information is evident, but other areas need better and more surveillance data. Further, the surveillance data need to be used in a more systematic manner for the development of research agendas and for the development and evaluation of intervention programs.


Information received from the NIOSH AFF Program (NIOSH, 2006a) related to inputs, activities, outputs, intermediate outcomes, and end outcomes in surveillance is summarized in the surveillance logic submodel (Figure 4-1). Several factors were missing in the creation of an accurate logic submodel to evaluate the program’s surveillance efforts. No formal infrastructure for the coordination of surveillance activities was described. A schema for identification of populations at risk that merited surveillance was not provided. And, planning input from stakeholders regarding surveillance activity was not identified.


Planning Inputs

Congress spelled out a specific charge to NIOSH for conducting surveillance in the Senate appropriations language of 1990 (as quoted in Funds were specifically earmarked for a “U.S. farm family health and hazard” surveillance program. Testimony rendered by agricultural safety and public health professions in support of the legislation was explicit that surveillance of these worksites was central to all ensuing effort. The phrase farm family was not intended to refer only to farmers, ranchers, and their families; rather, it referred to all persons performing tasks or residing on a farm, including hired laborers and accompanying family members. The other planning input that was referred to in the evidence package was the National Coalition for Agricultural Safety and Health report (Appendix 2-01 in NIOSH, 2006a), which suggested that adequate population-based rates were not available for agriculturally related diseases and injuries, therefore health and hazard surveys of agricultural workers needs to be conducted. In forestry, strategic planning evidence came from the Pacific Northwest Center and addressed northwest forestry only. Significant efforts related to fatal injury surveillance in the Alaska fishing sector have been conducted with evidence that Gulf Coast fishing is being addressed by one of the NIOSH Centers for Agricultural Disease and Injury Research, Education, and Prevention (Ag Centers).

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