California
NURSE Project
A summary
of this document is available in english and spanish.
(Un resumen de este documento está disponible en inglés y español.)
SUMMARY: CASE
192-548-01
A tractor
driver was pulling a discer through an apricot orchard. A
discer is made of two rows of round metal blades that the
tractor drags through the soil. The driver looked over his
shoulder to check the discer. As he turned to face forward
again, a low tree branch hit him on the head and knocked him
off the tractor.
The
driver fell between the back of the tractor and the discer.
The tractor was still pulling the discer forward. The driver
rolled as far out of the way as he could. A blade of the discer
caught his forearm and cut it to the bone. Luckily, the tractor
ran into a tree and stalled, so the blade was not pulled all
the way across the driver's arm.
He did
not have a phone or radio to call for help. Also, he was working
alone. The driver walked to a house about a quarter mile away,
where he called for an ambulance.
How
could this injury have been prevented?
- Trim
branches along orchard rows before driving a tractor down
the rows.
- Tractors
should have a rollover protective structure (ROPS) and seat
belts.
- Tractors
should have a cage to protect the driver from branches.
- Workers
should have a telephone or radio to call for help.
BACKGROUND
On November
18, 1992, the NURSE staff received a telephone call from a
rural ambulance service. That morning they had responded to
a agricultural injury in an apricot orchard. A tractor driver
was knocked off his tractor by a branch, then run over by
the farm implement (discer) his tractor was pulling. The driver
sustained a laceration to his forehead, and his right forearm
was almost severed.
A nurse
from the NURSE Project interviewed the worker in his home
on November 23, 1992. On December 4, 1992, the nurse discussed
the incident, by telephone, with one of the orchard's owners.
On December 17, 1992, the nurse conducted an on-site investigation.
NURSE staff also reviewed the Emergency Medical Services (EMS)
ambulance record and the hospital medical records.
The
California Occupational Safety and Health Administration (Cal/OSHA)
was not notified and did not investigate the incident.
During
the telephone interview, the farm owner stated that he had
a written safety program. However, this program was not available
for review at the time of the site visit. During this visit,
the nurse outlined the seven point injury prevention program
required by Title 8 California Code of Regulations 3203 --
Injury and Illness Prevention Program. The farmer said that
his written plan covered five of the seven points, but lacked
the written hazard communication and hazard evaluation components.
(As of July 1, 1991 the State of California requires all employers
to have a written seven point injury prevention program: 1.
designated safety person responsible for implementing the
program; 2. mode for ensuring employee compliance; 3. hazard
communication; 4. hazard evaluation through periodic inspections;
5. injury investigation procedures; 6. intervention process
for correcting hazards; and 7. provide safety training and
instruction.)
The
incident took place in an apricot orchard owned and operated
by a father and son. The farm includes grape vineyards and
apricot, plum, and nectarine orchards that cover approximately
1,000 acres. The farm employs 4 full-time workers, 20 casual
workers (working 1-12 weeks per year), 50 seasonal workers
(working 13-37 weeks per year), and 2 family members.
The
injured tractor driver had worked for the farm owners for
nine years and had eight years of experience in discing. He
stated that he had received safety training in discing. He
told the nurse that two years ago he had experienced a similar
incident where a branch hit him and cut his head, but had
not knocked him off his tractor.
INCIDENT
On November
18, 1992, at approximately 8:30 a.m., a 42 year-old male Hispanic
tractor driver was working alone, discing the ground between
rows of fruit trees. A discer has two rows of round metal
blades. The blades are dragged through the ground by a tractor,
which breaks up and cultivates the soil. The tractor used
was a low profile tractor, that is, a tractor with a low center
of gravity and a wide wheelbase.
The
tractor driver entered an apricot orchard after discing the
rows between plum trees. The tractor was about 60 feet into
the new row, traveling at an estimated speed of 4-5 miles
per hour. The driver turned around to check that his discer
was properly aligned in the row. The moving tractor passed
under a low branch. As he turned to face forward, this branch
struck him on the forehead and knocked him off the tractor.
He fell off the back of the tractor, into the space between
the tractor and the discer he was pulling.
There
was a distance of about ten feet between the back of the tractor
and the front of the discer. The driver rolled as far out
of the path of the moving discer as he could. The tractor
continued moving, but veered to the right, in the direction
of the tractor driver. One of the discer blades ran over his
right forearm, lacerating it almost to the bone. Before completely
severing the arm, the tractor and discer hit a tree and stopped.
The
injured tractor driver received a deep, four inch laceration
to his forearm, and a minor laceration to his forehead from
the branch. He got up and walked about one-quarter mile to
the nearest house to seek help. The homeowner called 911.
Emergency Medical Services (EMS) received the call at 8:49
a.m., and arrived on the scene at 8:55 a.m. They immobilized
him, applied dressings to his forehead to stop the bleeding,
and applied a splint to his right arm. An IV was started and
oxygen administered. The injured tractor driver was taken
to the nearest hospital, arriving at 9:19 a.m. His forehead
was stitched in the emergency department. He was given pain
medication, admitted to the hospital, and taken to the surgery
unit to repair his right arm laceration. He also suffered
multiple abrasions and experienced back pain. The injured
tractor driver was discharged from the hospital the next day
with appointments for follow-up visits to have his stitches
removed. At the time of the interview, five days after the
incident, he told the nurse from the NURSE Project that he
was experiencing severe back pain and dizziness.
PREVENTION STRATEGIES
- The
employer should have a comprehensive written injury prevention
program (Title 8 California Code of Regulations 3203. See
Background). In this incident, the employer's safety program
should have included components on hazard evaluation and
hazard communication. Hazard evaluation of the work environment
should include evaluating the orchard before it is disced.
Routine orchard maintenance should include cutting low branches
that overhang the rows. If a complete injury prevention
program had been written and implemented, this injury might
not have occurred.
- Tractors
should be equipped with seat belts. The use of a seat belt
would have prevented the tractor driver from falling off
the tractor when he was struck by the branch. Tractors with
seat belts must also be equipped with rollover protective
structures (ROPS). Although the California Code of Regulations
has a special section that exempts low profile tractors
used in orchards and vineyards from the ROPS requirement,
the safest alternative is to equip all tractors with seat
belts and ROPS. (A low profile tractor is 18 inches or less
from ground to chassis, with the front wheel spacing equal
to the rear wheel spacing.) If the tractor involved in this
incident had a seat belt and ROPS, the driver would not
have fallen off the tractor when he was struck by the branch
(Title 8 California Code of Regulations 3651: Agricultural
and Industrial Tractors, and Title 8 California Code of
Regulations 3653: Seat Belts. "Seat belt assemblies... shall
be provided on all equipment where rollover protection is
installed and employees shall be instructed in their use").
- Equipment
should be designed with safety engineering in mind. The
NURSE Project investigated a similar incident (NURSE Report
#3) in which a tractor driver was knocked off his tractor
by a branch. After the incident, the farm designed and built
a driver's cage with a steel mesh screen to protect the
tractor driver from low-lying branches. Being struck by
branches is a common occurrence. In this incident, the injured
worker reported that he had been struck by a branch and
injured his head in a previous incident. If the tractor
had been equipped with a protective cage for the driver,
this injury would not have occurred. (Fiberglass shields
are available commercially and may be installed on tractors
to prevent drivers from being hit by branches. However,
these are not popular with farm owners because they do not
last more than one season.)
- Employers
and manufacturers of agricultural equipment should consider
safety engineering when using or designing equipment. In
this incident, the most severe injury occurred when the
tractor pulled the discer forward over the driver's forearm.
If the tractor had a mechanism that would stop it when the
driver was not in the seat, the driver might not have been
run over by the discer. Some tractor manufacturers have
already incorporated this safety feature.
- Employers
and manufacturers of agricultural equipment should consider
safety accessories when using or designing equipment. The
discing of orchards is usually done alone and requires the
driver to continually turn around and check if the discer
is aligned in the row. If the tractor had a wide-angle rear
view mirror which the driver could use to check the discer
without turning his head, he might have seen the low branch
and avoided it in time. The tractor could also be equipped
with an alignment beam so that the driver could keep the
tractor aligned without looking over his shoulder. Tractors
that push instead of pull implements are also now available.
If any of these safety features had been in use, this injury
might not have occurred.
- Workers
should be issued portable communication devices to call
for help in emergencies. Also, employers who have workers
working alone should have a routine method of monitoring
their employees. In this incident, the worker had to walk
approximately one-quarter of a mile to request help. If
the injured worker had a portable communication device to
call the co-owner for help, emergency medical treatment
would not have been delayed while he walked to the nearest
telephone (Title 8 California Code of Regulations 3400(f):
"At isolated locations, provisions must be made in advance
for prompt medical attention in case of serious injuries.
This may be accomplished by... a telephone communication
system for contacting a doctor). If the injured worker had
been unable to walk, he may not have been found for several
hours and may have bled to death. Employers should establish
contact with workers on a periodic basis throughout the
day.
FURTHER INFORMATION
For further
information concerning this incident or other agriculture-related
injuries, please contact:
NURSE
Project
California Occupational Health Program
Berkeley office:
2151 Berkeley Way, Annex 11
Berkeley, California 94704
(510) 849-5150
Fresno
office:
1111 Fulton Mall, Suite 212
Fresno, California 93721
(209) 233-1267
Salinas
office:
1000 South Main St., Suite 306
Salinas, California 93901
(408) 757-2892
Disclaimer
and Reproduction Information: Information in NASD does not
represent NIOSH policy. Information included in NASD appears
by permission of the author and/or copyright holder. More
NASD Review: 04/2002
This
document,
CDHS(COHP)-FI-93-005-26
,
was extracted from a series of the Nurses Using Rural Sentinal
Events (NURSE) project, conducted by the California Occupational
Health Program of the California Department of Health Services,
in conjunction with the National Institute for Occupational
Safety and Health. Publication date: March 1993.
The
NURSE (Nurses Using Rural Sentinel Events) project is conducted
by the California Occupational Health Program of the California
Department of Health Services, in conjunction with the National
Institute for Occupational Safety and Health. The program's
goal is to prevent occupational injuries associated with agriculture.
Injuries are reported by hospitals, emergency medical services,
clinics, medical examiners, and coroners. Selected cases are
followed up by conducting interviews of injured workers, co-workers,
employers, and others involved in the incident. An on-site
safety investigation is also conducted. These investigations
provide detailed information on the worker, the work environment,
and the potential risk factors resulting in the injury. Each
investigation concludes with specific recommendations designed
to prevent injuries, for the use of employers, workers, and
others concerned about health and safety in agriculture.
|