# 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 • 

### D etails how injury actually happened • 

### Descriptive (vs. analytical) statistics • 

### D elay 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 . • 

### S urveillance 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?