Injury and Illness Surveillance of U.S. Agricultural Workers

Assessment of Recommendations and Actions

by Ramya Chari, Amii M. Kress, Jaime Madrigano

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Research Questions

  1. What actions could be taken to address panel recommendations directly related to surveillance?
  2. What is the overall achievability of each action, based on criteria relating to feasibility and desirability?

Agriculture remains one of America's oldest and most valued industries, but is also one of the most hazardous, with farmworkers experiencing high rates of injuries and illnesses. The National Institute for Occupational Safety and Health's (NIOSH) Agriculture, Forestry and Fishing (AgFF) Program provides leadership to prevent harm to workers in the three named sectors. Since its inception, the AgFF Program has spearheaded numerous surveillance initiatives to understand the magnitude of injuries and illnesses among agricultural worker populations, identify vulnerable groups, and evaluate the effectiveness of intervention measures.

In 2012, the program underwent a review from an independent panel convened to evaluate progress in program relevance and impact. While the panel offered a number of recommendations for improving surveillance, it provided little guidance on how to prioritize and achieve the recommendations. In 2015, NIOSH asked the RAND Corporation to assess options for action in response to panel recommendations. The goal of this report is to provide NIOSH with a practical assessment of the feasibility and desirability of carrying out actions to meet surveillance-related panel recommendations, given current AgFF Program resources and priorities.

The authors conducted literature reviews and targeted interviews to detail how actions could be implemented and identify barriers to their achievement. For each action, the authors applied criteria relevant to assessing feasibility (costs, partnership engagement, information availability and accessibility, policy barriers, timelines) and desirability (relevance to program priorities, information quality, and impact). Overall, the report identifies a number of actions that balanced both feasibility and desirability for NIOSH to consider as it determines the direction of the AgFF Program.

Key Findings

Direct Action and Extramural Funding Mechanisms Tend to Show Higher Achievability and Feasibility Than Do Actions That Depend on Partner Capabilities for Implementation

  • Actions that depend on partner engagement, resources, or capabilities may have lengthier timelines for establishing or building partnerships and negotiating agreements (including data use and data-sharing).
  • There is uncertainty in the availability and accessibility of information that could be obtained through such partnerships.
  • When looking at desirability, the results are more mixed.

Two Actions Had High Feasibility and Desirability Scores

  • Develop concise definitions of populations at occupational exposure risk, and profile them by AgFF commodity specialization, demographic factors, work organization patterns, worksite tasks across various enterprise types, and knowledge or use of emerging technologies.
  • Identify and evaluate the potential of existing data sources (including those currently or recently used by NIOSH) for illness and injury surveillance of agricultural workers.

Table of Contents

  • Chapter One

    Introduction and Project Background

  • Chapter Two

    Project Approach: Identification of Recommendations and Actions

  • Chapter Three

    Project Approach: Development of Implementation Scenarios for Actions

  • Chapter Four

    Project Approach: Criteria Development and Assessment of Actions

  • Chapter Five

    Description of Recommendations and Actions

  • Chapter Six

    Results of Actions Assessment

  • Chapter Seven

    Conclusions

The research reported here was prepared for the the National Institute for Occupational Safety and Health (NIOSH) and conducted by the Infrastructure Resilience and Environmental Policy Program within RAND Justice, Infrastructure, and Environment.

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