Iris Reyes

Immigrant dairy workers' perceptions of health and safety on the farm in America's Heartland.

BACKGROUND Dairy farming is dangerous. Yearly, farms grow fewer and larger by employing immigrant workers, who have limited industrial agriculture experience and safety and health training. METHODS We examined results of five focus groups with 37 Hispanic, immigrant dairy workers. Analysis followed a grounded theory approach and employed ATLAS.ti. RESULTS Reported injury experience affirmed the hazardous nature of dairy. Some workers received appropriate worker compensation benefits, whereas others were instructed to deny work-relatedness. Some employers covered medical injury costs out-of-pocket, whereas others did not. Cows were a major injury source. Pressure to work and weather were noted as injury risk factors. Worker compensation was poorly understood, and immigration status and fear of deportation influenced injury and hazard reporting. CONCLUSION Injury management practices range from benevolent to threatening. Workers compensation is poorly understood and undocumented status is an occupational hazard. We underscore the need for further research and immigration policy change.

Applying Learning Theory to Safety and Health Training for Hispanic Immigrant Dairy Workers

We designed a safety and health curriculum for dairy immigrant workers aiming to increase knowledge, encourage safe behavior, and reduce worker communication inequalities to prevent occupational injury and diseases. The design is largely based on the Taxonomy of Significant Learning and incorporated behavioral and adult learning theories and principles of occupational hazard control. Trainings were implemented with 836 Spanish-speaking workers from 67 farms in Wisconsin. Sixty-seven percent of workers reported never being trained before in dairy safety, 65% of these worked in dairy for 5 or fewers years, and 26% of workers reported being ever injured while working on dairy. Quantitative and qualitative evaluation of the trainings suggest that our curriculum successfully increased worker knowledge and promoted contemplation of safe practices. The overall knowledge gain of 25% was statistically significant (p < .01). Workers recalled at least one key concept, expressed confidence of adopting at least one safety behavior, and mentioned their intention to communicate safety concerns to farmers. To our knowledge, this is the first Taxonomy of Significant Learning application to occupational safety and health education. Our curriculum can support dairy farmers’ compliance with Occupational Safety and Health Administration’s annual training requirements by providing our basic safety and health training to workers at early job stages.

The Use of Audience Response System Technology With Limited-English-Proficiency, Low-Literacy, and Vulnerable Populations

ABSTRACT Audience response systems (ARS) have long been used to improve the interactivity of educational activities. Most studies of ARS have addressed education of literate trainees. How well these devices work with low-literacy subjects is not well studied. Information gathering on the training audience is an important use of ARS and helpful in improving the targeting of training information. However, obtaining demographic information from vulnerable populations with reasons to be concerned about divulging information about themselves has not been tested. In addition, a culturally competent method to effectively collect demographic and evaluation data of this growing population is essential. This project investigated the use of ARS to gather information from Hispanic immigrant workers, many of whom are socially vulnerable and have limited English proficiency (LEP) and low-literacy. Workers attended focus groups and were asked to use ARS devices or clickers to respond to questions. Questions were both categorical (multiple choice) and open-ended numerical (text entry), and varied from simple queries to more sensitive points regarding immigration. Most workers answered the one-key response categorical questions with little difficulty. In contrast, some participants struggled when responding to numerical questions, especially when the response required pressing multiple clicker keys. An overwhelming majority of participants reported that the clickers were comfortable and easy to use despite the challenges presented by the more complex responses. The error rate increased as question complexity increased and the trend across three ordered categories of response complexity reached statistical significance. Results suggest that ARS is a viable method for gathering dichotomous or higher-order categorical information from LEP and low-literacy populations in a group setting while assuring anonymity. However, it is recommended that clickers be developed and tested with fewer, bigger, and more widely separated buttons, and less printing on the buttons for these populations. Further research is needed to determine the effectiveness of using clickers with simplified configurations in the workplace as a tool to collect data for surveys and assessments and to better engage LEP and low-literacy workers in training sessions.

A Model Health and Safety Intervention for Hispanic Immigrants Working in the Dairy Industry

A Model Health and Safety Intervention for Hispanic Immigrants Working in the Dairy Industry Amy K. Liebman MPA, MA, Patricia Juarez-Carrillo MPH, PhD, Iris Anne C. Reyes MPH & Matthew C. Keifer MD, MPH a Amy K. Liebman and Patricia Juarez-Carrillo are affiliated with the Migrant Clinicians Network, Salisbury, Maryland, USA. b Iris Anne C. Reyes and Matthew C. Keifer are affiliated with the National Farm Medicine Center, Marshfield Clinic Research Foundation, Marshfield, Wisconsin, USA. Published online: 09 Jun 2014.

754 Farm mapping to assist, protect, and prepare emergency responders (farm mapper)

Background Farm Mapping to Assist, Protect and Prepare Emergency Responders (Farm MAPPER) is an interactive web-based tool developed by the NFMC that provides emergency responders onsite information about hazards, resources and physical layouts of agricultural operations. Emergency responders generally do not have right of entry to private farms to map them for future emergencies. Farm MAPPER provides a palate of icons representing items important in emergency events such hazards, access points, water sources, etc., even information on special needs farm residents. Methods The system was developed to allow a farmer to drag and drops icons on an overhead farm map using their computer. Through Farm MAPPER this information is accessible to emergency responders in the fire station, in-route by web connected device, or onsite using QR codes located on post box posts. This knowledge assists responders to efficiently and safely respond to on farm emergencies. MAPPER presently displays icons on Bing maps in an overhead bird’s eye view of the farm. Results The team developed and tested the prototype Farm MAPPER application with local farmers and conducted mock response with the Pittsville fire department using the MAPPER on a volunteer farms. Feedback was received from both groups. Farmers found it easy to use and expressed willingness to map their farms for the benefit of the emergency responders who might use the application. Emergency responders who participated in the mock responses found the application helpful in quickly locating the items that they needed to avoid or employ for their safety and response efficiency. They suggested modifications to the application which have since been incorporated. Conclusions The system was developed to handle geographic diversity, and will be available for worldwide adoption. The team is currently seeking collaborative opportunities to further expand the project reach beyond central Wisconsin.

Farm Mapping to Assist, Protect, and Prepare Emergency Responders: Farm MAPPER

ABSTRACT Responders such as firefighters and emergency medical technicians who respond to farm emergencies often face complex and unknown environments. They may encounter hazards such as fuels, solvents, pesticides, caustics, and exploding gas storage cylinders. Responders may be unaware of dirt roads within the farm that can expedite their arrival at critical sites or snow-covered manure pits that act as hidden hazards. A response to a farm, unless guided by someone familiar with the operation, may present a risk to responders and post a challenge in locating the victim. This project explored the use of a Web-based farm-mapping application optimized for tablets and accessible via easily accessible on-site matrix barcodes, or quick response codes (QR codes), to provide emergency responders with hazard and resource information to agricultural operations. Secured portals were developed for both farmers and responders, allowing both parties to populate and customize farm maps with icons. Data were stored online and linked to QR codes attached to mailbox posts where emergency responders may read them with a mobile device. Mock responses were conducted on dairy farms to test QR code linking efficacy, Web site security, and field usability. Findings from farmer usability tests showed willingness to enter data as well as ease of Web site navigation and data entry even with farmers who had limited computer knowledge. Usability tests with emergency responders showed ease of QR code connectivity to the farm maps and ease of Web site navigation. Further research is needed to improve data security as well as assess the program’s applicability to nonfarm environments and integration with existing emergency response systems. The next phases of this project will expand the program for regional and national use, develop QR code–linked, Web-based extrication guidance for farm machinery for victim entrapment rescue, and create QR code–linked online training videos and materials for limited English proficient immigrant farm workers.

The nasal microbiota of dairy farmers is more complex than oral microbiota, reflects occupational exposure, and provides competition for staphylococci

Allergic and autoimmune diseases had been attributed to lack of exposure to biodiversity, an important factor in regulating immune homeostasis in a healthy host. We posit that the microbiome of healthy dairy farmers (DF) will be richer than non-farmers (NF) living in urban settings due to exposure to a greater biodiversity in the dairy environment. However, no studies have investigated the relationships between microbiota of dairy farmers (DF) compared with urban non-farmers (NF). We compared the nasal and oral microbiota of dairy farmers (N_DF, O_DF, respectively) with nasal and oral microbiota of NF in the same geographical area. The N_DF showed high microbial diversity with hundreds of unique genera that reflected environmental/occupational exposures. The nasal and oral microbiomes clustered separately from each other using Principal Coordinate Analysis, and with DF harboring two-fold and 1.5-fold greater exclusive genera in their nose and mouth respectively, than did non-farmers. Additionally, the N_DF group had a lower burden of Staphylococcus spp. suggesting a correlation between higher microbial diversity and competition for colonization by staphylococci. The N_DF samples were negative for the mecA gene, a marker of methicillin-resistance in staphylococci. The lower burden of staphylococci was found to be independent of the abundance of Corynebacterium spp. Exposure to greater biodiversity could enhance microbial competition, thereby reducing colonization with opportunistic pathogens. Future studies will analyze whether exposure to livestock microbiomes offers protection from acute and chronic diseases.

P092 Algorithmic approach to injured workers: designed for dairy and pork, applicable across industries

Background Agriculture has again been listed as the most dangerous U.S. industry in 2015. Like other large animal production, dairy and pork operations consistently account for serious, restrictive, non-fatal injuries. This project was designed to develop a return to work software application to produce applicable light duty job assemblies based on worker limitations and available tasks on the farm. Methods Farm task data were collected by physical and occupational therapists at dairy and pork farms in Minnesota and „Wisconsin. The collection included heights, weights, and environmental considerations such as slippery surfaces. Narrative data from therapist collection had to be converted to a structured format to make most use of algorithmic functionality. Results The system, in prototype form, has been tested with workers, employers and clinicians. The application outputs suggested job tasks based on the limitations entered. Rather than a typical proscriptive output from physician to patient and employer, this application provides a prescriptive recommendation allowing the injured worker to get back to work sooner and safer. Farmers/employers still have the discretion to adjust the recommended tasks so long as they stay within the physical limitations outlined by the physician (e.g. cannot lift more than 10 lbs.). Conclusions The tool in prototype appears to be appealing to Insurance companies that offer Workers’ Compensation coverage and Farmers/employers who appreciate the guidance it offers in navigating a safe return to work of injured employees. Though few farmers realise the financial ramifications of keeping someone on time-loss, they quickly discern the value of the system, and often request more information about farm safety and injury prevention.

An Evaluation Tool for Agricultural Health and Safety Mobile Applications

ABSTRACT As the use of mobile devices and their software applications, or apps, becomes ubiquitous, use amongst agricultural working populations is expanding as well. The smart device paired with a well-designed app has potential for improving workplace health and safety in the hands of those who can act upon the information provided. Many apps designed to assess workplace hazards and implementation of worker protections already exist. However, the abundance and diversity of such applications also presents challenges regarding evaluation practices and assignation of value. This is particularly true in the agricultural workspace, as there is currently little information on the value of these apps for agricultural safety and health. This project proposes a framework for developing and evaluating apps that have potential usefulness in agricultural health and safety. The evaluation framework is easily transferable, with little modification for evaluation of apps in several agriculture-specific areas.

Facilitating Return to Work for Injured and Ill Animal Agriculture Workers

Iris Anne Reyes,1 MPH; Nancy Bellendorf,2 OTR; Tami Meehan,3 PT, DPT, OCS; Ron Wenger,3 PT, DPT, OCS, MTC; Christopher Kadolph4; Shaun Halstead4; Andrea Mahnke,4 MS; Bryan Weichelt,4 MS, MBA, PMP; William Ray,4 BS; Matthew Keifer,1 MD, MPH 1National Farm Medicine Center, Marshfield Clinic Research Foundation, Marshfield, Wisconsin, USA 2Work Safe Therapy & Ergonomics, Medford, Wisconsin, USA 3Wenger Physical Therapy, North Mankato, Minnesota, USA 4Biomedical Informatics Research Center, Marshfield Clinic Research Foundation, Marshfield, Wisconsin, USA