prevention of agricultural injuries: an evaluation of an education-based intervention
DESCRIPTION
Prevention of Agricultural Injuries: An Evaluation of an Education-based Intervention. LM Hagel, W Pickett, P Pahwa, L Day, RJ Brison, B Marlenga, T Crowe, P Snodgrass, K Ulmer, JA Dosman. Objective. - PowerPoint PPT PresentationTRANSCRIPT
Prevention of Agricultural Injuries: Prevention of Agricultural Injuries: An Evaluation of an Education-An Evaluation of an Education-
based Interventionbased Intervention
LM Hagel, W Pickett, P Pahwa, L Day,
RJ Brison, B Marlenga, T Crowe,
P Snodgrass, K Ulmer, JA Dosman
ObjectiveObjective
• To evaluate the effectiveness of an agricultural health and safety program in reducing risks for injury.
InterventionAgricultural Health and Safety Network
Features of the program• community-based• co-directed by members of the population
at risk• well funded• sustained program over 19 years
FARM SAFETY ISSUE
No. of Times Issue Addressed
1988 to 2006(all network
years)
1999 to 2006(most recent
8 years)
N N
Tractor safety 22 16
Farm machinery safety 36 19
Non-machinery hazards 14 7
Burden of farm injury 16 11
Personal and farm protection 16 6
Special populations at risk 8 6
Total Interventions 112 65
MethodsMethods
Design: Cross-sectional surveyDesign: Cross-sectional survey
SettingSetting
Southern Saskatchewan Rural Municipalities
Saskatchewan, Canada
Sampling
Multi stage
• Rural Municipal (RM) level
• Farm level
• Individual level
Data Collection
Instrument
• standardized mail questionnaire
• key informant on each farm
• January to April, 2007
Data Collection
Impact and Outcome Measures
• safety practices, farm hazards – farm level
• injury history– individual level
Data Collection
Exposure Measure
• years of membership
• 3 levels of exposure– None– 1 to 7 years of membership– 8 or more years
Statistical Analyses
Descriptive – demographic and operational
characteristics
Analytic– regression analyses
• adjusted RR (95% CI) • account for clustering, binomial regression
Results
Participants
50 Rural Municipalities
2,392 Farms
AHSN > 8 yrsn = 664 farms
AHSN < 8 yrsn = 1034 farms
AHSN 0 yrsn = 688 farms
Years in AHSN Significance
Factor High Low None
(%) (%) (%)
Grain production 86 90 87 *
Brown soil zone 12 31 21 *
University educated 14 15 22 *
Vulnerable populations: children young workers >65 year olds
543937
473834
524137
*NSNS
Demographic Comparisons
Years in AHSN Adjusted RR
High Low None None vs. High
(%) (%) (%) RR (95% CI)
ROPS absent 16 12 16 0.95 (0.69 - 1.30)
Shields absent on combines 13 9 8 0.64 (0.41 - 1.01)
Shields absent on augers 20 16 15 0.83 (0.59 - 1.17)
Ladder cages absent 79 79 80 1.05 (0.98 - 1.13)
No water hazard barriers 50 43 47 1.13 (0.96 - 1.33)
Physical Safety Hazards
Years in AHSN Adjusted RR
Children younger than7 years of age
High Low None None vs. High
(%) (%) (%) RR (95% CI)
Present in worksite 38 37 43 1.01 (0.84 - 1.21)
Ride in cabbed tractor 13 13 12 0.86 (0.53 - 1.41)
Assigned small farm jobs 14 13 13 0.96 (0.61 – 1.50)
Present during farm work 28 29 30 0.99 (0.76 - 1.28)
Hazardous Practices Children
Years in AHSN Adjusted RR
Young workers13 to 18 years old
High Low None None vs. High
(%) (%) (%) RR (95% CI)
Operate tractor > 20hp 32 30 30 0.95 (0.68 - 1.32)
Operate tractor w/out ROPS 12 12 11 1.15 (0.53 – 2.49)
Operate equip > 20 yrs 16 20 20 1.14 (0.65 – 2.01)
Work at heights 8 7 8 0.70 (0.70 - 1.81)
Work with large animals 18 19 18 0.82 (0.48 – 1.43)
Hazardous PractisesYoung Workers
Years in AHSN Adjusted RR
Young workers13 to 18 years old
High Low None None vs. High
(%) (%) (%) RR (95% CI)
Wear protective equipment 33 34 29 0.91 (0.65 - 1.27)
Trained before equip use 60 64 67 1.09 (0.89 - 1.39)
Trained with large animals 50 47 56 1.07 (0.82 - 1.41)
Supervised operating equip 40 46 43 1.10 (0.81 - 1.51)
Supervised w large animals 42 47 48 1.04 (0.77 - 1.40)
Training and Supervision Young Workers
Years in AHSN Adjusted RR
High Low None None vs. High
(%) (%) (%) RR (95% CI)
Farm injuries 2006 9 9 7 0.99 (0.74 - 1.32)
By location of treatment
Hospital or emergency 3 3 2 1.00 (0.99 - 1. 01)
Non-hospital setting 6 6 5 1.00 (0.98 - 1.01)
Injuries
Limitations
• Non-compliance with intervention
• Not possible to evaluate safety consciousness among non-participants
• unable to control for effect of exposure to other interventions
Strengths
• large and longstanding intervention
• large study population:– 5 492 people, 2 386 farms
• robust evaluation:– “hard” outcome measures
Conclusion 1
• After 19 years, the educational interventions were not associated with observable differences in farm safety practices, physical farm hazards or farm-related injury outcomes
Conclusion 2There is a need for the agricultural sector to extend its injury prevention initiatives to the full public health model. Education alone is insufficient.
Education
Engineering Enforcement
Publication:Hagel LM, Pickett W, Pahwa P, Day L, Brison RJ, Marlenga BL, Crowe T,
Snodgrass P, Ulmer K and Dosman JA. Prevention of agricultural injuries: An evaluation of an educational intervention. Injury Prevention 2008; 14(5)