Intervention Effectiveness in Finnish Agriculture

描述（由申请人提供）：本K01项目旨在通过指导研究和培训来提升候选人的研究生涯。该候选人具有职业和环境卫生博士学位，并在农业卫生和安全方面有丰富的经验。他的短期目标包括进行拟议的K01研究，领导爱荷华州类似项目的数据分析，并竞争两个R01奖项。他的长期目标包括在伤害流行病学和干预有效性方面建立强有力的研究路线。鉴于他的背景和最近的教员任命，他很适合成为一名独立调查员。爱荷华大学提供了一个优秀的研究环境和经验丰富的导师(博士。Craig Zwerling, Kelley Donham, Johannes Ledolter, Robert Ohsfeldt)。本研究有两个假设：1)与非成员相比，作为职业健康服务（OHS）成员的芬兰农民受伤率、呼吸系统疾病发病率和索赔费用较低；2)严重伤害与人口统计学、收入和农场特征有关。假设1通过回顾性队列研究进行检验，测量2002年OHS成员和倾向得分匹配的非成员之间的索赔率和成本是否存在差异。纵向方法（广义估计方程，时间序列）测量发病率的差异和随时间变化的趋势。假设2通过一项病例对照研究得到验证，该研究确定了严重乙型肝炎的危险因素。（这20%的案例代表了79%的保险费用）。这两项分析都基于一个大型的、定义明确的队列（2002年N=98,437）和关于伤害（N=6812）和职业病（N=464）的广泛数据。农业仍然是美国最危险的行业之一，需要采取有效的干预措施。本研究评估了一个完善的农业职业健康安全干预措施。研究结果对爱荷华州和其他地方的类似努力具有重要意义。本研究涉及NORA的三个优先领域和健康人2010的四个优先领域。

DESCRIPTION (provided by applicant): This K01 project aims to enhance the candidate's research career through mentored research and training. The candidate has a PhD in Occupational and Environmental Health, and considerable experience in agricultural health and safety. His short-term goals include conducting the proposed K01 research, leading data analyses in similar Iowa projects, and competing for two R01 awards. His long-term goals include establishing strong lines of research in injury epidemiology and intervention effectiveness. Given his background and recent faculty appointment, he is well positioned to become an independent investigator. The University of Iowa provides an outstanding research environment and experienced mentors (Drs. Craig Zwerling, Kelley Donham, Johannes Ledolter, Robert Ohsfeldt). This study has two hypotheses: 1) The Finnish farmers who are members of the Occupational Health Service (OHS) have lower injury rates, respiratory disease rates, and claim costs compared to non-members, and 2) Severe injuries are associated with demographic, income, and farm characteristics. Hypothesis 1 is tested through a retrospective cohort study, measuring whether the 2002 claim rates and costs differ between OHS members and propensity score matched non-members. Longitudinal methods (Generalized Estimating Equations, time series) measure differences in incidence rates and trends over time. Hypothesis 2 is tested through a case-control study that identifies risk factors for severe (>?1500) injuries (those 20% of cases that represent 79% of the insurance costs). Both analyses are based on a large, well-defined cohort (N=98,437 in 2002) and extensive data on injuries (N=6812) and occupational diseases (N=464). Agriculture remains one of the most hazardous industries in the US and effective interventions are needed. This study evaluates a well established agricultural OHS intervention. The results have great importance for similar efforts in Iowa and elsewhere. This study addresses three NORA priority areas and four Healthy People 2010 priority areas.