Evaluation of an intervention to reduce musculoskeletal hazards among fresh market vegetable growers

A framework for using data and collaboration to drive prevention through engineering design: Reducing injury and severity in greenhouse and nursery workers

INTRODUCTION

A framework of collaboration between safety professionals and design engineers was proposed that provided direction for utilizing analysis of quantitative and qualitative data to prevent worker injury. This interdisciplinary, context-steeped approach can be utilized across a variety of industries to promote risk reduction by designing equipment and processes to prevent common workplace injuries in the first place. Safety professional expertise in regional worker's compensation claims analysis (including statistical analysis on a quantitative basis and qualitative analysis of trends in written injury descriptions of circumstance) provided the starting point for identifying industries of interest for this approach.

METHOD

Followed by education of design engineers on safety approaches (including hazard identification, the ANSI/ASSP Z590.3 consensus-based standard), tools such as risk assessment matrices and methods for effective on-site work observation and interviews with workers affords transfer of knowledge. Design engineers then utilize safety influenced design problem identification and goal criteria to create and select concepts for eventual detail design and prototype testing on-site. This approach was implemented in a case-study at a Midwest greenhouse industry facility site in summer of 2019. Two problem areas were identified and addressed with two unique engineering designs that were prototyped and utilized at the facility with success.

PRACTICAL APPLICATION

This approach can apply to other industries and collaborative teams in the future to prevent worker injury by design.

Participatory Ergonomic Interventions for Improving Agricultural Work Environment: A Case Study in a Farming Organization of Korea

Farmers are often exposed to risk factors for musculoskeletal disorders through lifting, carrying heavy loads, and sustained or repeated full-body bending. Several relevant studies on ergonomic interventions have been conducted for specific agricultural tasks, such as harvesting and pruning, by experts without involving farmers. This study introduces ergonomic interventions to mitigate risk factors in a farming organization that cultivates peaches as the main crop based on ergonomic analysis of the entire peach farming cycle; subjective and objective evaluations of the proposed interventions are also performed. The ergonomic analysis and interventions were established based on consultations provided by an ergonomist, the government, and the organization members. Engineering controls were introduced for powered carts, sorters, and stools to reduce load carrying and awkward postures; moreover, thermal or cooling vests, winter shoes and gloves, and farmer hats were provided to alleviate cold or heat stresses. Administrative controls such as education/training and adjusting work–rest cycles were also recommended after considering the characteristics of the risk factors identified. The scores of the questionnaire survey from the organization members were high (>4.1 out of 5 for five questions), and postural loads for unstable postures by RULA were significantly reduced so as to avoid fast or immediate changes for the postures or working methods assessed. The study results are expected to help promote farmers’ health and enhance farming efficiency.

Approach for Assessing the Prevalence of Psychosocial Risks of Workers in the Greenhouse Construction Industry in South-Eastern Spain

This paper shows the prevalence of psychosocial risks for workers in the greenhouse construction industry in south-eastern Spain. Method: The assessment of the workers' psychosocial risks was carried out through simple random sampling, which uses a questionnaire containing 13 variables characterizing the companies, 14 variables characterizing the workers, and 15 questions proposed by the Mini Psychosocial Factors (MPFs) risk assessment method. A descriptive analysis and multiple correspondence analysis were performed on the sample data. Results: Greenhouse construction businesses in south-eastern Spain can generally be classified as small companies with an average annual turnover below EUR 2.0 million (69.3%), an average of 22.8 workers with an average age of 39.84 years old, most of whom are married, with an average of 1.76 children. The prevalence of workers at high risk was 2.9%, while 45.1% were at medium-high risk. Of the 12 psychosocial factors assessed using the MPF method, 7 of them presented a high level of worker risk: Mobbing (3.2%), Relationships (1.6%), Recognition (1.6%), Autonomy (12.9%), Emotional (8.0%), Control (4.8%), and Demands (3.2%). Lastly, the variables were grouped into four clusters, showing that larger companies are correlated with a medium (workers over 40 years of age or less than 25 years of age) to high (workers under 25 years of age) risk level in several of the psychosocial factors assessed for workers who are Spanish nationals, while in smaller companies, the workers are usually middle aged (between 25 and 40 years old) and from Eastern Europe or Africa, presenting either a low or high level of risk depending on the psychosocial factors and tasks performed. Impact of the results: The study reveals a lack of prevention management regarding psychosocial risks. Therefore, it is necessary to carry out new prevention programmes that optimise the psychosocial conditions of the workers, involving the workers, employers, and other social agents.

Remembering Ben-Tzion Karsh's scholarship, impact, and legacy

Dr. Ben-Tzion (Bentzi) Karsh was a mentor, collaborator, colleague, and friend who profoundly impacted the fields of human factors and ergonomics (HFE), medical informatics, patient safety, and primary care, among others. In this paper we honor his contributions by reflecting on his scholarship, impact, and legacy in three ways: first, through an updated simplified bibliometric analysis in 2020, highlighting the breadth of his scholarly impact from the perspective of the number and types of communities and collaborators with which and whom he engaged; second, through targeted reflections on the history and impact of Dr. Karsh's most cited works, commenting on the particular ways they impacted our academic community; and lastly, through quotes from collaborators and mentees, illustrating Dr. Karsh's long-lasting impact on his contemporaries and students.

Where Do Agricultural Producers Get Safety and Health Information?

There is little empirical guidance regarding communication sources and channels used and trusted by agricultural producers. The goal of this study was to characterize frequency of use and levels of trust in agricultural safety and health information sources and channels accessed by agricultural producers. A sample of 195 agricultural producers was surveyed at county fairs in Iowa. Information was collected about the frequency of use and level of trust in 14 information sources and channels. Associations between age, gender, and education level and use and trust of each information source or channel were estimated using logistic regression. The sample consisted of 72% men with a mean age of 50.1 (SD = 15.6) years. Newspaper and magazine articles were the most commonly used agricultural safety and health information source or channel; 77% (n = 140) of respondents reporting using them at least monthly. Among those reporting monthly or more frequent use, 75% reported trusting mostly or completely, compared with 58% using and 49% trusting the Internet. High levels of use and trust of newspaper and magazine articles did not vary significantly by age, gender, or education level. Age in the highest tertile (57-83 years) was marginally associated with lower odds of using, as well as using and trusting, all the information sources and channels studied except for medical clinics (use only: odds ratio [OR], 3.51, 95% confidence interval [CI], 0.79-15.64; use and trust: OR, 5.90, 95% CI, 0.91-38.42). These findings suggest that traditional media may be more effective than digital media for delivering agricultural safety and health information to agricultural producers. Medical clinics may be an untapped venue for communicating with older agricultural producers.

Social marketing campaign promoting the use of respiratory protection devices among farmers

This article describes the formal use of marketing concepts in a systematic approach to influence farmers to voluntarily increase respiratory protective device (RPD) use. The planning process for the project incorporated six key decision or action points, each informed by formative research or health behavior theory. The planning process included developing behavior change strategies based on a 4P model (product, price, place, and promotion). The resulting campaign elements included print and e-mail messages that leveraged motivators related to family and health in order to increase farmers' knowledge about the risks of exposure to dusty environments, four instructional videos related to the primary barriers identified in using RPDs, and a brightly colored storage bag to address barriers to using RPDs related to mask storage. Campaign implementation included a series of e-mails using a bulk e-mail subscription service, use of social media in the form of posting instructional videos on a YouTube channel, and in-person interactions with members of the target audience at farm shows throughout the Central States Center for Agricultural Safety and Health seven-state region. Evaluation of the e-mail campaigns indicated increased knowledge about RPD use and intent to use RPDs in dusty conditions. YouTube analytic data indicated continuing exposure of the instructional videos beyond the life of the campaign. The project demonstrates the efficacy of a planning process that incorporates formative research and clear decision points throughout. This process could be used to plan health behavior change interventions to address other agriculture-related health and safety issues.

An outcome evaluation of a New Zealand farm safety intervention: a historical cohort study

BACKGROUND

There is limited evidence that farm safety-related interventions based solely on an educational element have an effect on injury rates. Our aim was to evaluate a New Zealand national educational program, FarmSafe™ Awareness, for its effect on injury rates.

METHODS

We used a before-after design followed by a historical cohort study of sheep, beef, and dairy farmers/workers. The outcomes were work-related injuries, identified from workers compensation data. Cox regressions were used to compare intervention with matched control group rates.

RESULTS

FarmSafe™ Awareness was associated with significantly higher rates of work-related injury, than matched controls.

CONCLUSIONS

It is difficult to see how FarmSafe™ Awareness could be causing an increased rate of work-related injury. We detected no reporting bias, and selection bias is likely to act in the opposite direction to the observed results. We conclude that there is no evidence that FarmSafe™ Awareness prevents farm injury.

Safety and health hazard observations in Hmong farming operations

Agricultural workers have a high risk of occupational injuries, illnesses, and fatalities. However, there are very few standardized tools available to assess safety and health in agricultural operations. Additionally, there are a number of groups of agricultural workers, including Hmong refugees and immigrants, for which virtually no information on safety and health conditions is available. This study developed an observation-based methodology for systematically evaluating occupational health and safety hazards in agriculture, and pilot-tested this on several small-scale Hmong farming operations. Each observation assessed of range of safety and health hazards (e.g., musculoskeletal hazards, dust and pollen, noise, and mechanical hazards), as well as on factors such as type of work area, presence of personal protective equipment, and weather conditions. Thirty-six observations were collected on nine farms. The most common hazards observed were bending at the back and lifting <50 pounds. Use of sharp tools without adequate guarding mechanisms, awkward postures, repetitive hand motions, and lifting >50 pounds were also common. The farming activities observed involved almost no power equipment, and no pesticide or chemical handling was observed. The use of personal protective equipment was uncommon. The results of this assessment agreed well with a parallel study of perceived safety and health hazards among Hmong agricultural workers. This study suggests that small-scale Hmong farming operations involve a variety of hazards, and that occupational health interventions may be warranted in this community. The study also demonstrates the utility of standardized assessment tools and mixed-method approaches to hazard evaluation.

Ergonomics issues in national identity card for homeland security

Ever since the 9/11 terrorist attack, many countries are considering the use of smart national identity card (SNIC) which has the ability to identify terrorists due to its biometric verification function. However, there are many ergonomics issues in the use of SNIC, e.g. card credibility. This research presents a case study survey of Malaysian users. Although most citizens (>96%) own MyKad (Malaysia SNIC), many do not carry it around and use its applications. This defeats one of its main purposes, i.e. combating terrorism. Thus, the research investigates ergonomics issues affecting the citizens' Intention to Use (ITU) MyKad for homeland security by using an extended technology acceptance model. Five hundred questionnaires were collected and analysed using structural equation modelling. Results show that perceived credibility and performance expectancy are the key issues. The findings provide many countries with insights into methods of addressing ergonomics issues and increasing adoption of SNIC for homeland security.

Assessment of psychosocial risks faced by workers in Almería-type greenhouses, using the Mini Psychosocial Factor method

This work reports the use of the Mini Psychosocial Factor (MPF) method for assessing the psychosocial risks faced by agricultural workers in the greenhouses of Almería (Spain) with the aim of improving their health. The variables Rhythm, Mobbing, Relationships, Health, Recognition, Autonomy, Emotional Involvement, Support, Compensation, Control, Demands, and Mental Load were recorded using a pre-validated questionnaire containing 15 questions. The sex, age, and nationality of the respondents (n = 310) were also recorded, as were the type of greenhouse in which each worked, the size of the greenhouse, and the crop grown. The results showed psychosocial risks to exist for the workers. Multiple correspondence analysis, however, showed that moderate risks can be offset by new prevention programmes that improve Spanish legislation in terms of workers' salaries, worker-employer social days, work timetables to facilitate family life, and training courses. This could improve the work environment and health of Almería's greenhouse workers as well as their productivity.

Barriers to the adoption of ergonomic innovations to control musculoskeletal disorders and improve performance

Despite a growing number of published articles describing studies of ergonomic interventions, little is known about the barriers potential adopters face when deciding whether or not to adopt such innovations. To this end, the purpose of this paper is to examine the barriers identified by potential adopters of ergonomic innovations and compare barriers identified by individuals not interested in adopting to those identified by individuals planning to adopt. Eight hundred forty-eight fresh market vegetable farmers were mailed surveys measuring the adoption of and barriers to the adoption of several ergonomic innovations as part of a multi-year intervention study. Barriers such as cost, lack of information, never having seen the innovation used and not being able to try out the innovation were among the barriers identified. The barriers identified were moderated by whether or not the respondents were likely to adopt. Implications for diffusing ergonomic and safety innovations are discussed.

A 4-year intervention to increase adoption of safer dairy farming work practices

BACKGROUND

Traumatic and musculoskeletal injury rates have been high in dairy farming compared to other industries. Previous work has shown that social marketing efforts can persuade farm managers to adopt practices that reduce injury hazards compared to traditional practices if the new practices maintain profits.

METHODS

The intervention disseminated information to 4,300 Northeast Wisconsin dairy farm managers about three safer and more profitable production practices (barn lights, silage bags, and calf feed mixing sites) using information channels that these managers were known to rely on. We evaluated rolling, independent, community-based samples, at baseline and then again after each of four intervention years. We also evaluated samples from Maryland's 1,200 dairy farms after the second through the fourth year of the intervention. Maryland dairy managers read many of the same nationally distributed print mass media that we used in the intervention and so were a "partially exposed" comparison group.

RESULTS

The intervention to disseminate information about the innovations was successful. In comparisons before and after the intervention, Wisconsin managers reported getting more information about calf sites from public events and equipment dealers, about silage bags from other farmers and equipment dealers, and about barn lights from public events, other farmers, equipment dealers, consultants, and electrical suppliers. Wisconsin managers also reported getting more information than Maryland managers from public events for barn lights and silage bags. During years three and four, the intervention managed to sustain, but not improve, earlier increases in adoption and awareness from the first 2 years. After adjusting for farm manager and operation variables, intervention years was associated with increased Wisconsin manager adoption of two of three practices in comparisons between the baseline and the fourth intervention year: barn lights (odds ratio = 5.58, 95% confidence interval = 3.39-9.17) and silage bags (OR = 2.94, CI = 1.84-4.70). There were similar results for awareness of barn lights and the calf feeding sites. Compared to Maryland managers, Wisconsin managers reported greater awareness of barn lights.

CONCLUSIONS

Disseminating information to managers through information channels that they usually consulted was associated with increased reports of getting information and with greater adoption and awareness of safer, profit-enhancing work practices in a high hazard industry.

Musculoskeletal disorders in labor-intensive agriculture

This paper gives an overview of the extent of musculoskeletal disorders (MSDs) in agriculture, and a historical perspective on how ergonomics has been used to reduce the health effects of labor-intensive agriculture. A summary of exposure to MSD physical risk factors within various classes of crops, along with various administrative and engineering controls for abating MSDs in agriculture is given. These controls range from programmed rest breaks to mechanized or partially-mechanized operations. Worker-based approaches such as prone carts and platforms, and load transfer devices hold promise in combating the prevalent stooped work in agriculture. Including the worker as an integral contributor to all aspects of developing and implementing an intervention, and considering the psychosocial and socio-cultural aspects of the work environment are crucial elements of effective interventions for reducing MSDs. Despite the advent progress in new technologies in agricultural practices, reliance on labor, especially in fresh market fruits and vegetables, will always be a major cornerstone of agriculture for at least the foreseen future. It is encouraging to see the increased interest among health and safety professionals, epidemiologists, engineers, social scientists, and ergonomists throughout the world who are committed to the plight of reducing MSDs and other health problems among agricultural workers.

Evaluation of a 3year intervention to increase adoption of safer nursery crop production practices

BACKGROUND

We conducted a 3year intervention to increase awareness and adoption of eight more profitable nursery crop production practices that reduced certain traumatic and musculoskeletal injury hazards.

METHODS

We disseminated information to nursery managers across seven states using information channels they were known to rely on (e.g. trade publications, public events, university Extension, other managers). We evaluated rolling, independent, probability samples (n=1200) with mail questionnaires before the intervention and after each of 3 intervention years. We also evaluated samples (n=250) from a comparison group of New Zealand nursery managers.

RESULTS

The intervention was associated with increased awareness of four of the eight practices among US managers after year 3 compared to their baseline: zippers (20 vs. 32%, p<or=0.000), stools (11 vs. 22%, p<or=0.001), pruners (29 vs. 40%, p<or=0.014), and tarps (24 vs. 33%, p<or=0.009). There were no changes in adoption. New Zealand manager awareness was increased for hoes after year 2 compared to their baseline (35 vs. 52%, p<or=0.010).

CONCLUSIONS

A modest, regionwide information dissemination intervention was associated with increased awareness, but not adoption.

Orchard evaluation of ergonomically modified apple bucket

BACKGROUND

While preliminary laboratory tests indicate that a hip belt reduces the load on the back, neck and shoulders associated with musculoskeletal strain, an orchard trial is needed to more realistically assess both effectiveness and acceptability.

OBJECTIVE

to evaluate the hip belt's effectiveness in three areas: worker acceptance, worker productivity, and one-day muscle fatigue of the back and shoulder.

METHODS

Ninety-six New York apple harvest workers were randomly assigned to use the intervention hip belt or placebo belt for one week. In a second week all workers switched conditions. Subjects were interviewed at the end of each week to ascertain intervention acceptance. Employer records were reviewed to determine bushels picked per day. Subjects also underwent muscle fatigue testing at the beginning and again at the end of one workday during each week.

RESULTS

Ninety-one percent of the subjects favored the intervention hip belt. Use of the intervention did not appreciably slow picking speed (bushels per hour) as compared to placebo (8.8 bu/ hr vs. 8.89 bu/hr). Both were significantly faster than the regular equipment condition (8.13 bu/hr). No significant differences in one-day muscle fatigue were found with intervention use.

CONCLUSIONS

The belt was acceptable to the workers and did not hinder productivity. However, the anticipated ergonomic benefits were not demonstrable using one-day strength testing.

Understanding the ergonomic risk for musculoskeletal disorders in the United States agricultural sector

INTRODUCTION

Farming is a very large industry in the United States. Understanding the risks for injuries and more specifically musculoskeletal disorders in this industry poses a challenge for health officials.

METHODS

A review was conducted of the existing peer-reviewed publications prior to December 2006 about injuries and musculoskeletal disorders for farmers and farm workers. The aim was to review existing knowledge concerning: (1) the prevalence, types, and causes of farm-related injuries, paying particular attention to musculoskeletal disorders and the special populations within the agricultural sector, and (2) interventions that have been developed to reduce risk factors associated with farm-related injuries.

RESULTS

Farmers and farm workers experience high rates of low back, shoulder, and upper extremity disorders. Musculoskeletal disorders may disproportionately affect farm youth and migrant workers due to the types of farm tasks performed. There is an urgent need for improved and validated interventions to reduce exposures and to improve the health of farmers and farm workers.

DISCUSSION

Future farm-related musculoskeletal disorder research should emphasize: (1) better identification of exposures for special populations, (2) development of interventions for diverse farm populations, and (3) identification of additional exposures for musculoskeletal disorders. Inadequate understanding of musculoskeletal disorders in farming impedes efforts to prevent this common and important type of occupational injuries on farms.