggestions from the stakeholder community. One of the recommendations so far has been to 

utilize the National Academy of Sciences. Another recommendation is to have the Ag centers 

manage a working group. We welcome the opportunities. We don't have preconceived notions of 

who the advisory body would be. 

Thank you very much. 

Thank you Mary. Is there anyone else who is on the phone who wishes to speak? If so, please 

unmute your phone and identify yourself. >> [ Pause ] 

Michael, do you have any additional speakers? 

I do not. 

We don't have any additional speaking requests from participants. If you have comments that were 

not voice during this meeting I strongly encourage you to visit the Federal Register notice website 

and follow the instructions for making comments. As Dawn indicated, we are sincerely interested in 

your comments. Comments must be received by May 27, 2015. At this time I thank you for 

participating in this public meeting. We look forward to considering your input in planning future 

directions for agricultural injury surveillance. I will take one more moment to ask if there are any

speakers who have comments. If so, please unmute your phone and identify yourself. 

[ Pause ] 

Thank you very much for participating in the public meeting. This public meeting is now adjourned. 

[EVENT CONCLUDED ]