Scott Webb (Host): When we think about dangers in ag to youth, we most often think of the safety of the kids working, living and, for some, visiting the farm. Generally, youth are considered to be in good health, but what dangers lurk out there that may impact their good health, and what measures and/or strategies exist to make sure kids not only have a safe, but also a healthy environment?

And I'm pleased to be joined today by Linda Emanuel. She's a registered nurse, Community Health Director for the AgriSafe Network, and co-producer on her family farm in East Central Nebraska.

Welcome to Let's Talk with Carle Health, a podcast featuring Carle doctors, partners, and other experts bringing you topics important to your health and wellness. Today's podcast is made possible through funding from the National Institute for Occupational Safety and Health via the National Children's Center for Rural and Agricultural Health and Safety Emerging Issues Program. Learn more about the Carle Center for Rural Health and Farm Safety by visiting carle.org/farmsafety. That's C-A-R-L-E.org/farmsafety for resources, information, tips, and more. Let us help keep you and your family healthy and safe. I'm Scott Webb.

So Linda, thanks so much for joining me today. We're going to talk more as we've been doing here about youth and ag and the dangers and what we can do to protect them. So, what are some of the common everyday exposures in the working environment that youth may find themselves in?

Linda Emanuel: You know, youth work in agriculture, especially on family farms every day, and those exposures are as varied and as long as the day is. Some of those common everyday exposures that we think about, especially here in the Midwest, where a lot of row crop farmers and livestock producers, but some of those common exposures can be working with livestock. You know, they might be helping to care, feed. They may be part of barn clean out, grain bin clean out. There's a seasonal work of harvest such as planting and harvesting, then maintaining good fields as far as tillage equipment and taking care of the weeds. There's mowing, weed trimming, assisting in machine repair. And then, for some of the youth, they really enjoy working right alongside of their employers as kind of a mentorship, apprenticeship. So, they may be learning things like welding or plasma cutting. So, lots of everyday exposures.

Host: Yeah, it sounds like it, lots of exposures. And there may be, I guess, some more sort of chronic exposures, if you will. But I'm guessing there are some more acute things. So, let's talk about those acute exposures that we should be mindful of.

Linda Emanuel: Within agriculture, lots of work happens every day. And although we think that we can predict and be prepared, that's not always possible. One that comes immediately to mind this season is the weather. That wetness and dampness of cold weather can really lead to cold stress and frostbite, hypothermia, and some other just life-altering, changing things. There's also extreme heat in the summer; hot, humid conditions, you know, when they're working outside with fencing and working in barns and working with livestock.

And also, as youth may be helping to clean out the barns or if they're helping with manure pit clean out around some of those confinement facility operations, there can be some traumatic respiratory exposures that can really make kids sick. So, it's always, you know, an ounce of prevention is worth a pound of cure. So, preparing for the unexpected is always a good mantra.

Host: Yeah, it sure is. So, let's talk about PPE. What are the key things each youth should have in their possession for, you know, most days on the farm?

Linda Emanuel: Right. So PPE, personal protection equipment. I, as a nurse, and I'm a mother as well, like to think about the head to toe protection. Start at the top. When it comes to the head, think about the respiratory systems. So, having a couple of options for respiratory protection equipment is a good idea. The disposable respirators, those are the two-strap NIOSH-certified respirators, those are two things we really pound into our learners, is always choose a two-strap mask and it has the NIOSH certification on it. Having a disposable mask as well as a half-faced respirator is important and the fit is key when it comes to these respirators or these masks. There are ways that you can check for a good seal. Of course, what you're trying to do when you wear these masks is to protect yourself from those respiratory particulates from getting into your respiratory tract. And so, the fit is key there.

And then, as we kind of start working around the body there, the eyes, having good eye protection equipment, those impact-resistant glasses, and they should have the ANSI, that's A-N-S-I Z87 impact stamp on them that indicates that they've been tested, and then they should be able to protect you from all those projectile objects that come about maybe through weed trimming and that type of work. Goggles are a good idea, both the indirect, vented and the non-vented. It's good to have a couple of options for goggles. If I had to choose one, I would say the non-vented, because that protects them from any type of chemical vapors or aerosols that they might be working around.

Coming down the body there, we think about the gloves. Leather gloves are good for fencing and welding, but not good for chemicals. You know, chemicals, those leather gloves when you're working with chemicals are just like a second skin though. So, they're going to absorb any liquid they come in contact with. So, having a good pair of leather gloves as well as rubber gloves or nitrile rubber gloves for chemicals and that's even considering the dry chemicals they may be working with. And making sure those gloves fit well. We don't want their hands slipping inside the gloves, where they'll get frustrated and/or the glove may come off when they're in the middle of a task.

Working on down, I think about their clothing. It's always a good idea to throw a clean shirt or a clean pair of jeans or both into their backpack or whatever they keep their PPE in just so that if there is a spill, they're able to easily change their clothes. And then footwear, leather boots are great again when they're working around livestock or walking over uneven terrain such as fields. But leather footwear is not appropriate when they're working with any kind of liquids or chemicals that may soak in.

And we always say keep that PPE with you. We know that when farmers and ranchers are working on a specific farm site, if that PPE is not with them, more than likely, they will not go back to go get it. So, have a drawstring bag, something that they can keep their PPE in that fits them. And I forgot one part of the body, Scott, and that is the ears.

Host: Oh, sure.

Linda Emanuel: We got to protect our hearing. Saving that hearing capacity is so important. So, ear muffs work well for some folks, or they prefer the ear plugs. And all of these things, as we think about our youth, their sizes are going to be different. So, it's important that we find the PPE that fits the wearer.

Host: Yeah, Linda, I know that there are Ag Youth Worker Guidelines. And so, with that in mind, let's talk about the guidelines for determining age-appropriate tasks.

Linda Emanuel: As a mother, definitely, we all know our children mature differently, are built differently, right? Their physical nature, their mental nature is all different. And so, there are definitely tasks that are suitable for some youth and maybe not for others. And thankfully, professionals have studied this. And folks at the National Farm Center have come up with some really nice brochures and easy-to-download guidelines when it comes to those age-appropriate tasks, and they have a toolkit that goes along with it. So, I strongly encourage parents to take a look at it. They've broken down farm tasks by the nature of the work. So, that alone will help you to really digest and think, you know, "Is my youth ready to do this XYZ task?"

Host: Wondering, are there any health screenings or health promotion suggestions that should be done before youth starts on a farm job?

Linda Emanuel: I like to think about health as a journey. You know, from the day that we're born into this world into the day that we leave this world, we're on this journey of health. And so, who's part of that team that assists us to stay as healthy as our potential is? And so, who's part of that coaching staff?

Well, the first one I would think about are the parents. And then, it goes to their healthcare providers, maybe those folks that are within their local communities. And those healthcare providers can be physicians, pediatricians, can be nurse practitioners, as well as you think about their dentists, ophthalmologists, all of those people that are part of the team. So when it comes to screenings, we definitely recommend that the youth gets frequent health checkups and teen visits. A sports physical at the beginning of the school years are a nice gauge, "Is there any issues out there that we need to be aware of?" and then, furthering going down the line, making sure that their vaccinations are up-to-date, especially when working in agriculture, tetanus exposure is a valid and significant exposure. So, you know, making sure that if they're not up-todate on their tetanus shots, to get that booster.

And then, as I kind of lean more into or start thinking about health promotion behaviors, sleep. Gosh, you just cannot underestimate the benefit of good sleep. And for our school-age kids, recommendation is 9 to 12 hours per 24 hours. And for the teens, those 13 to 18 year olds, it's 8 to 10 hours per 24 hours. And it's all going to be individual, of course. A balanced diet, introducing them to new healthy foods, pack those nutritional snacks, make sure that they have water, good hydration. Decreasing their screen time is very important cognitively as well as for good relationships, watching their social media access. And encouraging them to be active and exercise. And luckily, here in agriculture, we can get outside and do some fun things with our families. And encouraging your youth to explore their hobbies and including them in family activities really helps to create a nice supportive bonding network.

Host: Yeah. And I'm sure you being a registered nurse, your family, folks on your farm, it's nice to have a medical professional nearby, right?

Linda Emanuel: It certainly is, and establishing that relationship early is key, because there becomes a trust and an understanding of each other as your youth grows into adulthood. And you're establishing those practices early on of the benefit of good health promotion and prevention, as well as when there's times that they will need care if there's an injury or an infection or a disease that comes about.

Host: What are some of the observable warning signs that signal a red flag indicating that medical help may be needed in youth or any farm workers?

Linda Emanuel: And observable is the key word there. And I think as mothers, and especially as nurses, we've learned to observe a patient, observe our kids, our family members, and our radar goes up if there's something that seems off. And so again, the head to toe assessment, you look at them physically, how are they acting, if they've been working outside, and they are guarding or gripping a specific part of their body that they may have injured a joint or strained a muscle.

Mentally, are they able to engage in activities that they previously were excited about or wanted to be part of? How is their cognition if you notice that maybe they're not connecting the dots like they used to? Has something changed there? If there's any difficulty with any sleep, or do they complain of dizziness, lightheadedness, or you notice that they're off balance? Maybe there was a blow to the head that you need to ask some questions about. Of course, the respiratory system is so important. So, watch if they have difficulty with breathing, shortness of breath, or labored respirations. The skin, you know, if they've been out in the sun, or maybe they've been working with some chemicals and you notice that they have some redness or burning. And watch their wounds, making sure that they do good wound care. But if you notice any increase signs of infection, such as draining or swelling or excessive pain or redness at that wound site, to get that taken care of and looked at.

Host: Yeah. Well, this has been good stuff today. Educational, as all of these have been for me, and I'm sure for listeners. Let's just finish up, talk about some of the unhealthy behavior trends that adults should be aware of. You said about screen time. My kids never worked on a farm, right? And so, I'm picturing them, if they were transported to a farm, and were working on a farm and just, you know, used to having their heads in their phones, and all of that implies, just wondering, what's some of the unhealthy behavior trends?

Linda Emanuel: So, yes, social media, those phones are great tools for us. And even in agriculture, we can do some wonderful things with our phones to help us to work more efficiently and effectively. But they can also be a huge distraction, and it can be part of many problems when it comes to the human factor of injuries or accidents. And so, some unhealthy behavior trends are the use of alcohol and tobacco, and that can be in the form of vaping and then as well as their social media use.

Interestingly, AgriSafe has been doing some work in looking at vaping among youth. And they found that the increase in vape use among rural youth is three times higher than the urban. That to me is just very interesting. Why is that higher?

Host: Yeah, why is that?

Linda Emanuel: Yeah. When digging into it, of course, studies are coming out with new information all the time. But it could be due to that the rural areas are less likely to be protected by that Comprehensive Tobacco Control Policies, which are mainly effective in reducing youth tobacco use, as well as the youth in rural areas may be less likely to be exposed to the anti-tobacco messages that you might be seeing when you're traveling about in an urban area. So, our radar is up, we're watching it. You know, that greater use of vape use in the rural youth may contribute to a greater tobacco use later on that could definitely impact health disparities.

Host: Oh, yeah. And I'm sure modeling is a big thing too, right? Kids pay attention to how their parents walk, talk, act, and their phone use, and perhaps vaping. And so, there's a lot of factors to consider in keeping our kids safe, but especially those down on the farm, right?

Linda Emanuel: Exactly. Right. Be careful of how you model, how you support, and how you educate your youth. Having open conversations about good, healthy behaviors can certainly go a long way, and it can be synergistic. The youth may learn some things from you, learn some things from school or FFA, maybe one of the organizations they're part of. And then, together, these behaviors can form just a really nice feedback healthy loop and be part of how our health is influenced. And it can have a multiplier effect on our family's health as well.

Host: Sure. I often feel when I get to the end of these, like we're just scratching the surface. And I feel like we've done that here today. Great information, really educational. I really appreciate your time. Thanks so much.

Linda Emanuel: Thank you. Appreciated your time as well.

Host: That's Linda Emanuel, Registered Nurse and Community Health Director for the AgriSafe Network.

And remember, you can count on Carle. Learn more about the Carle Center for Rural Health and Farm Safety by visiting carle.org/farmsafety, that's C-A-R-L-E.org/farmsafety for resources, information, tips, and much more. If you found this podcast helpful, please share it on your social channels and check out the entire podcast library for additional topics of interest. I'm Scott Webb. Thanks for listening and join us next time on Let's Talk with Carle Health.