The development of an intervention to improve the safety of community care nurses while driving and a qualitative investigation of its preliminary effects

This paper details the development of, and perceived role and effectiveness of an innovative intervention designed to ultimately improve the safety of a group of community care (CC) nurses while driving. Recruiting participants from an Australian CC nursing car fleet, qualitative responses from a series of open-ended questions were obtained from drivers (n = 36), supervisors (n = 22), and managers (n = 6). The findings supported the effectiveness of the intervention in reducing self-reported speeding and promoting greater insight into one’s behaviour on the road. This research has important practical implications in that it highlights the value of developing an intervention based on a sound theoretical framework and which is aligned with the needs and beliefs of personnel within a particular organisation.     

Evaluation of an in-vehicle monitoring system (IVMS) to reduce risky driving behaviors in commercial drivers: Comparison of in-cab warning lights and supervisory coaching with videos of driving behavior

ProblemRoadway incidents are the leading cause of work-related death in the United States.MethodsThe objective of this research was to evaluate whether two types of feedback from a commercially available in-vehicle monitoring system (IVMS) would reduce the incidence of risky driving behaviors in drivers from two companies. IVMS were installed in 315 vehicles representing the industries of local truck transportation and oil and gas support operations, and data were collected over an approximate two-year period in intervention and control groups. In one period, intervention group drivers were given feedback from in-cab warning lights from an IVMS that indicated occurrence of harsh vehicle maneuvers. In another period, intervention group drivers viewed video recordings of their risky driving behaviors with supervisors, and were coached by supervisors on safe driving practices.ResultsRisky driving behaviors declined significantly more during the period with coaching plus instant feedback with lights in comparison to the period with lights-only feedback (ORadj = 0.61 95% CI 0.43–0.86; Holm-adjusted p = 0.035) and the control group (ORadj = 0.52 95% CI 0.33–0.82; Holm-adjusted p = 0.032). Lights-only feedback was not found to be significantly different than the control group's decline from baseline (ORadj = 0.86 95% CI 0.51–1.43; Holm-adjusted p > 0.05).ConclusionsThe largest decline in the rate of risky driving behaviors occurred when feedback included both supervisory coaching and lights.Practical applicationsSupervisory coaching is an effective form of feedback to improve driving habits in the workplace. The potential advantages and limitations of this IVMS-based intervention program are discussed.     

“They’re lunatics on the road”: Exploring the normative influences of parents,friends, and police on young novices’ risky driving decisions

PurposeYoung novice drivers experience significantly greater risk of being injured or killed in car crashes than older more experienced drivers. This research utilised a qualitative approach guided by the framework of Akers’ social learning theory. It explored young novice drivers’ perspectives on risky driving including rewards and punishments expected from and administered by parents, friends, and police, imitation of parents’ and friends’ driving, and advantages and disadvantages of risky driving.MethodsTwenty-one young drivers (12 females, 9 males) aged 16–25 years (M = 17.71 years, SD = 2.15) with a Learner (n = 11) or Provisional (n = 10) driver licence participated in individual or small group interviews.Findings and conclusionsContent analysis supported four themes: (1) rewards and (2) punishments for risky driving, and the influence of (3) parents and (4) friends. The young novice drivers differed in their vulnerability to the negative influences of friends and parents, with some novices advising they were able to resist risky normative influences whilst others felt they could not. The authority of the police as enforcers of road rules was either accepted and respected or seen as being used to persecute young novices. These findings suggest that road safety interventions should consider the normative influence of parents and friends on the risky and safe behaviour of young novices. Police were also seen as influential upon behaviour. Future research should explore the complicated relationship between parents, friends, the police, young novices, and their risky driving behaviour.     

Gender differences and demographic influences in perceived concern for driver safety and support for impaired driving countermeasures

IntroductionDriving safety, impaired driving, and legislation to address these concerns remain important issues. It is imperative countermeasures be targeted toward the most appropriate groups. This paper explores the potential relationship between gender and driving attitudes toward safety issues and impaired-driving countermeasures.MethodThe data are from the 2007 Impaired Driving Survey commissioned by Transport Canada and Mothers Against Drunk Driving (MADD) Canada. The survey is a, stratified by region, telephone survey of 1,514 Canadian drivers 18 years of age and older with a valid driver's license who had driven within the past 30 days.ResultsThe findings illustrate a consistent impact of gender on these issues. Other variables were also identified as relevant factors although less consistently. Current findings suggest that strategies for building support for interventions, or for changing risk perception/concern for risky driving behaviors should be tailored by gender to maximize the potential for behavior change.ImpactThis information may assist program and policy developers through the identification of more or less receptive target groups. Future research directions are also presented.     

Conscientious personality and young drivers' crash risk

Introduction: Personality characteristics are associated with many risk behaviors. However, the relationship between personality traits, risky driving behavior, and crash risk is poorly understood. The purpose of this study was to examine the association between personality, risky driving behavior, and crashes and near-crashes, using naturalistic driving research methods. Method: Participants' driving exposure, kinematic risky driving (KRD), high-risk secondary task engagement, and the frequency of crashes and near-crashes (CNC) were assessed over the first 18 months of licensure using naturalistic driving methods. A personality survey (NEO-Five Factor Inventory) was administered at baseline. The association between personality characteristics, KRD rate, secondary task engagement rate, and CNC rate was estimated using a linear regression model. Mediation analysis was conducted to examine if participants' KRD rate or secondary task engagement rate mediated the relationship between personality and CNC. Data were collected as part of the Naturalistic Teen Driving Study. Results: Conscientiousness was marginally negatively associated with CNC (path c = − 0.034, p = .09) and both potential mediators KRD (path a = − 0.040, p = .09) and secondary task engagement while driving (path a = − 0.053, p = .03). KRD, but not secondary task engagement, was found to mediate (path b = 0.376, p = .02) the relationship between conscientiousness and CNC (path c′ = − 0.025, p = .20). Conclusions: Using objective measures of driving behavior and a widely used personality construct, these findings present a causal pathway through which personality and risky driving are associated with CNC. Specifically, more conscientious teenage drivers engaged in fewer risky driving maneuvers, and suffered fewer CNC. Practical Applications: Part of the variability in crash risk observed among newly licensed teenage drivers can be explained by personality. Parents and driving instructors may take teenage drivers' personality into account when providing guidance, and establishing norms and expectations about driving.     

Better effect of the use of a needle safety device in combination with an interactive workshop to prevent needle stick injuries

ObjectivesThis study compares the effectiveness of two types of interventions with no intervention on the prevention of needle stick injuries (NSIs).MethodsHealth care workers, who were at risk for NSIs, were eligible for this three-armed cluster randomized controlled trial. In total, 23 hospital wards were randomly assigned to 1 of 2 intervention groups, which were given either a needle safety device and a workshop (NW; 7 wards, n = 267) or a workshop only (W; 8 wards, n = 263), or to a control group (C; 8 wards, n = 266). The primary outcome was the half-year incidence of NSIs, which was measured through questionnaires and official notification at the occupational health service at baseline (T0), 6 months (T1) and 12 months (T2) after baseline. Analysis were done by intention to treat. This study is registered as a prospective randomized trial, number NTR1207.ResultsA statistically significant difference was found between the groups for the half-year incidence of NSIs (p = 0.046) on the basis of questionnaire data with ORs for reported NSIs for the NW group compared with the control group of 0.34 (95% CI: 0.13–0.91) and 0.45 (95% CI: 0.19–1.06) for the W group compared with the control group. The officially registered NSIs during the study period showed no statistical differences between the groups.ConclusionsThe combined intervention of the introduction of needle safety devices and an interactive workshop led to the highest reduction in the number of self-reported NSIs compared to a workshop alone or no intervention.     

Assessing the impact of risk-taking behavior on road crash involvement among University students residing in two Mediterranean countries

Surveillance systems are indispensable for injury prevention; yet, detailed electronic records are rarely available. The “Student’s Health Card” is a self-reporting electronic tool addressing health issues of University students, while aiming to actively involve them in preventive practices and health promotion. Utilizing data from the injury prevention related section, this study sought to investigate the impact of risk-taking behavior on road crash involvement among University students residing in two Mediterranean countries. A total of 978 University students, 451 Greek and 527 Italian, provided information on prior road crash involvement, as well as on eight behavioral variables, comprising a risky behavior score. Multiple logistic regression analysis was performed. The already known tendency for clustering of risky behaviors was evident. One degree increment in the risky behavior score was found to increase the risk of road crash involvement by 35%. Driving after drinking (OR = 2.55, CI = 1.53–4.26), riding with a drunk driver (OR = 2.19, CI = 1.08–4.45) and tobacco smoking (OR = 1.95, CI = 1.18–3.22) significantly multiplied the risk. Despite their better compliance with safety measures, Italian students, compared with Greek, reported worse alcohol-related driving habits and engaged more frequently in mobile phone use while driving. Clustering of risky behaviors was found to be an important predictor of road crash involvement. Screening and awareness of risk-taking propensity of University students could guide early intervention. The “Student’s Health Card” could provide, at minimal cost, reliable risk-taking and road crash involvement information, which is needed for both personal risk assessment and surveillance purposes.     

Protective factors associated with young passenger intervening in risky driving situations

IntroductionWhile the negative influence of passengers on driving is usually studied, young passengers may protect against young drivers' crash involvement by speaking out and trying to stop unsafe driving behavior. This study sought to examine psychosocial constructs of young passengers who are likely to intervene in their friends' risky driving.MethodUniversity students aged 17 to 25 years who were single (n = 123) or in a romantic relationship (n = 130) completed an online survey measuring protective factors.ResultsThe combination of individual, friend and (for participants in a relationship) romantic partner protective factors predicted self-reported passenger intervening intentions.Impact on IndustrySince peer passengers often increase young drivers' crash risk, research on passenger intervening has significant implications for road safety strategies. The findings provide support for the operationalization of protective factors in strategies that target passenger intervening behavior.     

Prevention of occupational injuries: Evidence for effective good practices in foundries

IntroductionOccupational injuries are a relevant research and practical issue. However, intervention studies evaluating the effectiveness of workplace injury prevention programs are seldom performed. Method: The effectiveness of a multifaceted intervention aimed at reducing occupational injury rates (incidence/employment-based = IR, frequency/hours-based = FR, severity = SR) was evaluated between 2008 and 2013 in 29 Italian foundries (22 ferrous; 7 non-ferrous; 3,460 male blue collar workers/year) of varying sizes. Each foundry established an internal multidisciplinary prevention team for risk assessment, monitoring and prevention of occupational injuries, involving employers, occupational physicians, safety personnel, workers' representatives, supervisors. Targets of intervention were workers, equipment, organization, workplace, job tasks. An interrupted time series (ITS) design was applied. Results: 4,604 occupational injuries and 83,156 lost workdays were registered between 2003 and 2013. Statistical analysis showed, after intervention, a reduction of all injury rates (− 26% IR, − 15% FR, −18% SR) in ferrous foundries and of SR (− 4%) in non-ferrous foundries. A significant (p = 0.021) ‘step-effect’ was shown for IR in ferrous foundries, independent of secular trends (p < 0.001). Sector-specific benchmarks for all injury rates were developed separately for ferrous and non-ferrous foundries. Conclusions: Strengths of the study were: ITS design, according to standardized quality criteria (i.e., at least three data points before and three data points after intervention; clearly defined intervention point); pragmatic approach, with good external validity; promotion of effective good practices. Main limitations were the non-randomized nature and a medium length post-intervention period. In conclusion, a multifaceted, pragmatic and accountable intervention is effective in reducing the burden of occupational injuries in small-, medium- and large-sized foundries. Practical Applications: The study poses the basis for feasible good practice guidelines to be implemented to prevent occupational injuries, by means of sector-specific numerical benchmarks, with potentially relevant impacts on workers, companies, occupational health professionals and society at large.     

Using a cluster randomized controlled trial to determine the effects of intervention of battery and hardwired smoke alarms in New South Wales,Australia: Home fire safety checks pilot program

IntroductionIn 2014, Fire & Rescue New South Wales piloted the delivery of its home fire safety checks program (HFSC) aimed at engaging and educating targeted top “at risk” groups to prevent and prepare for fire. This pilot study aimed to assess the effectiveness of smoke alarms using a cluster randomized controlled trial.MethodsSurvey questionnaires were distributed to the households that had participated in the HFSC program (intervention group). A separate survey questionnaire was distributed to the control group that was identified with similar characteristics to the intervention group in the same suburb. To adjust for potential clustering effects, generalized estimation equations with a log link were used.ResultsMultivariable analyses revealed that battery and hardwired smoking alarm usage increased by 9% and 3% respectively among the intervention group compared to the control group. Females were more likely to install battery smoke alarms than males. Respondents who possessed a certificate or diploma (AOR = 1.31, 95% CI 1.00–1.70, P = 0.047) and those who were educated up to years 8–12 (AOR = 1.32, 95% CI 1.06–1.64, P = 0.012) were significantly more likely to install battery smoke alarms than those who completed bachelor degrees. Conversely, holders of a certificate or diploma and people who were educated up to years 8–12 were 31% (AOR = 0.69, 95% CI 0.52–0.93, P = 0.014) and 24% (AOR = 0.76, 95% CI 0.60–0.95, P = 0.015) significantly less likely to install a hardwired smoke alarm compared to those who completed bachelor degrees.ConclusionsThis pilot study provided evidence of the benefit of the HFSC in New South Wales. Practical Applications: Fire safety intervention programs, like HFSC, need to be targeted to male adults with lower level of schooling even when they are aware of their risks.     

Prevalence and demographic differences in microaccidents and safety behaviors among young workers in Canada

IntroductionThe present study examines the self-reported frequency of non-lost work time workplace injuries (“microaccidents”) and the frequency of three types of work-related safety behaviors (i.e., safety voice, safety compliance, and safety neglect) recalled over a four-week period.MethodWe analyzed data on microaccidents and safety behaviors from 19,547 young workers (aged 15–25 years, Mdn = 18 years; 55% male) from multiple Canadian provinces.ResultsApproximately one-third of all young workers recalled experiencing at least one microaccident at work in the last four weeks. Comparisons across three age groups revealed that younger workers, particularly between the ages of 15–18, reported more frequent microaccidents, less safety voice, less safety compliance, and more safety neglect than workers aged 19–22. This pattern of results also held for comparisons between workers in 19–22 and 23–25 age groups, except for safety voice which did not differ between these two older age groups. In terms of gender, males and females reported the same frequency of microaccidents, but males reported more safety voice, more safety compliance, and more safety neglect than females did. The results and limitations of the present study are discussed.ConclusionFrequency of microaccidents and safety behavior vary among young worker age sub-groups.     

Epidemiology of occupational accidents among Iranian insured workers

Work-related accidents are considered as a major health problem worldwide. The aim of present study was to determine the epidemiological pattern of occupational accidents among workers insured by the Iranian Social Security Organization (ISSO) between 2001 and 2005.Subjects consisted of all workers and drivers who had a work-related accident during 2001–2005 and were registered in the Iranian Social Security Organization (ISSO) database according to the inspection reports. An ordinal logistic regression model (proportional odds regression model) was used to assess the concurrent effects of independent variables on accident outcomes.Overall, 86,437 work-related accidents were investigated. The accidents were more frequent in metal workplaces and electrical industries, respectively. More than half of the accidents were due to incautious activities. Workers’ age (age at the time of accident) (OR = 0.99, CI: 0.989–0.994), gender (OR = 1.3, CI: 1.191–1.683), marital status (OR = 1.25, CI: 1.143–1.675) as well as accident setting (OR = 1.88, CI: 1.728–1.975) had significant effect on accident outcomes. Pattern of occupational injuries in Iran was consistent with the global pattern for accident outcomes.     

Perspectives on safety: The impact of group membership,work factors and trust on safety performance in UK and Norwegian drilling company employees

This study is anchored in a contractor company providing well services for platform drilling on the Norwegian (NCS) and the UK Continental Shelves (UKCS). The research project has as its point of departure the potential influences of group level characteristics, structural work factors, trust, and safety behaviour on safety performance. Do perceptions and performance differ across Shelves? Are “nomadic” groups or employees that have more unpredictable shift rotations more exposed to accidents than others? Is high trust and sound safety behaviour enhancing good safety performance? The results are based on questionnaire data from two samples of personnel distributed across three installations on the UKCS and nine on the NCS with a response rate of 67%: N = 170 (UKCS) and N = 621 (NCS). In addition, two focus group interviews were held in each country, with 15 participants in each. The results show that our model makes sense. Shelf shows a significant influence on safety performance in all but the final stage in our five-step logistic regression model, indicating that the effect may be mediated by safety compliance and safety participation. Installations and different work teams have different exposure and structural work factors matter significantly. Somewhat counter-intuitively, employees who have a “nomadic” status and who hold the least regular shift rotations appear to have a lower risk of being involved in incidents. High trust in workmates buffers against incident involvement and the same applies for high safety compliance. The results, challenges and implications for research and safety practitioners are discussed.     

Effects of lead time of verbal collision warning messages on driving behavior in connected vehicle settings

IntroductionUnder the connected vehicle environment, vehicles will be able to exchange traffic information with roadway infrastructure and other vehicles. With such information, collision warning systems (CWSs) will be able to warn drivers with potentially hazardous situations within or out of sight and reduce collision accidents. The lead time of warning messages is a crucial factor in determining the effectiveness of CWSs in the prevention of traffic accidents. Accordingly, it is necessary to understand the effects of lead time on driving behaviors and explore the optimal lead time in various collision scenarios.MethodsThe present driving simulator experiment studied the effects of controlled lead time at 16 levels (predetermined time headway from the subject vehicle to the collision location when the warning message broadcasted to a driver) on driving behaviors in various collision scenarios.ResultsMaximum effectiveness of warning messages was achieved when the controlled lead time was within the range of 5 s to 8 s. Specifically, the controlled lead time ranging from 4 s to 8 s led to the optimal safety benefit; and the controlled lead time ranging from 5 s to 8 s led to more gradual braking and shorter reaction time. Furthermore, a trapezoidal distribution of warning effectiveness was found by building a statistic model using curve estimation considering lead time, lifetime driving experience, and driving speed.ConclusionsThe results indicated that the controlled lead time significantly affected driver performance.Practical applicationsThe findings have implications for the design of collision warning systems.     

Predicting the safety performance of volunteers: Does motivation for volunteering influence driving behavior?

Volunteering has long been known for its positive effects on the individual and the community. However, no research to date has examined the safety of individuals when volunteering their services. The safety of individuals when driving a vehicle is particularly a concern in the nonprofit sector as volunteers is leaving organizations due to fear of public liability. As such, this paper aims to identify the internal motivational factors influencing the safety of volunteers when driving a vehicle (n = 73). Utilizing Clary’s et al. [Clary, E.G., Snyder, M., Ridge, R.D., Copeland, J., Stukas, A.A., Haugen, J., Miene, P., 1998. Understanding and assessing the motivations of volunteers: a functional approach. Journal of Personality and Social Psychology 74, 1516–1530] scale of the motivational functions served by volunteering, we found that individuals who volunteer their services for ego-related functioning (protective) were more likely to report higher self-reported driving speeds, while individuals who volunteer their services for altruistic purposes (values) were more likely to report lower self-reported driving speeds. In turn, higher self-reported driving speeds were found to be associated with a greater number of self-reported crashes in the past two years. These results have important implications for volunteer driving organizations, as these results suggest that some motivations are associated with poorer driving performance.     

Association between safety leading indicators and safety climate levels

ObjectivesThe aim of this study was to evaluate the association of leading indicators for occupational health and safety, particularly safety inspections and non-compliances, with safety climate levels.MethodsNordic Occupational Safety Climate Assessment Questionnaire was employed to evaluate safety climate in cross-sectional design. The geographically diverse population of the inspection body made it possible to conduct the survey across 10 provinces in Iran. 89 completed questionnaires were obtained with a response rate of 47%. Except for management safety justice, the internal consistency of other six dimensions was found to be acceptable (α ≥ 0.7).ResultsMean scores of dimensions ranged from 3.50 in trust in the efficacy of safety systems (SD = 0.38) to 2.98 in workers' safety priority and risk non-acceptance (SD = 0.47). Tukey HSD tests indicated a statistically significant difference of mean scores among groups undergoing different number of safety inspections and those receiving different number of non-compliances (p < 0.05), with no significant differences based on safety training man-hours and sessions (p > 0.05). Spearman's rank-order correlation showed no relationship between work experience and number of non-compliances (correlation coefficient = − 0.04, p > 0.05) and between safety training man-hours and number of non-compliances (correlation coefficient = − 0.15, p > 0.05).ConclusionsOur results indicate that safety climate levels are influenced by number of safety inspections and the resultant non-compliances.Practical applicationsFindings suggest that safety non-compliances detected as a result of conducting safety inspections could be used to monitor the safety climate state. Establishing plans to conduct scheduled safety inspections and recording findings in the form of safety non-compliance and monitoring their trend could be used to monitor levels of safety climate.     

Effects of time-gap settings of adaptive cruise control (ACC) on driving performance and subjective acceptance in a bus driving simulator

A study was conducted to investigate the effects of time-gap settings and contents of secondary tasks on a fix-based bus driving simulator on drivers’ performance while reclaiming control from ACC in a car-following scenario of emergency brake by the lead vehicle. Thirty professional bus drivers drove on the simulator with the scenario of highway traffic flow under 12 random time-gap settings: from 0.64 s to 2.40 s with the interval of 0.16 s. As for the effects of secondary tasks, subjects were evenly divided into three conditions: no secondary task interference, simple secondary task, and complex task. The results demonstrated that different safety demarcations of time-gaps on subjective acceptance and driving performance can be found out. The integrated demarcations separated time-gaps into divisions that represented different levels of danger. It revealed that the safer time-gaps for different situations were: longer than 1.60 s for none-secondary task distraction and longer than 2.08 s for being continuously distracted by secondary tasks. The demand for simple tasks is relatively high, so a larger time-gap is needed for the driver to remain safe. This research has implications for the time-gap selection of ACC and effects of secondary task distraction on buses. A next logical step will focus on determining time-gaps for lead vehicles on curves or slopes, when multiple vehicles are present ahead, and modeling driver behavior and performance with ACC for cars, buses, and other types of vehicles.     

Identifying compensatory driving behavior among older adults using the situational avoidance questionnaire

IntroductionDriving self-regulation is considered a means through which older drivers can compensate for perceived declines in driving skill or more general feelings of discomfort on the road. One form of driving self-regulation is situational avoidance, the purposeful avoidance of situations perceived as challenging or potentially hazardous. This study aimed to validate the Situational Avoidance Questionnaire (SAQ, Davis, Conlon, Ownsworth, & Morrissey, 2016) and identify the point on the scale at which drivers practicing compensatory avoidance behavior could be distinguished from those whose driving is unrestricted, or who are avoiding situations for other, non-compensatory reasons (e.g., time or convenience).MethodSeventy-nine Australian drivers (M_age = 71.48, SD = 7.16, range: 55 to 86 years) completed the SAQ and were classified as a compensatory-restricted or a non-restricted driver based on a semi-structured interview designed to assess the motivations underlying avoidance behavior reported on the SAQ.ResultsUsing receiver-operator characteristic (ROC) analysis, the SAQ was found to have high diagnostic accuracy (sensitivity: 85%, specificity: 82%) in correctly classifying the driver groups. Group comparisons confirmed that compensatory-restricted drivers were self-regulating their driving behavior to reduce the perceived demands of the driving task. This group had, on average, slower hazard perception reaction times, and reported greater difficulty with driving, more discomfort when driving due to difficulty with hazard perception skills, and greater changes in cognition over the past five years.ConclusionsThe SAQ is a psychometrically sound measure of situational avoidance for drivers in baby boomer and older adult generations.Practical applicationsUse of validated measures of driving self-regulation that distinguish between compensatory and non-compensatory behavior, such as the SAQ, will advance our understanding of the driving self-regulation construct and its potential safety benefits for older road users.     

Risk factors associated with sick leave due to work-related injuries in Dutch farmers: an exploratory case-control study

Using data from an insurance company, the occurrence of sick leave among Dutch farmers due to work-related injuries, and the epidemiological risk factors were investigated. In this case-control study the cases had filed a sick leave claim for work-related injury from 1998–2001 and the controls had not filed any claim in this period. Most (74%) of all injuries were work-related. The most frequent types of injury (63%) were bruises, sprains/strains and fractures. Multivariable logistic regression analysis showed that farmers working in dairy farming (OR=2.6) or pig husbandry (OR=2.7), older farmers (OR=1.48 per 10 years) and smokers (OR=1.7) were at increased risk. Within dairy farming, a significant factor was contact with cows (OR=1.7 per 500 h); within pig husbandry, working > 60 h per week was a significant factor (OR=2.2). The population attributable risk was 24% for elimination of smoking, 23% for halving the number of hours' contact with cows in dairy farming and 18% for elimination of a working duration > 60 h per week in pig husbandry. Effective measures to prevent sick leave might be raising awareness that older farmers and smokers are at increased risk, and a focus on the risks of working with animals.