Research - Chemical and Biological Hazards, May 3, 1991

Gaps in Knowledge of Infectious Disease:
Particularly a lack of information about
infectious diseases in immunosuppressed
populations and effects on women of cer-
tain infectious diseases was noted as a
significant knowledge gap. Needlesticks,
associated with the incidental use of inject-
able antibiotics and veterinary biologicals,
have been noted as a problem.

Gases, Vapors, and Liquids

William Popendorf had the topic of gases,
vapors, and liquids. He approached it
from a rather generic standpoint. He
discussed a new paradigm for industrial
hygiene in agriculture. He argued that we
really have a special type of industrial
hygiene, and that is agricultural hygiene.

What is agricultural hygiene? The old
paradigm for industrial hygiene was recog-
nition, evaluation and control. But in
agriculture here we do not have the typical
industrial setting. We cannot do monitor-
ing on a daily basis. So we have to rely on
anticipating the problems that may be
occurring so that we can target the recog-
nition and evaluation. The key part of this
paradigm is anticipation.

The usual paradigm of control is source,
pathway, and person. Here we have to
concentrate on the source.

It is difficult, often impossible, to control
the pathway. It is impossible to ventilate a
strawberry field. It is difficult to put a
respirator and a rubber suit on somebody
who is working in 110°F heat in an or-
chard.

The third part of the paradigm is empha-
sizing practice standards rather than per-
formance standards in agriculture. Prac-
tice standards emphasize good practice,

Surgeon General's Conference on Agricultural Safety and Health - 1991

such as completely enclosed systems of
pesticide handling, whereas performance
standards, would stress methods such as
daily monitoring of pesticides.

The lack of industrial hygiene services, the
variation in the climates, the work practice,
seasonality, are all not typical of industrial
settings. Therefore, emphasizing practice
standards only makes sense.

Gaps in knowledge here include the prob-
lem of additive and multiple exposures.
We do have a situation in agriculture that
is, again, different from industry—always a
variety of different exposures in any one
given case.

There are additive and synergistic health
effects that are unknown. There is a need
for more agricultural hygienists. There are
precious few in this country that have the
particular training and understanding of
the agricultural processes and of the
socioeconomic and cultural differences
between the industry and agriculture ap-
proaches, which include cultural implica-
tions as well.

NEED FOR A COALITION

Finally, I would like to try to put together
the spirit I mentioned earlier and a para-
digm of what a national coalition for local
action might be. These thoughts came
through in our group in various ways.

If you can, envision in Figure 1 at the
center of the circle the farm family and
farmworker who are the target. They are
surrounded by a community, which in-
cludes a variety of different services and
groups: local extensions, farm groups, the
health care system, the public health de-
partments, media, and schools.

451
Elements of a National Agenda

@ Communication
© Community
e Surveilence

 

 

 

 

 

a NIOSH

 

 

 

 

 

Evaluati Foundations Health Other
valuation ¢ Care System “, Federal
SX Y Agencies
O $
Ss 8
& om
%
Farm Family
_ = aad
Farm Worker
eo i
Agribusiness S .@ / Medical / Health
% Rs Universities

Health Departments

Extension

Land Grant
Universities

Se

Figure 1. A National Coalition for Local Action.

Surrounding that, yet, are the national
resources that we have, including NIOSH,
other Federal agencies, medical and health
universities, land-grant universities, nation-
al extension service, agribusiness, and
foundations. There has to be com-
munication within that outer circle and
between that outer circle, to coordinate
the services that are available.

Also communication is needed directly to
that farm family and farmworker so that
we are working on the problems that are
of concern to them and are real for them
and of importance for them. We must also
utilize the community in which they live
and work to help them solve their own

452

problems.

That whole communication system has to
work. Included in that is the surveillance
and evaluation of the programs that are in
place to make sure, that whatever programs
that are in place are modified according to
the results of that surveillance and
evaluation system.

That is the paradigm that I think can result
in a true "National Coalition for Local
Action." Hopefully with the spirit of this
conference, we can be striving for that. I
think this conference has gone a long way
in helping to realize that end.O

Papers and Proceedings
Surgeon General’s Conference on Agricultural Safety and Health

FARMSAFE 2000 © A National Coalition for Local Action

Convened by the National institute for Occupational Safety and Health

April 30 ~ May 3, 1991, Des Moines, jowa

RESEARCH - MECHANICAL AND PHYSICAL HAZARDS

By Lorann Stallones, M.P.H., Ph.D.
Associate Professor, Department of Environmental Health
Colorado State University

 

and Physical Hazards.

 

Dr. Richard A. Lemen: Our next speaker will summarize the sessions on Research - Mechanical
To do that is Dr. Lorann Stallones, who received her bachelor’s degree
from the University of California in Santa Barbara, and her MPH and her Ph.D. from the University of
Texas, School of Public Health, in Houston. Dr. Stallones:

 

 

Well, that introduction does not give you a
very good idea about why I am up here
presenting physical and mechanical hazards
when ordinarily these are in the realm of
an engineer or an agriculture safety spe-
cialist. I would like to acknowledge those
people who made a contribution to my
being here. One of them is on the plat-
form with me, Dr. David Pratt; one of
them, I am sure, is in the audience, Dr.
John May. After I finished my Ph.D. in
Houston, I went up to Cooperstown, New
York, where I worked at the Mary
Imogene Bassett Hospital with the two of
them.

There are two things that you have to
know about David. One of the first things
that anybody ever told me about him was
that he could sell ice to Eskimos. I think
in this case, I was the Eskimo. The ice
was that we were in a farming community
and really needed to look at what the
problems were in that particular communi-
ty. As public health professionals, I think
that really is our obligation—one that we
have been remiss in fulfilling the
agricultural safety and health area.

The second thing you have to know about
David is that someone—the same person, of
course—told me that if you sat David down
in the middle of a desert he would start to
count sand. So, there he was in the center

Surgeon General's Conference on Agricultural Safety and Health - 1991

of an agricultural community, and he start-
ed counting. What we wanted to do, be-
cause David is a pulmonary physician, is
look at pulmonary disease among the far-
mers—of course a major problem.

So we put together a very detailed survey,
and we asked a lot of questions about
pulmonary disease. The last day before
this questionnaire went into print David
said, "I’ve heard that farmers have a lot of
injuries. Don’t you think, perhaps, we
should ask that question?" So we did.

When the questionnaires came back, about
10 percent of the farmers had had a work--
related injury in the past 12 months. We
thought that was extremely high and that
gave rise to ongoing surveillance where we
called this same group of farmers every
other month. Much of the data have been
reported in national meetings, and I think
it was an extremely important step in our
development.

From there I went to the University of
Kentucky where I met the other side of
this whole business. He was Larry Piercy,
who is an agricultural safety specialist who
has his master’s degree from the University
of Iowa, and who trained at the Institute of
Agricultural Medicine. He and a number
of other people work with the Kentucky
Farm and Home Safety Council.

453
Elements of a National Agenda

My advice to anyone who goes to Ken-
tucky is, if you do not want to become
involved, stay away from that group, be-
cause they get you involved. You will
automatically move through the ranks of
going to the meetings and suddenly one
day you will find yourself president of the
organization. The Kentucky Farm Bureau
is very active in that particular organiza-
tion.

But the person I really want to acknowl-
edge in all this is my uncle, who is a farm-
er in Idaho whose youngest son decided
that after spending quite a number of
years being a carpenter, he wanted to go
back and work on the farm. Really, the
reason we are here is to make sure that
those people who want to go back and
work on a farm will be able to work in a
safe and healthful environment.

MACHINERY AND VEHICLE HAZARDS

We have heard a lot about how important
injuries are among children and the elder-
ly, and I would like to introduce Tom
Bean’s (Ohio State University) general
duty clause. The general duty clause that
he proposed in our session was that old
tractors and old equipment are usually
used on the farm for general duty, and the
people who are responsible for that gener-
al duty are the old and the young.

So that gives rise to a situation where they
are at risk of injury because of the age of
the equipment that they are dealing with.
They also are the most vulnerable of the
population in terms of injury risk.

His major recommendations were that we
need to continue to aggressively evaluate
the safety standards that are developed by
. the American Society of Agricultural Engi-
neers.

454

 

The general duty clause that he proposed
in our session was that old tractors and
old equipment are usually used on the

farm for general duty, and the people who
are responsible for that general duty are
the old and the young.

 

One of the problems that has not been
looked at and that needs to be addressed
is to develop model standards for the tran-
sport of farm equipment and self-propelled
farm vehicles on the highways and public
roads. We may not pick up fatalities relat-
ed to road use of farm equipment, because
the person who dies may be the person

who is in the motor vehicle, not on the
tractor.

This is a very important area because, for
most equipment, there are no highway
standards for the transport of farm equip-
ment. In keeping with this, his proposal
was also to improve the lighting and the
marking of farm equipment. He also be-
lieved that it was very important to contin-
ue studies on educational techniques that
are successful.

MUSCULOSKELETAL HAZARDS

David Cochran is from the U.S. Occupa-
tional Safety and Health Administration,
and he addressed musculoskeletal hazards.
He focused primarily on cumulative trau-
ma disorders, about which we know very
little. If you look at the combined influ-
ences of stress and heat and the type of
work that is done on a farm, there are
some areas of research that are pressing.

His major proposal to reduce some of the

hazards was to consider packaging of ma-
terials to reduce back injuries. Materials

Papers and Proceedings
Research - Mechanical and Physical Hazards, May 3, 1991

can come to the farm in anywhere from
1-pound bags to 50-pound bags, which will
be lifted.

The point of view of the people who are
the moving materials around needs to be
considered in order to package them in a
safer manner. He also thought it was
important to identify hazards and create
solutions acceptable to the farmers,

ELECTRICAL HAZARDS

Robert McLymore from North Carolina
State University discussed electrical power.
There were three basic recommendations.

» One is that inspections of electrical wir-
ing are critical and need to be done on a
periodic basis.

>» The second is the need to adhere to the
National Electric Codes on the farms, and
that is frequently not done. Safety proce-
dures need to be established, particularly
when a farmer does the electrical wiring.
Inspections should be done upon comple-
tion of the work and must be done by a
trained electrician.

» Finally, of course, there is the issue of
overhead wires about which we have no
good solutions, but farm equipment fre-
quently does come in contact with over-
head wires on farms, and this is the agent
in many deaths.

NOISE

Matthew Marvel from Oneonta Health
Center discussed noise and Stress. His

primary focus was on noise.

He said that in those few studies that have
been done hearing loss is increased greatly
among farmers, that the loss of hearing

Surgeon General’s Conference on Agricultural Safety and Health - 1991

begins in the early ages, and that one of
the critical needs in this area is to improve
hearing protection in order to make the
equipment more acceptable for people

who need to wear it.

TECHNOLOGY TRANSFER

Murray Madsen from Deere Company
discussed technology transfer, and he fo-
cused on the need for improved sensors,
radar systems, systems to anticipate and
avoid overturns of tractors and systems to
alter collision courses. He believes that
there is a great need to incorporate human
factors into the engineering design commu-
nity, and he posed some rather interesting
questions, which I would like to read to
you.

> How does safety become a cultural value
that permeates all that each of us does?

> What are the skills needed to excel in
hazard recognition in the earliest stages of
design?

>» What is the measure of safety
improvement at the Stage when only con-
ceptual alternatives are being studied?

In order to have better technology transfer,
researchers need to participate in safety
research and intervention networks.

RESEARCH RESPONSIBILITY

John Crowley from the Farm and Industri-
al Equipment Manufacturers discussed
research and the responsibility of manufac-
turers for doing research and the public
sector responsibility for areas of research.
Many of the areas that he touched on were
also addressed by surveillance and by the
previous speaker, so I will skip over some
of those; but I would like to discuss a few

455
Elements of a National Agenda

of the things that have not been addressed
in great detail.

One of them was improving the handling
of agricultural chemicals, including closed
systems, improved worker protection, and
techniques that will minimize the loss of
chemicals so that we can reduce the total
amount of chemicals that are being used.
He also discussed the need for improved
air filtration systems—particularly in trac-
tors and in work environments where you
address not just dust levels but also chemi-
cal, gas, and vapor exposures.

 

Loggers are at even a higher risk of injury
death than farmers, but many of the risks

they encounter, farmers will encounter as
well because farmers do logging activities.

 

He discussed the need for devices to de-
tect hazardous materials, particularly gases
and vapors in enclosed, confined spaces.
We need to develop effective ways to gain
support and cooperation to fund projects.

FORESTRY

Penn Peters from the U.S. Forest Service
discussed the forestry perspective. Deaths
among loggers are about 30 times more
common than among other occupational
groups. Loggers are at even a higher risk
of injury death than farmers, but many of
the risks they encounter, farmers will en-
counter as well because farmers do logging
activities.

There is a marked lack of awareness of the
hazards of logging. Data systems need to
be developed to increase the understand-
ing of the circumstances in which the fatal-
ities and injuries occur.

456

REGULATION

Thomas Seymour from the Occupational
Safety and Health Administration (OSHA)
discussed the regulatory perspective and
made his three main points.

> One point was that existing standards
need to be fully evaluated.

> Second, we are in need of better injury
data.

> Third, data-gathering needs to be im-
proved so that we can further understand
the problems.

Farmers and ranchers must be involved in
the development of standards, because
OSHA has had problems in the ways that
they have attempted to address safety and
health on farms. National policy guidance
is needed in order to provide focus for
targeting proper areas of research and to
define the scope of research to be per-
formed within priority areas. There is a
need to address the role of behavior in
prevention of injuries and illnesses among
farmers.

Finally, some of the comments from the
audience that should be addressed were
the need for more coalitions, which do
more than raise funds for research but also
raise awareness, the need to identify the
interventions that work, and the need to
promulgate those interventions. Probably
most important was understanding more
about what incentives work so people do
the things that we know and we believe
are right.O

Papers and Proceedings
Surgeon General's Conference on Agricultural Safety and Health

FARMSAFE 2000 * A National Coalition for Local Action

Convened by the National Institute for Occupational Safety and Health

April 30 - May 3, 1991, Des Moines, lowa

INTERVENTION - AGRICULTURAL WORKERS’ PROTECTION
FROM HAZARDS

By David S. Pratt, M.D.
Director, New York Center for Agricultural Medicine and Health
Cooperstown, NY

 

 

Health Service for a period of time. Dr. Pratt:

Dr. Richard A. Lemen: Our next subject is to deal with Intervention - Agricultural Workers’
Protection from Hazards. You have heard a much better introduction of our next presenter by our
previous presenter. Dr. Pratt is a physician who trained with his undergraduate degree at the
University of New Hampshire, his medical degree from Tuft University, and was also in the U.S. Public

 

 

I would like to also take a moment not
only to thank Dr. Stallones, but also to
make special note of Jack Parker’s contri-
bution to our group. Jack was on the
phone with us on a continuing basis and
did a wonderful job getting our group
organized, and I appreciate his efforts very
much,

About the members of my group: it was
little bit like Dr. Stallones’ experience—

here I am a physician. You can see we

have lots of engineers here.

I would like just to make a note that we
were privileged to have an active farmer,
Gary Erisman, in our group. We were also
particularly happy to have Dr. Hogliind
join us, from Stockholm. You will see
some of his materials in just a moment.
Let us look to the future. He really
showed us what a bright and shining future
could look like for American agriculture.

We also had the special expertise of Dr.
Konz, who talked to us about application
of ergonomics—the notion of how people
interact with machines; and he gave some
special insights into how ergonomics might
help in the future of agriculture. You have
already heard about Vector control from
Kelley Donham today. We heard from

Surgeon General's Conference on Agricultural Safety and Health - 1991

Robert Pinger about some of the Vector
control problems. I will speak more about
some of the pest problems that affect
farmers and farmworkers. Then, finally,
Richard Fenske gave us a very nice discus-
sion approaching personal protective
equipment; I will share some of his slides
as well.

Then we had responders who brought us
back to Earth, told us what it was like in
the real world, and what goes on from the
perspective of a consulting engineer, Ray
Crammond, from the perspective of an
extension safety specialist with a wealth of
information, Rollin Schneider; and then
also from the perspective of an agricultural
engineer, L. Dale Baker, who is involved
every day in design and in product devel-
opment.

We entered the deliberations and discus-
sions by recognizing that the American
farmer and farm family face unique haz-
ards in this environment. In order to
make it safer for these people, we needed
to understand the special risks to which
they are exposed on an ongoing basis,
often recalling that farming and the home
environment are a single, contiguous, and
shared continuum.

457
Elements of a National Agenda

Thus, the children on the farm are at risk
for injuries from equipment, from animals,
and from chemicals on a frequent and
ongoing basis. The farm workforce is
older, as we have heard, and often includes
family members, part-time help, and mi-
grant workers, presenting a special and
unique variety of problems that need to be
dealt with.

The evolution of American agriculture as
it is today has led to decreasing profit
margins and increased levels of stress.
Demands on farmers today are very great,
indeed. As we have heard previously, they
are expected to be meteorologists, econo-
mists, agronomists, crop specialists, repair-
men, livestock breeders, and personnel
experts.

The special health risks and hazards pre-
sented by farm equipment, including the
ubiquitous tractor range from acute
traumatic injuries to chronic musculoskele-
tal disorders. Farmers and farmworkers
also face vector-borne diseases, as I men-
tioned earlier,

Dr. Donham pointed out that we are see-
ing cases of encephalitis in the northeast,
and in Wisconsin we are seeing an in-
creased amount of Lyme disease; also,
interestingly and preplexingly, malaria and
dengue fever. Agri-chemicals are also an
important issue here, and there are
other—in addition to agri-chemicals—toxic
exposures that can occur in this work envi-
ronment. Skin, the major organ systems,
and also the lung are at risk from toxins

and agri-chemicals.

Now, with that background, our group
decided to look at the Strategies from the
experts that I told you about. What Dr.
Parker and I did yesterday afternoon at the
conclusion of the deliberations is try to

458

distill from those Presentations the major
guiding principles that we gathered.

 

We also had it emphasized to us that, all
players, including the farmer and the
farmworker, need to be at the table when
we begin to redesign the Strategies for
intervention.

 

Those principles include the following:
There are major interventions available to
uS as a community of interested engineers,
Scientists, physicians, and farmers. These
would include three major options.

» One is the complete elimination of the
hazard.

> Two would be what we call Passive con-
trols; that is, the Operator would not neces-
sarily have to do anything to be protected.

> Three is active controls, where volitional
choices need to be made.

We also had it emphasized to us that, as
Dr. Stallones said, all players, including the
farmer and the farmworker, need to be at
the table when we begin to redesign the
strategies for intervention.

ELIMINATION OF HAZARDS

Many of the speakers emphasized that one
must apply the earliest possible interven-
tions to maximally reduce hazard expo-
sures. The elimination of hazards could
include machine redesign, job redesign,
and product substitution, or all three.

Now the benefits of redesign include the

fact that it would eliminate the problem at
the beginning. It is a permanent solution

Papers and Proceedings
Intervention - Agricultural Workers’ Protection from Hazards, May 3, 1991

to what was the problem, and it has—in the
nature of the design from the engineers—
planned for the potential misuse of that
equipment.

I would like to give an example of some
extremely innovative product design in the
agricultural realm: a Finnish tractor made
by the Valmet Company.

It has some unusual and unique features
that we were apprised of. First of all, the
controls in the cab, including the steering
apparatus, can rotate through 180°. A
farmer can face backwards with all his con-
trols facing the load that he is lifting.

This tractor also is articulated. The wheels
turn independently, and also it has an
automatic transmission. So the amount of
pressure that would have been needed to
depress a clutch is no longer an issue,
thereby eliminating some of the left knee
problems that had been identified by our
Swedish colleagues.

In addition, job redesign was discussed in
our group. A Swedish woman was shown
working in a dairy barn. She was carrying
numerous milking hoses.

It was calculated by the Swedish Farm-
workers Health and Safety Association that
she would have carried about 270 tons of
equipment during the milking year in a
60-cow barn. This caused a lot of shoulder
and neck problems.

The engineering job redesign group went
out to look at this, and they came up with
a solution: an overhead track on which
you can hang the milking apparatus and
Slide it from cow to cow. This reduced,
considerably, the workload and also
reduced the rate of injury and problems
with the shoulders in these workers.

Surgeon General's Conference on Agricultural Safety and Health - 1991

 

The IPM, as many of you know, often will
have a significant reduction in pesticide
application and frequently prompts the

choice of a less toxic compound in the
work environment.

 

We were also told that the use of integrat-
ed pest management (IPM) is a solution
that involves product substitution and ad-
ministrative control. The IPM, as many of
you know, often will have a significant
reduction in pesticide application and
frequently prompts the choice of a less
toxic compound in the work environment.
Please be mindful of the fact, as was em-
phasized in our group, that hazard elimina-
tion, at times, may need to be driven by
legislation or regulation, especially when
there are severe hazards and recognized
effective interventions are available.

PASSIVE CONTROLS

The next topic for discussion was passive
controls. Our presenters and responders
pointed out that in settings where com-
plete hazard elimination is not possible,
then passive controls may be applied.

Perhaps the best example of passive con-
trols is roll-over protective structures
(ROPS). Now, unfortunately, even if you
have a ROPS you should not be opening
the back window of an enclosed cab on a
tractor and certainly should never have a
child back there.

So, the passive systems are only as good as
the operator, and in this instance some of
the safety features of this cab have been
subverted by removing the rear window.
This breaks the sound reduction, as well as

459
Elements of a National Agenda

the internal environmental controls and,
indeed, puts a child at risk.

Other examples of Passive controls include
special kill-switches on chain Saws such
that when they buck or kick back they will
automatically be turned off.

Finally, another example of passive con-
trols includes what are called closed pesti-
cide loading and mixing systems. Those
Particular systems allow a completely
closed operation from the container into
the mixing vats, thereby never exposing the
worker,

ACTIVE CONTROLS

The next group of strategies was termed
active controls. Active controls are neces-
Sary when full hazard elimination or pas-
Sive controls are not Possible. Active con-
trols require that the worker Carry out a
protective behavior such as donning per-
sonal protective equipment, applying an
insect repellent, or reading and heeding
warning labels,

The ultimate in personal protective equip-
ment was shown. Astronauts were in-
volved in working outside a space shuttle,
which our colleagues at NASA call extra-
vehicular activity. This is a situation where
an active control system is absolutely man-
datory, since one could not even live in
that environment without that kind of gear
and garb.

You immediately recognize that that equi-
pment is wonderful, if you are going to be
in the cargo bay of a shuttle, but it would
be lousy to do your everyday activities,
whether at work or at home, in that kind
of a get-up. There are significant limita-
tions in personal Protective equipment, and
they were enumerated in OUr group as

460

follows: it is uncomfortable, it may im-
pose ventilatory stress, it certainly would
Teduce dexterity, and it may lead to heat
loading and heat stress on the workers.

is is especially true in people who work
in warm climates and need to be fully
covered.

Another point I should make about the
limitations: a pesticide worker was shown
wearing a non-woven garment that had a
materials failure. The armpit was torn out.
There was a gap in the underside of the
garment, so that would allow a pesticide to
escape onto the individual.

 

Finally, we heard that warnings, for all the
emphasis we put on them, frequently do
not work. They are temporary. They can
be wiped off, erased, or removed, They
have serious limitations. That is not to say
that our group completely rejected train-
ing, education, and knowledge. In fact,
one final thing that is shown here is an
attempt to inform, to make sure that the
agricultural population of Sweden is an
informed population, about tractors that
are designed with ergonomics in mind and
with safety in mind.

We saw what you might think of as Swed-
ish "Consumer Reports" of tractors that are
€rgonomically sound. The document was
developed by the Swedish Farmers Health

and Safety Association.

It was like a Michelin guide for restau-
rants. Four stars is excellent; three stars is
good; and so on and so forth, Such scor-
ing was resisted by the manufacturers in
Sweden but has been very popular among
the farmers and farmworkers,

Let me conclude by saying that our group

decided that intervention Strategies are
most effective when they are applied early

Papers and Proceedings
Intervention - Agricultural Workers’ Protection from Hazards, May 3, 1991

in the process. Passive controls are less
desirable but at times may be life-preserv-
ing and life-saving. Active controls are the
least desirable interventions because they
require forethought, modifications of be-
havior and, often, discomfort. Intervention
strategies should always incorporate the
knowledge of the users.

 

Intervention strategies are most effective
when they are applied early in the pro-

CesS.

Surgeon General's Conference on Agricultural Safety and Health - 1991

 

I am reminded of that little aphorism from
Japanese management that says, "The
worker has intimate knowledge of the
process." In this instance it is the farmer
and farmworker who have valuable, inti-
mate knowledge.

Finally, in conclusion, we agreed that seri-
ous attention should be paid to using all
the options to deal with what we all recog-
nize as a clear and present danger to the
American farmer and farmworker.O

461
Surgeon General's Conference on Agricultural Safety and Health
FARMSAFE 2000 « A National Coalition for Local Action

Convened by the National Institute for Occupational Safety and Heath

April 30 - May 3, 199 1, Des Moines, iowa

INTERVENTION - SAFE BEHAVIORS
AMONG ADULTS AND CHILDREN

By Walter J. Armbruster, Ph.D.
Associate Managing Director, Farm Foundation

 

 

Dr. Richard A. Lemen: Our next speaker will look at Intervention - Safe Behaviors Among Adults
and Children. To do this, we have Dr. Walter J. Armbruster, who received a bachelor’s degree and
a master’s degree in Agricultural Economics from Purdue University, and a doctorate in Agricultural
Economics from Oregon State University. Dr. Armbruster:

 

 

We know that surveillance and research
are, indeed, often Precursors to interven-
tion. Some of the discussion groups appar-
ently did more than work on the necessary
input to intervention, they even delivered
some of our group’s ideas for us. Be that
as it may, I hope we will not be too
repetitive.

The rapporteur for our discussion group,
Dr. David Hard, deserves a great deal of
credit for helping me put together an over-
view of what we discussed.

I was admonished by our group not to
generalize our discussion to the point that
we could have written the report before we
arrived. I see some of them in the audi-
ence monitoring my reporting.

I hope they recognize our discussion. In
some ways, Kelley Donham’s diagram of a
national coalition for local action could be
viewed as the game plan for our whole
discussion.

Achieving safe behaviors among adults and
children, which we hope to foster through
intervention, is an ongoing challenge. We
grappled with ideas on how to better inter-
vene to foster such behavior, so that it will
avoid unintentional injuries in the agricul-

tural occupations and create a safer and

462

healthier environment in which to live and
work.

Our recommendations consist of a combi-
nation of short- and long-term implications
or Suggested actions that are aimed at
immediate as well as future improvement
in agricultural safety and health. While
our discussion considered short- and long-
term differences, the ideas did not lead to
that framework very well.

We will introduce the ideas with the intent
that some are short-term and some longer
term in nature. We need to pay attention
to this as we think about how to imple-
ment these ideas and recommendations.

BEHAVIORAL CHANGE

There was rather widespread agreement in
our discussion group that our overall goal
is to achieve behavioral change that will
result in a safer, healthier living and work-
ing environment for those engaged in agri-
culture. We have a good deal of evidence,
e.g., from automobile seat belts, that pro-
viding education or information is not
sufficient, though we feel it is a necessary
precursor to achieve behavioral change.
What is necessary to change attitudes re-
garding health and Safety.

Papers and Proceedings
Intervention - Safe Behaviors Among Adults and Children, May 3, 1991

Mental health is an important aspect of
overall health and a necessary ingredient
of safe behavior. We had a bit of discus-
sion about that, although we did not focus
on it a great deal.

In trying to achieve behavioral change,
youth may provide a more readily adapt-
able audience than some of the older cli-
ents that we try to reach. Hence, a focus
on youth education and youth intervention
may be very effective in changing their
behaviors for their lifetime. We also be-
lieve that reaching adults through youth is
a very effective channel for modifying
adult behavior.

Similarly, we had some discussion about
the possibility of working with spouses to
help them understand the need for behav-
ioral change, to reach the farmer whose
behavior we are trying to change. We
discussed it generally in terms of the spou-
ses being the wives who would help the
husbands change his behavior.

But we all know that there are many wom-
en farmers, so I assume that it works the
other way also. We had a fair amount of
agreement that the husbands listen to the
wives; we did not have much discussion
about whether it works the other way. So
that is a hypothesis on my part. The point
is, indirect access for delivery of messages
as well as direct access, to our target audi-
ences, may be a very effective strategy for
achieving behavioral modification.

LOCAL EFFORTS

We discussed local and state coalitions for
working on agricultural health and safety
issues, educational resources, and access to
what is available in the various states. The
federal role in coalitions is to help coordi-
nate the state efforts, help avoid unneces-

Surgeon General's Conference on Agricultural Safety and Health - 1991

sary duplication, and provide funding for
the larger research base, intervention pro-
grams and mandated programs.

There was widespread recognition that
while local coalitions may be very effective
in delivery, they need a lot of help from
federal and state levels in achieving or
obtaining the resources with which to do
their work at the local level. We need to
think carefully about funding to make
coalitions functional.

At the local level, it was pointed out that
even a small amount of money is often
quite significant and creates the opportuni-
ty for leveraging into significant activities
that can have a realistic impact. I think
some of the discussion was in the context
that there is a lot of federal money and let
us get it down to the local level where it
will do some good.

As you think about it, the implication may
also be that at the local level you may be
able to raise the funds within the commu-
nity to put on some of the educational or
intervention activities that may be very
effective. Someone suggested that we
should not overlook the general businesses
in our community as a funding source.

Knowing that more than half of the farm-
ers in the U.S. receive more than half of
their income from off-farm sources, there
is a very direct stake in agricultural safety
and health for those employers who do not
necessarily have a direct connection with
agriculture. These employees who count
on having healthy employees who can be
on the job and are not using the insurance
benefits from that company’s program to
recover from injuries because of unsafe
practices or unhealthy conditions in their
farming operation.

463
Elements of a National Agenda

Another point we discussed was the need
to find ways to make it easy for individuals
to achieve change in behavior. One sug-
gestion was that when a farmer buys a
significant amount of chemicals, protective
clothing or protective gear needed to safely
handle the chemicals could be packaged as
part of the total product purchased.

You would not be given just a large can of
pesticides, but rather a large can of pesti-
cides with a safety suit attached directly to
it. Obviously, there are some cost con-
siderations that would need to be taken
into account.

A related point was made about making it
easy for farmers and agriculture workers to
purchase safety equipment in general. In
Some cases it is very difficult to locate a
local source. The individual may have to
find catalogs or go to significant effort to
locate the safety equipment needed.

So one of the opportunities or challenges
for local or state coalitions might be to
somehow assure that at least one source of
supply for necessary safety equipment is
available locally~a local cooperative or
some private outlet. Making sure that
those who need to purchase safety materi-
als can find them easily, should they listen
to our messages delivered through inter-
vention, ought to be emphasized.

RESEARCH

Then we turned our discussion to research.
There was a strong feeling that we need
better research on evaluating the effective-
ness of the various intervention programs
that are ongoing. I think somebody al-
ready made this point: if we are able to
measure changes in behavior and sort out
the links that they have to various inter-
ventions, then we can perhaps identify

464

which of those interventions are more
effective than others. We know that bud-
gets are tight. So that would imply with-
drawing funds from programs that are not
achieving, in order to obtain funding for
those that are successful or for new
programs.

The second issue regarding research that
we talked about was the need for more
basic research on the relationship between
behavioral change and intervention alter-
natives, whether it be education, regulation
or automatic protection from agents of
injury. We do not know the linkages very
well, so it makes it difficult to design new
programs or better programs.

There was some feeling that legislation
may be needed because education or other
forms of intervention are not very success-
ful, but there is also a feeling that legisla-
tion alone is unlikely to be effective. We
have a lot of evidence, again going back to
the seat belt example. Most or all states
have seat belt laws now, but that does not
mean that we have 100 percent of people
buckling up.

We need to motivate individuals and com-
munities, through education, to help modi-
fy behavior and accept or take advantage
of safety equipment and healthy choices.
We have a lot of anecdotal evidence, and I
think more than that, of individuals over-
riding built-in safety features. So we need
to use all of our approaches to achieve
safe behavior in the agricultural occupa-
tions.

COMMUNICATIONS

Finally, we had some discussion about the
important role of communications in achie-
ving behavioral change. We must pay
attention to communications and carefully

Papers and Proceedings
Intervention - Safe Behaviors Among Adults and Children, May 3, 1991

consider how to deliver intervention in a
manner that causes individuals to follow
through to implement the desired changes.

 

We also know that reaching adults
through youth is a very effective channel

for modifying adult behavior.

 

We must carefully consider the background
of targeted audiences, for example, age-ap-
propriate programs for youth and educa-
tion-level considerations, which dictate
delivery approaches. If you have a farm or
agricultural clientele or agricultural worke-
rs’ group who are not highly educated, you
may have to use cartoons, comic books,
and posters requiring minimal amounts of
reading.

Pictorial images way have to be used to get
your point across. People with a low level
of education are not going to read a
six-page handout with many details related
to safe behavior.

Similarly, if you are dealing with various
cultures—Hispanic comes to mind—culture
is quite important in how messages are
normally delivered or more favorably re-
ceived. Pictorial presentations and comic
book kinds of educational materials appar-
ently have a tradition of acceptance and
use in Spanish cultures.

A point was made that we need to be
careful that we draw on proper expertise—
whether we are trying to create age-
focused, education, or culturally appropri-
ate materials. A partial understanding by
somebody who is an expert in a particular
aspect of health or safety, but who knows
very little about child development stages,

Surgeon General's Conference on Agricultural Safety and Health - 1991

educational strategies, or cultural differ-
ences, or who is not a proficient translator,
may do more harm than good. That per-
son may garble the message or weaken the
impact of materials that could have much
more effect by getting the proper expertise
involved.

Another point regarding communications is
the use of a range of media, organizations,
and people to reach the target audience.
Direct as well as indirect approaches, as I
indicated earlier, repetitive messages, and
varying approaches are needed. Use all
the media, program opportunities, and the
organizational efforts to repeat messages
in various ways.

Finally, in communication, we need to be
careful that proper communication takes
place not only within coalitions at the
local, federal and state levels, but also up
and down the line.

We cannot have only top-down ap-
proaches. We know they will not work.
We cannot have only bottom-up approach-
es, because we know we will have difficulty
achieving access to good materials, etc.
We need to make sure that the communi-
cations between the coalitions at different
levels are fully utilized.

Finally, in closing, let me say that despite
the admonition of the participants in our
group, which was a large and actively in-
volved group of probably 75 or so, I may
have generalized too much in summarizing.
A written report will contain some of the
richness of discussion that I had to gener-
alize away from this morning.O

465
Surgeon General's Conference on Agricultural Safety and Health

FARMSAFE 2000 © A National Coalition for Local Action

Convened by the National Institute for Occupational Safety and Health

April 30 - May 3, 199 1, Des Moines, lowa

REPORT ON MIGRANT AND SEASONAL FARMWORKERS

By Valerie A. Wilk, M.S.
Health Specialist, Farmworker Justice Fund, Inc.

 

Seasonal Farmworkers.

 

Dr. Richard A. Lemen: The last speaker whom we have today will provide a Report on Migrant and
Valerie A. Wilk received a bachelor's degree from Knox College in Illinois,
and a master's degree in preventive medicine and environmental health from the University of lowa.
She is currently a health specialist with the Farmwor
to read a couple of things that her organization doe:
about this; but, as | see it, they try to make sense o
policy issues facing farmworkers, and they develop

ker Justice Fund in Washington, D.C.
Ss, and | am sure she is going to tell you more

ut of national and state-level occupational health
Strategies to address these issues. They attempt
Coalitions about these issues. Secondly, she also
directs the Farmworker Women’s Health Project, and she has just returned from a meeting on
migrant and seasonal farmworkers. She will tell us about that meeting, and tell you about some of

| just want

 

 

One of the advantages of Speaking abso-
lutely last on a panel is that a lot of the
previous speakers said some of the things
that I was planning to Say, So it makes my
job easier.

This is my first chance to attend this con-
ference, because for the last four days I
was in Buffalo, New York. During the
days of your conference, there was another
national agricultural conference—the 1991
National Conference on Migrant and Sea-
sonal Farmworkers. It brought together
over 1,300 migrant educators, farmworkers,
Migrant Head Start educators and direc-
tors, employment training workers, attor-
neys and health care workers—both clini-
cians as well as non-clinicians—people like
the physicians, nurses, and physician’s
assistants, as well as environmental special-
ists, health educators, and outreach work-
ers.

The theme of the conference was "United
for Progress." Over the four days, the
conference participants had a chance to
choose from over 160 workshops and ple-
nary sessions. The sessions were heard in

466

English, some in Spanish only, and some
were bilingual.

I am specifically focusing on the health
workshops of the conference. Then what
Id like to do is go over some of the recur-
ring themes and recommendations that
came out of that conference and leave you
with a couple of my observations from my
11 years of working with farmworker or-
ganizations.

THE NATIONAL CONFERENCE ON
MIGRANT AND SEASONAL
FARMWORKERS

I know that at least one of the previous
speakers on Monday spoke somewhat
about farmworkers, but I just want to tell
you, when we talk about migrant and sea-
sonal or non-migrant farmworkers, we are
talking about hired workers, In a 1990
demographic report, the Federal Office of
Migrant Health estimated that there are
four million farmworkers and their family
members in the United States.

Papers and Proceedings
Report on Migrant and Seasonal Farmworkers, May 3, 1991

They are predominantly people of color.
They are men and women; they are chil-
dren. They are Hispanic, African-
American, Haitian, West Indian, Southeast
Asian, or Native American. They pick the
fruits and vegetables; work in nurseries,
greenhouses, and mushroom sheds. They
hoe, weed, thin, and prune crops.

Almost one million farmworkers and their
families migrate. Migrant workers travel
throughout most of the United States.

The farmworker conference dealt with the
issue of child labor; it dealt with farm
injuries such as those related to falls from
ladders. We focused on issues of disability
and injuries from prolonged bending, stoo-
ping, heavy lifting, and carrying, and repet-
itive motion, including the musculoskeletal
effects on children and results seen in the
elderly.

One of the workshops dealt with workers’
compensation and the fact that in about
half of the states in the United States
farmworkers are not covered at all by
workers’ compensation. We also dealt
with the issue of pesticides, including farm-
worker poisonings from direct spray, from
drift, and from residues on the plants.

We talked about effective methods of
educating farmworkers and employers
about pesticide use and hazards. We also
talked about research projects being done,
and about farmworker health status in
general.

One of the points that came through, and
one of the other speakers on the panel
today has mentioned it, is that the work-
place and home are one and the same—
particularly in terms of migrant workers
where migrant labor camps are right in the
middle of fields. So when fields are

Surgeon General's Conference on Agricultural Safety and Health - 1991

sprayed, so is the home, so are the chil-
dren, even if they are not directly working
in the fields at that time.

We also dealt with the issue of farm ma-
chinery-related injuries, heat disorders, and
a major occupational hazard for hired
farmworkers, which is transportation-relat-
ed injuries. Farm labor contractors too
often transport workers in unsafe vans and
trucks. This unsafe transportation has
resulted in deaths and serious injuries of a
number of workers.

Most recently, in December 1990, in
Florida, four farmworkers were killed and
seven were seriously injured when a farm
labor contractor’s truck was broadsided by
a van, and the truck carrying the farm-
workers rolled over repeatedly. The
farmworkers had been riding in the back
of the truck on makeshift benches of
planks and cement blocks, which is a viola-
tion of the Migrant and Seasonal Agricul-
tural Worker Protection Act.

Farmworker advocates in the area had
reported this particular farm labor contrac-
tor for violations six months previously, but
nothing had been done. Because of this
inaction, four workers died and seven were
seriously injured.

We also discussed the issue of field sanita-
tion. In 1987 OSHA promulgated regula-
tions to require that drinking water, toilets
and hand washing facilities be provided by
employers for workers with 11 or more
workers on any given day in the fields.
The reality is that compliance is very low.
There have been a couple of studies in the
last year. In 1990, a study done with the
North Carolina School of Public Health
found that only 4 percent of farms were in
complete compliance with the Federal
Field Sanitation Standard. There was a

467
Elements of a National Agenda

study done in New Jersey in 1990 that
showed a figure of 16 percent compliance.

We discussed strategies to improve em-
ployer compliance and OSHA enforce-
ment. One of the issues that came out in
that workshop was the fact that the threat
of employer retaliation is so great. If you
have to rely on formal worker complaints,
there are very few workers who are willing
to risk their job if they know that OSHA
may not be out to inspect for a week or
two weeks or maybe 30 days. By that
time, the labor crew has already left that
farm and that work.

Another aspect of the field sanitation stan-
dard is drinking water. Common drinking
cups are a major problem, as is clean and

Sanitary drinking water at the worksite.

We also talked about children’s health and
Safety. Children drink and bath in contam-
inated water—water contaminated with pes-
ticides and fertilizers. We also talked
about injuries and about drownings in
tivers and irrigation ditches.

Another workshop that attracted a lot of
attention had to do with farmworker wom-
en and health. In March of this year, the
Farmworker Justice Fund sponsored the
First National Farmworker Women’s Con-
ference, It was the first event of our Far-
mworker Women’s Health Project.

We brought 63 farmworker women and
trainers to San Antonio for a three-day
conference, and all of the farmworker
women were women of color. They were
Hispanic, African-American, Haitian, and
Southeast Asian.

The meeting was held in three languages:

Spanish, English, and Haitian-Creole. We
will be publishing proceedings of that mee-

468

ting later this year. We brought two of the
farmworker women, who had been elected
by the group in San Antonio, to the Buffa-
lo Conference to present to that confer-
ence about the health priorities and rec-
ommendations that the women made in
San Antonio.

There are a number of health issues spe-
cific to women. For example, with regard
to field sanitation, urinary tract infections.
If there is no privacy or no clean facilities,
farmworker women will wait an entire day
before going to the bathroom. This js
Particularly troublesome for women during
their menstrual period and for pregnant
women.

With regard to farmworker women and
their exposure to Pesticides, there are
consequences of long-term exposure to the
reproductive system, such as infertility, as
well as the risk of miscarriages and birth
defects. In November of 1989, there was a
mass poisoning near Ruskin, Florida, and
there were about six pregnant women,
most of them in their first trimester, who
were among the workers who were poi-
soned.

Of those women, the medica] director of
the clinic who treated the workers knows
of two women—one who miscarried and
another who had a baby with birth defects
of the face and hand. There was another
case, which was unconfirmed, of a still-
birth.

Another issue facing farmworker women is
sexual harassment, rape, and even sexual
slavery in labor camps.

Housing is a major concern and occupied
various workshops at the conference—
substandard housing, overcrowded housing,
or no housing at all.

Papers and Proceedings
Report on Migrant and Seasonal Farmworkers, May 3, 1991

We have had reports of hundreds of work-
ers in Arizona living in the citrus groves,
sleeping under tarps with cardboard on the
ground. Also, in southern California there
are cases of workers who have been living
in holes in the ground in the canyons. I
just heard in Buffalo that in at least one
case, workers were being charged for rent
for the tree that they were sleeping under.

 

In a number of the workshops there were
very concrete examples of groups who had
worked in coalition, either within their

community or statewide, on particular
health and safety issues: workers’ compen-
sation or field sanitation.

 

What I have not shown you in these slides
are other occupational hazards that farm-
workers face: tuberculosis, involuntary
servitude, and employer retaliation. I have
heard through my office of a number of
situations where farmworkers have gotten
fired simply for asking a question about
the safety of farm equipment or about the
location of field sanitation facilities, or for
refusing to return to a recently sprayed
field, or for taking action and getting out
of a field while it was being sprayed.
There are no anti-retaliation protections
under the Federal Pesticide Law, and
OSHA’s anti-retaliation protections are so
time-consuming that with the seasonality of
farmwork, they offer little protection for
farmworkers.

THEMES AND RECOMMENDATIONS

What are some of the recurring themes
from the Buffalo conference? First of all,
there was the recognition of the impor-
tance of service providers, particularly
health care providers, being advocates for

Surgeon General's Conference on Agricultural Safety and Health - 1991

farmworkers; and that advocacy to correct
occupational and environmental health
problems was, indeed, preventive medicine
and extremely important. I have been
gratified to see over the years that this has
been a growing sentiment among migrant
health and migrant service providers.

There was a commitment to continued and
better coordination and communication
among programs to most effectively use
the resources available. Related to that
was the importance of coalition building
within one’s community and beyond on
farmworker health and safety issues. In a
number of the workshops there were very
concrete examples of groups who had
worked in coalition, either within their
community or statewide, on particular
health and safety issues: workers’ compen-
sation or field sanitation, for example.

Another theme was the importance of the
need for and the barriers to getting work-
place information, most strikingly the right
to know which pesticides are used and
when they are applied in the fields. An-
other theme was the importance of the use
of popular education methods to teach
farmworkers, that is, getting farmworkers
involved in a egalitarian way in training by
doing skits and interacting with volunteers
from the audience so you are not just
doing straight lecturing about health and
safety and pesticide safety.

The other thing, which I mentioned earlier,
is the extent of farmworker intimidation by
employers, and the lack of protection for
workers who demand and who question
and who actively try to make the work-
place safer.

Finally, I would like to leave you with two

observations. First of all, a National Co-
alition for Local Action, FarmSafe 2000,

469
Elements of a National Agenda

must include migrant and seasonal farm-
workers as equal partners.

Not only must farmworker family occupa-
tional safety and health issues be consid-
ered as seriously and as fully as farm fami-
ly health and safety issues—because so
many of these issues are similar and be-
cause farmworkers are important workers
within the agriculture industry—but also
farmworker leaders, community leaders,
and union leaders need to be involved in
the coalition as equal and active partners.
Farmworker advocacy organizations such
as the Farmworker Justice Fund can help
identify those farmworker leaders to par-
ticipate in this process.

Also, when we are talking about coalition
building, what struck me earlier with the
four components of a coalition, quite fran-
kly, was that two of those partners in a
coalition have been some of the biggest

470

barriers to farmworkers getting a safe and
a health workplace. Both industry and
government have opposed and have sub-
verted some of the attempts to protect
farmworkers, through legislation and regu-
lation.

A safe workplace makes economic sense,
and society picks up the tab when we have
unsafe workplaces. Action is needed, but
actions as have happened in the past can-
not continue. We need to look at different
ways of working together. We need to
convince industry and government that
changes need to be made, and we need to
support farmworkers in their efforts.

Some of the most cutting edge protection
for farmworkers have happened under
union contracts. We need to look at all
the different models to make sure that
farmworkers are equally protected.U

Papers and Proceedings
Surgeon General’s Conference on Agricuttural Safety and Health
FARMSAFE 2000 « A National Coalition for Local Action

Convened by the National Institute for Occupational Safety and Health
April 30 - May 3, 1991, Des Moines, lowa

OUTSTANDING FFA POSTER

By Rice C. Leach, M.D.
Chief of Staff, Office of the Surgeon General

 

Dr. Richard A. Lemen: Our next session is going to be chaired by Dr. Rice Leach, who Surgeon
General Antonia C. Novello appointed as her Chief of Staff in April 1990. As Chief of Staff, Dr. Leach
is responsible for coordinating the activities of the Office of the Surgeon General (OSG). Dr. Leach
came to the OSG from the Health Resources and Services Administration, Bureau of Health Care
Delivery and Assistance, where he was the Chief of the Public Health Service (PHS) Recruitment
Program. He began his PHS career in 1966 as a rotating intern at the PHS Hospital in New Orleans.
He has served the Indian Health Service (IHS) in numerous clinical and management assignments
including director of an IHS area, manager of the IHS AIDS program and associate director of the
IHS Office of Research Development. Dr. Leach has also served in the Bureau of Medical Services.
Dr. Leach was born in Lexington, Kentucky and received a B.A. from Amherst College, M.D. from the
University of Kentucky, and a Master of Science in Health Services Administration from the Harvard
University School of Public Health. He completed his preventive medicine residency at the University
of Arizona and an internal medicine residency at Tulane. Dr. Leach has served on the Federal
constituency section of the American Hospital Association, the South Dakota Statewide Health
Coordinating Council, the Board of the Arizona Hospital Association, and the education committee of
the Arizona Medical Association. Dr. Leach:

 

 

Dr. Novello would like to be with us today grounded in Denver and will be here later
but, as she said earlier, she has other obli- this afternoon.
gations. There is another physician who

would love to be here today, too, At this point in the program, we are going
Dr. J. Donald Millar. He has been de- to the first place award for the best FFA
tained by some occupational health stan- poster presentation. One of the judges
dards that say something to the effect that | who was recently president of an FFA
"There will be no planes leaving San association made the following statement
Francisco with broken radar." He is about the posters:

They were all outstanding. I spent a lot of time talking with the members, and it is obvious
that they take a great deal of pride in their programs. To tell the truth, judging is not nearly
as easy a task as I had thought. My compliments to NIOSH and the Surgeon General’s
Conference staff. Thanks for letting me be part of it all. It was exciting to see so many peo-
ple so fired up about safety.

Those are the comments of Sheryl Janko, The group judged to have the best poster

the immediate past president of the Iowa is the Amanda Clear Creek FFA Chapter

FFA Association. from Amanda, Ohio. Representing that
group are Mr. Gary Brumfield, the Safety
Program Chair, and Mr. Charles E. Miller,
the advisor.

Surgeon General’s Conference on Agricultural Safety and Health - 1991 471

 
Surgeon General's Conference on Agricultural Safety and Health

FARMSAFE 2000 ¢ A National Coalition for Local Action

Convened by the National Institute for Occupational Safety and Health

April 30 - May 3, 199 1, Des Moines, lowa

OSHA INITIATIVES IN
AGRICULTURAL SAFETY AND HEALTH

By Cynthia Douglass
Deputy Assistant Secretary of Labor
U.S. Occupational Safety and Health Administration

 

 

Dr. Rice C. Leach: Our first speaker is Cynthia Douglass, Deputy Assistant Secretary of Labor,
Occupational Safety and Health Administration in the United States Department of Labor. Ms.
Douglass was appointed Deputy Assistant Secretary of Labor in December 1989. She is responsible
to the Assistant Secretary for the external activities of the agency. She works with other Federal and
State agencies such as the Congress, the Environmental Protection Agency, labor unions, business,
and others to enhance worker safety and health. Prior to her time with the Labor Department, she

’

worked on a wide variety of issues including automobile safety, motor carrier Safety, economic
deregulation, and insurance. We have a very qualified spokesperson.

 

| give you Ms. Douglass:

 

Thank you very much. I am delighted to
be here. I am also delighted to be a par-
ticipant in the first Surgeon General’s
Conference on Agricultural Safety and
Health and want to thank Surgeon Gen-
eral Novello and Dr. Millar for inviting the
Occupational Safety and Health Adminis-
tration (OSHA) to Participate and speak at
this important meeting. I assure you that
OSHA wholeheartedly supports the Sur-
geon General’s attempts to prevent injury
and disease in the agricultural workplace.

My boss, the Assistant Secretary of Labor
for OSHA, Jerry Scannell, wanted very
much to be here to convey to you his con-
cerns about farmworker safety and health.
Unfortunately, as I am sure you all know,
there was a catastrophic explosion at a
fertilizer plant in Sterlington, Louisiana,
two days ago. Eight people were killed in
that explosion, and over 100 people were
injured.

472

Mr. Scannell flew there yesterday and
could not get a plane out in time to be
here this morning. Jerry believes that it is
important to personally let the community
and the workers know of OSHA’s commit-
ment to the workers of that facility. He
also believes that it keeps his heart and
soul focused on the primary goal of
OSHA, which is to assure every man and
woman a safe and healthful workplace.

He asked me to come here and talk with
you about OSHA’s program, and I am
delighted to be back in the Midwest. I am
from Kansas and went from there to
Washington, D.C. in 1976. I would note
that I was there in time for the huge farm-
€r protest in Washington, which was in
1977, and I believe again in 1978.

I still have a bumper sticker that was given
to me by some Kansas wheat farmers that
says: "If you don’t like wheat farmers, don’t
talk with your mouth full." Those are my
sentiments exactly.

Papers and Proceedings
OSHA Initiatives in Agricultural Safety and Health, May 3, 1991

As I said earlier, agricultural safety and
health has been one of Assistant Secretary
Scannell’s major concerns since becoming
Assistant Secretary of Labor for Occupa-
tional Safety and Health. I know he will
be pleased that this conference has been
so successful.

We are all appreciative that the Congress
appropriated the funds for this conference
and believe that the conference will help
further the education and relationships
necessary to reduce the shameful accident-
tate of farming. OSHA, in particular,
wants to develop a good relationship with
your community, because together we can
make a difference.

The breadth and depth of the subjects that
have been covered during the four days of
this conference is impressive. So is the
fact that there has been participation from
members of farm organizations, migrant
worker representatives, academic institu-
tions, safety and health professionals, the
states, and the government agencies, all of
which play an important role in this vital
area of agricultural safety and health. This
is truly the kind of national coalition and
partnership that can make a difference.

OSHA’s interest in working with you to
reduce the occupational deaths and inju-
ries in American agriculture is evidenced
by the fact that we have 17 staff people
attending this conference. In addition, a
number of the representatives of states,
which operate their own OSHA-approved
occupational safety and health programs
and OSHA-supported state consultation
programs, are attending. OSHA is com-
Mitted to efforts to improve safety and
health in agriculture.

Surgeon General’s Conference on Agricultural Safety and Health - 1991

THE OCCUPATIONAL SAFETY AND
HEALTH ADMINISTRATION

I want to tell you a little bit about OSHA
and how it operates. OSHA has jurisdic-
tion over occupational safety and health in
more than six million workplaces in
America, employing about 90 million
workers. We operate ona relatively small
budget for that, about $285 million, with
an authorized staff of a little over 2400
people, of whom approximately 1300 are
inspectors.

Our mission is to ensure safe and healthful
working conditions for working men and
women through a variety of means, includ-
ing regulations dealing with occupational
safety and health, education, training, and
technical assistance. Of course, we have
an enforcement program.

In carrying out this mission, we rely heavily
on a partnership that includes labor and
management, the states, the Federal gov-
ernment—NIOSH, for example—safety and
health professionals, and academia.

Our enforcement jurisdiction in agriculture
is limited by law to those farms that em-
ploy 11 or more workers. This means that
we do not enforce OSHA regulations on
the great majority of farms; 86 percent of
American farms are smaller, part-time
operations. We do have enforcement
authority in migrant labor camps.

We are all aware that agriculture is one of
the most hazardous of American indus-
tries, with 1,300 deaths and 120,000 dis-
abling injuries in 1989, according to Na-
tional Safety Council figures. Many of
those injuries involve children.

473
Actions for the Future

Therefore, OSHA has a big responsibility,
working within the limitations placed on it
by the appropriations language, to seek to
reduce these injuries and fatalities in the
farming industry. OSHA has the authority
to work with small farms. The only prohi-
bition is on enforcement.

For years that appropriation rider was
interpreted by OSHA to mean, just stay
out of the farm and stay away from the
farm community. We do not want
OSHA—we do not even want the word
spoken in the farm community.

But that is not what the statutory language
says. OSHA can give technical assistance
to farmers. We can work with your com-
munities.

 

The answer lies in education, training,
and increasing awareness of those haz-

ards and how they can be reduced.

 

We can help develop materials and train-
ing and educational seminars to aid in
increasing awareness and knowledge about
safety and health problems in agriculture
and the actions that may be taken to mini-
mize these problems. In that connection,
for example, we might seek the aid of
university-based agricultural safety and
health centers and other government agen-
cies, such as the extension service, to pro-
vide necessary expertise and guidance in
training staff members for outreach and
consultation activities.

We can also provide OSHA-supported

consultation services to small agricultural
employers. The consultation program is a

474

voluntary one and helps develop mutual
trust between farmers and OSHA. I might
point out that the representatives of
OSHA-supported consultation programs
recently met in Tucson, Arizona. One of
the principal items on their agenda was
consultation services in agriculture.

OSHA also reviews existing standards that
apply to agriculture, such as the roll-over
protective structures (ROPS) standard.

We look at whether these standards should
be modified to reflect changing conditions
in the United States, in the world, and in
the industry. We need your help, though,
on reviewing and modifying these stan-
dards, if we are to have good,
common-sense safety standards.

All too often OSHA is only regarded as an
enforcement agency. Enforcement is not
the principal answer to reducing hazards in
America’s agricultural worksites. The
answer lies in education, training, and
increasing awareness of those hazards and
how they can be reduced.

My boss, Jerry Scannell, has committed
OSHA to developing a positive commu-
nication goal. He wants to work with
others such as NIOSH and your organi-
zations and believes that if we do that, we
can have a significant impact on agricultur-
al safety and health.

During the 1970’s, OSHA had an advisory
committee on agricultural safety and
health. Jerry is considering the re-estab-
lishment of this committee.

We have been working to re-establish a

number of relationships with government
and private organizations, and we hope to

Papers and Proceedings
OSHA Initiatives in Agricultural Safety and Health, May 3, 1991

continue this. The message is that OSHA
wants to work with all of you to further
agricultural safety, education, and aware-
ness.

Farmers, themselves, recognize that they
work in a hazardous occupation. The
National Coalition for Agricultural Safety
and Health (NCASH) conducted a survey
of New York and Iowa farmers. More
than 70 percent of those farmers who were
surveyed said that their occupation was
more hazardous than other occupations.

In connection with that, I am gratified to
see that one of the concurrent sessions at
this conference dealt with behavioral
changes among both adults and children
working on the farms. Strategies must
incorporate new and innovative approaches
to behavior modification.

AGRICULTURAL SAFETY AND HEALTH

Let me tell you something about what
OSHA has been doing in agricultural safe-
ty and health. This is all relatively new, by
the way, just in the last 2 years. We have
been holding numerous meetings since
January of 1990, developing OSHA’s plans
and initiatives to carry out a program of
enhanced awareness of work-related haz-
ards in agriculture and how to cope with
them.

OSHA is working closely with NIOSH staff
from Dr. Millar’s office, meeting with our

OSHA executive staff to explain activities .

and to share ideas. We are doing this on a
regular basis. .

During a series of conferences on the
permissible exposure limits (PEL) for air

Surgeon General's Conference on Agricultural Safety and Health ~ 1991

contaminants in agriculture, a regulatory
initiative, NIOSH joined with OSHA to
explain our respective agencies’ work to
the attendees. This summer we will ask an
occupational health nurse intern serving on
our staff to further update OSHA staff on
the latest research findings of NIOSH in
agriculture and to determine how OSHA
can best utilize this NIOSH material to
maximize its own efforts.

OSHA also has held meetings and discus-
sions with the Rural Safety and Health
Committee of the American Farm Bureau;
USDA officials; the Office of Rural Health
Policy; Agricultural Division of the Nation-
al Safety Council; and the Farm Safety for
"Just Kids" organization. These are a few
of the organizations we have met and with
whom we have been working.

One of our most successful efforts was
production of various news feature mate-
rial and radio and television spot an-
nouncements for distribution to 3,500 rural
media during the National Farm Safety
Week of the National Safety Council in
September. These public service an-
nouncements were designed to call atten-
tion to the need for improved safety and
health measures on the farm. The fact
that OSHA is now taking an active role in
this area was also communicated.

The radio announcements alone were
carried by 249 stations, reaching an esti-
mated 4.5 million homes with over 14
million listeners. We hope to do this again
this year.

We have developed a fact sheet on farm

safety that points out that most of the
deaths and injuries on the farm are pre-

475