1 Surveillance of Personal Protective Equipment Practices in Agriculture Kimberly Faulkner, PhD, MPH for NIOSH and the National Personal Protective Technology Laboratory

2 Protecting U.S. farm crop workers  Personal Protective Equipment  Assess practices and barriers to best practices over time  Improve practices to reduce illness

3 Personal protective equipment A critical last line of defense

4 Personal protective equipment practices It’s only effective when selected and used correctly

5 Objectives  Study planning  Assessment of existing knowledge and methods  Development and administration of a standard questionnaire/focus groups

6 Study Planning  Study scope: Pesticide handlers, practices and barriers  Existing data sources  FLYER  PPE regulations

7 Study planning: Overview

8 Study Planning: Data sources

9 Study Planning: FLYER

10 Study Planning: PPE regulations  EPA WPS:  40 CFR , (c), (a)(2), b.1  Certification of Pesticide Applicators: 40 CFR 171  Labeling Requirements for Pesticides: 40CFR 156  OSHA Standard for Agriculture: 29 CFR 1928  OSHA PPE standards: 29CFR , and

11 Study Planning: Summary  Examine existing knowledge and do pre- assessment work on barriers  Identify partners and pool resources  Develop and administer questionnaire/focus groups  Develop and administer interventions

12 Objectives  Study planning  Assessment of existing knowledge and methods  Development and administration of a standard questionnaire

13 Assessing existing knowledge  National Agricultural Workers Study (NAWS)  NIOSH Sentinel Event Notification System for Occupational Risk (SENSOR)  Oregon OSHA Pesticide Emphasis Program

14 Assessing existing knowledge: NAWS  National sample, 1,230 interviews addressing PPE ( ); 99% complete  PPE appropriateness not known  Using PPE correctly not known

15 Assessing existing knowledge: SENSOR  Pesticide illnesses reported in 12 states  Only OR, WA, MI collected PPE data on at least 79% of cases ( ), N=178  PPE appropriateness not known  Using PPE correctly not known

16 Assessing existing knowledge: OR OSHA  Programmed inspection data  Oregon PPE regulations (EPA WPS & OSHA respiratory protection standard adopted in 2007)  Percent of establishments in violation of PPE regulations  Most common regulations violated  Doesn’t tell us about individual practices or barriers

17 Assessing existing knowledge: OR OSHA/Methods  348 programmed first inspections (of 375) from 2000 to 2007  Applicable regulations: ,  3 industries = 95% of inspections  fruit and tree nut farming  greenhouse/nursery/floriculture production,  other crop farming  1-10 employees = 55% of inspections

18 Assessing existing knowledge: OR OSHA/Results ( )

19 Assessing existing knowledge: OR OSHA/Results ( )

20 Assessing existing knowledge: OR OSHA/Results ( )

21 Assessing existing knowledge: OR OSHA/Summary  PPE violations are common and frequent, many are serious  Appropriateness of PPE for the establishment  Proper use of PPE for the establishment Individual PPE practices and barriers are not known

22 Objectives  Study planning  Assessment of existing knowledge and methods  Development and administration of a standard questionnaire/focus groups

23 Develop and administer standard  Questionnaires and focus groups (as appropriate)  Appropriate /inappropriate PPE  Appropriate use/misuse of PPE

24 Develop and administer standard  Appropriate/inappropriate PPE  EPA registration number for pesticides  or manufacturers specific name of pesticide  Relevant environmental controls  Duration of exposure  Type(s) and material(s) of PPE worn when mixing, loading or applying pesticides  If respirator used: NIOSH certification number  If applying pesticides: methods of application

25 Develop and administer standard  Proper use/misuse of PPE  proper size/fit  maintenance  inspection  storage  discarding PPE as required  clean area to put on and remove PPE  decontamination  For respirator users: lack of fit testing, medical evaluation, user-seal check, and proper filter replacement

26 Develop and administer standard  PPE concerns and barriers  For each type of PPE and handler group: What are the concerns, barriers and solutions?  Handler groups  commercial certified applicator  private certified applicator (Hispanic and Non-hispanic)  non-certified/WPS handler (Hispanic and Non-hispanic)  Anabaptist/Amish communities  Flyers: 17 s and 4 phone calls

27 Develop and administer standard: Surveillance 2012, 2013, …

28 Develop and administer standard  Partnerships  EPA/OR OSHA  State Cooperative Extension services  State Offices of Rural Health  State Departments of Health/Agriculture  PNASH  Farmworker Association of Florida

29 Develop and administer standard: Next steps (Apr Apr. 2011)  Expand/strengthen partnerships  Brainstorm with partners  Identify PPE concerns and barriers  Develop gold standard (questionnaire/focus groups)  Identify opportunities and challenges  Identifying and secure resources

30 Develop and administer standard: Summary  We need your help  How to access handlers and employers?  What are critical elements needed to assess practices?  What are the tools/methods to best be able to assess practices?  The benefit to you…  Results will inform educational and training outreach  Improved compliance and possibly reduced illnesses

31 Contact me Kimberly Faulkner, PhD, MPH Epidemiologist/Statistician NIOSH/National Personal Protective Technology Laboratory P.O. Box Pittsburgh, PA Tele: