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Meta-Analysis
. 2008 Jan 23;2008(1):CD006398.
doi: 10.1002/14651858.CD006398.pub2.

Interventions for preventing injuries in the agricultural industry

R H Rautiainen  1 , M M Lehtola, L M Day, E Schonstein, J Suutarinen, S Salminen, J Verbeek
Affiliations
Meta-Analysis

Interventions for preventing injuries in the agricultural industry

R H Rautiainen et al. Cochrane Database Syst Rev. .

Abstract

Background: Agriculture is more hazardous than most other industries. Many strategies have been introduced to reduce injuries in the field, yet the effectiveness of different interventions on occupational injuries still remains unclear.

Objectives: This review aims to determine the effectiveness of interventions to prevent occupational injuries among workers in the agricultural industry compared to no interventions or to alternative interventions.

Search strategy: Cochrane Central Register of Controlled Trials, Cochrane Injuries Group's specialised register, MEDLINE, EMBASE, PsychINFO, OSH-ROM (including NIOSHTIC and HSELINE) databases were searched up to June 2006. Reference lists of selected articles, relevant reviews and additional topic related databases and web sites were also searched. The searches were not restricted by language or publication status.

Selection criteria: Randomised controlled trials, cluster-randomised controlled trials, prospective cohort studies with a concurrent control group, and interrupted time series studies assessing any type of intervention aiming to prevent fatal or non-fatal injuries among workers in agriculture.

Data collection and analysis: Two reviewers conducted data extraction and study quality assessment independently. Rate ratios of randomised controlled trials were calculated and the effect sizes were combined in a meta-analysis. Interrupted time series studies were reanalysed and each of them studied for having an immediate and a progressive effect.

Main results: Five randomised controlled trials (RCTs) with 11,565 participants and three interrupted time series studies (ITSs) with 26.3 data points on average met the criteria. For educational interventions aiming at reducing injury rates among adults the pooled rate ratio after recalculation from effect sizes in three RCTs was 1.02 (95% CI 0.87 to 1.20). For educational interventions aiming at children the pooled rate ratio for injury rates in two RCTs was 1.27 (95% CI 0.51 to 3.16). One ITS that evaluated the effect of an intervention that included financial incentives decreased the injury level immediately after the intervention with an effect size of -2.68 (95% CI -3.80 to -1.56) but did not have a significant effect on the injury trend over time with an effect size of -0.22 (95% CI -0.47 to 0.03). One ITS study that evaluated the effect of legislation to ban Endosulfan pesticide on fatal pesticide poisonings increased the level of poisonings immediately after the introduction with an effect size of 2.20 (95% CI 0.97 to 3.43) but led to decrease in the trend of poisonings over time with an effect size of -2.15 (95% CI -2.64 to -1.66). One ITS study documented four different regulations aiming to increase the use of rollover protective structures (ROPS) on tractors and their effect on injuries and fatal injuries. The introduction of two different pieces of legislation requiring ROPS on new tractors sold after a certain date was associated with a decrease of fatal injuries over the long term (effect size -0.93 95% CI -1.02 to -0.03) but they were also associated with an increase of injuries in general (fatal and non-fatal injuries combined). Introduction of legislation requiring ROPS on all tractors, old tractors included, was not associated with a decrease but with an increase of injuries and fatal injuries over the long term.

Authors' conclusions: The selected studies provided no evidence that educational interventions are effective in decreasing injury rates among agricultural workers. Financial incentives could reduce injury rates. Legislation to ban pesticides could be effective. Legislation expanding the use of safety devices (ROPS) on new tractors was associated with a decrease in fatal injuries.

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Conflict of interest statement

The authors involved in this review have participated in intervention studies. Authors and co‐authors (RR, LD, SS and JS) were excluded from evaluating their own studies or studies of their close colleagues.

Figures

1.1
1.1. Analysis
Comparison 1 Educational intervention versus no intervention, Outcome 1 All injuries adults.
1.2
1.2. Analysis
Comparison 1 Educational intervention versus no intervention, Outcome 2 All injuries children and adolescents.
2.1
2.1. Analysis
Comparison 2 Insurance incentive versus no intervention, Outcome 1 Level of injury claims.
2.2
2.2. Analysis
Comparison 2 Insurance incentive versus no intervention, Outcome 2 Slope of injury claims.
3.1
3.1. Analysis
Comparison 3 Pesticide ban versus no intervention, Outcome 1 Level of poisoning deaths.
3.2
3.2. Analysis
Comparison 3 Pesticide ban versus no intervention, Outcome 2 Slope of poisoning deaths.
4.1
4.1. Analysis
Comparison 4 Technical measures in all tractors versus no intervention, Outcome 1 Level of injury rates.
4.2
4.2. Analysis
Comparison 4 Technical measures in all tractors versus no intervention, Outcome 2 Slope of injury rates.
5.1
5.1. Analysis
Comparison 5 Technical measures in new tractors versus no intervention, Outcome 1 Level of injury rates.
5.2
5.2. Analysis
Comparison 5 Technical measures in new tractors versus no intervention, Outcome 2 Slope of injury rate.
See this image and copyright information in PMC

Update of

  • doi: 10.1002/14651858.CD006398

References

References to studies included in this review

Gadomski 2006 {published data only}
    1. Gadomski A, Ackerman S, Burdick P, Jenkins P. Efficacy of the North American guidelines for children's agricultural tasks in reducing childhood agricultural injuries. American Journal of Public Health 2006;96(4):722‐7. - PMC - PubMed
Lee 2004 {published data only}
    1. Lee BC, Westaby JD, Berg RL. Impact of a national rural youth health and safety initiative: results from a randomized controlled trial. American Journal of Public Health 2004;94(10):1743‐9. - PMC - PubMed
Pekkarinen 1994 {published data only}
    1. Pekkarinen A, Anttonen H, Pramila S. Accident Prevention in Reindeer Herding Work. Arctic 1994;47(2):124‐7.
Rasmussen 2003 {published data only}
    1. Rasmussen K, Carstensen O, Lauritsen JM, Glasscock DJ, Hansen ON, Jensen UF. Prevention of farm injuries in Denmark. Scandinavian Journal of Work Environment and Health 2003;29(4):288‐96. - PubMed
Rautiainen 2004 {published data only}
    1. Rautiainen RH, Lange JL, Hodne CJ, Schneiders S, Donham KJ. Injuries in the Iowa Certified Safe Farm Study. Journal of Agricultural Safety and Health 2004;10(1):51‐63. - PubMed
Rautiainen 2005 {published data only}
    1. Rautiainen RH, Ledolter J, Sprince NL, Donham KJ, Burmeister LF, Ohsfeldt R, Reynolds SJ, Phillips KT, Zwerling C. Effects of premium discount on workers compensation claims in agriculture in Finland. American Journal of Industrial Medicine 2005;48(2):100‐9. - PubMed
Roberts 2003 {published data only}
    1. Roberts DM, Karunarathna A, Buckley NA, Manuweera G, Sheriff MH, Eddleston M. Influence of pesticide regulation on acute poisoning deaths in Sri Lanka. Bulletin of the world Health Organization 2003;81(11):789‐98. - PMC - PubMed
Springfeldt 1993a {published data only}
    1. Springfeldt B. Effects of occupational safety rules and measures with special regard to injuries (Doctoral dissertation). Sweden: The Royal Institute of Technology, Department of Work Science, 1993.
Springfeldt 1993b {published data only}
    1. Springfeldt B. Effects of occupational safety rules and measures with special regard to injuries (Doctoral dissertation). Sweden: The Royal Institute of Technology, Department of Work Science, 1993.
Springfeldt 1993c {published data only}
    1. Springfeldt B. Effects of occupational safety rules and measures with special regard to injuries (Doctoral dissertation). Sweden: The Royal Institute of Technology, Department of Work Science, 1993.
Springfeldt 1993d {published data only}
    1. Springfeldt B. Effects of occupational safety rules and measures with special regard to injuries (Doctoral dissertation). Sweden: The Royal Institute of Technology, Department of Work Science, 1993.

References to studies excluded from this review

Cole 2002 {published data only}
    1. Cole H, Piercy L, Struttmann T, Westneat S. Improving farmers' self‐protective behavior with a narrative‐based tractor safety community education program. 6th International Conference, Scientific Committee on Educational and Training in Occupational Health, ICOH. October 28‐30, 2002.
Forst 2004 {published data only}
    1. Forst L, Lacey S, Hua YC, Jimenez R, Bauer S, Skinner S, Alvarado R, Nickels L, Zanoni J, Petrea R, Conroy L. Effectiveness of community health workers for promoting use of safety eyewear by Latino farm workers. American Journal of Industrial Medicine 2004;46(6):607‐13. - PubMed
Glasscock 1997 {published data only}
    1. Glasscock DJ, Hansen ON, Rasmussen K, Carstensen O, Lauritsen J. The West Jutland Study of Farm Accidents: A Model for Prevention. Safety Science 1997;25(1‐3):105‐12.
Hawk 1995 {published data only}
    1. Hawk C, Gay J, Donham K, Chapman R. Prevention and control of pediatric agricultural injuries: Evaluation of a community‐oriented educational intervention. Agricultural Health and Safety: Workplace, Environment, Sustainability. Boca Raton, FL: CRC Press, 1995:369‐78.
Jansson 1988 {published data only}
    1. Jansson BR. Safety education and training of Swedish farmer‐loggers. Journal of Social Occuppational Medicine 1988;38(4):113‐7. - PubMed
Landsittel 2001 {published data only}
    1. Landsittel DP, Murphy DJ, Kiernan NE, Hard DL, Kassab C. Evaluation of the Effectiveness of Educational Interventions in the Pennsylvania Central Region Farm Safety Pilot Project. American Journal of Industrial Medicine 2001;40(2):145‐52. - PubMed
Legault 2000 {published data only}
    1. Legault ML, Murphy DJ. Evaluation of the Agricultural Safety and Health Best Management Practices Manual. Journal of Agricultural Safety and Health 2000;6(2):141‐53. - PubMed
Marlenga 2002 {published data only}
    1. Marlenga B, Pickett W, Berg RL. Evaluation of an enhanced approach to the dissemination of the North American Guidelines for Children's Agricultural Tasks: a randomized controlled trial. Preventive Medicine 2002;35:150‐9. - PubMed
Myers 2004 {published data only}
    1. Myers ML, Cole HP, Westneat SC. Cost‐effectiveness of a ROPS retrofit education campaign. Journal of Agricultural Safety and Health 2004;10(2):77‐90. - PubMed
Myers 2005 {published data only}
    1. Myers ML, Cole HP, Westneat SC. Cost effectiveness of a dealer's intervention in retrofitting rollover protective structures. Injury Prevention 2005;11(3):169‐73. - PMC - PubMed
Pekkarinen 2006 {published data only}
    1. Pekkarinen A. Changes in reindeer herding work and their effect on occupational accidents. International Journal of Circumpolar Health 2006;65(4):357‐64. - PubMed
Reinhart 1997 {published data only}
    1. Reinhart DD, Bean TL, McCaslin NL, Nieto R. A Design for Tailgate Safety Training in Ohio. Journal of Agromedicine 1997;4(3/4):363‐7.
Stave 2007 {published data only}
    1. Stave C, Torner M, Eklof M. An intervention method for occupational safety in farming ‐ evaluation of the effect and process. Applied Ergonomics 2007;38:357‐68. - PubMed

Additional references

Abend 1998
    1. Abend EL, Halman EM. Decreasing injury rates through voluntary participation in worker training programs. Proceedings of the International Summer Conference of the National Institute for Farm Safety. Winnipeg, Manitoba, Canada., 1998 June 21‐25.
Baker 1984
    1. Baker SP, O'Neill B, Karpf RS. The injury fact book. Lexington, MA: Lexington Books, 1984.
Buchan 1993
    1. Buchan VV, Hewitt SJ. 15 month follow‐up evaluation of farm safety day camps in Fruita and Montrose. High Plains Intermountain Center for Agricultural Health and Safety, Colorado State University, Fort Collins, Colorado 1993 Dec.
Campbell 1966
    1. Campbell DT, Stanley JC. Experimental and quasi‐experimental designs for research. Chicago: Rand McNally, 1966.
Campbell 2001
    1. Campbell MK, Mollison J, Grimshaw JM. Cluster trials in implementation research: estimation of intracluster correlation coefficients and sample size. Statistics in Medicine 2001;20(3):391‐9. - PubMed
Carstensen 1998
    1. Carstensen O, Rasmussen K, Lauritsen J, Glasscock D, Hansen ON. The west Jutland study on prevention of farm accidents, phase 3: a randomized intervention study among 200 Danish farms [abstract]. Proceedings of the 4th World Conference on Injury Prevention and Control. Amsterdam, Netherlands, 1998 May 17‐20; Vol. 2.
Carstensen 2001
    1. Carstensen O. Farm accidents: a Danish model for prevention. How to reduse workplace accidents: accident prevention programmes in the member states of the European Union. Office for Official Publications of the European Communities, Luxembourg, 2001:75‐81.
Cordes 1991
    1. Cordes DH, Foster D. Preventive measures in agricultural settings. Occupational medicine: State of the art reviews 1991;6(3):541‐50. - PubMed
DeRoo 2000
    1. DeRoo LA, Rautiainen RH. A systematic review of farm safety interventions. American Journal of Preventive Medicine 2000;18(Suppl 4):51‐62. - PubMed
Donham 2006
    1. Donham KJ, Rautiainen R, Lange J, Schneiders S. Injury and Illness Costs in the Certified Safe Farm Study. The Journal of Rural Health 2006 June (submitted). - PubMed
Downs 1998
    1. Downs SH, Black N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non‐randomised studies of health care interventions. Journal of Epidemiology and Community Health 1998;52(6):377‐84. - PMC - PubMed
Duperrex 2007
    1. Duperrex O, Roberts I, Bunn F. Safety education of pedestrians for injury prevention. Cochrane Database of Systematic Reviews 2002, Issue 2. [DOI: 10.1002/14651858.CD001531] - DOI - PMC - PubMed
EPOC 2006
    1. The Cochrane Effective Practice and Organisation of Care Group (EPOC). Including Interrupted Time Series (ITS) Designs in a EPOC Review. EPOC Methods Paper. http://www.epoc.uottawa.ca/inttime.pdf [accessed 12.07.06].
Haddon 1980
    1. Haddon W Jr. Options for the prevention of motor vehicle crash injury. Israel Journal of Medical Science 1980;16(1):45‐65. - PubMed
Hartling 2004
    1. Hartling L, Brison RJ, Crumley ET, Klassen TP. Pickett W. A systematic review on interventions to prevent childhood farm injuries. Pediatrics 2004;114(4):483‐96. - PubMed
Heidt 1984
    1. Heidt H, Groh G. Schwerpunkte landwirtschaftlicher Arbeitsunfälle und Möglichkeiten zu ihrer Verhütung. Landtechnik 1984;39:35‐40.
Higgins 2005
    1. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions. The Cochrane Collaboration 2008:Version 5.0 [updated February 2008]. Available from www.cochrane‐handbook.org.
ILO 1987
    1. Resolution adopted by the Fourteenth International Conference of Labour Statisticians. http://www.ilo.org/public/english/bureau/stat/download/res/isco.pdf [accessed 24.05.2006]. International Labour Organization, 1987 October‐November.
ILO 2002
    1. Facts on agriculture. http://www.ilo.org/public/english/bureau/inf/download/wssd/pdf/agricultu... [accessed 15.6.2006]. International Labour Organization, 2002.
Keifer 2000
    1. Keifer MC. Effectiveness of interventions in reducing pesticide overexposure and poisonings. American journal of preventive medicine 2000;18(4S):80‐9. - PubMed
Lundqvist 1996
    1. Lundqvist P. Evaluation of the improvements in working conditions on farms funded by the Swedish Working Life Fund. Journal of Agricultural Safety and Health 1996;2:191‐6.
McCurdy 2000
    1. mcCurdy SA, Carroll DJ. Agricultural injury. American journal of industrial medicine 2000;38(4):463‐80. - PubMed
Murphy 1992
    1. Murphy DJ. Safety and Health for Production Agriculture, Textbook Number 5. St. Joseph, MI: ASAE, American Society of Agricultural Engineers, 1992.
Murphy 1996
    1. Murphy DJ, Kiernan NE, Chapman LJ. An occupational health and safety intervention research agenda for production agriculture: does safety education work?. American journal of industrial medicine 1996;29(4):392‐6. - PubMed
Myers 1998
    1. Myers ML. Agriculture and Natural Resources Based Industries. In: Stellman JE editor(s). Encyclopedia of Occupational Health and Safety. 4. Vol. 3, Geneva: Industries and occupations, 1998:Chapter 64.2.
Peden 2002
    1. Peden M, McGee K, Sharma G. The injury chartbook: a graphical overview of the global burden of injuries. Geneva: World Health Organization, 2002.
Ramsay 2001
    1. Ramsay C, Grimshaw J, Grilli R. Robust methods for analysis ofinterrupted time series designs for inclusion in systematic reviews. 9th Annual Cochrane Colloquium. Oct 2001, Lyon.
Ramsay 2003
    1. Ramsay CR, Matowe L, Grilli R, Grimshaw JM, Thomas RE. Interrupted time series designs in health technology assessment: lessons from two systematic reviews of behaviour change strategies. International Journal of Technology Assessment in Health Care 2003;19(4):613‐23. - PubMed
Reed 1994
    1. Reed D. Notes from the field: agricultural injury prevention: a farm‐church partnership. Applied Occupational and Environmental Hygiene 1994;9:93‐7.
Reed 2000
    1. Reed DB, Claunch DT. Nonfatal farm injury incidence and disability to children: a sytematic review. American journal of preventive medicine 2000;18(4S):70‐9. - PubMed
Reynolds 2000
    1. Reynolds SJ, Groves W. Effectiveness of Roll‐Over Protective Structures in reducing farm tractor fatalities. American Journal of Preventive Medicine 2000;18(Suppl 4):63‐9. - PubMed
Robinson 2002
    1. Robinson KA, Dickersin K. Development of a highly sensitive search strategy for the retrieval of reports of controlled trials using PubMed. International Journal of Epidemiology 2002;31(1):150‐3. - PubMed
Spangenberg 2002
    1. Spangenberg S, Mikkelsen KL, Kines P, Dyreborg J, Baarts C. The construction of the Oresund link between Denmark and Sweden: the effect of a multifaceted safety campaign. Safety Science 2002;40:457‐65.
Springfeldt 1998
    1. Springfeldt B, Thorson J, Lee BC. Sweden's thirty‐year experience with tractor rollovers. Journal of Agricultural Safety and Health 1998;4(3):173‐80.
Stone 2003
    1. Stone B. Tractor Rollover Protective Structure Incentive Program. Agricultural Centers Tractor‐Related Injury and Death Workshop Record:128‐138, NIOSH. Pittsburgh, PA, 2003 February 13‐14.
Suutarinen 2004
    1. Suutarinen J. Management as a risk factor for farm injuries. Journal of agricultural safety and health 2004;10(1):39‐50. - PubMed
Thorson 1999
    1. Thorson J, Springfeldt B. Successful prevention of tractor accidents in Sweden [Lyckad profylax i Sverige mot traktorolyckor]. Läkärtidningen 1999;96(18):2219‐20. - PubMed
UNSD 2006
    1. International Standard Industry Classification Rev. 4 (draft). United Nations Statistics Division, United Nations Classifications Registry. http://unstats.un.org/unsd/cr/registry/regcst.asp?Cl=27&Lg=1 [accessed 24.05.2006].
Verbeek 2005
    1. Verbeek J, Salmi J, Pasternack I, Jauhiainen M, Laamanen I, Schaafsma F, Hulshof C, Dijk F. A search strategy for occupational health intervention studies. Occupational and Environmental Medicine 2005;62(10):682‐7. - PMC - PubMed
Vidanapathirana 2005
    1. Vidanapathirana J, Abrahamson MJ, Forbes A, Fairley C. Maas media interventions for promoting HIV testing. Cochrane Database of Systematic Reviews 2005, Issue 3. [DOI: 10.1002/14651858.CD004775.pub2] - DOI - PubMed
WRI 2006
    1. World Resource Institute. Earth trends, agricultural labor force. http://earthtrends.wri.org/searchable_db/index.php?action=select_countri... [accessed 01.04.2006].

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