Other Programmatic Elements Identified by the Committee - Agriculture Forestry and Fishing Research at NIOSH - page 138

publications, which are all the more remarkable because NIOSH did not formu-
late epidemiologically derived guidance for nurses “in the field” that might have
resulted in more precise targeting of efforts to the highest-risk agricultural worksite
exposures in the 10 funded states. Outputs of the OHNAC program included peer-
reviewed publications targeting clinicians and others, which form the backbone
of formal instructional materials (including clinical texts); continuing education
updates; self-study courses; simulations; and seminar content.
Overall, the output of the AFF Program has been substantial in health services
research and training, although less than output of other kinds, such as informa-
tion aimed directly at workers. At times, a lack of planning and organization has
hampered progress. It is not always clear how conducting health services research
and training fits with the other missions of the NIOSH AFF Program.
Other Outcomes
There is evidence that some NIOSH-funded health services research projects
may be influencing industries tangentially related to the AFF sector and to the topic
of occupational safety and health. Those industries span a continuum from liability
insurance carriers to equipment manufacturers—such as those producing tractors
or fishing vessel cable winching devices—to health and safety product vendors.
The influence of NIOSH can be detected in the marketplace: from the presence
of safety-enhanced end-user products to the belief by the insurance industry that
use of these products reduces occupational injury and illness. The reductions may
occur because of the effect on worker social factors, sector development of financ-
ing incentives, changes in organizational work-setting procedures and supervision,
introduction of new and improved technologies for prevention of ill effects or
their timely clinical detection, or adjustments in how basic medical care is de-
ployed. And the projects have enhanced the professional development of classically
trained agricultural engineers, industrial hygienists, safety professionals, industrial
nurses, and so on whose career trajectories evolved from full-time employment in
sector-related industry to university-based Ag Centers, occupational health clinics,
and other private venues, such as the National Safety Council. Examples of these
outcomes include the following:
• The Certified Safe Farms project has received funding from the health
insurance industry in Iowa. This may be an important first step in reaching the
ultimate goal of making preventive health services available to farmers.
• In 1997, extramural AFF Program staff at the University of Iowa sponsored
consensus-building activity, including a capstone conference to develop an ap-
proach to implementing a nation-wide tractor-related injury and death prevention