Review of Health Effects Research - Agriculture Forestry and Fishing Research at NIOSH - page 83

to various extents over the life of the AFF Program. Stakeholders with whom it
was more difficult to hold a discussion, such as farm workers and forestry work-
ers, did not appear to be consulted during planning. The array of other partners
was large, and some were not consulted by AFF Program staff during planning.
The Alaska fishing safety program has been quite successful, because it began with
good surveillance and progressed to the design and implementation of research in
an organized way, which contributed greatly to its efficacy.
A pivotal NIOSH-sponsored symposium on agriculture was the 1991 Surgeon
General's Conference on Agricultural Safety and Health. It came at a critical point
in the history of the discipline and had far-reaching favorable consequences for
the agriculture component of the AFF Program. The national and international
workshops on commercial fishing safety also came at a critical point in establish-
ing plans for the Alaska Field Station. While local and regional impact has clearly
been made, it is not clear that NIOSH has had a similar impact on a national level
in forestry or other aspects of fishing.
Planning, production, and other inputs were used effectively to promote the
major activities in the Alaska fishing program. It is a well-defined program with a
small scope that effectively addresses risk of death by drowning, hypothermia, or
traumatic injury in a small number of workers. In contrast, the forestry compo-
nent attempts to address the safety and health needs of a larger number of workers
without the benefit of surveillance or well-articulated planning. Agriculture is a
vast topic with diverse worker populations and exposures; surveillance has been
fragmented in agriculture. It has at times been effective but not consistently. Inputs,
including surveillance, were used effectively to plan and implement some projects,
such as the Childhood Agricultural Injury Prevention initiative. For projects tar-
geting adult workers, the benefits gained from planning and production resources
have been less obvious because outcome measures are not available.
Some sources of inputs were adequate. For example, inputs from the Alaska
fishing program were excellent. Other AFF projects had less adequate inputs, par-
tially because of cultural, geographic, financial, and other types of barriers; the pau-
city of interventions aimed directly at farm workers is evidence of the limitation.
Overall, a lack of evidence of strategic planning and coordination was apparent
and may explain some of the variability in the quality of inputs.
There is little evidence that input was obtained from vulnerable working
populations, such as farm or forestry workers, owners of small farms or forestry
enterprises, the elderly, and non-English speaking workers.
ACTIVITIES
Activities are defined as the effort and work of the AFF Program, its staff, and
its extramural partners. The committee has defined health effects research activi-