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

2. 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. 3 Personal protective equipment A critical last line of defense

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

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

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

7. 7 Study planning: Overview

8. 8 Study Planning: Data sources

9. 9 Study Planning: FLYER

10. 10 Study Planning: PPE regulations  EPA WPS:  40 CFR 170.170.7, 170.240(c), 170.232 (a)(2), 170.230.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 1910.132- 1910.136, and 1910.138

11. 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. 12 Objectives  Study planning  Assessment of existing knowledge and methods  Development and administration of a standard questionnaire

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

14. 14 Assessing existing knowledge: NAWS  National sample, 1,230 interviews addressing PPE (1999-2001); 99% complete  PPE appropriateness not known  Using PPE correctly not known

15. 15 Assessing existing knowledge: SENSOR  Pesticide illnesses reported in 12 states  Only OR, WA, MI collected PPE data on at least 79% of cases (2001-05), N=178  PPE appropriateness not known  Using PPE correctly not known

16. 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. 17 Assessing existing knowledge: OR OSHA/Methods  348 programmed first inspections (of 375) from 2000 to 2007  Applicable regulations: 1910.132-138, 170.240  3 industries = 95% of inspections  fruit and tree nut farming  greenhouse/nursery/floriculture production,  other crop farming  1-10 employees = 55% of inspections

18. 18 Assessing existing knowledge: OR OSHA/Results (2000-07)

19. 19 Assessing existing knowledge: OR OSHA/Results (2000-07)

20. 20 Assessing existing knowledge: OR OSHA/Results (2000-07)

21. 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. 22 Objectives  Study planning  Assessment of existing knowledge and methods  Development and administration of a standard questionnaire/focus groups

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

24. 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. 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. 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 emails and 4 phone calls

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

28. 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. 29 Develop and administer standard: Next steps (Apr. 2010-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. 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. 31 Contact me Kimberly Faulkner, PhD, MPH Epidemiologist/Statistician NIOSH/National Personal Protective Technology Laboratory P.O. Box 18070 Pittsburgh, PA 15236-0070 Tele: 412-386-6609 Email: KFaulkner@cdc.gov