Review of Health Effects Research - Agriculture Forestry and Fishing Research at NIOSH - page 84

ties as surveillance of injuries and illness; identification and characterization of
the unique health and safety risks faced by special populations; identification and
characterization of health effects associated with chemical, physical, and biological
agents encountered in AFF occupations; development of methods to characterize
and measure potentially hazardous substances and exposures; and development of
methods and strategies for the transfer of health effects knowledge to others who
design and evaluate interventions and outreach mechanisms.
The AFF Program has at best modest reach into some AFF sectors. For example,
geographic dispersion of AFF worksites, rural isolation, non-English dialects, so-
cial dynamics, access to workers at occupational sites, the undocumented status
of some exposed AFF workers, and patterns of worksite task organization may
militate against effective penetration. Nevertheless, Congress's intent was clear:
to safeguard and promote the safety and health of AFF worker populations in the
nation's fundamental interest.
The committee separated its assessment of the health effects research portion of
the AFF Program into review of National Traumatic Occupational Fatality (NTOF)
Surveillance System activities and industry-specific activities. NTOF is an intramu-
ral effort that relies on state-level death certification programs and, for the purposes
of the AFF Program, appears to have focused largely on agricultural events with a
secondary emphasis on forestry-related fatalities. The limitations of the system are
openly acknowledged and include the lack of program-related comprehensiveness
given the gaps in industry and occupation coding in state vital-statistics programs.
States with some of the nation's leading agricultural and forestry production do
not code their death certificates for industry or occupation. In addition, because
data are provided by key informants, such as family members of the deceased or
local coroners, key occupational features and exposures may be missing. The use
of NTOF data to target Fatality Assessment and Control Evaluation (FACE) pro-
gram initiatives and portions of the Occupational Health Nurses in Agricultural
Communities (OHNAC) program appears problematic because the methods used
by NTOF were flawed.
Industry-specific health effects programs encompassed both intramural and
extramural activity and were highly varied. In forestry, there were activities in-
volving interagency working groups, FACE investigation reports, and machine
harvesting exposure assessment. In agriculture, some research programs focused on
disease and injury surveillance, biomonitoring and exposure assessment, and haz-
ard surveillance. In fishing, surveillance of worksite trauma and interagency policy
working group activity occurred. Collectively, those activities expanded program
effort well beyond the narrow goal specified by NIOSH for the AFF Program. In
total, the industry-specific activities were much more congruent with congressional
intent than with the narrow NIOSH-defined focus.