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Growing Agricultural Education: Embracing Health and Safety
Growing Agricultural Education: Embracing Health and Safety Image

Authors: Bruce H. Alexander, Jeff B. Bender, Diane Kampa, Matthew C. Keifer, Amy K. Liebman, Carol Peterson, Ruth Rasmussen, Lisa Schiller, Brad Schloesser, and Carolyn Sheridan

Journal of Agromedicine Vol. 21 , Iss. 3,2016

ABSTRACT:
On May 28, 2015, the Upper Midwest Agricultural Safety and Health Center (UMASH), the University of Wisconsin-Eau Claire’s College of Nursing and Health Sciences, the AgriSafe Network, and the Southern Minnesota Center of Agriculture co-sponsored a forum to discuss agriculture health and safety education.  Attendees varied by discipline including farmers, educators, agricultural media, company human resource managers, nurses, physicians, and veterinarians.  Specifically, the assembled group was interested in improving agricultural health and safety and reducing injuries through agricultural education.  The forum participants were charged with identifying better ways to incorporate safety and health as part of our educational curricula, targeting educational strategies for the next generation of farmers and workers, and strategizing on ways to improve health and safety in the changing agricultural sectors.  This synopsis highlights some of the key items discussed during the meeting and some needed next steps.

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A Pilot Project to Develop Culturally and Linguistically-Appropriate Pesticide/Chemical Education Materials for Hmong Produce Growers
A Pilot Project to Develop Culturally and Linguistically-Appropriate Pesticide/Chemical Education Materials for Hmong Produce Growers Image

Authors: Hultberg A, Schermann M, Yang P.

Journal of Agromedicine. Minneapolis, Minnesota. June 9, 2014

ABSTRACT:
The purpose of this project was to provide culturally-appropriate pesticide education for Hmong farmers in Minnesota and develop a cohort of peer educator farmers. The number of Hmong farmers continues to increase in Minnesota, yet few easy-to-understand sources of pesticide safety information exist for this community, and farmers may be using chemicals incorrectly, posing a threat to public health and worker safety. Eight Hmong farmers were selected to participate based on project partner input, their leadership potential and interest in the topic. Farm visits provided information on the type of chemicals used, crops grown, personal protective equipment (PPE) usage, and chemical storage. Participants attended four participatory workshops on key pesticide safety topics: PPE, measuring chemicals, reading chemical labels. Each workshop included hands-on learning and skills-building components. Participants presented on pesticide safety at the Immigrant and Minority Farmer Conference February, 2013, and led a pesticide safety class for March 2013. A poster and picture-based handout with simple English was developed with farmer input and distributed to other farmers. Hmong farmers seek a broad range of agricultural information and skills, including pesticide safety information. Seven of 8 farmers in the project cohort used non-restricted chemicals; one farmer had taken Pesticide Applicator Training. Seven of 8 were not literate in English, and reported inconsistently reading chemical labels or not understanding pre-harvest interval restrictions. Adolescent family members were often asked to translate, including chemical safety information. Participants had very little interaction with Extension or other traditional sources of agricultural education. Future research should focus on developing pesticide curriculum and education delivery methods for non-English speaking farmers. Agricultural education and outreach efforts should include Hmong-speaking staff and use non-computer methods such as phone and mail to reach Hmong farmers. Adolescents should be targeted as “gatekeepers” of information on Hmong farms and included in future studies and outreach efforts. Clinicians should consider providing pesticide education about the safety risks associated with improper use when working with the Hmong community. Sampling studies to determine levels of pesticide residue on fresh produce at farmers markets could determine the extent to which farmers (Hmong or otherwise) are following pre-harvest interval restrictions.

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Characterization of Air Contaminants Associated with Type of Swine Production Facilities
Characterization of Air Contaminants Associated with Type of Swine Production Facilities Image

Authors: Murphy D, Engelman S, Raynor PC, Ramachandran G, Alexander BH.

Journal of Agromedicine. Minneapolis, Minnesota. June 09, 2014

ABSTRACT:
Workers in the swine industry are frequently exposed to respiratory hazards including organic dusts, bioaerosols, gases, and endotoxin. As production practices in the swine industry continue to evolve to meet growing demand and in response to consumer and food industry preference, the change in practices may cause a change in the working environment. The extent to which these air contaminants vary by the type of swine production facility is not clear. The objective of this research is to characterize air contaminant concentration and variability associated with differing swine rearing practices. This project characterizes air contaminants in a facility with parallel sow/farrow rearing systems (gestation crates and open gestation pens), and finishing pens using dry and wet feed delivery systems. Time-weighted average respirable dust and endotoxin concentrations are measured at stationary locations. Real-time measures of respirable dust, hydrogen sulfide, ammonia, and carbon dioxide concentrations, and temperature and relative humidity are measured to assess temporal and spatial variability throughout the site. The contaminant concentrations will be summarized to estimate average, peak, and spatial distributions and compared between the type of production system. The measures will be repeated in cold and warm weather months. Initial measurements indicate concentrations of ammonia and hydrogen sulfides are modestly higher in the gestation crate housing, while respirable dust concentrations are higher in the pens. There is considerable variability in concentrations with space and time. All concentrations measured to date are below occupational exposure limits. Characterizing airborne contaminants in swine production operations by type of facility will identify the potential impact facility type has on workers, which can then be evaluated along with animal welfare needs. Understanding variability of exposure by type of operation will inform future research on the control of air contaminants within these systems. Additionally, studies that evaluate potential respiratory health effects will be better designed with knowledge of the range and types of exposures. The second phase of this study will repeat these assessments in several facilities with differing configurations to characterize the range of these exposures across the industry.

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Reptile-Associated Salmonellosis in Minnesota, 1996-2011
Reptile-Associated Salmonellosis in Minnesota, 1996-2011 Image

Authors: Whitten T. Bender JB, Smith KE, Leano F, Scheftel J.

Zoonoses Public Health. St. Paul, Minnesota. Jun. 9, 2014

ABSTRACT:
Reptile-associated salmonellosis (RAS) occurs when Salmonella is transmitted from a reptile to a human. This study describes the epidemiology of RAS in Minnesota during 1996-2011. All Minnesotans with confirmed Salmonella infections are reported to the Minnesota Department of Health (MDH). Case patients are interviewed about illness characteristics and risk factors, including foods eaten, drinking and recreational water exposures, contact with ill people, and animal contact. Willing RAS case patients can submit stool from the reptile for culture. Serotype and pulsed-field gel electrophoresis (PFGE) subtype of Salmonella isolates from reptiles and case patients are compared. Of 8389 sporadic (not associated with an outbreak) non-typhoidal salmonellosis case patients in Minnesotans during 1996-2011, 290 (3.5%) reported reptile exposure. The median age of case patients with reptile exposure was 11 years, 31% were under the age of 5 years and 67% were under the age of 20 years; 50% were female. The median illness duration was 8 days; 23% required hospitalization. The most commonly reported reptile exposures were lizard (47%), snake (20%), turtle (19%) and a combination of reptile types (14%). Eighty-four per cent of isolates from case patients who reported reptile exposure were Salmonella enterica subspecies I. The three most common serotypes were Typhimurium (15%), Enteritidis (7%) and subspecies IV serotypes (7%). Of 60 reptiles testing positive for Salmonella, 36 (60%) yielded the same Salmonella serotype as the human isolate. Twenty-six of 27 reptile isolates that were subtyped by PFGE were indistinguishable from the human isolate. Of these, 88% were subspecies I; the most common serotypes were Enteritidis (12%), Typhimurium (8%), and Bareilly (8%). RAS accounts for approximately 3.5% of salmonellosis cases in Minnesota, primarily affecting children. The majority of isolates from case patients and reptiles belonged to Salmonella subspecies I, suggesting that reptiles are a source of human infection with serotypes not traditionally considered to be reptile-associated.

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Needlestick Injuries in Livestock Workers and Prevention Programs
Needlestick Injuries in Livestock Workers and Prevention Programs Image

Authors: M.L. Buswell MD, M. Hourigan, A. Nault & J. Bender PhD.

Journal of Agromedicine. St. Paul, Minnesota. June 9, 2014

ABSTRACT:
Veterinary medicine and agriculture have historically lacked needlestick injury (NSI) research, education, and mitigation due to the absence of zoonotic blood-borne pathogens and the “perceived” benign nature of the injury. However, depending on the procedure/pharmaceutical used, these injuries may include mild/severe bacterial or fungal infections, lacerations, local inflammation, vaccine/antibiotic reactions, amputation, miscarriage, and death. The objective of this report is to identify published case reports and case series/surveys on human needlestick exposure to veterinary biologics, and to review literature and educational documents describing needlestick prevention strategies for agricultural workers and veterinarians. An electronic database search was conducted using PubMed© and CABI©. Key search terms: PubMed© – “Needlestick Injuries” [MeSH] veterinar*, “Vaccination/veterinary” [MeSH]) AND “Occupational Exposure” [MeSH], “Vaccination/veterinary” [MeSH]) AND “Occupational Exposure” [MeSH]; CABI© – needlestick injuries.sh. Article inclusion criteria were those detailing NSI in agricultural workers only. Abstracts of all search results were read and relevant articles compiled into a RefWorks© database. References cited within articles were examined to locate additional articles. Fifty-six articles were identified. Literature consisted of case reports (n = 14), survey/case series articles (n = 11), prevention guidance documents (n = 6), and background articles (n = 25). Forty-eight cases were found. Twenty-four identified injury location: 13 (54.2%) NSI to the hands: three to the right, eight to the left, and two were not specified. Eight injuries were to the legs (33.3%): five to the right and three were not specified. Of the 48 cases, 11 (22.9%) involved oil-adjuvanted vaccines. The remaining products included: other vaccines, antibiotics, analgesics/sedatives, and hormones. Forty-six (95.8%) of 48 cases reported seeking medical attention. Of the 11 survey/case series articles: two focused on oil-adjuvant products, one on Brucellosis RB51 vaccine, three on tilmicosin, and five were non-specific. General recommendations from guidance documents included: proper animal restraint, avoid recapping needles, do not bend needles, do not put needle caps in your mouth, provide appropriate training, provide sharps containers, report injuries, seek medical attention. NSI in agriculture workers and veterinarians can result in injury and loss of work. It appears that NSI awareness is limited among workers. There is a need for comprehensive programs to prevent NSI on livestock operations.

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Perception of the Importance of Human-Animal Interactions on Cattle Flow and Worker Safety in Minnesota Dairy Farms
Perception of the Importance of Human-Animal Interactions on Cattle Flow and Worker Safety in Minnesota Dairy Farms Image

Authors: Sorge US, Cherry C, Bender JB.

Journal of Dairy Science. Minnesota. May 16, 2014

ABSTRACT:
Proper cattle-handling techniques (stockmanship) are important to ensure calm animals and a safe work environment for dairy workers on farm. The objectives of this study were to (1) assess Minnesota dairy herd owners’ attitudes toward stockmanship, its perceived importance for cow comfort and worker health, and the establishment of calm cattle movement; and (2) identify current resources and methods of stockmanship training on Minnesota dairy farms. A stratified-random sample of Minnesota dairy farmers were contacted via mail to participate in a 28-question survey. One hundred eight bovine dairy producers participated. Most commonly, respondents learned their cattle handling skills from family members (42.6%) and 29.9% of producers had participated in previous stockmanship training. Producers thought that the skill of the human handler was the most important factor in establishing good cattle flow. Cattle-handling techniques was the third most common topic for new-employee orientation after training in milking parlor protocols and milking parlor disinfection. Time limitations and language barrier were considered serious challenges for worker training. Work-related injuries were responsible for lost work days in the previous year in 13.3% of dairy herds and 73.3% of those injuries occurred while working with cattle. Producers perceived that cattle-related injuries were predominantly the handler’s fault: either because of not paying enough attention to the animal or due to poor cattle handling skills. Facility design was considered the least important for the occurrence of worker injuries. Although no causal inference can be made, herds that had workers who had previously participated in stockmanship training had a 810 ± 378 kg (mean ± standard error of the mean) higher rolling herd average than those that did not, even after adjusting for herd size and bulk tank somatic cell count. However, 50% of respondents were not interested in attending future stockmanship training sessions. In conclusion, cattle handling skills are considered important by Minnesota dairy producers to ensure worker safety and cow flow. Limited availability of time, language barrier, and a perceived lack of training materials were considered challenges during the training of workers on farms.

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Use of personal protective measures by Thai Households in areas with avian influenza outbreaks
Use of personal protective measures by Thai Households in areas with avian influenza outbreaks Image

Authors: Somrongthong R, Beaudoin AL, Bender J, Laosee O, Pakinsee S, Sitthi-amorn C.

Zoonosis and Public Health. Bangkok, Thailand. Feb. 21, 2012

ABSTRACT:
Thailand has had multiple poultry outbreaks of highly pathogenic avian influenza (HPAI) H5N1 since its first emergence in 2004. Twenty-five human cases of HPAI H5N1 avian influenza have been reported in the country, including 17 fatalities, and contact with infected dead or dying poultry has been identified as a risk factor for human infection. This study assessed the use of protective equipment and hand hygiene measures by Thai poultry-owning households during activities involving poultry contact. Surveys conducted in 2008 included questions regarding poultry-related activities and protective measures used during an HPAI outbreak (2005) and 3 years after the study location’s last reported outbreak (2008). For both time periods, poultry owners reported limited use of personal protective equipment (PPE) during all activities and inconsistent hand washing practices after carrying poultry and gathering eggs. This is the first time that PPE use in Thailand has been quantified for a large study group. These data are important for ongoing characterization of HPAI risk and for the crafting of educational messages.

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Prevalence and Characterization of Staphylococcus aureus, including Methicillin Resistant Staphylococcus aureus, Isolated from Bulk Tank Milk from Minnesota Dairy Farms
Prevalence and Characterization of Staphylococcus aureus, including Methicillin Resistant Staphylococcus aureus, Isolated from Bulk Tank Milk from Minnesota Dairy Farms Image

Authors: Haran KP, Godden S, Boxrud D, Jawahir S, Bender J, Sreevatsan S.

Journal of Clinical Microbiology. St. Paul, Minnesota. Dec. 14, 2011

ABSTRACT:
Staphylococcus aureus is a common causative agent of bovine mastitis in dairy herds. The emergence of methicillin-resistant Staphylococcus aureus (MRSA) in hospitals as well as the community is a significant and costly public health concern. S. aureus-related bovine mastitis is a common reason for therapeutic and/or prophylactic use of antibiotics on dairy farms. In this study, herd prevalence of S. aureus, including MRSA, was estimated from bulk tank milk (BTM) from Minnesota farms. A total of 150 pooled BTM samples from 50 farms, collected over 3 seasons (spring, summer, and fall of 2009), were assessed. Herd prevalence of methicillin-susceptible S. aureus (MSSA) was 84%, while MRSA herd prevalence was 4%. A total of 93 MSSA isolates and 2 MRSA isolates were recovered from 150 BTM samples. Antibiotic susceptibility testing of S. aureus isolates showed pansusceptibility in 54 isolates, resistance to a single antibiotic class in 21 isolates, resistance to two antibiotic classes in 13 isolates, and resistance to ≥3 antibiotics classes and thus multidrug resistance in 5 isolates. The two MRSA isolates displayed resistance to β-lactams, cephalosporins, and lincosamides and were multiresistant. Staphylococcal protein A gene (spa) typing identified spa types t529 and t034 most frequently among methicillin-susceptible isolates, while t121 was observed in MRSA isolates. Seven isolates, including the two MRSA isolates, produced staphylococcal enterotoxins B, C, D, and E on overnight culture. MRSA isolates were further genotyped using multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE). Of the 2 MRSA isolates, one had a composite genotype profile of MLST ST 5-PFGE USA100-unknown spa type, which has been reported among hospital-associated MRSA isolates, while the second isolate carried the MLST ST 8-PFGE USA300-spa type t121 genotype, commonly identified among community-associated MRSA isolates. These results suggest that MRSA genotypes associated with hospitals and community can be isolated from milk at very low rates.

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Characterization of influenza A outbreaks in Minnesota swine herds and measures taken to reduce risk of zoonotic transmission
Characterization of influenza A outbreaks in Minnesota swine herds and measures taken to reduce risk of zoonotic transmission Image

Authors: Beaudoin A, Johnson S, Davies P, Bender J, Gramer M.

Zoonoses Public Health. St. Paul, Minnesota. Jul. 18, 2011

ABSTRACT:
Influenza A virus infections commonly cause respiratory disease in swine and can be transmitted between people and pigs, with potentially novel strains introduced into herds and spilling back into the human population. The goals of this study were to characterize influenza infections in Minnesota pigs and assess biosecurity measures used by swine workers. Veterinarians submitting influenza-positive swine samples to the University of Minnesota Veterinary Diagnostic Laboratory between October 2007 and April 2009 were surveyed regarding disease-related information and biosecurity procedures at each farm. Influenza-positive samples were submitted year-round, peaking in spring and fall. H1N1 was the most commonly detected subtype (56%), followed by H3N2 (14%) and H1N2 (12%). Most positive submissions were associated with illness in growing pigs (median age 8.8 weeks, IQR 5-15). Median morbidity and mortality were 25% (IQR 10-48) and 2% (IQR 0.5-3.5), respectively. Vaccination of sows and growing pigs was conducted at 71% and 7.9% of the swine farms, respectively. Specialized footwear was reported as the most common form of protective equipment used by workers. Employee vaccination for seasonal influenza was 19%. The sow vaccination rate in this study is consistent with national data, although growing pig vaccination is lower than the national average. Seasonal and age trends identified here may provide diagnostic guidance when growing pigs experience respiratory disease. Inconsistent use of protective equipment and employee vaccination at swine farms indicates the need for further discussion and research of approaches to minimize interspecies influenza transmission on swine farms.

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Prevalence of low-pathogenic avian influenza and evaluation of management practices in Minnesota backyard poultry flocks
Prevalence of low-pathogenic avian influenza and evaluation of management practices in Minnesota backyard poultry flocks Image

Authors: Yendell SJ, Rubinoff I, Lauer D, Bender JB, Scheftel J.

Zoonoses Public Health. St. Paul, Minnesota. Jul. 6, 2011

ABSTRACT:
Low-pathogenicity avian influenza (LPAI) viruses have caused illness in poultry and humans with poultry contact. To determine whether there is evidence of exposure to avian influenza viruses (AIV) among backyard poultry in Minnesota and their human caretakers, 150 flocks of backyard birds were sampled for antibodies to AIV from August 2007 through December 2008. One hundred flocks were tested through routine slaughter surveillance by the Minnesota Board of Animal Health and an additional 50 flocks were contacted and sampled by study investigators. Blood was collected from 10 to 13 birds from each flock and a survey of biosecurity and management practices was administered to the flock owner. Blood samples were tested by agar gel immunodiffusion (AGID) for influenza A antibodies. Tested flocks had a median flock size of 100 birds (range: 12-800 birds), and were most commonly owned for meat for personal use (81% of respondents), fun or hobby (58%) and eggs for personal use (56%). Although 7% of flock owners reported that their birds had shown respiratory signs in the previous 3 months, only 1 of 150 flocks tested positive for influenza by AGID. Antibodies to LPAI H6N1 were detected in the positive flock. The owner of the positive flock did not have antibodies to H6 or other common AIV. Based on the findings of this study, the risk of transmission of LPAI viruses from backyard poultry to owners in Minnesota appears to be low under current conditions and management practices.

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Facilitating Return to Work for Injured and Ill Animal Agriculture Workers
Facilitating Return to Work for Injured and Ill Animal Agriculture Workers Image

Authors: Reyes IA, Bellendorf N, Meehan T, Wenger R, Kadolph C, Halstead S, Mahnke A, Weichelt B, Ray W, Keifer M.

Journal of Agromedicine. Wisconsin. June 9, 2014

ABSTRACT:
Large animal production, like much of agriculture, is dangerous. Non-fatal injuries in pork and dairy production are commonplace and can often be serious, leading to restrictions. The cost of workplace injuries in dairy and pork is unknown but given the frequency of injury among agricultural workers, it is without doubt a substantial burden to these industries. As dairy and pork industries grow, producers hire more workers who face the risks inherent in the agricultural workplace and whose injuries are increasingly cared for by primary care clinicians. Yet, clinicians are often unfamiliar with the physical demands of farming, are poorly equipped to manage farm injuries and illnesses and have few resources to facilitate workers’ return to work. Producers have difficulty understanding and adapting the traditional return to work sheets in the context of farm tasks. All too often, the injured worker is declared unsuitable to return to work which results in loss of wages and productivity at home. This also results in increased workers’ compensation and a slowed operation that the employer must manage. This translational project will develop an interactive software application designed for clinicians to guide early return to work planning for injured workers in the dairy and pork industries. Concepts for developing transitional work plans commonly used in non-agricultural industries will be applied. A functional job analysis will be developed and will consist of hazards, loads and exposure risks, images and descriptions of tasks to guide clinicians in the planning of returning injured workers using alternative light duty job assemblies. This program will likely improve communication between employer, employee and clinician and enhance worker participation in the return to work decision making. It will also reduce workers’ compensation costs for the employer. More importantly, it will address an unmet need in agricultural health and safety, that of connecting the clinician to the farm to reduce disability and sustain an adequate, safe workforce for the growing agriculture industry.

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The Use of Audience Response Systems Technology with Limited English Proficient, Low Literate and Vulnerable Populations
The Use of Audience Response Systems Technology with Limited English Proficient, Low Literate and Vulnerable Populations Image

Authors: Keifer M, Reyes IA, Liebman AK, Juarez-Carrillo P.

Journal of Agromedicine. Wisconsin. June 9, 2014

ABSTRACT:
Audience Response Systems (ARS) have been used to improve the interactivity of educational activities for many years. 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 populations with reasons to be concerned about divulging information about themselves, often referred as “vulnerable” has also not been tested. In addition, a culturally competent method to effectively collect demographic and evaluation data of this 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. Hispanic immigrant dairy workers were invited to attend focus groups and were asked to use the clickers to respond to a series of 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 participants 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 keys on the clicker. An overwhelming majority of participants reported that the clickers were comfortable and very easy to use despite the challenges that the more complex responses appeared to present. The error rate increased as response complexity increased and the trend across three ordered categories of response complexity reached statistical significance. The results suggest that ARS is a viable method for gathering dichotomous or higher order categorical information from LEP and low literate populations in a group setting while assuring anonymity to respondents. However, it is recommended that clickers be developed and tested with bigger and more widely separated buttons, a limited number of 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 to collect data for surveys and assessments.

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Surveillance of Disease and Injury in Wisconsin Dairy Farmers and Workers
Surveillance of Disease and Injury in Wisconsin Dairy Farmers and Workers Image

Authors: Keifer MC, Sandberg S, Reyes IA, Waring SC, Alexander B, Gerberich SG.

Journal of Agromedicine. Wisconsin. June 9, 2014

ABSTRACT:
The objective of this project is to establish, as well as maintain, a comprehensive working surveillance system designed to identify illness and injury among dairy farmers and farmworkers throughout the state of Wisconsin. Emphasis is to capture occupational, technological and workforce changes within the industry to determine the impact on health and safety. Procedures are underway to establish the first population-based estimates of incidence of injury and illness in Wisconsin dairy farmers utilizing available resources. Additionally, the project plans to create a surveillance instrument which will include questions regarding illness and injury among workers and their families, and farm owners, as well as process changes within their operation. Subsequent surveying will be used for the identification of both high and low risk activities on the farm and establish if the approach to certain farming related tasks influence risk. Initial estimates of our population cohort have been generated. In addition, as part of a sub-study the manual clinical text abstraction procedure has provided listings of common farm terminology for Natural Language Processing (NLP) development to efficiently and electronically define farmers within medical records that might be missed by matching medical records against other sources. The surveillance instrument design is in final stages awaiting piloting. Change in this industry, including the modernization of equipment, a shift in the demographic of workers as well as the increase in facility size to account for current market demands will surely have an impact on occupational risk factors. Results from our project may impact factors from medical expenditures and hospitalization rates to future agricultural safety policies and procedures. This modifiable surveillance instrument will provide continual disease and injury monitoring and potentially serve as a template for the surveillance of a wide variety of agriculturally based occupations. As well, the cohort will be able to provide additional population-based research projects. A prospective birth cohort study is currently in development. In addition, the novel approach of NLP to efficiently define farmers within medical record text can be applied to other occupations once development and training are complete.

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Antibody prevalence of low-pathogenicity avian influenza and evaluation of management practices in Minnesota backyard poultry flocks
Antibody prevalence of low-pathogenicity avian influenza and evaluation of management practices in Minnesota backyard poultry flocks Image

Authors: Yendell SJ, Rubinoff I, Lauer D, Bender JB, Scheftel J

Zoonoses Public Health, 2012

ABSTRACT:
Low-pathogenicity avian influenza (LPAI) viruses have caused illness in poultry and humans with poultry contact. To determine whether there is evidence of exposure to avian influenza viruses (AIV) among backyard poultry in Minnesota and their human caretakers, 150 flocks of backyard birds were sampled for antibodies to AIV from August 2007 through December 2008.

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Survey of occupational hazards in Minnesota veterinary practices in 2012
Survey of occupational hazards in Minnesota veterinary practices in 2012 Image

Authors: Fowler H, Holzbauer S, Smith K, Scheftel J

Journal of the American Veterinary Medical Association. Minnesota. Jan. 15, 2016

ABSTRACT:
The goal of this study is to identify the scope of occupational hazards encountered by veterinary personnel and compare hazard exposures between veterinarians and technicians working in small and large animal practices. A survey of Minnesota veterinary personnel was conducted between February 1 and December 1, 2012. Adult veterinary personnel working in clinical practice for > 12 months were eligible to participate. Information was collected on various workplace hazards as well as on workplace safety culture.

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Characterizing the Role of Animal Exposures in Cryptosporidiosis and Shiga Toxin-producing Escherichia coli Infections: South Dakota, 2012
Characterizing the Role of Animal Exposures in Cryptosporidiosis and Shiga Toxin-producing Escherichia coli Infections: South Dakota, 2012 Image

Authors: Daly RF, Hill NT

Zoonoses Public Health. Jan. 5, 2016

ABSTRACT:
Cryptosporidium spp. and Shiga toxin-producing Escherichia coli strains (STEC) are important causes of human illness. Incidence rates of these illnesses are high in South Dakota compared to the USA as a whole. Direct animal contact has been identified as a possible route of exposure for these illnesses. Ruminant animals may carry STEC subclinically, while young ruminants are common sources of zoonotic strains of Cryptosporidium. South Dakota patients with either STEC or cryptosporidiosis during 2012 were interviewed regarding seven categories of animal exposure: (i) petting zoo/fair attendance, (ii) animal event/rodeo attendance, (iii) feed/pet store visits, (iv) farm visits, (v) employment or residence at a farm, (vi) residence with pets and (vii) visiting other households with pets. Of the 50 STEC cases, 78.0% reported animal exposure prior to illness onset, with 23.3% having lived or worked on a farm. Farm visitors in particular had high degrees of animal contact and infrequently practiced personal protective measures. Of the 115 cryptosporidiosis cases, 87.8% reported animal exposures, with 45.6% having lived or worked on a farm and 29.0% having visited a farm prior to illness. Cases with farm exposures reported a high degree of direct animal contact and inconsistent use of personal protective measures. Cryptosporidiosis patients were significantly more likely than STEC patients to have lived or worked on a farm prior to their illness and were older on average. Patients with these illnesses had high rates of animal contact prior to illness. Animal contact on farms emerged as an important exposure route. Educational messages about personal protective measures should be directed at these individuals.

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Fitting Farm Safety into Risk Communications Teaching, Research and Practice
Fitting Farm Safety into Risk Communications Teaching, Research and Practice Image

Authors: Evans J, Heiberger S

Journal of Applied Communications, Vol 99 No. 3, 2015

ABSTRACT:
New safety challenges are emerging as agriculture evolves within the complexity of serving a growing world population. The nation’s most hazardous industry is struggling to provide safe working environments in the face of demographic changes in the agricultural work force, new technologies, new kinds of enterprises, pushback against regulation, and other forces. Such changes introduce new forms of occupational risk and create greater need for appropriate safety communications. This study examined potentials for improving engagement of the agricultural media, which serve as primary information channels for farmers. Those who teach agricultural communications are key gatekeepers in preparing skilled professional agricultural journalists and other agricultural communicators. Therefore, the study focused on potentials for strengthening skills in farm safety communications through teaching programs in agricultural journalism and communications. The second and related purpose involved advancing understanding of conceptual linkages between farm safety communications and risk communications, using a safety-oriented framework of risk communications. A mixed methods research design involved quantitative and qualitative approaches using an online survey among faculty representatives in 23 agricultural communications programs at universities throughout the nation. Responses identified encouraging potentials and useful direction for integrating farm safety into agricultural communications courses. Findings also shed helpful light on conceptual linkages between risk communications and a seemingly “lost cousin” — farm safety communications. They pointed to new potentials for agricultural communications teaching and scholarship in strengthening connections between theory and practice in risk communications (including farm safety communications) related to agriculture.

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Live animal markets in Minnesota, a potential source for emergence of novel influenza A viruses and interspecies transmission
Live animal markets in Minnesota, a potential source for emergence of novel influenza A viruses and interspecies transmission Image

Authors: Choi MJ, Torremorell M, Bender JB, Danila R, Smith KE, Boxrud D, Ertl JR, Yang M, Suwannakarn K, Her D, Nguyen J, Uyeki TM, Levine M, Jhung M, Vetter S, Wong K, Sreevatsan S, Lynfield R

Clinical Infectious Diseases. Jul. 29, 2015

ABSTRACT:
Live animal markets have been implicated in transmission of influenza A viruses (IAVs) from animals to people. We sought to characterize IAVs at 2 live animal markets in Minnesota to assess potential routes of occupational exposure and risk for interspecies transmission. We implemented surveillance for IAVs among employees, swine, and environment (air and surfaces) during a 12-week period (October 2012-January 2013) at 2 markets epidemiologically associated with persons with swine-origin IAV (variant) infections. Real-time reverse transcription polymerase chain reaction (rRT-PCR), viral culture, and whole-genome sequencing were performed on respiratory and environmental specimens, and serology on sera from employees at beginning and end of surveillance. At markets where swine and persons are in close contact, swine-origin IAVs are prevalent and potentially provide conditions for novel IAV emergence.

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Validation of Good Agricultural Practices (GAP) on Minnesota Vegetable Farms
Validation of Good Agricultural Practices (GAP) on Minnesota Vegetable Farms Image

Authors: Hamilton KE, Umber J, Hultberg A, Tong C, Schermann, Diaz-Gonzalez F, Bender JB

Foodborne Pathogens Disease. St. Paul, Minnnesota. Jan. 7, 2015

ABSTRACT:
The United States Food and Drug Administration and the Department of Agriculture jointly published the “Guide to Minimize Microbial Food Safety Hazards for Fresh Fruits and Vegetables,” which is used as a basis for Good Agricultural Practices (GAP) audits. To understand barriers to incorporation of GAP by Minnesota vegetable farmers, a mail survey completed in 2008 was validated with visits to a subset of the farms. This was done to determine the extent to which actual practices matched perceived practices. Two hundred forty-six producers completed the mail survey, and 27 participated in the on-farm survey. Over 75% of the on-farm survey respondents produced vegetables on 10 acres or less and had 10 or fewer employees. Of 14 questions, excellent agreement between on-farm interviews and mail survey responses was observed on two questions, four questions had poor or slight agreement, and eight questions had no agreement. Ninety-two percent of respondents by mail said “they took measures to keep animals and pests out of packing and storage buildings.” However, with the on-site visit only 45% met this requirement. Similarly, 81% of respondents by mail said “measures were taken to reduce the risk of wild and/or domestic animals entering into fruit and vegetable growing areas.” With direct observation, 70% of farms actually had taken measures to keep animals out of the growing areas. Additional, on-farm assessments were done regarding employee hygiene, training, presence of animals, water sources, and composting practices. This validation study demonstrated the challenge of creating nonleading and concise questions that are not open to broad interpretation from the respondents. If mail surveys are used to assess GAP, they should include open-ended questions and ranking systems to better assess farm practices. To provide the most accurate survey data for educational purposes or GAP audits, on-farm visits are recommended.

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Personal Protective Equipment Use and Hand Washing among Animal Farmers: A Multi-Site Assessment
Personal Protective Equipment Use and Hand Washing among Animal Farmers: A Multi-Site Assessment Image

Authors: Odo NU, Raynor PC, Beaudoin A, Somrongthong R, Scheftel JM, Donahue JG, Bender JB

Journal of Occupational and Environmental Hygiene. Minneapolis, Minnesota. January 2015

ABSTRACT:
The goal of this study was to compare and contrast the use of personal protective equipment (PPE) and the practice of handwashing among participants of four studies assessing poultry and swine farms in the midwestern United States and in Thailand. This largely descriptive exercise was designed to assess and compare the frequency of these protective practices among the study populations. There were a total of 1113 surveys analyzed across the four studies. The respondents included workers in direct contact with animals as well as flock owners and veterinarians tending to farms. Handwashing was the most common practice observed among all participants with 42% “always” and 35% “sometimes” washing their hands after contact with the animals. This practice was least common among Minnesota swine workers. Even Thai poultry farmers, who demonstrated the lowest overall PPE use, reported a higher frequency of handwashing. Mask use during animal farming activities (“always” or “sometimes”) was least commonly practiced, ranging from 1% in Thailand to 26% among backyard poultry farmers in Minnesota. Minnesota poultry and swine farmers had similar frequencies of mask (26%) and glove use (51% and 49%). All other comparisons differed significantly across the four sites (p-values <0.05). The use of PPE in animal farming differed by study location and is likely related to prevalent norms in the respective regions. Overall, the use of PPE did not appear to be influenced by the particular animal (poultry or swine) being farmed. These findings may prove useful to regulating bodies and farm owners in formulating policy or planning strategies for improving personal hygiene practices in animal farming and preparing for influenza and other potential zoonotic disease outbreaks.

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Evaluation of risk and protective factors for work-related bite injuries to veterinary technicians certified in Minnesota
Evaluation of risk and protective factors for work-related bite injuries to veterinary technicians certified in Minnesota Image

Authors: Nordgren L, Gerberich S, Alexander B, Church T, Bender J, Ryan A

Journal of the American Veterinary Medical Association. Minneapolis, Minnesota. Aug. 15, 2014

ABSTRACT:
The objective of this study is to identify risk and protective factors for work-related bite injuries among veterinary technicians certified in Minnesota. A questionnaire was mailed to CVTs who previously participated in a survey regarding work-related injuries and did (cases; 301 surveys sent) or did not (controls; 567) report qualifying work-related animal bite injuries in the preceding 12 months. Descriptive statistics were summarized. Demographic and work-related variables for the month preceding the bite injury (for cases) or a randomly selected month (controls) were assessed with univariate analysis (489 CVTs) and multivariate analysis of a subset of 337 CVTs who worked in small or mixed mostly small animal facilities. Several work-related factors were associated with the risk of work-related bite injury to CVTs. These findings may serve as a basis for development of intervention efforts and future research regarding work-related injuries among veterinary staff.

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E. coli 0157:H7 Surveillance in Agricultural Populations in Minnesota
E. coli 0157:H7 Surveillance in Agricultural Populations in Minnesota Image

Authors: Klumb C, Saunders S, Smith K

Journal of Agromedicine. Minneapolis, Minnesota. June 9, 2014

ABSTRACT:
Escherichia coli O157:H7 (O157) is an important cause of enteric illness, causing an estimated 96,000 infections and 31 deaths annually in the United States. O157 infections are primarily foodborne but can also occur from contact with infected animals (especially cattle and other ruminants) or their environment. Population-based surveillance data for O157 infections in agricultural populations are sparse, and the extent to which animal agriculture exposures contribute to O157 disease burden is unknown. All O157 cases in Minnesota were interviewed about illness characteristics and potential exposures. Retrospective surveillance data from 1996-2011 were collated from electronic databases and surveillance interview forms. Prospective surveillance for O157 in 2012 included detailed follow-up of agricultural exposures. Descriptive analyses were performed using SAS version 9.2 (SAS Institute, Cary, N.C.). During 1996–2011, 358 (14%) of the 2,623 O157 cases in Minnesota had a documented animal agriculture exposure in the week before illness onset. Of these 358 cases, 52% were female, 93% were white, 91% were non-Hispanic, and the median age was 11 years (range, 5 months–89 years). Eighty-seven percent of the 358 cases had bloody diarrhea, and 36% were hospitalized (median stay, 4 days). Prior to their illness, 143 (40%) of the 358 cases with animal agricultural exposures lived on a farm, 61 (17%) worked on a farm, 142 (39%) visited a farm; 127 (35%) reported direct animal contact, and 198 (55%) reported contact with an animal’s environment. In 2012, 23 (19%) of 124 E. coliO157 cases had an animal agriculture exposure before illness onset. Of these 23 cases, 7 (30%) lived on a farm, 1 (4%) worked on a farm, 11 (48%) visited a farm or petting zoo, and 4 (17%) had multiple exposures. Agricultural exposures can account for a substantial proportion of O157 infections in Minnesota. We will develop practical interventions through awareness campaigns, personal protective equipment recommendations, and job duty modifications. Industry leaders can be valuable collaborators in promoting these initiatives with agricultural populations. In the future we will use social media outlets (Twitter and Facebook) and publications in trade journals to promote interventions.

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Needlestick Injuries in Agriculture Workers and Prevention Programs
Needlestick Injuries in Agriculture Workers and Prevention Programs Image

Authors: Buswell M, Hourigan M, Nault A, Bender JB.

Journal of Agromedicine. St. Paul, Minnesota. 2015

ABSTRACT:
There are a variety of biologics, vaccines, antibiotics, and hormones used in animal agriculture. Depending upon the procedure or pharmaceutical used, accidental injections or product exposures can result in mild to severe injuries. Needlestick injury (NSI) prevention, research, and education for veterinarians and agriculture workers is limited. The objective of this study was to collect and review published case reports and case series/surveys on human needlestick exposure to veterinary biologics and to summarize needlestick prevention strategies for agricultural workers/veterinarians. A search was conducted of PubMed and Centre for Agriculture Bioscience International (CABI) databases. References were reviewed to identify additional articles. NSI among agricultural workers were primarily included in this review. Thirty articles were applicable to exposures in agricultural settings. Relevant literature consisted of case reports, survey/case series articles, prevention documents, and background articles. Fifty-nine case patients were identified. Most of these cases were associated with exposures to specific vaccines or veterinary products. Injury location was identified from 36 individuals: 24 (67%) NSI to the hands, 10 (28%) injuries to the legs, and 2 to other body locations. Of the 59 cases, 20 (34%) involved oil-adjuvant vaccines. Evidence of hospitalization was recorded for 30 case patients. The length of hospitalization was available from 11 case patients. Median length of hospitalization was 3 days (range: 1-4). Surgical intervention was reported in 25 case patients. Outcome information was available on 30 case patients. Fifteen made a complete recovery within 2 weeks of treatment, 14 had residual sequelae attributed to the injury, and there was 1 reported death. Of the 13 survey/case series articles: 2 focused on oil-adjuvant products, 1 on Brucellosis RB-51 vaccine, 3 on tilmicosin, 1 on Salmonella enteritidis vaccine, 1 on high-pressure injection, and 5 were nonspecific. NSI in agriculture workers and veterinarians can result in significant bodily injury and loss of work. There is a need for varied and comprehensive educational programs for agricultural workers and veterinarians to prevent NSI on livestock operations.

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COMIC: Safety and Health on the Farm- It's your Right and it's the Law
COMIC: Safety and Health on the Farm- It

Authors: Liebman AK, Juárez-Carillo P, Sáenz S, and Guerrero F.

Am. J. Ind. Med, 2013

ABSTRACT:
The Agriculture, Forestry, and Fishery (AgFF) Sector workforce in the US is comprised primarily of Latino immigrants. Health care access for these workers is limited and increases health disparities.  This article addresses health care access for immigrant workers in the AgFF Sector, and the workforce providing care to these workers.

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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 Image

Authors: Liebman AK, Juarez-Carrillo P, Reyes IA, Keifer MC.

Journal of Agromedicine. Salisbury, Maryland. 2014

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Looking for lessons in the child agricultural labor law dust-up
Looking for lessons in the child agricultural labor law dust-up Image

Authors: Keifer MC, Heiberger S

Journal of Agromedicine, 2012

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New NIOSH-Funded Center Focuses on Safety and Health in Changing Agricultural Landscape
New NIOSH-Funded Center Focuses on Safety and Health in Changing Agricultural Landscape Image

Authors: Heiberger S, Alexander B, Keifer M, Bender J

Streamline newsletter, March/June 2012

ABSTRACT:
Addressing potential safety and health problems in agriculture is a complex job due to the dynamic nature of the industry and changing demographics of the workforce. The new Upper Midwest Agricultural Safety and Health (UMASH) Center is meeting these challenges with projects that will ultimately improve our understanding of the impact of these changes on the health of workers, and will develop tools available to clinicians in
the care and prevention of injury and illness.

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The future structure of childhood agricultural injury prevention: first the blueprint
The future structure of childhood agricultural injury prevention: first the blueprint Image

Authors: Keifer MC

Journal of Agromedicine, 2012

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Unique ag safety and health issues of migrant and immigrant children
Unique ag safety and health issues of migrant and immigrant children Image

Authors: McLaurin J, Liebman AK

Journal of Agromedicine, 2012

ABSTRACT:
Immigrant and migrant youth who live and work in agricultural settings experience unique agricultural safety and health issues. Mobility, poverty, cultural differences, immigration status, language, education, housing, food security, regulatory standards and enforcement, and access to childcare and health care influence exposure risk and the well-being of this population. Approximately 10% of the migrant agricultural labor force is composed of unaccompanied minors, whose safety and health is further compounded by lack of social supports and additional stresses associated with economic independence. This paper examines the current demographic and health data, regulatory protections, and programs and practices addressing safety and health in this sector of youth in agriculture. Gaps in knowledge and practice are identified, with emphasis on data collection and regulatory limitations. Best practices in programs addressing the special needs of this population are highlighted. Recommendations identify seven priority areas for impact to promote transformative change in the agricultural health and safety concerns of unaccompanied minors and children of immigrant, migrant and seasonal farmworkers. This framework may be used to examine similar needs in other identified subpopulations of children as they merit attention, whether now or in the future.

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The migrant clinicians network: connecting practice to need and patients to care
The migrant clinicians network: connecting practice to need and patients to care Image

Authors: Garcia D, Hopewell J, Liebman AK, Mountain K

Journal of Agromedicine, 2012

ABSTRACT:
Migrant Clinicians Network advocates for migrants and clinicians, develops appropriate resources, engages outside partners, conducts translational research, and runs programs that support clinical care on the front line of migrant health. Migrant Clinicians Network’s goal is to improve health care for migrants by providing support, technical assistance, and professional development to clinicians in Federally Qualified Health Centers and other healthcare delivery sites with the ultimate purpose of providing quality health care that increases access and reduces disparities for migrant farmworkers and other mobile underserved populations. In this article the authors examine the migrant population in the United States, a brief history of clinicians working in migrant health, and the scope of current Migrant Clinicians Network activities, including occupational and environmental health.

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Lessons learned from the child agricultural labor law debate
Lessons learned from the child agricultural labor law debate Image

Authors: Heiberger S

Journal of Agromedicine, 2012

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The quality of drinking water in North Carolina farmworker camps
The quality of drinking water in North Carolina farmworker camps Image

Authors: Bischoff WE, Weir M, Summers P, Chen H, Quandt SA, Liebman AK, Arcury TA

Am J Public Health, 2012

ABSTRACT:
The purpose of this study was to assess water quality in migrant farmworker camps in North Carolina and determine associations of water quality with migrant farmworker housing characteristics.  We collected data from 181 farmworker camps in eastern North Carolina during the 2010 agricultural season. Water samples were tested using the Total Coliform Rule (TCR) and housing characteristics were assessed using North Carolina Department of Labor standards.

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Streptococcus suis meningitis in swine worker, Minnesota, USA
Streptococcus suis meningitis in swine worker, Minnesota, USA Image

Authors: Fowler HN, Brown P, Rovira A, Shade B, Klammer K, Smith K, Scheftel JM

Emerg Infect Dis, 2013

ABSTRACT:
Streptococcus suis is a major bacterial pathogen in swine worldwide. Historically, cases in humans have occurred sporadically, mostly in Asia. However, an outbreak in China involved 215 human cases and 39 deaths. Only 3 human cases of S. suis disease were documented in the United States before 2011: 2 domestically acquired cases in New York and Hawaii, and 1 case in a person in California who was probably exposed in the Philippines. We describe a case of S. suis disease in a swine worker in Minnesota, USA.

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Occupational Health Policy and Immigrant Workers in the AFF Sector
Occupational Health Policy and Immigrant Workers in the AFF Sector Image

Authors: Liebman, A. K., Wiggins, M. F., Fraser, C., Levin, J., Sidebottom, J. and Arcury, T. A.

Am. J. Ind. Med, 2013

ABSTRACT:
Immigrant workers make up an important portion of the hired workforce in the Agricultural, Forestry and Fishing (AgFF) sector, one of the most hazardous industry sectors in the US. Despite the inherent dangers associated with this sector, worker protection is limited.  This article describes the current occupational health and safety policies and regulatory standards in the AgFF sector and underscores the regulatory exceptions and limitations in worker protections. Immigration policies and their effects on worker health and safety are also discussed. Emphasis is placed on policies and practices in the Southeastern US.

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Hazards faced by informal recyclers in the squatter communities of Asunción, Paraguay
Hazards faced by informal recyclers in the squatter communities of Asunción, Paraguay Image

Authors: Cunningham R, Simpson C, Keifer MC

International Journal of Occupational and Environmental Health, 2012

ABSTRACT:
Informal recycling is widespread in developing countries and involves the collection, sorting, and selling of recyclable materials. Workers are exposed to hazards including the risk of cuts and musculoskeletal injury, infection, exposure to medical waste, and respiratory conditions like bronchitis, pneumonia, and sinusitis and often use insufficient personal protective equipment.  The objective is to assess the occupational and environmental health hazards faced by informal recyclers working at a landfill in Asunción, Paraguay.

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Developing the 2012 national action plan for protecting children in agriculture
Developing the 2012 national action plan for protecting children in agriculture Image

Authors: Lee BC, Gallagher SS, Liebman AK, Miller ME, Marlenga B

Journal of Agromedicine, 2012

ABSTRACT:
In 1996 the US launched a National Childhood Agricultural Injury Prevention Initiative, guided by an action plan generated by a 42-member multidisciplinary committee. A major update to the plan was released following the 2001 Summit on Childhood Agricultural Injury Prevention. From the year 2010 through 2011 a comprehensive assessment of progress to date was conducted followed by the drafting, review and finalizing of a new action plan-“The 2012 Blueprint for Protecting Children in Agriculture.” This paper briefly describes the purpose and process for generating the new action plan then provides a listing of the 7 goals and 26 strategies within the plan. These goals and strategies account for trends in childhood agricultural injuries, changes in agricultural production and the demographics of its workforce, effectiveness of interventions, and the increasing use of social media, marketing and social networking. Primary funding for this project was provided by the National Institute for Occupational Safety and Health (NIOSH), which continues to serve as the lead federal agency for the national initiative.

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Blueprint for Protecting Children in Agriculture: The 2012 National Action Plan
Blueprint for Protecting Children in Agriculture: The 2012 National Action Plan Image

Authors: Lee BC, Gallagher SS, Liebman AK, Miller ME, Marlenga B

Marshfield Clinic Report, 2012

ABSTRACT:
This National Action Plan takes an updated look at preventing childhood agricultural injury and death.  The Blueprint endeavor builds upon the 1996 plan that launched a national initiative leading to a remarkable reduction in nonfatal injuries among children who live on, visit and work onfarms. The 2012 Blueprint re-sets priorities to reflect changes in agricultural production and worker profiles. The Blueprint is a product of input from the general public as well as leading researchers in childhood agricultural safety and health. Draft versions of goals and strategies were critiqued by nearly 100 stakeholders, and then posted online to solicit further public input.

The 38-page report emphasizes the need for:

– Affordable, accessible and high quality child care options for farm families and hired farm workers.

– Increased involvement of employers, farm organizations and agribusinesses in creating a culture of safety.

– Improved injury and fatality data collection with inclusion of underserved populations such as Anabaptists and seasonal workers.

– Increased attention to reaching young farm parents and teen workers via social media outlets.

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Research-to-practice transition of a portable cholinesterase monitoring kit: how does it affect the work of clinics?
Research-to-practice transition of a portable cholinesterase monitoring kit: how does it affect the work of clinics? Image

Authors: Treadwell RJ, Keifer MC

Washington State Journal of Public Health Practice. Spokane, Washington. 2012

ABSTRACT:
To identify work-related factors in large and small occupational health and rural clinics that may impact sustained utilization of a portable cholinesterase (ChE) monitoring kit within those settings.

Primary interview data were collected in April and May of 2009 from three occupational medical clinics that offer ChE monitoring to pesticide handlers in eastern Washington State. Participants were identified by their involvement in the state ChE monitoring program and selected by size.

Key informant responses to a setting-specific interview guide were recorded. The Normalization Process Model (NPM) was used to identify factors that may promote or inhibit successful normalization of the kit into routine clinical practice. Interview data was organized with opensource qualitative analysis software. Themes were identified and applied to specific dimensions of the NPM for analysis.

Volume of blood samples, procedural efficiency, patient trust, limited staffing disruption, and effective communication between key players within the monitoring system were some identified work-related factors that may promote kit normalization in clinics. The NPM identified several work-related factors that may positively dispose a portable ChE kit to normalization in a clinical setting. Clinics both large and small may be able to use the NPM to determine how a new clinicbased intervention may positively or negatively affect the workload of its staff.

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

Authors: Liebman AK, Juarez-Carrillo PM, Reyes IA, Keifer MC

American Journal of Industrial Medicine, 2016

ABSTRACT:

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.

We examined results of five focus groups with 37 Hispanic, immigrant dairy workers. Analysis followed a grounded theory approach and employed ATLAS.ti.  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.

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Personal protection by Thai households in avian influenza outbreaks
Personal protection by Thai households in avian influenza outbreaks Image

Authors: Somrongthong R, Beaudoin AL, Bender J, Laosee O, Pakinsee S, Sitthi-amorn C

Zoonosis and Public Health, 2012

ABSTRACT:
Thailand has had multiple poultry outbreaks of highly pathogenic avian influenza (HPAI) H5N1 since its first emergence in 2004. Twenty-five human cases of HPAI H5N1 avian influenza have been reported in the country, including 17 fatalities, and contact with infected dead or dying poultry has been identified as a risk factor for human infection. This study assessed the use of protective equipment and hand hygiene measures by Thai poultry-owning households during activities involving poultry contact. Surveys conducted in 2008 included questions regarding poultry-related activities and protective measures used during an HPAI outbreak (2005) and 3 years after the study location’s last reported outbreak (2008). For both time periods, poultry owners reported limited use of personal protective equipment (PPE) during all activities and inconsistent hand washing practices after carrying poultry and gathering eggs. This is the first time that PPE use in Thailand has been quantified for a large study group. These data are important for ongoing characterization of HPAI risk and for the crafting of educational messages.

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Recovery of staphylococci from computer keyboards in a veterinary medical centre and the effect of routine cleaning
Recovery of staphylococci from computer keyboards in a veterinary medical centre and the effect of routine cleaning Image

Authors: Bender JB, Schiffman E, Hiber L, Gerads L, Olsen K

Veterinary Record, 2012

ABSTRACT:
Computers play a vital role in veterinary clinics for grading, examining results, updating records, giving discharge instructions and maintaining billing information. Few studies have documented the degree of contamination or practical methods to disinfect computer equipment within the veterinary clinic setting. The intent of the present study was to characterise the frequency of recovery of Staphylococcus species from computer keyboards from a veterinary teaching hospital setting and to evaluate the effect of daily cleaning. From three keyboards in a treatment area, three in a dermatology area and one in office 70 environmental samples were cultured for Staphylococcus. As an indirect measure to assess cleanliness, samples were collected and tested using the 3M Clean-Trace Luminometer (relative light units [RLU]). Of the 25 Staphylococcus recovered 13 were Staphylococcus species, seven Staphylococcus pseudintermedius, four Staphylococcus aureus and one mixed colony of both Staphylococcus species and S pseudintermedius. The median RLU was 2098 (range 132 to 11,590). Routine cleaning decreased the recovering of Staphylococcus and the RLU values. In summary, the study results demonstrate the value of routine cleaning of keyboards and the need for on-going and regular education of staff and students about good hand hygiene.

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Risk factors for exposure to influenza a viruses, including subtype H5 viruses, in Thai free-grazing ducks
Risk factors for exposure to influenza a viruses, including subtype H5 viruses, in Thai free-grazing ducks Image

Authors: Beaudoin AL, Kitikoon P, Schreiner PJ, Singer RS, Sasipreeyajan J, Amonsin A, Gramer MR, Pakinsee S, Bender JB

Transbound Emerg Dis., 2012

ABSTRACT:
Free-grazing ducks (FGD) have been associated with highly pathogenic avian influenza (HPAI) H5N1 outbreaks and may be a viral reservoir. In July-August 2010, we assessed influenza exposure of Thai FGD and risk factors thereof. Serum from 6254 ducks was analysed with enzyme-linked immunosorbent assay (ELISA) to detect antibodies to influenza A nucleoprotein (NP), and haemagglutinin H5 protein. Eighty-five per cent (5305 ducks) were seropositive for influenza A. Of the NP-seropositive sera tested with H5 assays (n = 1423), 553 (39%) were H5 ELISA positive and 57 (4%) suspect. Twelve per cent (74 of 610) of H5 ELISA-positive/suspect ducks had H5 titres ≥ 1 : 20 by haemagglutination inhibition. Risk factors for influenza A seropositivity include older age, poultry contact, flock visitors and older purchase age. Study flocks had H5 virus exposure as recently as March 2010, but no HPAI H5N1 outbreaks have been identified in Thailand since 2008, highlighting a need for rigorous FGD surveillance.

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A framework for developing research protocols for evaluation of microbial hazards and controls during production that pertain to the quality of agricultural water contacting fresh produce that may be consumed raw
A framework for developing research protocols for evaluation of microbial hazards and controls during production that pertain to the quality of agricultural water contacting fresh produce that may be consumed raw Image

Authors: Harris LJ, Bender J, Bihn EA, Blessington T, Danyluk MD, Delaquis P, Goodridge L, Ibekwe AM, Ilic S, Kniel K, Lejeune JT, Schaffner DW, Stoeckel D, Suslow TV

J Food Prot, 2012

ABSTRACT:
Agricultural water may contact fresh produce during irrigation and/or when crop protection sprays (e.g., cooling to prevent sunburn, frost protection, and agrochemical mixtures) are applied. This document provides a framework for designing research studies that would add to our understanding of preharvest microbial food safety hazards and control measures pertaining to agricultural water. Researchers will be able to use this document to design studies, to anticipate the scope and detail of data required, and to evaluate previously published work. This document should also be useful for evaluating the strength of existing data and thus should aid in identifying future research needs. Use of this document by the research community may lead to greater consistency or comparability than currently exists among research studies, which may ultimately facilitate direct comparison of hazards and efficacy of controls among different commodities, conditions, and practices.

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Herd-level risk factors associated with fecal shedding of Shiga toxin-encoding bacteria on dairy farms in Minnesota, USA
Herd-level risk factors associated with fecal shedding of Shiga toxin-encoding bacteria on dairy farms in Minnesota, USA Image

Authors: Cho S. Diez-Gonzalez F, Fossler C, Wells SJ, Hedberg CW, Kaneene JB, Ruegg P, Warnick L, Bender JB

Canadian Veterinary Journal, 2013

ABSTRACT:
This study aimed to identify herd-level risk factors associated with fecal shedding of Shiga toxin-encoding bacteria (STB) on dairy cattle farms in Minnesota, USA.

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Influenza A(H1N1)pdm09 virus among healthy show pigs, United States
Influenza A(H1N1)pdm09 virus among healthy show pigs, United States Image

Authors: Gray GC, Bender JB, Bridges CB, Daly RF, Krueger WS, Male MJ, Heil GL, Friary JA, Derby RB, Cox NJ

Emerging Infectious Diseases, 2012

ABSTRACT:
Within 5 months after the earliest detection of human influenza A(H1N1)pdm09 virus, we found molecular and culture evidence of the virus in healthy US show pigs. The mixing of humans and pigs at swine shows possibly could further the geographic and cross-species spread of influenza A viruses.

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Prevalence, antibiotic resistance and molecular charcterisation of Staphylococcus aureus in Pigs at agricultural fairs in the USA
Prevalence, antibiotic resistance and molecular charcterisation of Staphylococcus aureus in Pigs at agricultural fairs in the USA Image

Authors: Dressler AE, Scheibel RP, Wardyn S, Harper AL, Hanson BM, Kroeger JS, Diekema DJ, Bender JB, Gray GC, Smith TC

Veterinary Record, 2012

ABSTRACT:
Fairs and petting zoos have been associated with outbreaks of zoonotic disease. Previously, the presence of meticillin-resistant Staphylococcus aureus (MRSA) was documented in commercial pigs; therefore, it was hypothesised that antibiotic-resistant S aureus may also occur in pigs exhibited at agricultural fairs. To test this hypothesis, 157 pigs were swabbed at two state fairs in 2008 to 2009. Both nares were sampled and cultures were grown in enrichment broth, then plated onto selective MRSA plates and blood plates. S aureus was confirmed using phenotypic and molecular methods, and was analysed using spa typing, gene-specific polymerase chain reaction and antibiotic susceptibility testing. The presence of S aureus was confirmed in samples collected from pigs exhibited at USA pig shows. Twenty-five of 157 (15.9 per cent) samples were positive for S aureus. Two isolates (8 per cent) were resistant to meticillin; 23/25 (92 per cent), 14/25 (56 per cent) and 15/25 (60 per cent) were resistant to tetracycline, erythromycin and clindamycin, respectively. spa typing revealed multiple isolates of spa type t034 (9/25, 36 per cent) and t337 (7/25, 28 per cent) and singletons of t002, t209, t526, t1236, t1334, t1683, t3075, t5784 and t5883. These results verify the presence of antibiotic-resistant S aureus in pigs exhibited at USA fairs, suggesting that pigs are a potential reservoir for S aureus within this environment.

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Health care access for immigrant workers in AFF sector in southeastern US
Health care access for immigrant workers in AFF sector in southeastern US Image

Authors: Frank, A. L., Liebman, A. K., Ryder, B., Weir, M. and Arcury, T. A.

Am. J. Ind. Med, 2013

ABSTRACT:
The Agriculture, Forestry, and Fishery (AgFF) Sector workforce in the US is comprised primarily of Latino immigrants. Health care access for these workers is limited and increases health disparities.  This article addresses health care access for immigrant workers in the AgFF Sector, and the workforce providing care to these workers.

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Publications
Growing Agricultural Education: Embracing Health and Safety Image
Growing Agricultural Education: Embracing Health and Safety
Authors: Bruce H. Alexander, Jeff B. Bender, Diane Kampa, Matthew C. Keifer, Amy K. Liebman, Carol Peterson, Ruth Rasmussen, Lisa Schiller, Brad Schloesser, and Carolyn Sheridan Journal of Agromedicine Vol. 21 , Iss. 3,2016 ABSTRACT: On May 28, 2015, the Upper Midwest Agricultural Safety and Health Center (UMASH), the University of Wisconsin-Eau Claire’s College of Nursing and Health Sciences, the AgriSafe Network, and the Southern Minnesota Center of Agriculture co-sponsored a forum to discuss agriculture health and safety education.  Attendees varied by discipline including farmers, educators, agricultural media, company human resource managers, nurses, physicians, and veterinarians.  Specifically, the assembled group was interested in improving agricultural health and safety and reducing injuries through agricultural education.  The forum participants were charged with identifying better ways to incorporate safety and health as part of our educational curricula, targeting educational strategies for the next generation of farmers and workers, and strategizing on ways to improve health and safety in the changing agricultural sectors.  This synopsis highlights some of the key items discussed during the meeting and some needed next steps. READ ARTICLE
A Pilot Project to Develop Culturally and Linguistically-Appropriate Pesticide/Chemical Education Materials for Hmong Produce Growers Image
A Pilot Project to Develop Culturally and Linguistically-Appropriate Pesticide/Chemical Education Materials for Hmong Produce Growers
Authors: Hultberg A, Schermann M, Yang P. Journal of Agromedicine. Minneapolis, Minnesota. June 9, 2014 ABSTRACT: The purpose of this project was to provide culturally-appropriate pesticide education for Hmong farmers in Minnesota and develop a cohort of peer educator farmers. The number of Hmong farmers continues to increase in Minnesota, yet few easy-to-understand sources of pesticide safety information exist for this community, and farmers may be using chemicals incorrectly, posing a threat to public health and worker safety. Eight Hmong farmers were selected to participate based on project partner input, their leadership potential and interest in the topic. Farm visits provided information on the type of chemicals used, crops grown, personal protective equipment (PPE) usage, and chemical storage. Participants attended four participatory workshops on key pesticide safety topics: PPE, measuring chemicals, reading chemical labels. Each workshop included hands-on learning and skills-building components. Participants presented on pesticide safety at the Immigrant and Minority Farmer Conference February, 2013, and led a pesticide safety class for March 2013. A poster and picture-based handout with simple English was developed with farmer input and distributed to other farmers. Hmong farmers seek a broad range of agricultural information and skills, including pesticide safety information. Seven of 8 farmers in the project cohort used non-restricted chemicals; one farmer had taken Pesticide Applicator Training. Seven of 8 were not literate in English, and reported inconsistently reading chemical labels or not understanding pre-harvest interval restrictions. Adolescent family members were often asked to translate, including chemical safety information. Participants had very little interaction with Extension or other traditional sources of agricultural education. Future research should focus on developing pesticide curriculum and education delivery methods for non-English speaking farmers. Agricultural education and outreach efforts should include Hmong-speaking staff and use non-computer methods such as phone and mail to reach Hmong farmers. Adolescents should be targeted as “gatekeepers” of information on Hmong farms and included in future studies and outreach efforts. Clinicians should consider providing pesticide education about the safety risks associated with improper use when working with the Hmong community. Sampling studies to determine levels of pesticide residue on fresh produce at farmers markets could determine the extent to which farmers (Hmong or otherwise) are following pre-harvest interval restrictions. READ ARTICLE
Characterization of Air Contaminants Associated with Type of Swine Production Facilities Image
Characterization of Air Contaminants Associated with Type of Swine Production Facilities
Authors: Murphy D, Engelman S, Raynor PC, Ramachandran G, Alexander BH. Journal of Agromedicine. Minneapolis, Minnesota. June 09, 2014 ABSTRACT: Workers in the swine industry are frequently exposed to respiratory hazards including organic dusts, bioaerosols, gases, and endotoxin. As production practices in the swine industry continue to evolve to meet growing demand and in response to consumer and food industry preference, the change in practices may cause a change in the working environment. The extent to which these air contaminants vary by the type of swine production facility is not clear. The objective of this research is to characterize air contaminant concentration and variability associated with differing swine rearing practices. This project characterizes air contaminants in a facility with parallel sow/farrow rearing systems (gestation crates and open gestation pens), and finishing pens using dry and wet feed delivery systems. Time-weighted average respirable dust and endotoxin concentrations are measured at stationary locations. Real-time measures of respirable dust, hydrogen sulfide, ammonia, and carbon dioxide concentrations, and temperature and relative humidity are measured to assess temporal and spatial variability throughout the site. The contaminant concentrations will be summarized to estimate average, peak, and spatial distributions and compared between the type of production system. The measures will be repeated in cold and warm weather months. Initial measurements indicate concentrations of ammonia and hydrogen sulfides are modestly higher in the gestation crate housing, while respirable dust concentrations are higher in the pens. There is considerable variability in concentrations with space and time. All concentrations measured to date are below occupational exposure limits. Characterizing airborne contaminants in swine production operations by type of facility will identify the potential impact facility type has on workers, which can then be evaluated along with animal welfare needs. Understanding variability of exposure by type of operation will inform future research on the control of air contaminants within these systems. Additionally, studies that evaluate potential respiratory health effects will be better designed with knowledge of the range and types of exposures. The second phase of this study will repeat these assessments in several facilities with differing configurations to characterize the range of these exposures across the industry. READ ARTICLE
Reptile-Associated Salmonellosis in Minnesota, 1996-2011 Image
Reptile-Associated Salmonellosis in Minnesota, 1996-2011
Authors: Whitten T. Bender JB, Smith KE, Leano F, Scheftel J. Zoonoses Public Health. St. Paul, Minnesota. Jun. 9, 2014 ABSTRACT: Reptile-associated salmonellosis (RAS) occurs when Salmonella is transmitted from a reptile to a human. This study describes the epidemiology of RAS in Minnesota during 1996-2011. All Minnesotans with confirmed Salmonella infections are reported to the Minnesota Department of Health (MDH). Case patients are interviewed about illness characteristics and risk factors, including foods eaten, drinking and recreational water exposures, contact with ill people, and animal contact. Willing RAS case patients can submit stool from the reptile for culture. Serotype and pulsed-field gel electrophoresis (PFGE) subtype of Salmonella isolates from reptiles and case patients are compared. Of 8389 sporadic (not associated with an outbreak) non-typhoidal salmonellosis case patients in Minnesotans during 1996-2011, 290 (3.5%) reported reptile exposure. The median age of case patients with reptile exposure was 11 years, 31% were under the age of 5 years and 67% were under the age of 20 years; 50% were female. The median illness duration was 8 days; 23% required hospitalization. The most commonly reported reptile exposures were lizard (47%), snake (20%), turtle (19%) and a combination of reptile types (14%). Eighty-four per cent of isolates from case patients who reported reptile exposure were Salmonella enterica subspecies I. The three most common serotypes were Typhimurium (15%), Enteritidis (7%) and subspecies IV serotypes (7%). Of 60 reptiles testing positive for Salmonella, 36 (60%) yielded the same Salmonella serotype as the human isolate. Twenty-six of 27 reptile isolates that were subtyped by PFGE were indistinguishable from the human isolate. Of these, 88% were subspecies I; the most common serotypes were Enteritidis (12%), Typhimurium (8%), and Bareilly (8%). RAS accounts for approximately 3.5% of salmonellosis cases in Minnesota, primarily affecting children. The majority of isolates from case patients and reptiles belonged to Salmonella subspecies I, suggesting that reptiles are a source of human infection with serotypes not traditionally considered to be reptile-associated. READ ARTICLE
Needlestick Injuries in Livestock Workers and Prevention Programs Image
Needlestick Injuries in Livestock Workers and Prevention Programs
Authors: M.L. Buswell MD, M. Hourigan, A. Nault & J. Bender PhD. Journal of Agromedicine. St. Paul, Minnesota. June 9, 2014 ABSTRACT: Veterinary medicine and agriculture have historically lacked needlestick injury (NSI) research, education, and mitigation due to the absence of zoonotic blood-borne pathogens and the “perceived” benign nature of the injury. However, depending on the procedure/pharmaceutical used, these injuries may include mild/severe bacterial or fungal infections, lacerations, local inflammation, vaccine/antibiotic reactions, amputation, miscarriage, and death. The objective of this report is to identify published case reports and case series/surveys on human needlestick exposure to veterinary biologics, and to review literature and educational documents describing needlestick prevention strategies for agricultural workers and veterinarians. An electronic database search was conducted using PubMed© and CABI©. Key search terms: PubMed© – “Needlestick Injuries” [MeSH] veterinar*, “Vaccination/veterinary” [MeSH]) AND “Occupational Exposure” [MeSH], “Vaccination/veterinary” [MeSH]) AND “Occupational Exposure” [MeSH]; CABI© – needlestick injuries.sh. Article inclusion criteria were those detailing NSI in agricultural workers only. Abstracts of all search results were read and relevant articles compiled into a RefWorks© database. References cited within articles were examined to locate additional articles. Fifty-six articles were identified. Literature consisted of case reports (n = 14), survey/case series articles (n = 11), prevention guidance documents (n = 6), and background articles (n = 25). Forty-eight cases were found. Twenty-four identified injury location: 13 (54.2%) NSI to the hands: three to the right, eight to the left, and two were not specified. Eight injuries were to the legs (33.3%): five to the right and three were not specified. Of the 48 cases, 11 (22.9%) involved oil-adjuvanted vaccines. The remaining products included: other vaccines, antibiotics, analgesics/sedatives, and hormones. Forty-six (95.8%) of 48 cases reported seeking medical attention. Of the 11 survey/case series articles: two focused on oil-adjuvant products, one on Brucellosis RB51 vaccine, three on tilmicosin, and five were non-specific. General recommendations from guidance documents included: proper animal restraint, avoid recapping needles, do not bend needles, do not put needle caps in your mouth, provide appropriate training, provide sharps containers, report injuries, seek medical attention. NSI in agriculture workers and veterinarians can result in injury and loss of work. It appears that NSI awareness is limited among workers. There is a need for comprehensive programs to prevent NSI on livestock operations. READ ARTICLE
Perception of the Importance of Human-Animal Interactions on Cattle Flow and Worker Safety in Minnesota Dairy Farms Image
Perception of the Importance of Human-Animal Interactions on Cattle Flow and Worker Safety in Minnesota Dairy Farms
Authors: Sorge US, Cherry C, Bender JB. Journal of Dairy Science. Minnesota. May 16, 2014 ABSTRACT: Proper cattle-handling techniques (stockmanship) are important to ensure calm animals and a safe work environment for dairy workers on farm. The objectives of this study were to (1) assess Minnesota dairy herd owners’ attitudes toward stockmanship, its perceived importance for cow comfort and worker health, and the establishment of calm cattle movement; and (2) identify current resources and methods of stockmanship training on Minnesota dairy farms. A stratified-random sample of Minnesota dairy farmers were contacted via mail to participate in a 28-question survey. One hundred eight bovine dairy producers participated. Most commonly, respondents learned their cattle handling skills from family members (42.6%) and 29.9% of producers had participated in previous stockmanship training. Producers thought that the skill of the human handler was the most important factor in establishing good cattle flow. Cattle-handling techniques was the third most common topic for new-employee orientation after training in milking parlor protocols and milking parlor disinfection. Time limitations and language barrier were considered serious challenges for worker training. Work-related injuries were responsible for lost work days in the previous year in 13.3% of dairy herds and 73.3% of those injuries occurred while working with cattle. Producers perceived that cattle-related injuries were predominantly the handler’s fault: either because of not paying enough attention to the animal or due to poor cattle handling skills. Facility design was considered the least important for the occurrence of worker injuries. Although no causal inference can be made, herds that had workers who had previously participated in stockmanship training had a 810 ± 378 kg (mean ± standard error of the mean) higher rolling herd average than those that did not, even after adjusting for herd size and bulk tank somatic cell count. However, 50% of respondents were not interested in attending future stockmanship training sessions. In conclusion, cattle handling skills are considered important by Minnesota dairy producers to ensure worker safety and cow flow. Limited availability of time, language barrier, and a perceived lack of training materials were considered challenges during the training of workers on farms. READ ARTICLE
Use of personal protective measures by Thai Households in areas with avian influenza outbreaks Image
Use of personal protective measures by Thai Households in areas with avian influenza outbreaks
Authors: Somrongthong R, Beaudoin AL, Bender J, Laosee O, Pakinsee S, Sitthi-amorn C. Zoonosis and Public Health. Bangkok, Thailand. Feb. 21, 2012 ABSTRACT: Thailand has had multiple poultry outbreaks of highly pathogenic avian influenza (HPAI) H5N1 since its first emergence in 2004. Twenty-five human cases of HPAI H5N1 avian influenza have been reported in the country, including 17 fatalities, and contact with infected dead or dying poultry has been identified as a risk factor for human infection. This study assessed the use of protective equipment and hand hygiene measures by Thai poultry-owning households during activities involving poultry contact. Surveys conducted in 2008 included questions regarding poultry-related activities and protective measures used during an HPAI outbreak (2005) and 3 years after the study location’s last reported outbreak (2008). For both time periods, poultry owners reported limited use of personal protective equipment (PPE) during all activities and inconsistent hand washing practices after carrying poultry and gathering eggs. This is the first time that PPE use in Thailand has been quantified for a large study group. These data are important for ongoing characterization of HPAI risk and for the crafting of educational messages. READ ARTICLE
Prevalence and Characterization of Staphylococcus aureus, including Methicillin Resistant Staphylococcus aureus, Isolated from Bulk Tank Milk from Minnesota Dairy Farms Image
Prevalence and Characterization of Staphylococcus aureus, including Methicillin Resistant Staphylococcus aureus, Isolated from Bulk Tank Milk from Minnesota Dairy Farms
Authors: Haran KP, Godden S, Boxrud D, Jawahir S, Bender J, Sreevatsan S. Journal of Clinical Microbiology. St. Paul, Minnesota. Dec. 14, 2011 ABSTRACT: Staphylococcus aureus is a common causative agent of bovine mastitis in dairy herds. The emergence of methicillin-resistant Staphylococcus aureus (MRSA) in hospitals as well as the community is a significant and costly public health concern. S. aureus-related bovine mastitis is a common reason for therapeutic and/or prophylactic use of antibiotics on dairy farms. In this study, herd prevalence of S. aureus, including MRSA, was estimated from bulk tank milk (BTM) from Minnesota farms. A total of 150 pooled BTM samples from 50 farms, collected over 3 seasons (spring, summer, and fall of 2009), were assessed. Herd prevalence of methicillin-susceptible S. aureus (MSSA) was 84%, while MRSA herd prevalence was 4%. A total of 93 MSSA isolates and 2 MRSA isolates were recovered from 150 BTM samples. Antibiotic susceptibility testing of S. aureus isolates showed pansusceptibility in 54 isolates, resistance to a single antibiotic class in 21 isolates, resistance to two antibiotic classes in 13 isolates, and resistance to ≥3 antibiotics classes and thus multidrug resistance in 5 isolates. The two MRSA isolates displayed resistance to β-lactams, cephalosporins, and lincosamides and were multiresistant. Staphylococcal protein A gene (spa) typing identified spa types t529 and t034 most frequently among methicillin-susceptible isolates, while t121 was observed in MRSA isolates. Seven isolates, including the two MRSA isolates, produced staphylococcal enterotoxins B, C, D, and E on overnight culture. MRSA isolates were further genotyped using multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE). Of the 2 MRSA isolates, one had a composite genotype profile of MLST ST 5-PFGE USA100-unknown spa type, which has been reported among hospital-associated MRSA isolates, while the second isolate carried the MLST ST 8-PFGE USA300-spa type t121 genotype, commonly identified among community-associated MRSA isolates. These results suggest that MRSA genotypes associated with hospitals and community can be isolated from milk at very low rates. READ ARTICLE
Characterization of influenza A outbreaks in Minnesota swine herds and measures taken to reduce risk of zoonotic transmission Image
Characterization of influenza A outbreaks in Minnesota swine herds and measures taken to reduce risk of zoonotic transmission
Authors: Beaudoin A, Johnson S, Davies P, Bender J, Gramer M. Zoonoses Public Health. St. Paul, Minnesota. Jul. 18, 2011 ABSTRACT: Influenza A virus infections commonly cause respiratory disease in swine and can be transmitted between people and pigs, with potentially novel strains introduced into herds and spilling back into the human population. The goals of this study were to characterize influenza infections in Minnesota pigs and assess biosecurity measures used by swine workers. Veterinarians submitting influenza-positive swine samples to the University of Minnesota Veterinary Diagnostic Laboratory between October 2007 and April 2009 were surveyed regarding disease-related information and biosecurity procedures at each farm. Influenza-positive samples were submitted year-round, peaking in spring and fall. H1N1 was the most commonly detected subtype (56%), followed by H3N2 (14%) and H1N2 (12%). Most positive submissions were associated with illness in growing pigs (median age 8.8 weeks, IQR 5-15). Median morbidity and mortality were 25% (IQR 10-48) and 2% (IQR 0.5-3.5), respectively. Vaccination of sows and growing pigs was conducted at 71% and 7.9% of the swine farms, respectively. Specialized footwear was reported as the most common form of protective equipment used by workers. Employee vaccination for seasonal influenza was 19%. The sow vaccination rate in this study is consistent with national data, although growing pig vaccination is lower than the national average. Seasonal and age trends identified here may provide diagnostic guidance when growing pigs experience respiratory disease. Inconsistent use of protective equipment and employee vaccination at swine farms indicates the need for further discussion and research of approaches to minimize interspecies influenza transmission on swine farms. READ ARTICLE
Prevalence of low-pathogenic avian influenza and evaluation of management practices in Minnesota backyard poultry flocks Image
Prevalence of low-pathogenic avian influenza and evaluation of management practices in Minnesota backyard poultry flocks
Authors: Yendell SJ, Rubinoff I, Lauer D, Bender JB, Scheftel J. Zoonoses Public Health. St. Paul, Minnesota. Jul. 6, 2011 ABSTRACT: Low-pathogenicity avian influenza (LPAI) viruses have caused illness in poultry and humans with poultry contact. To determine whether there is evidence of exposure to avian influenza viruses (AIV) among backyard poultry in Minnesota and their human caretakers, 150 flocks of backyard birds were sampled for antibodies to AIV from August 2007 through December 2008. One hundred flocks were tested through routine slaughter surveillance by the Minnesota Board of Animal Health and an additional 50 flocks were contacted and sampled by study investigators. Blood was collected from 10 to 13 birds from each flock and a survey of biosecurity and management practices was administered to the flock owner. Blood samples were tested by agar gel immunodiffusion (AGID) for influenza A antibodies. Tested flocks had a median flock size of 100 birds (range: 12-800 birds), and were most commonly owned for meat for personal use (81% of respondents), fun or hobby (58%) and eggs for personal use (56%). Although 7% of flock owners reported that their birds had shown respiratory signs in the previous 3 months, only 1 of 150 flocks tested positive for influenza by AGID. Antibodies to LPAI H6N1 were detected in the positive flock. The owner of the positive flock did not have antibodies to H6 or other common AIV. Based on the findings of this study, the risk of transmission of LPAI viruses from backyard poultry to owners in Minnesota appears to be low under current conditions and management practices. READ ARTICLE
Facilitating Return to Work for Injured and Ill Animal Agriculture Workers Image
Facilitating Return to Work for Injured and Ill Animal Agriculture Workers
Authors: Reyes IA, Bellendorf N, Meehan T, Wenger R, Kadolph C, Halstead S, Mahnke A, Weichelt B, Ray W, Keifer M. Journal of Agromedicine. Wisconsin. June 9, 2014 ABSTRACT: Large animal production, like much of agriculture, is dangerous. Non-fatal injuries in pork and dairy production are commonplace and can often be serious, leading to restrictions. The cost of workplace injuries in dairy and pork is unknown but given the frequency of injury among agricultural workers, it is without doubt a substantial burden to these industries. As dairy and pork industries grow, producers hire more workers who face the risks inherent in the agricultural workplace and whose injuries are increasingly cared for by primary care clinicians. Yet, clinicians are often unfamiliar with the physical demands of farming, are poorly equipped to manage farm injuries and illnesses and have few resources to facilitate workers’ return to work. Producers have difficulty understanding and adapting the traditional return to work sheets in the context of farm tasks. All too often, the injured worker is declared unsuitable to return to work which results in loss of wages and productivity at home. This also results in increased workers’ compensation and a slowed operation that the employer must manage. This translational project will develop an interactive software application designed for clinicians to guide early return to work planning for injured workers in the dairy and pork industries. Concepts for developing transitional work plans commonly used in non-agricultural industries will be applied. A functional job analysis will be developed and will consist of hazards, loads and exposure risks, images and descriptions of tasks to guide clinicians in the planning of returning injured workers using alternative light duty job assemblies. This program will likely improve communication between employer, employee and clinician and enhance worker participation in the return to work decision making. It will also reduce workers’ compensation costs for the employer. More importantly, it will address an unmet need in agricultural health and safety, that of connecting the clinician to the farm to reduce disability and sustain an adequate, safe workforce for the growing agriculture industry. READ ARTICLE
The Use of Audience Response Systems Technology with Limited English Proficient, Low Literate and Vulnerable Populations Image
The Use of Audience Response Systems Technology with Limited English Proficient, Low Literate and Vulnerable Populations
Authors: Keifer M, Reyes IA, Liebman AK, Juarez-Carrillo P. Journal of Agromedicine. Wisconsin. June 9, 2014 ABSTRACT: Audience Response Systems (ARS) have been used to improve the interactivity of educational activities for many years. 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 populations with reasons to be concerned about divulging information about themselves, often referred as “vulnerable” has also not been tested. In addition, a culturally competent method to effectively collect demographic and evaluation data of this 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. Hispanic immigrant dairy workers were invited to attend focus groups and were asked to use the clickers to respond to a series of 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 participants 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 keys on the clicker. An overwhelming majority of participants reported that the clickers were comfortable and very easy to use despite the challenges that the more complex responses appeared to present. The error rate increased as response complexity increased and the trend across three ordered categories of response complexity reached statistical significance. The results suggest that ARS is a viable method for gathering dichotomous or higher order categorical information from LEP and low literate populations in a group setting while assuring anonymity to respondents. However, it is recommended that clickers be developed and tested with bigger and more widely separated buttons, a limited number of 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 to collect data for surveys and assessments. READ ARTICLE
Surveillance of Disease and Injury in Wisconsin Dairy Farmers and Workers Image
Surveillance of Disease and Injury in Wisconsin Dairy Farmers and Workers
Authors: Keifer MC, Sandberg S, Reyes IA, Waring SC, Alexander B, Gerberich SG. Journal of Agromedicine. Wisconsin. June 9, 2014 ABSTRACT: The objective of this project is to establish, as well as maintain, a comprehensive working surveillance system designed to identify illness and injury among dairy farmers and farmworkers throughout the state of Wisconsin. Emphasis is to capture occupational, technological and workforce changes within the industry to determine the impact on health and safety. Procedures are underway to establish the first population-based estimates of incidence of injury and illness in Wisconsin dairy farmers utilizing available resources. Additionally, the project plans to create a surveillance instrument which will include questions regarding illness and injury among workers and their families, and farm owners, as well as process changes within their operation. Subsequent surveying will be used for the identification of both high and low risk activities on the farm and establish if the approach to certain farming related tasks influence risk. Initial estimates of our population cohort have been generated. In addition, as part of a sub-study the manual clinical text abstraction procedure has provided listings of common farm terminology for Natural Language Processing (NLP) development to efficiently and electronically define farmers within medical records that might be missed by matching medical records against other sources. The surveillance instrument design is in final stages awaiting piloting. Change in this industry, including the modernization of equipment, a shift in the demographic of workers as well as the increase in facility size to account for current market demands will surely have an impact on occupational risk factors. Results from our project may impact factors from medical expenditures and hospitalization rates to future agricultural safety policies and procedures. This modifiable surveillance instrument will provide continual disease and injury monitoring and potentially serve as a template for the surveillance of a wide variety of agriculturally based occupations. As well, the cohort will be able to provide additional population-based research projects. A prospective birth cohort study is currently in development. In addition, the novel approach of NLP to efficiently define farmers within medical record text can be applied to other occupations once development and training are complete. READ ARTICLE
Antibody prevalence of low-pathogenicity avian influenza and evaluation of management practices in Minnesota backyard poultry flocks Image
Antibody prevalence of low-pathogenicity avian influenza and evaluation of management practices in Minnesota backyard poultry flocks
Authors: Yendell SJ, Rubinoff I, Lauer D, Bender JB, Scheftel J Zoonoses Public Health, 2012 ABSTRACT: Low-pathogenicity avian influenza (LPAI) viruses have caused illness in poultry and humans with poultry contact. To determine whether there is evidence of exposure to avian influenza viruses (AIV) among backyard poultry in Minnesota and their human caretakers, 150 flocks of backyard birds were sampled for antibodies to AIV from August 2007 through December 2008. READ ARTICLE
Survey of occupational hazards in Minnesota veterinary practices in 2012 Image
Survey of occupational hazards in Minnesota veterinary practices in 2012
Authors: Fowler H, Holzbauer S, Smith K, Scheftel J Journal of the American Veterinary Medical Association. Minnesota. Jan. 15, 2016 ABSTRACT: The goal of this study is to identify the scope of occupational hazards encountered by veterinary personnel and compare hazard exposures between veterinarians and technicians working in small and large animal practices. A survey of Minnesota veterinary personnel was conducted between February 1 and December 1, 2012. Adult veterinary personnel working in clinical practice for > 12 months were eligible to participate. Information was collected on various workplace hazards as well as on workplace safety culture. READ ARTICLE
Characterizing the Role of Animal Exposures in Cryptosporidiosis and Shiga Toxin-producing Escherichia coli Infections: South Dakota, 2012 Image
Characterizing the Role of Animal Exposures in Cryptosporidiosis and Shiga Toxin-producing Escherichia coli Infections: South Dakota, 2012
Authors: Daly RF, Hill NT Zoonoses Public Health. Jan. 5, 2016 ABSTRACT: Cryptosporidium spp. and Shiga toxin-producing Escherichia coli strains (STEC) are important causes of human illness. Incidence rates of these illnesses are high in South Dakota compared to the USA as a whole. Direct animal contact has been identified as a possible route of exposure for these illnesses. Ruminant animals may carry STEC subclinically, while young ruminants are common sources of zoonotic strains of Cryptosporidium. South Dakota patients with either STEC or cryptosporidiosis during 2012 were interviewed regarding seven categories of animal exposure: (i) petting zoo/fair attendance, (ii) animal event/rodeo attendance, (iii) feed/pet store visits, (iv) farm visits, (v) employment or residence at a farm, (vi) residence with pets and (vii) visiting other households with pets. Of the 50 STEC cases, 78.0% reported animal exposure prior to illness onset, with 23.3% having lived or worked on a farm. Farm visitors in particular had high degrees of animal contact and infrequently practiced personal protective measures. Of the 115 cryptosporidiosis cases, 87.8% reported animal exposures, with 45.6% having lived or worked on a farm and 29.0% having visited a farm prior to illness. Cases with farm exposures reported a high degree of direct animal contact and inconsistent use of personal protective measures. Cryptosporidiosis patients were significantly more likely than STEC patients to have lived or worked on a farm prior to their illness and were older on average. Patients with these illnesses had high rates of animal contact prior to illness. Animal contact on farms emerged as an important exposure route. Educational messages about personal protective measures should be directed at these individuals. READ ARTICLE
Fitting Farm Safety into Risk Communications Teaching, Research and Practice Image
Fitting Farm Safety into Risk Communications Teaching, Research and Practice
Authors: Evans J, Heiberger S Journal of Applied Communications, Vol 99 No. 3, 2015 ABSTRACT: New safety challenges are emerging as agriculture evolves within the complexity of serving a growing world population. The nation’s most hazardous industry is struggling to provide safe working environments in the face of demographic changes in the agricultural work force, new technologies, new kinds of enterprises, pushback against regulation, and other forces. Such changes introduce new forms of occupational risk and create greater need for appropriate safety communications. This study examined potentials for improving engagement of the agricultural media, which serve as primary information channels for farmers. Those who teach agricultural communications are key gatekeepers in preparing skilled professional agricultural journalists and other agricultural communicators. Therefore, the study focused on potentials for strengthening skills in farm safety communications through teaching programs in agricultural journalism and communications. The second and related purpose involved advancing understanding of conceptual linkages between farm safety communications and risk communications, using a safety-oriented framework of risk communications. A mixed methods research design involved quantitative and qualitative approaches using an online survey among faculty representatives in 23 agricultural communications programs at universities throughout the nation. Responses identified encouraging potentials and useful direction for integrating farm safety into agricultural communications courses. Findings also shed helpful light on conceptual linkages between risk communications and a seemingly “lost cousin” — farm safety communications. They pointed to new potentials for agricultural communications teaching and scholarship in strengthening connections between theory and practice in risk communications (including farm safety communications) related to agriculture. READ ARTICLE
Live animal markets in Minnesota, a potential source for emergence of novel influenza A viruses and interspecies transmission Image
Live animal markets in Minnesota, a potential source for emergence of novel influenza A viruses and interspecies transmission
Authors: Choi MJ, Torremorell M, Bender JB, Danila R, Smith KE, Boxrud D, Ertl JR, Yang M, Suwannakarn K, Her D, Nguyen J, Uyeki TM, Levine M, Jhung M, Vetter S, Wong K, Sreevatsan S, Lynfield R Clinical Infectious Diseases. Jul. 29, 2015 ABSTRACT: Live animal markets have been implicated in transmission of influenza A viruses (IAVs) from animals to people. We sought to characterize IAVs at 2 live animal markets in Minnesota to assess potential routes of occupational exposure and risk for interspecies transmission. We implemented surveillance for IAVs among employees, swine, and environment (air and surfaces) during a 12-week period (October 2012-January 2013) at 2 markets epidemiologically associated with persons with swine-origin IAV (variant) infections. Real-time reverse transcription polymerase chain reaction (rRT-PCR), viral culture, and whole-genome sequencing were performed on respiratory and environmental specimens, and serology on sera from employees at beginning and end of surveillance. At markets where swine and persons are in close contact, swine-origin IAVs are prevalent and potentially provide conditions for novel IAV emergence. READ ARTICLE
Validation of Good Agricultural Practices (GAP) on Minnesota Vegetable Farms Image
Validation of Good Agricultural Practices (GAP) on Minnesota Vegetable Farms
Authors: Hamilton KE, Umber J, Hultberg A, Tong C, Schermann, Diaz-Gonzalez F, Bender JB Foodborne Pathogens Disease. St. Paul, Minnnesota. Jan. 7, 2015 ABSTRACT: The United States Food and Drug Administration and the Department of Agriculture jointly published the “Guide to Minimize Microbial Food Safety Hazards for Fresh Fruits and Vegetables,” which is used as a basis for Good Agricultural Practices (GAP) audits. To understand barriers to incorporation of GAP by Minnesota vegetable farmers, a mail survey completed in 2008 was validated with visits to a subset of the farms. This was done to determine the extent to which actual practices matched perceived practices. Two hundred forty-six producers completed the mail survey, and 27 participated in the on-farm survey. Over 75% of the on-farm survey respondents produced vegetables on 10 acres or less and had 10 or fewer employees. Of 14 questions, excellent agreement between on-farm interviews and mail survey responses was observed on two questions, four questions had poor or slight agreement, and eight questions had no agreement. Ninety-two percent of respondents by mail said “they took measures to keep animals and pests out of packing and storage buildings.” However, with the on-site visit only 45% met this requirement. Similarly, 81% of respondents by mail said “measures were taken to reduce the risk of wild and/or domestic animals entering into fruit and vegetable growing areas.” With direct observation, 70% of farms actually had taken measures to keep animals out of the growing areas. Additional, on-farm assessments were done regarding employee hygiene, training, presence of animals, water sources, and composting practices. This validation study demonstrated the challenge of creating nonleading and concise questions that are not open to broad interpretation from the respondents. If mail surveys are used to assess GAP, they should include open-ended questions and ranking systems to better assess farm practices. To provide the most accurate survey data for educational purposes or GAP audits, on-farm visits are recommended. READ ARTICLE
Personal Protective Equipment Use and Hand Washing among Animal Farmers: A Multi-Site Assessment Image
Personal Protective Equipment Use and Hand Washing among Animal Farmers: A Multi-Site Assessment
Authors: Odo NU, Raynor PC, Beaudoin A, Somrongthong R, Scheftel JM, Donahue JG, Bender JB Journal of Occupational and Environmental Hygiene. Minneapolis, Minnesota. January 2015 ABSTRACT: The goal of this study was to compare and contrast the use of personal protective equipment (PPE) and the practice of handwashing among participants of four studies assessing poultry and swine farms in the midwestern United States and in Thailand. This largely descriptive exercise was designed to assess and compare the frequency of these protective practices among the study populations. There were a total of 1113 surveys analyzed across the four studies. The respondents included workers in direct contact with animals as well as flock owners and veterinarians tending to farms. Handwashing was the most common practice observed among all participants with 42% “always” and 35% “sometimes” washing their hands after contact with the animals. This practice was least common among Minnesota swine workers. Even Thai poultry farmers, who demonstrated the lowest overall PPE use, reported a higher frequency of handwashing. Mask use during animal farming activities (“always” or “sometimes”) was least commonly practiced, ranging from 1% in Thailand to 26% among backyard poultry farmers in Minnesota. Minnesota poultry and swine farmers had similar frequencies of mask (26%) and glove use (51% and 49%). All other comparisons differed significantly across the four sites (p-values
Evaluation of risk and protective factors for work-related bite injuries to veterinary technicians certified in Minnesota Image
Evaluation of risk and protective factors for work-related bite injuries to veterinary technicians certified in Minnesota
Authors: Nordgren L, Gerberich S, Alexander B, Church T, Bender J, Ryan A Journal of the American Veterinary Medical Association. Minneapolis, Minnesota. Aug. 15, 2014 ABSTRACT: The objective of this study is to identify risk and protective factors for work-related bite injuries among veterinary technicians certified in Minnesota. A questionnaire was mailed to CVTs who previously participated in a survey regarding work-related injuries and did (cases; 301 surveys sent) or did not (controls; 567) report qualifying work-related animal bite injuries in the preceding 12 months. Descriptive statistics were summarized. Demographic and work-related variables for the month preceding the bite injury (for cases) or a randomly selected month (controls) were assessed with univariate analysis (489 CVTs) and multivariate analysis of a subset of 337 CVTs who worked in small or mixed mostly small animal facilities. Several work-related factors were associated with the risk of work-related bite injury to CVTs. These findings may serve as a basis for development of intervention efforts and future research regarding work-related injuries among veterinary staff. READ ARTICLE
E. coli 0157:H7 Surveillance in Agricultural Populations in Minnesota Image
E. coli 0157:H7 Surveillance in Agricultural Populations in Minnesota
Authors: Klumb C, Saunders S, Smith K Journal of Agromedicine. Minneapolis, Minnesota. June 9, 2014 ABSTRACT: Escherichia coli O157:H7 (O157) is an important cause of enteric illness, causing an estimated 96,000 infections and 31 deaths annually in the United States. O157 infections are primarily foodborne but can also occur from contact with infected animals (especially cattle and other ruminants) or their environment. Population-based surveillance data for O157 infections in agricultural populations are sparse, and the extent to which animal agriculture exposures contribute to O157 disease burden is unknown. All O157 cases in Minnesota were interviewed about illness characteristics and potential exposures. Retrospective surveillance data from 1996-2011 were collated from electronic databases and surveillance interview forms. Prospective surveillance for O157 in 2012 included detailed follow-up of agricultural exposures. Descriptive analyses were performed using SAS version 9.2 (SAS Institute, Cary, N.C.). During 1996–2011, 358 (14%) of the 2,623 O157 cases in Minnesota had a documented animal agriculture exposure in the week before illness onset. Of these 358 cases, 52% were female, 93% were white, 91% were non-Hispanic, and the median age was 11 years (range, 5 months–89 years). Eighty-seven percent of the 358 cases had bloody diarrhea, and 36% were hospitalized (median stay, 4 days). Prior to their illness, 143 (40%) of the 358 cases with animal agricultural exposures lived on a farm, 61 (17%) worked on a farm, 142 (39%) visited a farm; 127 (35%) reported direct animal contact, and 198 (55%) reported contact with an animal’s environment. In 2012, 23 (19%) of 124 E. coliO157 cases had an animal agriculture exposure before illness onset. Of these 23 cases, 7 (30%) lived on a farm, 1 (4%) worked on a farm, 11 (48%) visited a farm or petting zoo, and 4 (17%) had multiple exposures. Agricultural exposures can account for a substantial proportion of O157 infections in Minnesota. We will develop practical interventions through awareness campaigns, personal protective equipment recommendations, and job duty modifications. Industry leaders can be valuable collaborators in promoting these initiatives with agricultural populations. In the future we will use social media outlets (Twitter and Facebook) and publications in trade journals to promote interventions. READ ARTICLE
Needlestick Injuries in Agriculture Workers and Prevention Programs Image
Needlestick Injuries in Agriculture Workers and Prevention Programs
Authors: Buswell M, Hourigan M, Nault A, Bender JB. Journal of Agromedicine. St. Paul, Minnesota. 2015 ABSTRACT: There are a variety of biologics, vaccines, antibiotics, and hormones used in animal agriculture. Depending upon the procedure or pharmaceutical used, accidental injections or product exposures can result in mild to severe injuries. Needlestick injury (NSI) prevention, research, and education for veterinarians and agriculture workers is limited. The objective of this study was to collect and review published case reports and case series/surveys on human needlestick exposure to veterinary biologics and to summarize needlestick prevention strategies for agricultural workers/veterinarians. A search was conducted of PubMed and Centre for Agriculture Bioscience International (CABI) databases. References were reviewed to identify additional articles. NSI among agricultural workers were primarily included in this review. Thirty articles were applicable to exposures in agricultural settings. Relevant literature consisted of case reports, survey/case series articles, prevention documents, and background articles. Fifty-nine case patients were identified. Most of these cases were associated with exposures to specific vaccines or veterinary products. Injury location was identified from 36 individuals: 24 (67%) NSI to the hands, 10 (28%) injuries to the legs, and 2 to other body locations. Of the 59 cases, 20 (34%) involved oil-adjuvant vaccines. Evidence of hospitalization was recorded for 30 case patients. The length of hospitalization was available from 11 case patients. Median length of hospitalization was 3 days (range: 1-4). Surgical intervention was reported in 25 case patients. Outcome information was available on 30 case patients. Fifteen made a complete recovery within 2 weeks of treatment, 14 had residual sequelae attributed to the injury, and there was 1 reported death. Of the 13 survey/case series articles: 2 focused on oil-adjuvant products, 1 on Brucellosis RB-51 vaccine, 3 on tilmicosin, 1 on Salmonella enteritidis vaccine, 1 on high-pressure injection, and 5 were nonspecific. NSI in agriculture workers and veterinarians can result in significant bodily injury and loss of work. There is a need for varied and comprehensive educational programs for agricultural workers and veterinarians to prevent NSI on livestock operations. READ ARTICLE
COMIC: Safety and Health on the Farm- It
COMIC: Safety and Health on the Farm- It's your Right and it's the Law
Authors: Liebman AK, Juárez-Carillo P, Sáenz S, and Guerrero F. Am. J. Ind. Med, 2013 ABSTRACT: The Agriculture, Forestry, and Fishery (AgFF) Sector workforce in the US is comprised primarily of Latino immigrants. Health care access for these workers is limited and increases health disparities.  This article addresses health care access for immigrant workers in the AgFF Sector, and the workforce providing care to these workers. VIEW COMIC
A model health and safety intervention for Hispanic immigrants working in the dairy industry Image
A model health and safety intervention for Hispanic immigrants working in the dairy industry
Authors: Liebman AK, Juarez-Carrillo P, Reyes IA, Keifer MC. Journal of Agromedicine. Salisbury, Maryland. 2014 READ ARTICLE
Looking for lessons in the child agricultural labor law dust-up Image
Looking for lessons in the child agricultural labor law dust-up
Authors: Keifer MC, Heiberger S Journal of Agromedicine, 2012 READ ARTICLE
New NIOSH-Funded Center Focuses on Safety and Health in Changing Agricultural Landscape Image
New NIOSH-Funded Center Focuses on Safety and Health in Changing Agricultural Landscape
Authors: Heiberger S, Alexander B, Keifer M, Bender J Streamline newsletter, March/June 2012 ABSTRACT: Addressing potential safety and health problems in agriculture is a complex job due to the dynamic nature of the industry and changing demographics of the workforce. The new Upper Midwest Agricultural Safety and Health (UMASH) Center is meeting these challenges with projects that will ultimately improve our understanding of the impact of these changes on the health of workers, and will develop tools available to clinicians in the care and prevention of injury and illness. READ ARTICLE
The future structure of childhood agricultural injury prevention: first the blueprint Image
The future structure of childhood agricultural injury prevention: first the blueprint
Authors: Keifer MC Journal of Agromedicine, 2012 READ ARTICLE
Unique ag safety and health issues of migrant and immigrant children Image
Unique ag safety and health issues of migrant and immigrant children
Authors: McLaurin J, Liebman AK Journal of Agromedicine, 2012 ABSTRACT: Immigrant and migrant youth who live and work in agricultural settings experience unique agricultural safety and health issues. Mobility, poverty, cultural differences, immigration status, language, education, housing, food security, regulatory standards and enforcement, and access to childcare and health care influence exposure risk and the well-being of this population. Approximately 10% of the migrant agricultural labor force is composed of unaccompanied minors, whose safety and health is further compounded by lack of social supports and additional stresses associated with economic independence. This paper examines the current demographic and health data, regulatory protections, and programs and practices addressing safety and health in this sector of youth in agriculture. Gaps in knowledge and practice are identified, with emphasis on data collection and regulatory limitations. Best practices in programs addressing the special needs of this population are highlighted. Recommendations identify seven priority areas for impact to promote transformative change in the agricultural health and safety concerns of unaccompanied minors and children of immigrant, migrant and seasonal farmworkers. This framework may be used to examine similar needs in other identified subpopulations of children as they merit attention, whether now or in the future. READ ARTICLE
The migrant clinicians network: connecting practice to need and patients to care Image
The migrant clinicians network: connecting practice to need and patients to care
Authors: Garcia D, Hopewell J, Liebman AK, Mountain K Journal of Agromedicine, 2012 ABSTRACT: Migrant Clinicians Network advocates for migrants and clinicians, develops appropriate resources, engages outside partners, conducts translational research, and runs programs that support clinical care on the front line of migrant health. Migrant Clinicians Network’s goal is to improve health care for migrants by providing support, technical assistance, and professional development to clinicians in Federally Qualified Health Centers and other healthcare delivery sites with the ultimate purpose of providing quality health care that increases access and reduces disparities for migrant farmworkers and other mobile underserved populations. In this article the authors examine the migrant population in the United States, a brief history of clinicians working in migrant health, and the scope of current Migrant Clinicians Network activities, including occupational and environmental health. READ ARTICLE
Lessons learned from the child agricultural labor law debate Image
Lessons learned from the child agricultural labor law debate
Authors: Heiberger S Journal of Agromedicine, 2012 READ ARTICLE
The quality of drinking water in North Carolina farmworker camps Image
The quality of drinking water in North Carolina farmworker camps
Authors: Bischoff WE, Weir M, Summers P, Chen H, Quandt SA, Liebman AK, Arcury TA Am J Public Health, 2012 ABSTRACT: The purpose of this study was to assess water quality in migrant farmworker camps in North Carolina and determine associations of water quality with migrant farmworker housing characteristics.  We collected data from 181 farmworker camps in eastern North Carolina during the 2010 agricultural season. Water samples were tested using the Total Coliform Rule (TCR) and housing characteristics were assessed using North Carolina Department of Labor standards. READ ARTICLE
Streptococcus suis meningitis in swine worker, Minnesota, USA Image
Streptococcus suis meningitis in swine worker, Minnesota, USA
Authors: Fowler HN, Brown P, Rovira A, Shade B, Klammer K, Smith K, Scheftel JM Emerg Infect Dis, 2013 ABSTRACT: Streptococcus suis is a major bacterial pathogen in swine worldwide. Historically, cases in humans have occurred sporadically, mostly in Asia. However, an outbreak in China involved 215 human cases and 39 deaths. Only 3 human cases of S. suis disease were documented in the United States before 2011: 2 domestically acquired cases in New York and Hawaii, and 1 case in a person in California who was probably exposed in the Philippines. We describe a case of S. suis disease in a swine worker in Minnesota, USA. READ ARTICLE
Occupational Health Policy and Immigrant Workers in the AFF Sector Image
Occupational Health Policy and Immigrant Workers in the AFF Sector
Authors: Liebman, A. K., Wiggins, M. F., Fraser, C., Levin, J., Sidebottom, J. and Arcury, T. A. Am. J. Ind. Med, 2013 ABSTRACT: Immigrant workers make up an important portion of the hired workforce in the Agricultural, Forestry and Fishing (AgFF) sector, one of the most hazardous industry sectors in the US. Despite the inherent dangers associated with this sector, worker protection is limited.  This article describes the current occupational health and safety policies and regulatory standards in the AgFF sector and underscores the regulatory exceptions and limitations in worker protections. Immigration policies and their effects on worker health and safety are also discussed. Emphasis is placed on policies and practices in the Southeastern US. READ ARTICLE
Hazards faced by informal recyclers in the squatter communities of Asunción, Paraguay Image
Hazards faced by informal recyclers in the squatter communities of Asunción, Paraguay
Authors: Cunningham R, Simpson C, Keifer MC International Journal of Occupational and Environmental Health, 2012 ABSTRACT: Informal recycling is widespread in developing countries and involves the collection, sorting, and selling of recyclable materials. Workers are exposed to hazards including the risk of cuts and musculoskeletal injury, infection, exposure to medical waste, and respiratory conditions like bronchitis, pneumonia, and sinusitis and often use insufficient personal protective equipment.  The objective is to assess the occupational and environmental health hazards faced by informal recyclers working at a landfill in Asunción, Paraguay. READ ARTICLE
Developing the 2012 national action plan for protecting children in agriculture Image
Developing the 2012 national action plan for protecting children in agriculture
Authors: Lee BC, Gallagher SS, Liebman AK, Miller ME, Marlenga B Journal of Agromedicine, 2012 ABSTRACT: In 1996 the US launched a National Childhood Agricultural Injury Prevention Initiative, guided by an action plan generated by a 42-member multidisciplinary committee. A major update to the plan was released following the 2001 Summit on Childhood Agricultural Injury Prevention. From the year 2010 through 2011 a comprehensive assessment of progress to date was conducted followed by the drafting, review and finalizing of a new action plan-“The 2012 Blueprint for Protecting Children in Agriculture.” This paper briefly describes the purpose and process for generating the new action plan then provides a listing of the 7 goals and 26 strategies within the plan. These goals and strategies account for trends in childhood agricultural injuries, changes in agricultural production and the demographics of its workforce, effectiveness of interventions, and the increasing use of social media, marketing and social networking. Primary funding for this project was provided by the National Institute for Occupational Safety and Health (NIOSH), which continues to serve as the lead federal agency for the national initiative. READ ARTICLE
Blueprint for Protecting Children in Agriculture: The 2012 National Action Plan Image
Blueprint for Protecting Children in Agriculture: The 2012 National Action Plan
Authors: Lee BC, Gallagher SS, Liebman AK, Miller ME, Marlenga B Marshfield Clinic Report, 2012 ABSTRACT: This National Action Plan takes an updated look at preventing childhood agricultural injury and death.  The Blueprint endeavor builds upon the 1996 plan that launched a national initiative leading to a remarkable reduction in nonfatal injuries among children who live on, visit and work onfarms. The 2012 Blueprint re-sets priorities to reflect changes in agricultural production and worker profiles. The Blueprint is a product of input from the general public as well as leading researchers in childhood agricultural safety and health. Draft versions of goals and strategies were critiqued by nearly 100 stakeholders, and then posted online to solicit further public input. The 38-page report emphasizes the need for: – Affordable, accessible and high quality child care options for farm families and hired farm workers. – Increased involvement of employers, farm organizations and agribusinesses in creating a culture of safety. – Improved injury and fatality data collection with inclusion of underserved populations such as Anabaptists and seasonal workers. – Increased attention to reaching young farm parents and teen workers via social media outlets. READ ARTICLE
Research-to-practice transition of a portable cholinesterase monitoring kit: how does it affect the work of clinics? Image
Research-to-practice transition of a portable cholinesterase monitoring kit: how does it affect the work of clinics?
Authors: Treadwell RJ, Keifer MC Washington State Journal of Public Health Practice. Spokane, Washington. 2012 ABSTRACT: To identify work-related factors in large and small occupational health and rural clinics that may impact sustained utilization of a portable cholinesterase (ChE) monitoring kit within those settings. Primary interview data were collected in April and May of 2009 from three occupational medical clinics that offer ChE monitoring to pesticide handlers in eastern Washington State. Participants were identified by their involvement in the state ChE monitoring program and selected by size. Key informant responses to a setting-specific interview guide were recorded. The Normalization Process Model (NPM) was used to identify factors that may promote or inhibit successful normalization of the kit into routine clinical practice. Interview data was organized with opensource qualitative analysis software. Themes were identified and applied to specific dimensions of the NPM for analysis. Volume of blood samples, procedural efficiency, patient trust, limited staffing disruption, and effective communication between key players within the monitoring system were some identified work-related factors that may promote kit normalization in clinics. The NPM identified several work-related factors that may positively dispose a portable ChE kit to normalization in a clinical setting. Clinics both large and small may be able to use the NPM to determine how a new clinicbased intervention may positively or negatively affect the workload of its staff. READ ARTICLE
Immigrant dairy workers
Immigrant dairy workers' perceptions of health and safety on the farm in America's Heartland
Authors: Liebman AK, Juarez-Carrillo PM, Reyes IA, Keifer MC American Journal of Industrial Medicine, 2016 ABSTRACT: 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. We examined results of five focus groups with 37 Hispanic, immigrant dairy workers. Analysis followed a grounded theory approach and employed ATLAS.ti.  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. READ ARTICLE
Personal protection by Thai households in avian influenza outbreaks Image
Personal protection by Thai households in avian influenza outbreaks
Authors: Somrongthong R, Beaudoin AL, Bender J, Laosee O, Pakinsee S, Sitthi-amorn C Zoonosis and Public Health, 2012 ABSTRACT: Thailand has had multiple poultry outbreaks of highly pathogenic avian influenza (HPAI) H5N1 since its first emergence in 2004. Twenty-five human cases of HPAI H5N1 avian influenza have been reported in the country, including 17 fatalities, and contact with infected dead or dying poultry has been identified as a risk factor for human infection. This study assessed the use of protective equipment and hand hygiene measures by Thai poultry-owning households during activities involving poultry contact. Surveys conducted in 2008 included questions regarding poultry-related activities and protective measures used during an HPAI outbreak (2005) and 3 years after the study location’s last reported outbreak (2008). For both time periods, poultry owners reported limited use of personal protective equipment (PPE) during all activities and inconsistent hand washing practices after carrying poultry and gathering eggs. This is the first time that PPE use in Thailand has been quantified for a large study group. These data are important for ongoing characterization of HPAI risk and for the crafting of educational messages. READ ARTICLE
Recovery of staphylococci from computer keyboards in a veterinary medical centre and the effect of routine cleaning Image
Recovery of staphylococci from computer keyboards in a veterinary medical centre and the effect of routine cleaning
Authors: Bender JB, Schiffman E, Hiber L, Gerads L, Olsen K Veterinary Record, 2012 ABSTRACT: Computers play a vital role in veterinary clinics for grading, examining results, updating records, giving discharge instructions and maintaining billing information. Few studies have documented the degree of contamination or practical methods to disinfect computer equipment within the veterinary clinic setting. The intent of the present study was to characterise the frequency of recovery of Staphylococcus species from computer keyboards from a veterinary teaching hospital setting and to evaluate the effect of daily cleaning. From three keyboards in a treatment area, three in a dermatology area and one in office 70 environmental samples were cultured for Staphylococcus. As an indirect measure to assess cleanliness, samples were collected and tested using the 3M Clean-Trace Luminometer (relative light units [RLU]). Of the 25 Staphylococcus recovered 13 were Staphylococcus species, seven Staphylococcus pseudintermedius, four Staphylococcus aureus and one mixed colony of both Staphylococcus species and S pseudintermedius. The median RLU was 2098 (range 132 to 11,590). Routine cleaning decreased the recovering of Staphylococcus and the RLU values. In summary, the study results demonstrate the value of routine cleaning of keyboards and the need for on-going and regular education of staff and students about good hand hygiene. READ ARTICLE
Risk factors for exposure to influenza a viruses, including subtype H5 viruses, in Thai free-grazing ducks Image
Risk factors for exposure to influenza a viruses, including subtype H5 viruses, in Thai free-grazing ducks
Authors: Beaudoin AL, Kitikoon P, Schreiner PJ, Singer RS, Sasipreeyajan J, Amonsin A, Gramer MR, Pakinsee S, Bender JB Transbound Emerg Dis., 2012 ABSTRACT: Free-grazing ducks (FGD) have been associated with highly pathogenic avian influenza (HPAI) H5N1 outbreaks and may be a viral reservoir. In July-August 2010, we assessed influenza exposure of Thai FGD and risk factors thereof. Serum from 6254 ducks was analysed with enzyme-linked immunosorbent assay (ELISA) to detect antibodies to influenza A nucleoprotein (NP), and haemagglutinin H5 protein. Eighty-five per cent (5305 ducks) were seropositive for influenza A. Of the NP-seropositive sera tested with H5 assays (n = 1423), 553 (39%) were H5 ELISA positive and 57 (4%) suspect. Twelve per cent (74 of 610) of H5 ELISA-positive/suspect ducks had H5 titres ≥ 1 : 20 by haemagglutination inhibition. Risk factors for influenza A seropositivity include older age, poultry contact, flock visitors and older purchase age. Study flocks had H5 virus exposure as recently as March 2010, but no HPAI H5N1 outbreaks have been identified in Thailand since 2008, highlighting a need for rigorous FGD surveillance. READ ARTICLE
A framework for developing research protocols for evaluation of microbial hazards and controls during production that pertain to the quality of agricultural water contacting fresh produce that may be consumed raw Image
A framework for developing research protocols for evaluation of microbial hazards and controls during production that pertain to the quality of agricultural water contacting fresh produce that may be consumed raw
Authors: Harris LJ, Bender J, Bihn EA, Blessington T, Danyluk MD, Delaquis P, Goodridge L, Ibekwe AM, Ilic S, Kniel K, Lejeune JT, Schaffner DW, Stoeckel D, Suslow TV J Food Prot, 2012 ABSTRACT: Agricultural water may contact fresh produce during irrigation and/or when crop protection sprays (e.g., cooling to prevent sunburn, frost protection, and agrochemical mixtures) are applied. This document provides a framework for designing research studies that would add to our understanding of preharvest microbial food safety hazards and control measures pertaining to agricultural water. Researchers will be able to use this document to design studies, to anticipate the scope and detail of data required, and to evaluate previously published work. This document should also be useful for evaluating the strength of existing data and thus should aid in identifying future research needs. Use of this document by the research community may lead to greater consistency or comparability than currently exists among research studies, which may ultimately facilitate direct comparison of hazards and efficacy of controls among different commodities, conditions, and practices. READ ARTICLE
Herd-level risk factors associated with fecal shedding of Shiga toxin-encoding bacteria on dairy farms in Minnesota, USA Image
Herd-level risk factors associated with fecal shedding of Shiga toxin-encoding bacteria on dairy farms in Minnesota, USA
Authors: Cho S. Diez-Gonzalez F, Fossler C, Wells SJ, Hedberg CW, Kaneene JB, Ruegg P, Warnick L, Bender JB Canadian Veterinary Journal, 2013 ABSTRACT: This study aimed to identify herd-level risk factors associated with fecal shedding of Shiga toxin-encoding bacteria (STB) on dairy cattle farms in Minnesota, USA. READ ARTICLE
Influenza A(H1N1)pdm09 virus among healthy show pigs, United States Image
Influenza A(H1N1)pdm09 virus among healthy show pigs, United States
Authors: Gray GC, Bender JB, Bridges CB, Daly RF, Krueger WS, Male MJ, Heil GL, Friary JA, Derby RB, Cox NJ Emerging Infectious Diseases, 2012 ABSTRACT: Within 5 months after the earliest detection of human influenza A(H1N1)pdm09 virus, we found molecular and culture evidence of the virus in healthy US show pigs. The mixing of humans and pigs at swine shows possibly could further the geographic and cross-species spread of influenza A viruses. READ ARTICLE
Prevalence, antibiotic resistance and molecular charcterisation of Staphylococcus aureus in Pigs at agricultural fairs in the USA Image
Prevalence, antibiotic resistance and molecular charcterisation of Staphylococcus aureus in Pigs at agricultural fairs in the USA
Authors: Dressler AE, Scheibel RP, Wardyn S, Harper AL, Hanson BM, Kroeger JS, Diekema DJ, Bender JB, Gray GC, Smith TC Veterinary Record, 2012 ABSTRACT: Fairs and petting zoos have been associated with outbreaks of zoonotic disease. Previously, the presence of meticillin-resistant Staphylococcus aureus (MRSA) was documented in commercial pigs; therefore, it was hypothesised that antibiotic-resistant S aureus may also occur in pigs exhibited at agricultural fairs. To test this hypothesis, 157 pigs were swabbed at two state fairs in 2008 to 2009. Both nares were sampled and cultures were grown in enrichment broth, then plated onto selective MRSA plates and blood plates. S aureus was confirmed using phenotypic and molecular methods, and was analysed using spa typing, gene-specific polymerase chain reaction and antibiotic susceptibility testing. The presence of S aureus was confirmed in samples collected from pigs exhibited at USA pig shows. Twenty-five of 157 (15.9 per cent) samples were positive for S aureus. Two isolates (8 per cent) were resistant to meticillin; 23/25 (92 per cent), 14/25 (56 per cent) and 15/25 (60 per cent) were resistant to tetracycline, erythromycin and clindamycin, respectively. spa typing revealed multiple isolates of spa type t034 (9/25, 36 per cent) and t337 (7/25, 28 per cent) and singletons of t002, t209, t526, t1236, t1334, t1683, t3075, t5784 and t5883. These results verify the presence of antibiotic-resistant S aureus in pigs exhibited at USA fairs, suggesting that pigs are a potential reservoir for S aureus within this environment. READ ARTICLE
Health care access for immigrant workers in AFF sector in southeastern US Image
Health care access for immigrant workers in AFF sector in southeastern US
Authors: Frank, A. L., Liebman, A. K., Ryder, B., Weir, M. and Arcury, T. A. Am. J. Ind. Med, 2013 ABSTRACT: The Agriculture, Forestry, and Fishery (AgFF) Sector workforce in the US is comprised primarily of Latino immigrants. Health care access for these workers is limited and increases health disparities.  This article addresses health care access for immigrant workers in the AgFF Sector, and the workforce providing care to these workers. READ ARTICLE

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