This study involved pre-survey responses from Gear Up for Ag^™ program participants in the U.S. AHSA applies pre-and post-surveys evaluation of programs based on Kirkpatrick’s Four-Level Training Evaluation Model (Kirkpatrick and Kirkpatrick, 2006). This Evaluation Model is commonly used for workplace safety programs involving a specific group of working participants. The pre-survey was administered two to three weeks prior to outreach program delivery, and the post-survey was administered one to three months following the program. Although all participants receive a Health and Safety Kit with appropriately sized PPE (value $12-$60 US, depending on program) they are mainly incentivized to complete the pre-survey by knowing that their PPE sizes will be correctly accounted for. Many young adult participants wanted access to PPE that fit them correctly. Participants are incentivized with a small cooler bag (value, $5 US) for completion of the post-survey. Each participant had access to one pre- and post-survey, as the Gear Up for Ag^™ program is administered through the enrollment of an agricultural education course within a university or college. The COVID-19 pandemic had little effect on survey response rates since 2020 when the program was modified to continue in virtual, in-person, or combination formats. The collection of this data was not originally intended for research purposes, as the intent is to provide detailed information to customize and improve nonprofit outreach programs in an agricultural community. For example, pre-survey questions focus on ‘respiratory symptoms experienced during agricultural work’ and respirator use when working on the farm, but do not ask where these respiratory symptoms occurred or what task was related to the symptoms, as question responses were used to stimulate program discussion and participation.

All pre- and post-survey variables are described in Table 1. The pre-survey collects demographic information such as gender, education type (university/community college), country, age, production type, and farm tasks. The pre-survey does not collect information on U.S. citizenship status or ethnicity. In 2020, with consultation from two swine veterinarians, the tasks of administering pharmaceuticals/vaccines, transporting hogs (as livestock) on roadways, taking care of piglets, and performing welding tasks (maintenance purposes, for example) were added to the pre-survey. Only U.S. participants who referenced involvement in hog production were included for data analysis. Additional pre-survey questions included self-reported respiratory symptoms and experiences using NIOSH-certified respirators. Photos were provided with survey questions about NIOSH-certified respirator use and respirator fit testing for clarification.

Post-survey responses were used to learn about knowledge retention and changes in safety behaviors following the program. The post-survey collects demographic information and questions about perceived value of the program and use of NIOSH-certified respirators and purchase of additional respirators following the program. During the respiratory health portion of the Gear Up for Ag^™ program, all participants participate in a feedback activity focused on identifying areas or specific tasks on the farm where they are most likely to use the respiratory protection received in the Health and Safety Kit. Participants noted activities where they were “most likely to use the respirators that they received” on a Post-It^® note to share with other participants on a white board. During this activity, demographic variables are not collected since the participation in the feedback is completely anonymous. These written responses were collected specifically from hog producers and electronically transposed this information into spreadsheet format. All data for this project was acquired from 2017 to 2021. The analysis of AHSA survey data was reviewed by the University of Iowa IRB and was determined to be not human subjects research (HSR) because analysis activities “are limited to the use of de-identified survey data gathered to tailor the creation and delivery of educational outreach to a specific audience.”

Pre- and post-survey responses were exported from SurveyMonkey into a CSV data file using 5 Python. R Studio© (version 1.3.1093, 2020) was used to categorize responses. Pre-survey data was used to calculate participant proportions on demographic variables and for responses related to farm tasks performed, respiratory symptoms experienced during agricultural work, previous experience using of NIOSH-certified respirators on the farm and having ever been fit tested for a respirator (see Table 1 for variable descriptions). Post-survey data was used to calculate proportions of participants who found value in receiving respiratory protection as part of an educational program, if they used the respirators after the program, and if they purchased additional respirators after the program. Although the researchers were initially interested in examining gender-specific differences in survey responses, two-proportions Z-tests were used to examine potential differences in proportions according to all recorded demographic factors including education type, age, and gender. For larger sample size comparisons (≥ N = 6) with binomial data, the Z-test is the preferred means for comparison of groups within a sample population (Mishra et al., 2019). For comparisons of small sample sizes (≤ N = 5), a more conservative chi-square test for proportions was used. A value of p ≤ 0.05 was used to indicate a statistically significant Z-test or chi-square test result. The age category was split on the median into two age groups (18–20 yrs and 21–30 yrs). Initial results demonstrated that no differences in proportions were observed due to education type and age category. Comparative analysis was shifted to the initial aim, which was to examine potential gender differences among survey responses. Blank answers on the surveys were categorized as ‘missing’ data. Since pre- and post-surveys were not matched, the researchers treated them as separate datasets and refrained from making direct comparisons between pre- and post-survey responses. Qualitative responses were categorized by an industrial hygienist, who identified “key terms” for areas of the farm or farm tasks where participants stated they were most likely to use the respirator received as part of the educational program. Proportions were calculated for the categorized qualitative responses. Demographic data was not available for qualitative responses.

Pre- and post-survey demographics of young adult Gear Up for Ag^™ participants who were hog producers are shown in Table 2. Overall, 86% of participants who identified as hog producers completed the pre-survey (n=703) and 26% (n=212) completed the post-survey. Of those who completed the survey, about 73% were male and 27% were female, further validating the increasing trend of more female participants in the Gear Up for Ag^™ program. Female producers were slightly more likely to complete the post-survey, but no other pre- and post- survey demographic differences were observed. Most of the young adult hog producers were in the Midwestern region (86%), and 14% were in the West or Southwest. The participants were evenly split among community college and university agricultural program enrollment, most were 18–25 years old. Most young adult hog producers (85%) reported beginning work on the farm and/or assistance with farm chores when they were younger than 8 years old (data not shown).

The most common farm tasks were reported in the pre-survey and are producers are described in Table 3. These include working and moving hogs (83%), unloading or loading feed/hay (70%), cleaning pens/housing (67%), feeding hogs (60%), and cleaning bins or other types of grain/feed storage (59%). Males were significantly more likely than females to report feeding hogs, cleaning out grain bins or feed storage, mixing or grinding feed, and transporting hogs on roadways. Females were significantly more likely than males to report taking care of piglets. Similar proportions of males and females reported moving hogs, unloading hay or feed, cleaning housing, and administering pharmaceuticals/vaccines.

Pre- and post-survey findings are presented in Table 4. Over a third (39.8%) of young adult hog producers stated that they had experienced respiratory symptoms while performing agricultural work, and 49.8% stated that they have never experienced respiratory symptoms. The survey did not indicate where these respiratory symptoms occurred or what task was related to the symptoms. There were no significant demographic differences in self-reported respiratory symptoms. Many participants reported that they were already wearing respirators before the program, with 76% stating that they at least “always” or “sometimes” wear filtering facepiece respirators when working in dusty areas. However, young adult female producers were more likely than male producers to report only “sometimes” or “never” wearing filtering facepiece respirators (Table 4). Female producers were more likely than males to leave the question about use of filtering facepiece respirators blank. Almost a third (30%) of participants stated that they have had experience wearing a cartridge style respirator on the farm, although this appears to be mostly male producers. Males were much more likely than females to report experience with this respirator type (37% of males stated “yes” as compared to only 13% of females). The proportion of individuals reported having been fit tested for a respirator was 5%. Male producers were significantly more likely to report having been fit tested for a respirator when compared to females. Female producers were significantly more likely to report that they were “unsure” if they had been fit tested, even though photos of respirator fit testing were provided in the pre-survey.

Overall, the majority (79%) of young adult hog producers reported that they found value in receiving two types of respirators as part of an educational program, even before participating in the program. Young adult male producers were significantly more likely to answer “yes” (83%) as compared to female producers (67%), who were also significantly more likely to answer “unsure” (22%).

The Gear Up for Ag^™ program seemed to be effective, with 43% and 41% of young adult hog producers answering that they were ‘very likely’ or ‘likely’ to wear the filtering facepiece respirator (N95) that they received in the Health and Safety Kit. In addition, 36% and 43% of young adult hog producers answering that they were ‘very likely’ or ‘likely’ to wear the reusable cartridge style respirator that they received. A higher proportion of male producers (45%) reported that they were “very likely” to wear the filtering facepiece respirator (N95) (45%) as compared to female producers (34%) (p=0.112), who indicated they were ‘somewhat likely’ (50%). A higher proportion of female producers (18%) reported they were ‘not likely’ to wear the cartridge style respirator following the program as compared to males (9%) (p = 0.066). Approximately 20% of participants went out and purchased additional respirators for themselves or someone else following the program. A higher proportion of female producers (18%) reported they were ‘not likely’ to wear the cartridge style respirator following the program as compared to males (9%) (p = 0.066). Unlike the pre-survey results, there were few statistically significant differences observed among gender in the post-survey.

Participants involved in hog production reported during the Gear Up for Ag^™ program that they were most likely to use their respirators while handing grain or feed, including work in grain bins (33%), while powerwashing or disinfecting (27%), when moving hogs (general) 14%, during hog loadouts specifically (10%), while sweeping inside the barn (8%), for non-specific work in farrowing barns (4%), or when checking or unclogging mechanized feeding equipment (4%).

In this project, we observed that more than a third of young adult hog producers stated that they had experienced respiratory symptoms while working on the farm. This is comparable to what was summarized by Von Essen et al., which found that 20% to 40% of hog confinement workers experienced respiratory symptoms such as cough, wheezing, and shortness of breath (2010). Although this demonstrates that respiratory health may be a concern among this group, the current study did not examine the potential “cause” of the respiratory symptoms experienced since the survey intent was to provide information for the Gear Up for Ag^™ program. Many young adult hog producers report engaging in tasks where respirators were previously recommended by Hetzel and Grisso at Virginia Cooperative Extension (2007, 2020). Although young male producers were more likely to engage in high-risk activities where respirators are “highly recommended,” such as cleaning out grain bins and mixing/grinding feed, it is important to note that both male and female producers are involved in an array of tasks where respiratory protection may be recommended or even required if the specific environment has airborne levels exceeding occupational exposure limits.

Most young adult hog producers enrolled in Gear Up for Ag^™ programs are already using respirators on their operations with some frequency, and this proportion reporting general use of respirators is higher than previously reported by older producers. For example, 76.2% of young adult hog producers in this study reported ‘always’ or ‘sometimes’ wearing a filtering facepiece respirator (N95) when performing agricultural work in dusty environments, and 30.4% reported that they had worn a cartridge style respirator when performing different tasks on the farm. In comparison, a respirator use survey conducted by NIOSH in 2001 found that only 5.8% of agricultural employees reported wearing a respirator in a 12-month period (NIOSH, 2003). More recent studies have found that 17–48% of agricultural producers and workers report wearing respirators (Mitchell and Schenker, 2008; Syamlal et al., 2013; Casey & Mazurek, 2017). The findings from this study do indicate that the self-reported use among respirators by these young adult producers is trending in a positive direction. More research is needed to examine the factors in this potential shift in safety culture. The recent COVID-19 pandemic heightened occupational awareness of respiratory protection, due to media coverage and the shortages of N95 respirators experienced from March 2020 to May 2021 (Gereffi, 2020). Additional research by ASHA plans to examine the impact of COVID-19 on the potential awareness of, access to, and use of NIOSH-certified respiratory protection by this young adult agricultural working population. This work is considered outside the scope of this project since it involved additional data collected in 2022.

It was unknown from the survey if these young adults considered “dusty environments” to be inside of the hog barn or housing. For example, a 2002 study among older Midwestern farmers indicated very low use of respirators inside of livestock confinement housing (only 3% reported wearing respirators in this scenario) (Carpenter et al., 2002). The aforementioned European study found that personal exposures of hog producers were highly variable but demonstrated potential to reach recommended exposure limits for dust including bioaerosols (OSHA PEL-TWA, ACGIH TLV-TWA) (Radon, et al., 2001). The qualitative responses collected from young adult hog producers during the program indicate that they do plan to use the respirators in barn environments, such as when performing cleaning tasks, working with feed or feed equipment, moving hogs, and for general use in farrowing rooms. These responses were in line with a previous study that found that tasks like moving hogs and swine weaning resulted in potentially higher dust concentrations (O’Shaughnessy et al., 2009).

Although many young adult hog producers reported wearing respirators, most of them have not been properly fit tested for a respirator or do not know what respirator fit testing is. Only 5% of young adult hog producers reported being fit tested for a respirator, and approximately 13% were ‘unsure’ if they were fit tested. Male producers were more likely to report having been fit tested than female producers. ASHA educators noted that in conversations with these young adults, they were likely to have been fit tested for another “off-farm” job, such as at an autobody shop or grain elevator, and that the fit test was not necessarily for the respirator they were using on their farm. Respirator fit testing should be completed prior to starting a job that requires respirator use. Fit testing is important, since it determines whether a specific respirator fits the face of the wearer.

According to the OSHA Respirator Protection Standard (OSHA, 2006), workers may use respirators voluntarily even if measured exposures are below exposure limit. In this scenario, respirator fit testing is still a good recommendation for young adults working in agriculture who want to use respirators. The qualifications for the OSHA voluntary use provision may not be applicable to many young adult producers in the Gear Up for Ag! program, since over half report working on their family farm (Gibbs et al., 2020). In some cases, these young adults may work on the farm but may not be considered an employee, or the farm is a small agricultural business and considered ‘exempt’ from OSHA regulation. The authors believe that all individuals working on the farm should be protected from respiratory hazards and that the guidelines stated in the OSHA Respirator Protection Standard, Appendix D are still applicable in these situations involving young adult producers (Appendix D to Section 1910.134 Mandatory Information for Employees Using Respirators When Not Required Under the Standard, OSHA, 2006). Due to the differences in facial anthropometric dimensions, fit testing is especially important for female producers. Most young adult producers enrolled in Gear Up for Ag^™ programs are relatively new to adult-sized respirators since they are typically only 18–25 years old.

This study revealed several significant gender differences in the reported rates of respiratory protection use. Male producers were significantly more likely to report wearing both respirator types, and more likely to report finding value in receiving respirators as part of an educational program as compared to female producers. In fact, 22% of female producers stated they were “unsure” if they found value in receiving NIOSH-certified respirators as part of an educational program, as compared to only 9% of males. It is interesting that these differences were statistically significant in the pre-survey, even though both genders self-reported experiencing respiratory symptoms while performing agricultural work. Perhaps this is because young male producers were more likely to engage in activities considered high risk, such as cleaning out grain bins and mixing/grinding feed—whereas females were more likely to engage in tasks where recommended respirator use is less clear. This includes tasks such as cleaning pens, unloading feed, or moving hogs. Our findings have highlighted significant gender differences in the types of tasks being performed on the farm. Like Von Essen et al. (2010), we assert that more research is needed on respiratory exposures during these tasks where respirators are ‘recommended.’ Additional information regarding differential exposures would help outreach professionals to better educate young producers about respirator use. Due to the variable nature of work in the pork production industry, task-specific guidance is more likely to be implemented.

More research is also needed to investigate the gender differences that were observed. Female hog producers were also slightly more likely to report ‘not likely’ to wear the cartridge style respirator or purchase an additional respirator following the Gear Up for Ag^™ program. Although these differences were not statistically significant (p ≤ 0.05), the findings still implied similar trends in reduced self-reported respirator use among young adult female producers, even after the delivery of an educational program. If gender differences are to be overcome by a broad agricultural health and safety program emphasizing respiratory health and the importance of using respiratory protection, then a) specific resources should be developed to inform on gender-specific needs, and b) multiple types and sizes of correctly sized NIOSH-certified respirators should be offered to participants, c) participants should be encouraged to partake in respirator fit testing.

The Gear Up for Ag^™ program was effective in that young adult hog producers reported using the 2-strap filtering facepiece respirator and half mask cartridge respirator that they received following the program. Previous research has indicated that these two types of respirators seem to be preferred by hog producers, in contrast to other respirator preferences by poultry or grain facility workers (Popendorf et al., 2011). In addition, 20% of participants reported that they purchased an additional respirator for themselves or someone else after the program. Qualitative data collected during the program showed that many young adult hog producers planned on using the respirators in specific situations and environments.

Although the pre- and post-surveys were administered to the same group of young adult producers, one of the biggest limitations to this study is that individual pre- and post-survey responses were not matched. Pre- and post-survey matching is commonly done in intervention studies. The aim of this project was simply to evaluate trends of self-reported symptoms and safety behaviors and not to quantify specific changes in individual behaviors. The pre- and post-survey were treated as distinct datasets.

In the pre- and post-surveys, there was missing data (see Table 4). For example, the pre-survey questions on self-reported use of filtering facepiece and cartridge style respirators had 11% and 13% of the data missing, respectfully. ‘Missing’ data in Table 4 meant that the survey question response was left blank. Photos were included in the survey to clarify examples of the NIOSH-certified respiratory protection. Young adults enrolled in the Gear Up for Ag^™ programs are completing these surveys primarily because they want to receive correctly sized PPE. Participation in the surveys did not require that all answers be completed. Female producers were more likely than male producers to leave survey answers blank when asked about their experiences wearing NIOSH-certified filtering facepiece respirator (pre-survey) and when asked if they purchased an additional respirator for themselves or someone else after the program (post-survey), indicating either uncertainty about the question or less desire to answer.

Unlike the pre-survey results, there were no statistically significant differences observed among gender in the post-survey. This was likely impacted by missing data for the gender question and the low post-survey response rates. There was n =26 missing for ‘gender’ in the post-survey. The post-survey is administered one to three months following the program. The response rate to the post survey was low (25%), but typical of agricultural working populations (Avemegah et al., 2021). Post-survey response rates were impacted if the Gear Up for Ag^™ program occurred at the end of the college semester. It was difficult for AHSA educators to contact young adult participants post-semester or post-graduation. The qualitative responses were informative, but these responses were likely impacted by program participation. No follow up occurred to see if these young adult producers really did use their respirators for specified tasks. Due to the short period of time between program delivery and the post-survey, we could not obtain information about potential shifts in respiratory symptoms.

Lastly, the results from this study may not be generalizable to all young adult hog producers since the surveys were focused on young adult producers who were simultaneously enrolled in two- or four-year collegiate agriculture production programs. Education level may have impacted the higher proportions of young adult hog producers reporting respiratory protection usage on the farm, for example. Collegiate education has previously been found to impact the adoption of other hog production management practices and acceptance of technology (Gillespie et al., 2004).

These limitations reflect some of the downsides to using survey data originally intended for outreach purposes. However, to our knowledge this is one of the most extensive survey datasets with regards to respiratory protection knowledge and behaviors reported by young adults working in U.S. livestock production. The authors believe that valuable trends in self-reported health and safety behaviors may still be assessed.