Resources/References

Farming, and Farming Injuries

Crush Injuries

Crush injuries occur when trapped in or under machinery or when one or more body parts are pinched or jammed. The pressure of being crushed by heavy farm machinery can rupture skin, rip muscles, sever nerves and/or splinter bone, resulting in trauma or death.

Most crush accidents occur during cropping or while performing machinery maintenance. Many are caused by tractor rollovers, but crushing can also result from using all-terrain vehicles, being stepped on or trampled by livestock, having a load drop on you, adding attachments to machinery and/or having fingers pulled into moving machinery.

• On average, tractor rollovers crush 110 farmers annually in the U.S.
• Crushing is the fifth-leading type of fatal injury on the farm.

Farm use: corn pickers and combines to harvest corn. A corn picker strips the stalks close to the ground using a pronged header. It then feeds them into a combine, which husks them with huge, sharp, rotating rollers. A conveyor belt carries the husked ears further into the machine, where they are dropped into a large, moving container.

According to the National Agricultural Safety Database, “Virtually every farmer knows of a family member, friend or neighbor who has been injured in a corn picker.”

Common Corn Picker/Combine Injuries

• Corn pickers’ rollers are responsible for many farm worker injuries because the corn stalks tend to plug them if the machine is moving either too quickly or slowly. Workers attempting to free the stalk can lose their hands and arms as the rollers continue to rotate, because the rollers rotate at about 12 feet per second. That means a farm worker holding a stalk, even at a distance of three feet away from a roller, has less than half a second to let go.
• Many deaths occur when operate combines that use hydraulic cylinders to hold the combine up. If the cylinders fail, the combine falls, crushing them beneath it.
• Some modern corn pickers/combines are larger than a typical vehicle lane of a highway. Consequently, driving them on public roads creates the potential for accidents.

Pain Information

• International Association for the Study of Pain: http://www.iasp-pain.org/
• American Pain Society: http://americanpainsociety.org/
• Academy of Integrative Pain Management: http://www.aapainmanage.org/
• American Academy of Pain Medicine: http://www.painmed.org/
• American Chronic Pain Association: https://theacpa.org/
• National Fibromyalgia and Chronic Pain Association: http://www.fmcpaware.org/

Institute of Medicine Report

In 2011, the Institute of Medicine (IOM) released a report regarding pain as a public health problem in the United States. The IOM recommended relieving pain become a national priority [9].

National Pain Strategy

In 2016, The U.S. Department of Health and Human Services outlined the nation’s first coordinated plan for reducing chronic pain in The National Pain Strategy (NPS). It was developed by a diverse team of experts from around the nation. The National Pain Strategy is a roadmap toward achieving a system of care in which all people receive appropriate, high quality and evidence-based care for pain [10].

CDC Guideline for Prescribing Opioids for Chronic Pain

In 2016, the Center for Disease Control released the guideline for prescribing opioids for chronic pain.

Cubital Tunnel Syndrome

Cubital tunnel syndrome may cause pain, numbness, and tingling or muscle weakness in the arm or hand. The cubital tunnel is the area of the “funny bone” where the ulnar nerve runs through this tunnel.

Additional References Used In Module

1. Caliandro P1, La Torre G, Padua R, Giannini F, Padua L. Treatment for ulnar neuropathy at the elbow Cochrane Database Syst Rev. 2012 Jul 11; 7.
2. Chou R. et al. Management of Postoperative Pain: A Clinical Practice Guideline from the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists’ Committee on Regional Anesthesia, Executive Committee and Administrative Council. 2015 (12) 8. Journal of Pain.
3. Lund, Ann T. and Peter C. Amadio. Treatment of Cubital Tunnel Syndrome: Perspectives for the Therapist. The Journal of Hand Therapy. Apr-June 2006.
4. Nabhan, A. et al. Simple Decompression of the Subcutaneous Anterior Transposition of the Ulnar Nerve for Cubital Tunnel Syndrome. Journal of Hand Surgery (British and European Volume, 2005) 30B: 5:521-524.
5. Page, M. Gabrielle et al. Risk of opioid abuse and biopsychosocial characteristics associated with this risk among chronic pain patients attending a multidisciplinary pain treatment facility. 2015. The Clinical Journal of Pain.
6. Pain Terminology, International Association for the Study of Pain. Www. Iasp-pain.org.
7. Robertson, C. and J. Saratsiotis. A Review of Compressive Ulnar Neuropathy at the Elbow. J Manipulative Physiol Ther 2005: 28:345.
8. Turk, Dennis et al. Interdisciplinary Pain Management. American Pain Society White Paper American Pain Society.