Intervention Effectiveness in Finnish Agriculture

Details

• Personal Author:
  Donham, Kelley ; Ledolter J ; Ohsfeldt R ; Rautiainen, Risto ; Zwerling C
• Description:
  Background. Agriculture remains one of the most hazardous industries in the US and effective interventions are needed. We conducted a systematic review of interventions in agriculture, and we evaluated a well-established agricultural occupational health service (OHS) intervention in Finland. This study addressed three NORA priority areas: asthma and chronic obstructive pulmonary disease, traumatic injuries, and intervention effectiveness research. This K01 research career award also enhanced the Principal Investigator's research career through mentored research and training. The University of Iowa provided the research environment and mentors (Drs. Craig Zwerling, Kelley Donham, Johannes Ledolter, Robert Ohsfeldt). Methods. This research had two hypotheses: 1) Farmers who are members of the Occupational Health Service (OHS) have lower injury rates, respiratory disease rates, and claim costs compared to non-members, and 2) Serious injuries are associated with demographic, income, and farm characteristics. We analyzed insurance records of 93,550 self-employed Finnish farmers. We ranked injury causes by claim cost and used multiple logistic regressions to identify risk factors for (any) injury and serious injury (injuries exceeding claim costs of €2000 Euros). Hypothesis 1 was tested in a retrospective cohort study, measuring if 2002 claim rates and costs differed between OHS members and non-members. Hypothesis 2 was tested in a multiple logistic regression analysis identifying risk factors for injury and serious injury. Serious claims (>€2000 Euros) represent about 20% of the cases and 80% of the insurance costs. Both analyses were based on a large, well-defined cohort (N=93,550) and data on injuries (N=5507) and occupational diseases (N=302) in 2002. Comprehensive claims data (N=222,848 claim cases) from 1982 to 2008 for this population were acquired in 2008. Analyses of those data continue, and new proposals are under preparation, expanding this research utilizing the new data. Results. A total of 5507 compensated injuries occurred in 2002 (rate 5.9/100 person-years); 1167(21%) of them were serious (rate 1.25/100 person-years). The causes/sources resulting in most costly claims were motor vehicles; stairs, scaffoldings, and ladders; trailers and wagons; floors, walkways, and steps; other structures and obstacles; augers, mills, and grain handling equipment; horses; combines and harvesting equipment; tractor steps; and uneven and slippery terrain. Older age, male gender, higher income level, greater field size, residing on the farm, Finnish language (vs. Swedish), and animal production were risk factors for injury. Unexpectedly, OHS membership was also a risk factor for injury. The risk factors for serious injury were similar; however, the effects of age, income level, and the raising of horses were more prominent. Language, residence on the farm, farm ownership status, and OHS membership were not risk factors for serious injury, indicating potential biases in claims reporting between different demographic groups. OHS members (vs. non-members) reported more minor injuries, while there were no differences between members and non-members in serious claims. Average claim costs were €1717 Euros for OHS members and €1875 Euros for non-members (p=0.005). Conclusions. Cost-effective prevention efforts should address: older age, male gender, larger income and operation size, livestock production, motor vehicle incidents, falls from elevation, and slips, trips and falls. OHS membership increased claims (particularly minor claims), but decreased claim costs. These findings initiated changes in the OHS system in Finland, emphasizing the importance of hazard identification and removal on farms. Research continues, examining the effect of the intervention and the potential biases in claims reporting between OHS members and non members. [Description provided by NIOSH]
• Subjects:
  Agriculture Asthma Asthma, Occupational Farmers Hazardous Substances Occupational Health Risk Assessment Risk Factors Safety
• Keywords:
  Agricultural Industry Chronic Obstructive Pulmonary Disease COPD Hazard Identification Injuries Intervention Effectiveness Occupational Health Services Risk Factors
• Series:
  Grant Final Reports
• Publisher:
  National Institute for Occupational Safety and Health
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Final Grant Report
• Place as Subject:
  Iowa ; OSHA Region 6 ; OSHA Region 7 ; Texas
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  OEP - Office of Extramural Programs
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  1-32
• NIOSHTIC Number:
  nn:20061067
• NTIS Accession Number:
  PB2022-100325
• Citation:
  Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, K01-OH-008300, 2008 Oct; :1-32
• Contact Point Address:
  Risto Rautiainen, PhD, Assistant Professor, The University of Iowa, 103 IREH, Oakdale Campus, Iowa City, IA 52242-5000
• Email:
  risto-rautiainen@uiowa.edu
• Federal Fiscal Year:
  2009
• Performing Organization:
  University of Iowa
• Peer Reviewed:
  False
• Start Date:
  20050801
• Source Full Name:
  National Institute for Occupational Safety and Health
• End Date:
  20080731
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:a97a7193693cd5fa3476ccfd07c989c1d8e6b8ec0e6a2eee848e0ce3706de1e3b3ff71cf325e267a3651221363710d77b66c95cec94f210d941a002c903fa940
• Download URL:
  https://stacks.cdc.gov/view/cdc/219019/cdc_219019_DS1.pdf
• File Type:
  [PDF - 399.85 KB ]