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Injury and Illness Costs in the Certified Safe Farm Study


  • The Certified Safe Farm study has been funded by NIOSH (#U06/CCU712913), Iowa Wellmark Foundation, Pioneer Hi-Bred International Inc., Iowa Pork Producers Council, National Pork Producer's Council, and Iowa's Injury Prevention Research Center. NIOSH funding was instrumental in initiating the project and has remained the main source of funding throughout the study. The AgriSafe Network of clinics provide CSF services to farmers at the local level, and the Spencer AgriSafe clinic and staff, including Carolyn Sheridan, Kristine Fisher, and Maureen Christensen, and farm safety consultants Mike McMullen, Carolyn Jones, and Jamie Abel were instrumental in conducting this study. The University of Iowa investigators (including Kelley Donham, Kendall Thu, Natalie Roy, Risto Rautiainen, Carol Hodne, LaMar Grafft, and Paul Whitten) initiated the program, obtained funding, provided coordination of research efforts, and trained health care providers and farm safety consultants. For further information, contact: Kelley J. Donham, DVM, DACVPM, University of Iowa, 100 Oakdale Campus, 132 IREH, Iowa City, IA 52242; e-mail


ABSTRACT: Context:The Certified Safe Farm (CSF) intervention program aims to reduce occupational injuries and illnesses, and promote wellness to reduce health care and related costs to farmers, insurers, and other stakeholders.Purpose:To evaluate the cost effectiveness of CSF.Methods:Farms (316) located in a 9-county area of northwestern Iowa were recruited and randomized into intervention and control cohorts. Intervention farms received occupational health screenings, health and wellness screening, education, on-farm safety reviews, and performance incentives. For both cohorts, quarterly calls over 3 years were used to collect self-reported occupational injury and illness information, including costs to the farmers and their insurers.Findings:Annual occupational injury and illness costs per farmer paid by insurers were 45% lower in the intervention cohort ($183) than in the control cohort ($332). Although out-of-pocket expenses were similar for both cohorts, combined costs of insurance and out-of-pocket expenses were 27% lower in the intervention cohort ($374/year per farmer) compared to the control cohort ($512/year per farmer). Within the cohort of intervention farmers, annual occupational injury and illness cost savings were directly associated with on-farm safety review scores. Reported health care costs were $237 per farmer in the safest farms (those farms scoring in the highest tertile) versus $485 per farmer in the least safe farms (lowest tertile).Conclusions:Results suggest that farmers receiving the intervention had lower health care costs for occupational injuries and illnesses than control farmers. These cost savings more than cover the cost of providing CSF services (about $100 per farm per year).