NIOSH eNews

From the Director’s Desk

John Howard, M.D.
Director, NIOSH
March eNews 2012

Sharing Solutions for Similar Problems:
International Collaborations Benefit U.S. Workers and Workers Globally

Later this month, more than 2,000 specialists in occupational safety and health from around the world will meet at the 30th Congress of the International Commission on Occupational Health (ICOH). This conference, co-sponsored by NIOSH, is a rare occasion for so many world leaders in our field to do business face to face. Such a large gathering with a common goal is a perfect opportunity for those working in occupational safety and health to share solutions that will benefit worker safety and health everywhere.

The risks of occupational injuries and illnesses identified for U.S. workers are also key problems for workers globally. Although there are no true global surveillance systems for occupational illness and injury, the International Labor Organization (ILO) estimates that, based on available data collected from member countries, each year about 2.2 million people die from occupational injuries or illnesses. Of this total, about 350,000 deaths are estimated to be caused by fatal occupational injuries. The remaining deaths are from occupational illnesses. Such illnesses often go unrecognized in early stages. Typically, death occurs decades after the original exposure that caused the disease.

These numbers suggest the enormous burden that work-related hazards place on world economies, including ours, and the terrible toll in human pain and loss. The need to partner globally and share knowledge and interventions across borders drives NIOSH’s Global Collaborations Program /niosh/programs/global/. The mission of this program, under the National Occupational Research Agenda (NORA), is to collaborate with international partners on building capacity and sharing knowledge.

The Global Collaborations Program strategic plan contributes to the goals of the 10 NORA Sectors, which focus on U.S. workers and emphasize topics that are also critically important for workers in other countries. Collaborations, partnerships, membership in standards organizations, research, and information exchange with global partners on specific projects and in areas of mutual interest fill knowledge gaps and enhance the impact of projects for workers, both in the United States and in other countries. These partnerships yield new insights, methods, and products that make workplaces safer not only in other countries, but also in the United States. They promote international stability, to the economic benefit of U.S. employers and workers who produce the goods that supply our export stream. They continue the longstanding tradition of U.S. fellowship and leadership in the world community.

The key strategic goals of the Global Collaborations Program address six topics:

1. Enhance global occupational safety and health through international collaborations.
2. Reduce silicosis.
3. Reduce road traffic injuries of workers.
4. Reduce blood-borne pathogens among healthcare workers.
5. Prevent worker illness globally from exposure to nanomaterials.
6. Improve global mining safety and health.

Partnerships that benefit all of us here and abroad include these examples:

• Nanotechnology collaborations serve as a model, with strong international collaborations leading to preventive actions in participating countries.
• Other "hot" emerging issues drawing global partnerships include climate change effects on workers, indium tin oxide, green and safe jobs, and prevention by design.
• The use of simple guidance to assess and manage exposures has been greatly advanced by experiences in Europe, because of implementation of the Registration, Evaluation, Authorization and Restriction of Chemical Substances (REACH) regulation, which places responsibility on chemical manufacturers to provide guidance on how to safely manage risks from the chemicals. The design and use of simple guidance toolkits has broadened beyond chemicals to safety, ergonomics, and sector hazards in the United States and other countries. NIOSH staff and partners also provide technical assistance and training to build capacity in less developed countries. See an accompanying article in this issue of eNews about NIOSH training in Indonesia on radiographic reading and spirometry.

ICOH has been a longstanding partner of NIOSH in addressing the many needs and opportunities of global occupational safety and health. I am pleased that Dr. Marilyn Fingerhut, a member of the ICOH Board, represents NIOSH on the International Scientific Committee that has helped to organize the 30th Congress of ICOH, and I am honored to present on behalf of NIOSH at the March 22 plenary session. Take a look at this link to see the impressive breadth of topics to be covered: http://www.icohcongress2012cancun.org/ .

Finally, prior to the ICOH Congress, the World Health Organization (WHO) Network of Collaborating Centers in Occupational Health will hold the 9th Network Meeting. The Network, which I have the pleasure to chair, includes more than 60 institutions that work together with WHO and partner with the ILO to help countries meet their commitments to the World Health Assembly Resolution "Global Plan of Action for Workers’ Health 2008–2017". To learn more about the resolution go to http://apps.who.int/gb/ebwha/pdf_files/WHA60/A60_R26-en.pdf, or to learn more about the WHO Network of Collaborating Centers go to www.who.int/occupational_health.

Study Links Heavy Diesel Exposure, Risk for Non-Metal Miners

In a study of non-metal miners in the United States, scientists from NIOSH and the National Cancer Institute reported that heavy exposure to diesel exhaust increased risk of death from lung cancer. The results were distributed in two papers on March 2 from the Journal of the National Cancer Institute and posted to the JNCI website on March 5.
http://www.cancer.gov/newscenter/pressreleases/2012/DieselMinersPressRelease

CROPS Designs for Tractors Available on Web

In February, NIOSH released an enhanced website containing information and designs for installing cost-effective rollover protective structures (CROPS) on tractors. CROPS have been designed for 28 tractors in four tractor model series. /niosh/topics/aginjury/crops/

A National Look at the Risks of Brazilian Blowout

On March 1, ABC Television’s Good Morning America noted that NIOSH and four other federal agencies have warned about the risk of exposures to formaldehyde in the popular Brazilian Blowout hair treatment. The television clip is available at http://abcnews.go.com/GMA/video/brazilian-blowout-consumer-alert-formaldehyde-danger-15824476. NIOSH’s health hazard evaluation report addressing occupational risk for salon workers is posted at /niosh/hhe/reports/pdfs/2011-0014-3147.pdf.

Get Instant Notification of New HHE Program Reports!

Sign up now for the NIOSH Health Hazard Evaluation Program RSS feed and receive timely notification when a new HHE final report is released. The RSS feed is an easy and efficient way to receive a notices of new HHE reports. Sign up at /niosh/hhe/feed1.xml and/or provide feedback on this new featuring by emailing the program at HHERequestHelp@cdc.gov.

2012 Safe-in-Sound Excellence in Hearing Loss Prevention Award Winners

NIOSH and the National Hearing Conservation Association (NHCA) presented in February the 2012 Safe-in-Sound Excellence in Hearing Loss Prevention Awards™ at the 37^th Annual Hearing Conservation Conference in New Orleans. The awards honor exceptional hearing loss prevention programs, and they recognize individuals or organizations for innovation and dedication to fostering and implementing advances in the prevention of hearing loss. For more information, including a list of winners, go to /niosh/updates/upd-02-23-12.html.

ASTM Developing Proposed Dermal Wipe Sample Standard

The ASTM International Workplace Air Quality Subcommittee is developing a proposed new technical standard to gain a better understanding of the risks workers face from dermal exposures. This subcommittee, chaired by Dr. Kevin Ashley of NIOSH, develops voluntary consensus standards for the sampling and analysis of chemical agents related to occupational exposure. The goal of this effort is to create a consensus standard method for sampling and analyzing chemical agents from skin surfaces so that exposure data from different individuals, time, locations and other factors can be compared and contrasted. For more information, go to http://www.astm.org/sn-environmental.

Injuries Before and After the Needlestick Safety and Prevention Act

In February correspondence to The New England Journal of Medicine, Dr. Elayne Kornblatt Phillips (University of Virginia) and colleagues reported findings from a NIOSH-funded research project that the Needlestick Safety and Prevention Act contributed to the decline in percutaneous injuries among U.S. hospital workers. The findings also support the concept that well-crafted legislation bolstered by effective enforcement can be a motivating factor in the transition to injury-control practices and technologies, resulting in a safer work environment and workforce. Read more about this project at http://www.nejm.org/doi/full/10.1056/NEJMc1110979.

NIOSH and Singapore Workplace Safety and Health Institute to Partner

NIOSH and the Workplace Safety and Health Institute of Singapore began a 5-year partnership agreement in February that recognizes the importance of research and new knowledge in developing and applying preventive measures in occupational safety and health. The agreement also recognizes that the agencies share a common mission to contribute to the prevention of occupational injuries and diseases. For more information, go to /niosh/updates/upd-02-24-12.html.

ILO Standard Images Available on DVD

ILO Standard Digital Images (ILO 2011-D) in DICOM Format are now available on DVD. For more information, go to http://www.ilo.org/safework/info/publications/WCMS_168337/lang--en/index.htm. These images are for use in classifying digital chest images displayed on diagnostic monitors for findings associated with the presence and severity of pneumoconiosis. Local distributors are listed at the following web link, http://www.ilo.org/global/publications/ilo-bookstore/order-locally/countries/lang--en/index.htm. For more information, see the NIOSH digital imaging updates web page /niosh/topics/chestradiography/digital-imaging-updates.html.

Radiation and Worker Health Advisory Board Members Appointed

On February 10, President Obama announced his intent to appoint Dr. David Kotelchuck and Loretta R. Valerio as members of the Advisory Board on Radiation and Worker Health. The Advisory Board includes a balance of perspectives from scientists, physicians, and workers in order to fulfill its role of advising NIOSH and the U.S. Department of Health and Human Services on activities under the Energy Employees Occupational Illness Compensation Program Act. Their appointments to the Advisory Board are expected to be effective before the next Advisory Board meeting in June. http://www.whitehouse.gov/the-press-office/2012/02/10/president-obama-announces-more-key-administration-posts.

Conference Planned for Home Care Stakeholders

FHI 360 invites you to Quality Work, Quality Care: A State-of-the-Art, National Conference for Home Care Stakeholders. The conference, co-sponsored by NIOSH, will be held from April 2, in Washington, D.C. To register or for more information, go to http://homecareconference.fhi360.org.

NIOSH Congratulates....

Dr. Christine Branche Tops Women in Safety List

Dr. Christine Branche, Principal Associate Director of NIOSH and Director of the NIOSH Office of Construction Safety and Health, was recognized as one of the 100 Women Making a Difference in the Safety, Health & Environmental Profession in a recently released publication by the ASSE’s Women In Safety Engineering (WISE) common interest group. The list honors women who have, or are currently, making a difference through their work and dedication to protecting people, property and the environment. For more information or to purchase the book go to http://www.asse.org/practicespecialties/wise/index.php.

Dr. Jennifer Lincoln Recognized by National Fisherman

Jennifer Lincoln, Director of the NIOSH Commercial Fishing Safety Research Program, has received the first Life Saver award by National Fisherman magazine. Dr. Lincoln and her team are credited with developing emergency winch stops, vessel hatch and door monitors, and working with Alaska fishermen to field-test personal flotation devices, among many other efforts. /niosh/topics/fishing/.

News from Our Partners

Work-Related Burns Identified

The Michigan Department of Community Health and Michigan State University issued a report on the new state burn surveillance system that identified 1461 work-related burns in 2009 from hospital and emergency department medical, state worker compensation and state poison control center records (Click on annual reports and then the burn report at www.oem.msu.edu). The official Bureau of Labor Statistics based on employer reports for the same year identified only 450 burns, 69% less. The Michigan surveillance program is used to target educational activities and enforcement investigations.

California Resources for Preventing Worker Illness from Indoor Pesticide Exposure

The California Department of Public Health’s Occupational Health Branch (OHB) has a new website and fact sheets on how to reduce or eliminate human exposures to pesticides that occur indoors. These resources address illnesses from fumigations indoors, from pesticide drifts that enter from outside, and other indoor exposures to workers in California. More information is available at http://www.cdph.ca.gov/programs/ohsep/Pages/IndoorPest.aspx.

New OSHA Publication Focuses on Noise Protection in Construction

A new Occupational Safety and Health Administration (OSHA) educational publication, Protecting Yourself from Noise in Construction, provides information for construction workers and employers on the hazards of loud noise in construction, how noise levels are measured, and how to find out if noise on the job site or from tools is loud enough to cause hearing loss. (http://www.osha.gov/pls/publications/publication.searchResults?pSearch=3498).

Call for Nominations for HOPE Award

The American Journal of Health Promotion announces a call for nominations for the Robert F. Allen Symbol of HOPE Award. This award is presented annually to honor an individual who has made outstanding contributions to promoting cultural diversity within health promotion, or serving the health promotion needs of underserved populations. Deadline for nominations is April 25. More information is available at http://www.healthpromotionjournal.com/index.php?com_route=view&key=nomination.

WHO Publishes Nanotechnology Backgrounder

The World Health Organization (WHO) is developing guidelines on protecting workers from potential risks of manufactured nanomaterials. As an initial step towards the development of these guidelines, WHO prepared a draft background document proposing content and focus of the guidelines. The background document and the peer-review comments are posted for public comment on the project website at http://www.who.int/occupational_health/topics/nanotechnologies/en/. Comments will be accepted via email at nanohealth@who.int through March 31. For more information, contact Vladimir Murashov at vmurashov@cdc.gov.

NIEHS Seeks Input on OSH Hazardous Substance Training Needs

The NIEHS Superfund Research Program is seeking input on critical gaps, challenges, and potential strategies to address the needs for potential occupational safety and hazardous substance training programs in emerging technologies (examples: nanotechnology, remediation, and exposure science). This request for information aims to gather information on how to best train and protect workers from these hazards through continuing education, short courses, and advanced training. For more information, see NOT-ES-12-007. Input is welcome from all interested parties.

University of Indonesia Sponsors NIOSH Training Courses

A physician participates in the practicum session
of spirometry training.

In February NIOSH provided the ILO/NIOSH B Reader Workshop and Examination and spirometry training courses at the University of Indonesia to a group of physicians and nurses. The training was provided at the request and sponsorship of the Chair of the Department of Community Medicine, University of Indonesia. The collaboration between NIOSH and this Indonesian agency has been invaluable to efforts of improving the diagnosis and care of workers throughout Indonesia who are exposed to dusts that could potentially cause occupational respiratory diseases, and enhancing capacities of local physicians in identifying and quantifying occupational respiratory disease among these workers. For more information on radiography or spirometry, go to /niosh/topics/spirometry/.

New Health Hazard Evaluation Reports Now Available

Evaluating CO Exposures during Personal Watercraft Rescue Operations

HHE Program investigators responded to a request from a county fire rescue department to evaluate carbon monoxide (CO) exposures during rescue operations that use personal watercraft. Investigators found that some fire fighters’ exposures to CO were above the peak occupational exposure limits, and that personal watercraft can create hazardous levels of CO. HHE Program investigators recommended (1) management require the use of a rescue board during responses and training, (2) the department develop maintenance schedules for the personal watercrafts that follow the manufacturer’s recommendations, (3) the department replace older personal watercrafts with new models that have emission controls, and (4) fire fighters minimize the amount of time that personal watercrafts idle or operate at slow speeds during responses and training.

Evaluating Exposures at Aluminum Can Manufacturing Facility

HHE Program investigators evaluated employee concerns about exposures to metalworking fluids, inorganic acids, printing inks, and noise at an aluminum beverage can manufacturing facility. Investigators found that employees were not overexposed to metalworking fluids, inorganic acids, dibutylaminoethanol, or endotoxin, but were overexposed to noise. Investigators recommended that (1) managers use engineering controls to reduce noise and test employees’ hearing at hire and annually thereafter, (2) employees in the lacquer spray, necker, and printer areas wear ear plugs and ear muffs, and (3) use of a can cleaner that is safer the facility instead of hydrofluoric acid.

Links to these HHE reports can be found at /niosh/hhe/whats_new.html

New Fatality Assessment and Control Evaluation (FACE) Program Reports Now Available

Journeyman Mason Dies After Stepping Backward Off a Raised Mobile Scaffold

Factors that contributed to the death of the journeyman include failure to re-install the guardrails at the ends of the working platform when erecting the scaffold and failure to install proper planking prior to raising the scaffold.
/niosh/face/stateface/mi/08mi009.html

Electrician Electrocuted While Restoring Service at a Personal Residence

Factors that contributed to the death of the electrician include failure to shut off the power at the breakers during service restoration, failure to regularly test the personal protective equipment, and failure to field test insulated gloves and sleeves prior to each use. /niosh/face/stateface/ky/08KY065.html

Plumber Dies After the Collapse of a Trench Wall

Factors that contributed to the death of the plumber include failure to use an adequate protection system for trench cave-ins; failure to conduct daily inspections of the excavations, adjacent areas, and protective systems; and failure to provide worker training to recognize hazards associated with the excavation and trenching activities. /niosh/face/stateface/ny/07NY033.html

Immigrant Roofer Electrocuted When an Aluminum Ladder Platform Hoist Contacts Overhead Power Line

Factors that contributed to the death of the roofer include failure to eliminate the use of the conductive tools and equipment, including ladders, in proximity to energized overhead power lines; failure to conduct a job site survey prior to the start of the project to identify potential hazards such as energized overhead power lines; and failure to provide a safety program. /niosh/face/stateface/ma/10ma019.html

Two 11^th Grade Students Shocked at Electrical Technology Vocational School

Factors that contributed to the non-fatal shocking of the students include failure to develop safety and health plans, failure to conduct a job safety analysis, failure to routinely review and enforce lockout/tagout programs, and failure to provide relevant training. /niosh/face/stateface/ma/11ma1NF.html

Immigrant Roofer Struck by a Bag of Gravel that Fell from a Roof

Factors that contributed to the death of the roofer include failure to use a rope pulley system with brakes for hoisting and lowering tasks; failure to use standard operating procedures for using a pulley system; failure to barricade off the pulley’s fall zone; and failure to provide a safety and health program and training that includes hazard recognition and the avoidance of unsafe conditions. /niosh/face/stateface/ma/10ma032.html

Mechanic Pinned between Multi Terrain Loader’s Lift Arm and Frame

Factors that contributed to the death of the mechanic include failure to ensure that safeguards and interlocks were used and properly functioning and not bypassed; failure to lower the lift arm and lock the arm cylinder prior to exiting, and to be seated in the cab when using the loader controls; failure to use lockout/tagout procedures for maintenance tasks; failure to provide a safety and health program; and failure to prohibit employees from performing potentially hazardous tasks alone in isolated areas. /niosh/face/stateface/ma/09ma044.html

Falling Metal Grates Fatally Injures Warehouse Worker

Factors that contributed to the death of the warehouse worker include failure to secure infrequently accessed materials stored within rack systems, failure to have rear guards on the racks, failure to have a safety program with topics related to warehouse operations, failure to provide training in multiple languages as needed, and failure to ensure all federal and state required trainings and licenses for forklift operators were valid and up-to-date. /niosh/face/stateface/ma/09ma042.html

New Fire Fighter Fatality Investigation and Prevention Program Reports Available

Career Fire Fighter Killed, Another Injured by Vehicle While Working at an Interstate Grass Fire

Fire fighters working to suppress a grass fire burning in the median of an interstate had minimal time to avoid being struck by a vehicle that unexpectedly entered into their work zone. This incident demonstrated the need for fire departments to develop pre-incident plans regarding response protocols, scene safety, and traffic control for roadway emergency work zones to give emergency responders time to react and protect themselves from oncoming traffic. /niosh/fire/reports/face201036.html

Fire Fighter Dies From Attempted Rescue of Worker from a Confined Space

A volunteer fire fighter died while attempting to rescue a municipal utility worker from an underground sewer. Factors that contributed to the death of the fire fighter include failure to recognize the hazards involved with a confined space, failure to provide standard operating procedures for confined space technical rescue operations; and failure to use an effective incident management system for a confined space technical rescue operation. /niosh/fire/reports/face201031.html

WTC Health Program Updates

Extension of the World Trade Center Health Registry

NIOSH plans to extend funding for the WTC Health Registry. Continuing the registry will ensure ongoing data collection for victims of the September 11, 2001, attacks on the World Trade Center. The registry will continue to provide a central, unified database to help assess health effects among persons exposed to the WTC disaster. To access the announcement, go to http://www.grants.gov and do a basic search for RFA-OH-12-001. For more information, contact Travis Kubale (513) 841–4461 or George Bockosh at (412) 352–5181.

Remembering Dr. Stephen M. Levin

The World Trade Center Health Program mourns the loss of Dr. Stephen M. Levin, a dedicated physician and worker advocate who passed away on February 7. Dr. Levin was a professor of preventative medicine at Mount Sinai School of Medicine, and a leader in the monitoring and treatment of responders for World Trade Center-related illnesses. He will be remembered for his many contributions in occupational and environmental medicine, including his advocacy and dedication to World Trade Center responders.

NORA

Draft National Mining Agenda Available

The draft National Mining Agenda, as part of the National Occupational Research Agenda (NORA), is now available for public comment at /niosh/nora/. The agenda identifies seven strategic objectives designed to address top safety and health concerns and to promote the greatest opportunities to advance safety and health within the mining industry. Comments on the agenda may be submitted to the NIOSH Docket Office through October 30, 2012. Contact the NORA coordinator, noracoordinator@cdc.gov, with general questions or suggestions or to join others to work on these goals.

r2p Corner

NIOSH and EPA Establish New Partnership

NIOSH has signed a partnership agreement with the National Center for Environmental Assessment (NCEA), Environmental Protection Agency. Through the partnership, NIOSH and the EPA/NCEA will work cooperatively to share information and coordinate research activities as they relate to the development of risk assessment methods for evaluating the risks of chemical exposures in the workplace and environment. For more information, contact Christine Sofge (NIOSH) at CSofge@cdc.gov.

What’s new on the NIOSH Science Blog?

Hair, Formaldehyde, and Industrial Hygiene

A recent settlement requires the makers of Brazilian Blowout hair straightener to warn consumers and hair stylists about formaldehyde in their products. Read more from guest blogger, Dede Montgomery, on how the Center for Research on Occupational and Environmental Toxicology at Oregon Health and Science University worked with their partners to raise awareness of this issue. http://blogs.cdc.gov/niosh-science-blog/2012/02/hair-smoothers/

Federal Register Notices

For a full listing of NIOSH official publications for rules, proposed rules, and notices for 2011, go to /niosh/fedreg.html.

New Communication Products

Home Healthcare Worker Factsheets:

• How to Prevent Violence on the Job
• How to Prevent Latex Allergies
• How to Prevent Musculoskeletal Disorders
• How to Prevent Exposure in Unsafe Conditions
• How to Prevent Car Accidents
• How to Prevent Needlestick and Sharps Injuries

Instructor’s Guide: Nonverbal Communication for Mine Emergencies

/niosh/mining/pubs/pubreference/outputid3677.htm

Medium Frequency Mine Emergency Communications-An Emerging Technology (Technology News 546)

/niosh/mining/pubs/pubreference/outputid3682.htm.

Call for Abstracts

Isocyanates and Health: Past, Present and Future
Early bird abstract submission. Deadline for submission is July 15. Late breaking papers and posters. Deadline for submission is September 7. http://secure.cirpd.org/isocyanates2012/content/index.cfm?service=main&page=general_information

Upcoming Conferences & Workshops

Manual Materials Handling Workshop: Engineered Solutions for Manual Handling Jobs
February 8–9, 2012, Atlanta, GA
http://www.modexshow.com/education/mmhWorkshop.aspx?ref=attendees

Personal Protective Equipment Selection, Use, and Expectations: NIOSH PPT Stakeholder Meeting
March 20–21, Pittsburgh, PA
https://www.team-psa.com/niosh/stakeholders/2012

30th International Congress on Occupational Health, Occupational Health for All: From Research to Practice
March 18–23, 2012, Cancun, Mexico
http://www.icohcongress2012cancun.org/1024/ingles/index.aspx?seccion=inicio.html&titulo=Home

Association of periOperative Registered Nurses 59^th Annual Congress—Look for us Booth 6053!
March 24–29, 2012, New Orleans, LA
http://www.aorncongress.org/

Quality Work, Quality Care: A State-of-the-Art, National Conference for Home Care Stakeholders
April 2, Washington, D.C.
http://homecareconference.fhi360.org

American Association of Occupational Health Nurses, Inc. (AAOHN)
April 22–25, Nashville, TN
https://www.aaohn.org/

National Academy of Sciences Colloquium: The Science of Science Communication
May 21–22, Washington DC.
http://www.nasonline.org/programs/sackler-colloquia/upcoming-colloquia/science-communication.html?utm_medium=etmail&utm_source=National%20Academies%20Press&utm_campaign=Sackler%20Invite%20II%20-%20with%20share%20tools&utm_content=Downloader&utm_term

22^nd Annual Social Marketing Conference - Ideas Beyond Borders
June 15–16, Clearwater, FL
https://cmetracker.net/USF/Files/Brochures/221038.pdf

American Public Health Association
October 27–31, 2012. San Francisco, CA
http://www.apha.org/meetings/AnnualMeeting/

Isocyanates and Health: Past, Present and Future
November 1–2, Bethesda, MD
http://secure.cirpd.org/isocyanates2012/content/index.cfm?service=main&page=general_information

A comprehensive list of upcoming conferences can be found at /niosh/exhibits.html.

Word of the Month

CROPS— or cost-effective rollover protective structures, are structures developed by NIOSH as an alternative to installing commercially available ROPS, which are hard to find, or as an option for wheeled agricultural tractors that are older, and for which ROPS are not commercially available. See /niosh/topics/aginjury/crops/ for more information.