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AgriSafe Health Services: An Innovative
Occupational Health Model
Denise Andress, RNWest River Health Services
Hettinger, ND
Phone: 1-701-567-6177Email: [email protected]
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MissionMission
• The Mission of the Network is to support a growing network of trained agricultural health and safety professionals that assure access to preventive service for farm and ranch families and the agricultural community.
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Vision
We envision a day when farmers and ranchers across the country have access to highly trained AgriSafe clinicians.
They will provide superior disease management and prevention services to match the farmer and rancher specific exposures.
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Why AgriSafe?
• Agriculture is the nation’s most hazardous occupations
• Even though mining death rates have decreased in the past 20 years, Ag has been consistently high
• 55 deaths per 100,000 workers in the past year• 45 injuries per 100,000 workers in the past
year• Over 44% U.S. farmworker households have at
least one disabled member• Cost of disabling injuries in agriculture
exceeded 2.7 billion in 1990 alone!
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Why AgriSafe?
• Health Insurance
• Workman’s Compensation
• Regulatory Agencies
• Barriers
• Prevention Services
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Unique Occupational Health Needs
Farmers and ranchers suffer from an increased incidence of:
• respiratory diseases• zoonotic diseases• skin cancer• chronic back pain• musculoskeletal disorders• arthritis• hearing loss• depression• disabling injuries• occupational fatalities
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AgriSafe ModelAgriSafe Model
Serves as an early point of entry into the health care system before serious conditions develop.
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AgriSafe ModelAgriSafe Model
• Menu of services:
– Occupational health screenings
– On site farm site evaluations
– Personal protective equipment (PPE) sales and education
– Educational programs
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AgriSafe Service LocationsAgriSafe Service Locations
• Commodity Groups Meetings/conferences
• Pesticide Applicator Training
• Farm Association Meetings/conferences
• Grain Elevators
• County Fairs
• Seed Dealers
• Stockyards
• Machine Dealerships
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Agricultural Occupational Health and Safety Training
• Target audience– Practicing health professionals
serving rural areas– Nurses and other health
professionals intending to establish AgriSafe Clinics
– Health professional students intending to practice in rural areas
– Health professions graduate students including veterinarians intending to enter public practice.
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Collaboration - ReferralsCollaboration - Referrals
• Family Physicians– Nurses
• Hospitals• Public Health• Specialists
– Ear/Nose/ Throat– Pulmonologists– Audiologists
• Chiropractor• Mental Health
Services• Pharmacists• Social Services• Occupational Health• Parish Nurses
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Agricultural Respiratory Diseases
• Agricultural dust exposure
• Toxic fumes
• Agricultural chemicals
• Infectious diseases
• Prevention– Environmental assessment– Personal protective equipment
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Agricultural Skin Diseases
• Contact Dermatitis
• Sun and heat induced dermatitis
• Anthropod induced dermatitis
• Plant induced dermatitis
• Infectious dermatitis
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Agricultural Pesticides
• Organocholorines
• Organophosphates
• Pyrethoids
• Neonicodenoids
• Herbicides
• Fumigants
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General Environmental Hazards
• Water pollution
• Air pollution
• Solid waste
• Confined animal feeding operations
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Musculosketal Diseases
• Pain
• Chronic pain
• Acute pain
• Injuries
ERGONOMICS!!
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Physical Factors Affecting Health in Agriculture
• Heat injuries
• Cold injuries
• Vibration injuries
• Noise induced hearing loss
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Psychosocial Condition
• Social structure of farming and ranching communities.
• The sources and pychophysiopathology of stress.
• Anxiety disorders• Depression• Screening, treatment and prevention of
stress-related disorders• Suicide and prevention
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Acute Agricultural Injuries
• Injury statistics
• Special medical considerations of agricultural injuries
• Injury scenarios and prevention
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Hazards of Pharmaceuticals
• Veterinary biologicals of human health importance
• Needle sticks• Antibiotic; individual health risk and risk
of resistant microbes• Health hazards of growth promotants
– Estrogenic compounds– Progesterone compounds– Bovine growth hormones– Oxytocin– Prostaglandins
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Rural Zoonotic Infectious Diseases
• General epidemiologic characteristics of zoonoses
• Summary of zoonotic diseases associated with the production of:– Swine– Dairy cattle– Sheep and goats– Poultry
• General environmental reservoirs
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Prevention
• Regulations
• Engineering
• Education
• Personal Protected Equipment
• Ergonomics
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Health Promotion in the Health Promotion in the Farming CommunityFarming Community
Social Services
Schools
Churches
Health Systems Government
Insurance/ Business
Mental HealthProviders
AgriSafe Clinic
Universities
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Community LinkagesCommunity Linkages
• Think beyond the provision of direct clinical services.
• AgriSafe providers can be the link to other health professionals to get them on track with the latest agricultural health and safety information.
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Occupational Health ServicesOccupational Health Services
Agricultural Specific Screening Services
– Occupational History
– Lung Function screening
– Hearing Test
– Skin Cancer Screening
– Back/Spine Lifting Safety Assessment
– Cholinesterase
– Tetanus Immunization
General Health Screening Services
– Height/weight evaluation– Blood Pressure– Cholesterol
Referral to Health Care Providers
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Client Consent & OrientationClient Consent & Orientation
Pulmonary Function TestingCholesterol and
Cholinesterase Screening
Blood Pressure Height-Weight Evaluation and other Vital Signs
Hearing Testing
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Identification of High Risk AreasIdentification of High Risk Areas
Health and Safety Education Specific to the farmer’s needs and the needs of
their spouse, children,other family members.
REFERRALS PLANNING
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Personal Protective EquipmentPersonal Protective EquipmentFit, Education and SalesFit, Education and Sales
Farmer, ranchers and their families, local businesses, vendors, and
media
Respirator Fit Testing
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Farm Site EvaluationFarm Site Evaluation
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A collaborative research project between Iowa’s Center for Agricultural Safety and Health (I-CASH) at The University of Iowa and the AgriSafe Network
PROGRAM OBJECTIVE: to improve the health and well-being of farmers and their families by offering an innovative incentive package from public and private sector partners
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– This model uses theory from the fields of epidemiology, engineering, industrial hygiene, ergonomics, and regulation.
– Includes education based on a combination of applied theories from safety education, social psychology, and public health.
– Inclusion of health and safety in the management of the farm operation is crucial.
Certified Safe Farm (CSF)Certified Safe Farm (CSF)
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Certified Safe Farm (CSF)Certified Safe Farm (CSF)
• Remove or modify on-farm work hazards • Preventive health screening services to
detect and prevent high risk health conditions on the farm
• Identify informational needs and provide educational material
• Evaluation of data, including:
Illness, injuries, fatalities, PPE usage, modification of work hazards, and Insurance costs and coverage.
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CSF Focus Group Responses January 2006
Question: Have you changed any of your health habits as a result of being in the CSF program?
• Carry earplugs at all times• Began wearing sun safe hats, use sun-screen more
often• Began wearing dust masks more often• Made diet changes and try to exercise more• Began wearing gloves when mixing chemicals; let
the elevator do chemical application
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Safety Improvements (1998-02)
• 1,292 improvements reported including:
• 207 SMV signs, • 60 PTO master shields• 32 driveline shields• 77 machine guards/shields, • 83 lockout/tagout items, • 35 fire extinguishers• 139 lighting and marking items• 6 tractor ROPS, 3 skid steer loader cages
• Total value ~$70,000 or $650 per farm
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Network ExpansionNetwork Expansion
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• Must complete the 40 hour agricultural health training provided by Iowa’s Center for Agricultural Safety and Health (I-CASH) at the University of Iowa.
• Must pass I-CASH course exams.
• Maintain annual .5 CEU requirements.
• Must adhere to the Network’s Operations Manual and the affiliation agreement.
Required Professional Standards ofRequired Professional Standards of AgriSafe Clinic Providers AgriSafe Clinic Providers
Required Professional Standards ofRequired Professional Standards of AgriSafe Clinic Providers AgriSafe Clinic Providers
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SummarySummary
• The AgriSafe approach to health care delivery reflects innovation in bringing the best preventive services to the farming and ranching population.
• AgriSafe health professionals should be considered as a “dissemination arm” to bring information directly to farmers and other health professionals.
• AgriSafe members receive multiple benefits including technical assistance in the development of clinical and educational services.
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Contact InformationContact Information
Denise Andress, RNCommunity Health ManagerWest River Health ServicesHettinger, ND 58639Phone (701) [email protected]