FUTURE DIRECTIONS FOR THE 

SURVEILLANCE 

OF AGRICULTURAL INJURIES; PUBLIC 

MEETING COMMENTS 

NIOSH DOCKET NUMBER 281, CDC-2015-0005

Risto Rautiainen, PhD

Professor, University of Nebraska Medical Center

Director, Central States Center for Agricultural Safety and Health

Chair, NORA AgFF Surveillance Working Group

March 30, 2015
Background

• NIOSH agricultural injury surveillance has served an 

important function 

• NIOSH Surveillance has provided information on injuries 

to self-employed farmers, ranchers, children, youth and 

minorities who are excluded from Bureau of Labor 

Statistics and other surveillance mechanisms. 
Important features of the NIOSH injury 

surveillance have included:

• National system, including regional data

• Large samples

• Good response rates

• Covered key populations

• Owner operators

• Children and youth 

• Minorities

• Rate estimates

• Injury characteristics
Limitations

• Irregular 

• State, local data

• Cost and lost time information

• Details how injury actually happened 

• Descriptive (vs. analytical) statistics

• Delay in getting reports out

• Locating data and reports
Situation

• NIOSH decision to discontinue injury surveillance leaves 

an unmet need in the agricultural safety and health field.

• Surveillance is needed in the future

• Documenting burden, need, impact

• Tracking progress

• Detecting emerging issues

• Justifying the existence of NIOSH AgFF program 
NORA AgFF Surveillance Goals

• Strategic Goal: 

• Improve surveillance within the Agriculture, Forestry, and Fishing 

(AgFF) Sector to describe:

• the nature, extent, and economic burden of occupational illnesses, 

injuries, and fatalities; occupational health hazards; and worker 

populations at risk for adverse health outcomes.
NORA Surveillance, Cont.

• Intermediate goals:

• Maximize the use of existing surveillance resources in AgFF in the 

short-term to describe: the nature, extent, and economic burden of 

occupational illnesses, injuries, and fatalities; occupational 

hazards; and worker populations at risk for adverse health 

outcomes. 

• Development over time of an effective national surveillance system 

for AgFF (in collaboration with other sectors)
NORA Surveillance, Cont.

• Action Steps

• Assemble a list of accessible datasets 

• Maintain, expand, existing surveillance systems

• Exploration of new approaches

• Maintain estimates of at-risk populations

• Explore feasibility of using hours at risk 

• Surveillance within the forestry industry

• Expand NIOSH Fishing Injury Database 
NORA Surveillance, Cont.

• Action Steps, cont.

• Hold a national meeting of surveillance experts 

• Use occupation and industry coding in databases

• Advocate for resource allocation 

• Use variables to identify vulnerable populations

• Improve comparability of data over time

• Increase level of detail in occupational illness, injury, and fatality 

surveillance data 
Implementing National Academies 

Recommendations, 2011

• Implement comprehensive surveillance system

• Conduct research on surveillance systems

• Convene panel of experts to develop new approaches

• Implement pilot surveillance systems

• Evaluate quality of pilot surveillance systems
What type of information should be 

collected, optimally:

• Populations

• Numbers of workers/individuals at risk

• Demographic characteristics

• Working hours, by tasks

• Injuries

• Counts and rates, by personal and farm categories

• Characteristics, cost, lost time

• Work-related illnesses, symptoms

• Material damage in incident

• Occupational exposures: dust, noise, pesticides, etc.

• Adoption of preventive measures: ROPS, PPE etc.
Important features

• Regular: 1, 2 or 5 year interval

• Standardized data collection instruments

• Covering key populations: operators, family members

• Industry (NAICS) and occupation (SOC) coding

• Comparable internationally (incl. Eurostat)

• Incident characteristics: 

• Time, Location, Task, Cause/Source, Type of incident

• Injury characteristics: 

• ICD10 outcome, Body part, Lost time, Cost (out of pocket, 

insurance), Severity index
Potential mechanisms

• Continue collaboration with NASS and BLS; mail surveys, 

phone surveys 

• Collaborate with NSC, surveys

• Collaborate with Farm Market iD; online surveys; 

notification by email and the media 

• Unifying State trauma system databases

• Press / media clipping services

• Case investigations (FACE)

• Epidemiological/statistical analyses of existing data 

sources; previous NIOSH surveys, CFOI, BLS data

• Clearinghouse for pulling together data from all sources 
Ultimate purpose – Prevention

• Population info –> who is at risk? 

• Injury info -> what should be prevented; where, when, 

why, and how?

• Injury + exposure info -> what are risk / protective factors 

for injury?

• Ongoing data collection - > are we making progress?

• Population + injury info -> magnitude of the problem –> 

what is the appropriate size of investment into prevention, 

nationally?
THANK YOU!

Questions?