Introduction: The NIOSH Fire Fighter Fatality Investigation and Prevention Program (FFFIPP) conducts independent investigations of selected fire fighter line-of-duty deaths (LODD) and offers recommendations to prevent similar deaths. The purpose of the current study was to provide information on more recent FFFIPP recommendations and to determine if recommendations have changed over time. Methods: Fatality investigations completed from 2006 to 2014 were selected for this study with recommendations being assigned into twelve major categories when possible. The most frequently occurring recommendations were then rank ordered overall and then by medical and traumatic fire fighter LODD. Results: There were 1,067 total recommendations made in the published fire fighter investigative reports for both medical and trauma-related fire fighter fatalities for the period 2006–2014. Of these, 784 (73%) could be placed within one of the 12 categories noted previously. The top 10 recommendation categories overall were: 1. Medical screening, 2. Fitness and wellness program, 3. Training, 4. Medical clearance, 5. Standard Operating Procedures/Standard Operating Guidelines (SOPs/SOGs), 6. Incident command, 7. Strategy and tactics, 8. Communications, 9. Personal protective equipment and 10. Staffing. Conclusions: The leading recommendations from the NIOSH FFFIPP medical investigations between 2006 and 2014 did not change compared to those made between 1998 and 2005, with the exception of the addition of “medical clearance for duty”. There were changes for the traumatic injury leading recommendations for 2006–2014, with the major change being “training”, which was the leading FFFIPP recommendation for traumatic injuries for this time period. Practical applications: The intent of the FFFIPP is to influence fire departments and fire fighters to critically assess and evaluate situations/circumstances similar to those identified by NIOSH investigations and implement the recommendations offered to prevent additional fire fighter fatalities.

The agriculture, forestry, and fishing (AgFF) industry sector has had the highest rate of work-related deaths over the past several years. Tractors are the single largest source of occupational fatalities in this industry sector, and tractor rollovers are the largest category of tractor fatalities. The risk of death due to tractor rollovers has been found to be reduced considerably when rollover protective structures (ROPS) are used in conjunction with seatbelts. Increasing the number of tractors with ROPS and seatbelts is one way in which tractor rollover fatalities can be mitigated. The NIOSH cost-effective rollover protective structure (CROPS) project was designed as a demonstration project to determine if CROPS, a type of ROPS, could be retrofitted in the field and were acceptable to farmers. To this end, the CROPS project was successful, with 50 tractors being retrofitted with CROPS in the field. All study participants were asked to complete a pretest, test, and posttest regarding the CROPS retrofit demonstration and their knowledge and attitudes toward ROPS. CROPS demonstrators were the participants who retrofitted their tractors with CROPS. Demonstrators were asked to recruit three to five other participants, known as observers, to watch the demonstration. The rationale was to generate interest in ROPS/CROPS among other farmers and community leaders. Overall, 16% of the participants had youth operating tractors on their farms. Participants reported that 44 youth operated tractors on their farms, more than 25% of these young tractor operators were 4 to 10 years old, and half of the youth operating tractors on participant farms were 13 years old or younger. Only one participant group (demonstrators) included individuals who had all of their tractors protected with ROPS/CROPS for young tractor operators (28%), but they accounted for only one farm each among the New York and Virginia demonstrators. The survey question on ROPS importance did not show an overall increase after respondents participated in the CROPS demonstration project. However, one Virginia observer asked to become a Virginia demonstrator and installed a CROPS on his tractor. Additionally, the questions on attitude toward ROPS showed a general increase in mean scores, with the some of the lowest response categories on the follow-up survey not being selected by respondents, indicating a potentially positive impact on participants’ safety attitudes toward ROPS. For the safety attitude questions, the majority remained the same. This study indicates there is still much work to be done to reduce the number of deaths in production agriculture due to tractor rollovers. CROPS could be a valuable addition to the efforts of retrofitting ROPS on tractors in order to reduce the number of deaths due to tractor rollovers.

The NIOSH cost-effective roll-over protective structure (CROPS) demonstration project sought to determine whether three prototype roll-over protective structures (ROPS) designed to be retrofitted on Ford 8N, Ford 3000, Ford 4000, and Massey Ferguson 135 tractors could be installed in the field and whether they would be acceptable by the intended end users (farmers). There were a total of 50 CROPS demonstrators (25 in New York and 25 in Virginia), with 45 observers attending the New York CROPS demonstrations and 36 observers attending the Virginia CROPS demonstrations, for a total of 70 participants in New York and 61 in Virginia. The oldest retrofitted tractors were 77 to 62 years old, while the newest retrofitted tractors were 40 to 37 years old. The most frequently retrofitted tractor in the CROPS demonstration project was a Ford 3000 series tractor (n = 19; 38%), followed by Ford 4000 (n = 11; 22%), Massey Ferguson 135 (n = 11; 22%), and Ford 8N (n = 9; 18%). A major issue of CROPS retrofitting was the rear wheel fenders. The effort involved in disassembling the fenders (removing the old bolts was often faster by cutting them with a torch), modifying the fender mounting brackets, and then reinstalling the fenders with the CROPS generally required the most time. In addition, various other semi-permanent equipment attachments, such as frontend loaders, required additional time and effort to fit with the CROPS. Demonstrators were asked to rank the reasons why they had not retrofitted their tractors with ROPS until they had enrolled in the CROPS demonstration program. ROPS "cost too much" was ranked as the primary reason for participants in both states (80% for New York and 88% for Virginia). The second highest ranked reasons were "ROPS wasn't available" for Virginia (80%) and "hassle to find ROPS" for New York (69%). The third highest ranked reasons were "not enough time to find ROPS" for New York (67%) and "hassle to find ROPS" for Virginia (79%). All demonstrators and observers indicated that they were glad to have participated in the CROPS project.

OBJECTIVE: To determine prevalence of carpal tunnel syndrome (CTS) among poultry processing employees while taking into account non-occupational factors and assess any association between CTS prevalence and exposure groups. METHODS: Performed a cross-sectional survey to assess CTS (n = 318). A CTS case was defined as an employee with self-reported CTS symptoms, an abnormal hand symptom diagram, and an abnormal nerve conduction study (NCS). Log-binomial regression was used to estimate prevalence ratios. RESULTS: Three hundred and one participants had sufficient symptom information or NCS data to be classified. 126 (42%) of 301 participants had evidence of CTS. In the adjusted analysis, the highest exposure group had CTS prevalence that was significantly higher than that for the lower exposure group [PR: 1.61; 95% CI = (1.20, 2.17)]. CONCLUSIONS: Increasing levels of hand activity and force were associated with increased CTS prevalence among participants. Recommendations were provided to reduce exposure to these risk factors.

Agriculture has consistently been identified as one of the most dangerous industries. In recent years, it has had the highest work-related fatality rate and ranks in the top three industries for the greatest number of work-related fatalities [1], [2], [3], [4]. Production agriculture is the industry subsector that is most closely affiliated with the occupation of farming. Because of the role of farms as both a home and a workplace, along with the nature of work done on farms, youth are exposed to many unique hazards. This is often further impacted by the rural location, which can delay prompt medical response and emergency assistance. | The problem of children being injured while living on, visiting, or working on farms has been recognized for several decades [5], [6]. Data suggest that about 115 youths under age 20 years die on farms each year, and an estimated 15,876 farm-related injuries (where injury is defined as any condition occurring on the farm operation resulting in at least 4 hours of restricted activity) occur to the same age group. Machinery is the primary source of fatalities; tractors are the single largest identifiable source of fatalities within this category. Fatality rates for young workers in agriculture production were found to be over 3.5 times higher than rates for young workers in all other industries [7], [8].

The National Institute for Occupational Safety and Health (NIOSH) has been the lead federal agency of the national Childhood Agricultural Injury Prevention Initiative (CAIPI) since the program's inception in 1996 and in this role, collaborated with numerous partners in childhood agricultural injury prevention activities. This collaboration has likely helped achieve the current reduction in childhood agricultural injury. The paper looks at existing groups with past and current childhood agricultural injury prevention activities for partnering strategies that could contribute to reducing the morbidity and mortality of childhood agricultural injuries. Based upon the review, suggestions are made for future partnering strategies to continue progress in this area.

This research compares state-level rollover protective structure (ROPS) prevalence rates from the early and mid-1990s to those observed in the years 2001 and 2004. In addition, state-level ROPS prevalence rates are compared to state-level tractor overturn fatality rates. Tractor data for 1993-1995 and for 2001 and 2004 for all tractors and ROPS-equipped tractors in use on U.S. farms were derived from surveys conducted for NIOSH by the USDA-NASS. Changes in ROPS prevalence rates at the state level between the two time periods were assessed using a two-sample paired t-test with unequal sample sizes. Poisson regression was used to assess the association between ROPS prevalence rates and tractor overturn fatality rates at the state level. Overall, 49 of the 50 states had an observed increase in the percentage of farm tractors equipped with ROPS from 1993-1995 to 2001 and 2004. This increase was statistically significant for 34 states. Large shifts in ROPS prevalence were found within individual states and in clusters of states. These include a major increase in the southeastern U.S. and some western states. However, a core of states in the northeast (many of them in or near the Appalachian Mountains) through the upper midwest remain in the bottom quartile for ROPS prevalence. For the years 1992 through 2004, the highest fatality rates were observed in many of the same states that were identified previously as having persistently low ROPS prevalence rates. There is a clear relationship between low state-level ROPS prevalence rates and high state-specific tractor overturn fatality rates. While progress has been made in increasing the percentage of ROPS-equipped farm tractors, it is projected that ROPS prevalence rates will not reach a protective level nationally until after 2015. Regionally, the northeast and midwest will not reach protective levels of ROPS-equipped tractors until after 2020. Based on the adoption rates observed, tractor overturn rates will likely continue to be a more localized, but significant, public health issue for several states beyond the year 2020. The results of this study show the geographic areas of the U.S. where the greatest need exists, and where a greater emphasis should be placed on ROPS promotion activities. However, addressing this public health issue on a large scale will require resources and an organized commitment, which have historically been lacking.