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Updated: Dec 13, 2025

Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
Published on: January 15, 2017
Editorial: The Power of Safety Professionals to Effect Change
1Rollins School of Public Health, Emory University, Atlanta, Georgia.
Abstract:
In 2006, Cole et al. (2006) reported on tractor overturn-related injuries in Kentucky from a random sample of farmers that numbered 6,063 respondents. The highest number of people who experienced tractor overturns were operators 16 to 20 years old. In 2007, at a National Institute for Occupational Safety and Health (NIOSH) Tractor Safety Initiative meeting in Colorado, John Myers of NIOSH presented a map of the states with the highest overturn fatality rates: Tennessee, Kentucky, West Virginia, Ohio, Pennsylvania, and Illinois. Significantly, four of these states, including Kentucky, overlap the Appalachian region (Cole, 2007; Hard and Myers, 2001). In Kentucky, this region involves farming on slopes, as examined by Saman et al. (2012), who found a high-risk cluster of tractor overturns among ten Kentucky counties in the Appalachian region, with a 97% increased risk of overturn as compared to other Kentucky counties. In 1971, James Arndt of Deere & Company presented a 50-year review of rollover protective structures (ROPS) at a Society of Automotive Engineers (SAE) conference. Arndt (1971) estimated that, over the previous 50 years, 30,000 operators had been killed when crushed by tractor overturns in agriculture and construction work. Since then, ROPS have been recognized as an effective device to prevent death in the event of a tractor overturn (Reynolds and Groves, 2000). Nevertheless, the epidemic of tractor-related deaths has continued into the modern era, and the cost of ROPS has been found to be a significant barrier to retrofitting tractors that lack ROPS (Myers et al., 1998). To provide a low-cost alternative, NIOSH safety engineers have designed, tested, and provided instructions for building and fitting cost-effective ROPS (CROPS) onto pre-ROPS tractors (i.e., tractors built before 1968) (Hard et al., 2016).
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