1. Osteoarthritis and Farm Youth: An Ounce of Prevention is Worth a Pound of Cure Amber Wolfe Tuesday, July 28, 2015 3:00 p.m. EDT

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6. AgrAbility: USDA-sponsored program that assists farmers, ranchers, and other agricultural workers with disabilities. – Partners land grant universities with disability services organizations. Currently 20 state projects – National AgrAbility Project: Led by Purdue’s Breaking New Ground Resource Center. Partners include: Goodwill of the Finger Lakes The Arthritis Foundation, Heartland Region University of Illinois at Urbana-Champaign Colorado State University – More information available at www.agrability.org www.agrability.org

7. Creak, Crack, Moan and Groan: Farm Kids Get Arthritis Too! WORKING SMARTER, NOT HARDER, TO PREVENT ARTHRITIS PAIN IN AGRICULTURE Rural Arthritis Education Curriculum Resource

8. Agriculture is one of the most hazardous industries in the nation. An estimated 1.04 million children and adolescents under 20 years of age resided on farms in 2009, with about 590,000 of these youth performing work on the farms. In addition to the youth who lived on farms, an additional 307,000 children and adolescents were hired to work on U.S. farms in 2006. Estimated 3,601 injuries performing farm work- highest rate is from livestock work. SOURCE: Agricultural Safety: 2009 Injuries to Youth on Farms - USDA, National Agricultural Statistics Service SOURCE: 2007 Census of Agriculture- USDA, National Agricultural Statistics Service

9. Over 1/3 of US farmers have a diagnosed form of arthritis. The average age of the US farmer is 57 years old. How do these facts affect the working dynamic of the farming culture across generations?

10. Are more farm youth taking over tasks that they are not physically fit for? Are they capable of handling those tasks? Are there other factors in their life that may affect their joint strength?

11. JUVENILE ARTHRITIS Juvenile arthritis is the term used to describe arthritis in children. The most common type that children get is juvenile idiopathic arthritis (idiopathic means “from unknown causes”). There are several other forms of arthritis affecting children. Juvenile arthritis affects children of all ages and ethnic backgrounds. About 294,000 American children under age 18 have arthritis or other rheumatic conditions.

12. OSTEOARTHRITIS Most common form seen in farmers and agricultural workers. But many youth agricultural workers do not know they may be at risk of developing osteoarthritis. Osteoarthritis is not a normal consequence of aging. FARM YOUTH ARE AT RISK.

13. WHY ARE YOUTH AT RISK? Lack of experience Unfamiliar with the work Enthusiasm outweighs judgment Risk-takers Driven to succeed Reluctant to ask questions

14. FACTORS AND RISKS ON THE FARM Stress- market prices, family, animal health, schedule, diet Overuse of Body and Joints- lifting, bending, carrying, squatting, kneeling, pulling, pushing, grasping, etc. Age/weight/genetics School/athletic injuries External Factors- weather, uncontrollable livestock, accidents, machinery malfunctions

15. SOURCES OF JOINT STRESS ON THE FARM Driving tractors, combines, grain trucks (whole body vibration) Hitching implements Throwing, stacking hay Milking cows and other livestock work Lifting and carrying heavy feed bags Lifting and carrying water buckets Fixing fence Using hand tools

16. RESEARCH? Youth Osteoarthritis Survey Results –Student Surveys- 241/322 returned –Illinois FFA Surveys- 173 completed Compiled Data- 414 Responses –Residence Majority- Town/Village –Average Age- 16.5 –Farm Labor- 68.3% Yes/31.7% No –Sex- 59.4% Male/40.6% Female

18. WHEN A FARM KID HAS ARTHRITIS… Farmers and ranchers with arthritis are faced with many obstacles that limit their ability to continue farming. Like farming, arthritis is often a 24-hour, 7-day a week occupation. As hard as it is for a farmer to change routine, life-style changes can be beneficial. And not all change has to use technology. – Pain, fatigue, and stiffness are effects of arthritis that can limit a farmer and rancher. – It may cause difficulty completing a specific task, hinder the progress of daily activities, or even leave them feeling completely overwhelmed. – From simple physical tasks – getting on the tractor, loading feed – to social activities, arthritis can interfere with one’s life.

19. ARTHRITIS MANAGEMENT 1.Get a proper diagnosis- early detection 2.Work with a team of health care providers 3.Get proper exercise/watch weight and diet 4.Age appropriate farm chores 5.Joint protection- body mechanics/ergonomics 6.Use assistive technologies- if appropriate 7.Manage stress and pace yourself- work simplification 8.Be educated- unproven remedies

20. North American Guidelines for Children’s Agricultural Tasks North American Guidelines for Children’s Agricultural Tasks – http://www.nagcat.org http://www.nagcat.org Penn State Extension – http://extension.psu.edu /business/ag- safety/youth- safety/children-and- safety-on-the-farm http://extension.psu.edu /business/ag- safety/youth- safety/children-and- safety-on-the-farm

22. AgeDevelopmentally Appropriate Work Tasks Birth–4  None. Children this age should not be exposed to work hazards. 5–9  Tasks of short duration that do not require hand-eye coordination  Projects with hand tools, not power tools  Help with watering plants and feeding small animals (pets/orphans)  Collect eggs 10–13  Hand raking, digging  Limited power tool use (supervision); hand tools better  Operating lawn mower (push mower, flat surface, under supervision) or garden tractor  Handling and assisting with animals 13–16  Still needs adult supervision but ready for more adult jobs such as equipment operation and maintenance  Manual handling of feed and feeding animals  Can operate a tractor over 20 PTO horsepower or connect/ disconnect parts to or from tractor at ages 14 and 15 after the completion of a 10- hour training program  Can assist with and operate (including stopping adjusting, and feeding) the following after completing a 10-hour training program: cornpicker, cotton picker, grain combine, hay mower forage harvester, hay baler, potato digger, feed grinder, crop dryer, forage blower, auger, the unloading mechanism of a nongravity -type self-unloading wagon or trailer, power post-hole digger, power post driver or nonwalking rotary tiller 16–18  May be ready to work with tractors, self-propelled machinery, augers, elevators, and other farm equipment, but must earn this responsibility. Should be trained, educated, and supervised at regular intervals.

23. BASIC ERGONOMICS Goal of Ergonomics: to make sure workers are uninjured, safe, and comfortable, as well as productive in their jobs Ergonomics finds the best fit between the worker and the job by finding the right tools and environment. DO THE MATH! Physical Capabilities + Body Limitations + Work Tasks + Tools Available + Environment = ERGONOMICS

24. How can we make sure youth workers are uninjured, safe, comfortable, and productive? Find the best fit between worker and job. Ergonomically, determine the: physical capabilities of the youth worker tasks to be completed tools to be used job environment Redesign the tools or redesign how the work process is completed. Injuries are prevented as a natural result of improved work posture, reduced force, or less repetition. Put ergonomic changes into operation along with training on how to work safely.

25. OPERATION MODIFICATIONS Educate on the dangers of jumping off of wagons and out of machinery Encourage use of mounting aids or steps If age permits, provide utility vehicles, or carts to prevent carrying heavy loads Provide adjustable seats/stools for working at tool benches Educate on livestock awareness, keeping clear working areas and pathways, and danger in chutes Encourage use of anti-fatigue mats and wearing proper footwear Teach proper mounting and lifting techniques Provide additional mirrors, adaptable handles and controls, or other needed tools

26. ASSISTIVE TECHNOLOGY Tool Adaptations Longer handles Larger diameter handles Support braces Step stools Utility vehicles Specialty tools Operation Modifications Downsizing herds Changing crops/products Hiring more employees

27. TOOL ADAPTATIONS Air suspension seats, shock absorption Permanent steps or lifts, extendable ladder steps, raised milking parlors Shoulder slings, utility carts and vehicles, ergonomic tools, long-handled or padded tool handles Blocks under bench legs, adjustable seats/stools Anti-fatigue mats, proper footwear, anti-vibration hand protection Additional mirrors, adaptable handles and controls

28. Creak, Crack, Moan and Groan: Farm Kids Get Arthritis Too! WORKING SMARTER, NOT HARDER, TO PREVENT ARTHRITIS PAIN IN AGRICULTURE Rural Arthritis Education Curriculum Resource

29. WRITTEN CURRICULUM: 1. Grades 7-12 2. Written as 1 continual lesson, or 3 individual lessons 3. Classroom or Lab settings Written Lesson Plans Include – Materials – Objectives – Interest Approaches – Talking Points and Content – Accompanying Slides – Teachable Moments Activities – Oral Review Quiz Questions – References

30. PILOT TESTING The complete lesson plan curriculum was pilot- tested in 14 class settings in 8 schools (7 high school, 1 middle school) in Central and Southern Indiana over a 7 week time period. Settings included traditional classrooms, agricultural labs and FFA meetings. Lesson Plan Feedback -Teacher Evaluations- 10 out of 10 returned -Student Evaluations- 197 out of 322 returned

31. Creak, Crack, Moan and Groan: Farm Kids Get Arthritis Too! WORKING SMARTER, NOT HARDER, TO PREVENT ARTHRITIS PAIN IN AGRICULTURE Rural Arthritis Education Curriculum Resource

32. ADDITIONAL LINKS Click the “green i” for more info! Click the “house” to go to the home screen. THE CURRICULUM HAS 3 CONTENT SECTIONS: 1. Arthritis and Youth 2. Stressful Farming Tasks 3. Ergonomics and Assistive Technology There is a quiz at the end of each section. This quiz must be passed with a minimum score of 80% to proceed to the next section. At any point in time, a student may return to the home screen by clicking on the house icon in the lower left corner of the slides. This will re-start your session at the beginning of the current section.

33. BEGIN SECTION 1 THERE ARE 5 EXTRA SECTIONS: 1. Rural Youth: Assess Your Joint Health Quiz 2. Classroom Hands-On Lab Experiments 3. Classroom Engineering Challenge 4. References 5. Completion Certificate Some slides have an extra info icon, or other resources linked to the information- check them out! Make sure you listen to the audio marked with the speaker icon on some slides! To begin the first section, click on the link below. ADDITIONAL LINKS Click the “green i” for more info! Click the “house” to go to the home screen.

34. REVIEW/RESOURCES POLL QUESTIONS CHAT QUESTIONS ?

35. Creak, Crack, Moan and Groan: Farm Kids Get Arthritis Too! Amber Wolfe AgrAbility Project Coordinator Arthritis Foundation awolfe@arthritis.org?