Appendix F: 10th Anniversary Brief History of ICASH

A History of Iowa’s Center for Agricultural Safety and

Health: The First Decade

By Kelley J. Donham, I-CASH Director


(Reference the year 2000 annual report of Iowa’s Center for Agricultural Safety and Health)



This year of the new millennium, Iowa’s Center for Agricultural Safety and Health (I-CASH) celebrates its first 10 years of existence. This article will trace the “ancient” history of the organization from the original thoughts, the early existence, and the major accomplishments. Finally, I will look into the crystal ball for possible future directions.


Ancient History

Since 1955, there has been an Institute of Agricultural Medicine (IAM) at The University of Iowa, (now called the Institute for Rural and Environmental Health). The IAM was founded with the mission of identifying and preventing health and injury problems in our agriculture population.

The IAM was initiated as a research organization within The College of Medicine. In 1973 the focus was expanded to include training and outreach in agricultural medicine. From 1947 through 1986 there was a position of Extension Safety Specialist at Iowa State University to generate information programs, and extend them throughout the state via the network of regional and county offices. The missions of The University of Iowa and Iowa State University were common in their concern for the welfare of the farmer. However, they differed in that the University of Iowa stressed research and health professional training in agricultural illnesses, while Iowa State University emphasized safety education to the farm population. Geographic separation and the difference in focus resulted in little interaction between the two institutions in this area. Unfortunately, the Safety Specialist left Iowa State University in 1986 and the

position was not filled until 1990. Additionally, the lack of state or national policy regarding agricultural health and safety in agriculture resulted in little funding for research and training at The University of Iowa. Therefore, activities remained at a relatively low level.

In 1984–1985, I had the opportunity to spend a sabbatical year in Sweden, working with the health organization called Lantbrukshälsan (Farmer’s Health). The ideas formed in Sweden came home with me, but waited for the “right soil and moisture conditions to germinate”.

In 1986, Iowa Representative David Osterberg, (Mount Vernon) and chair of the Agricultural Committee, consulted with me about opportunities for a educational  travel opportunity  to Sweden to investigate farm safety and agricultural chemical programs in that country. Excited about what he had seen, upon his return (in consultation with Donham) initiated legislation to establish a model agricultural health and safety clinic in Iowa, utilizing ideas from the

Swedish program. Two such model programs were established under the direction of ICASH at The University of Iowa (at Marshalltown, and Satori Hospital in Waterloo). This program grew to a total of 22 clinics and became known as the AgriSafe Network.

Other ideas generated around that time (1988) were an initiative to create a public health policy for agriculture health and safety in Iowa and the United States. That policy process was called “Agriculture at Risk”.  This process ultimately led to the National Agricultural Health Program of the National Institute for Occupational Safety and Health (NIOSH).

This, now 24-million-dollar annual program, has led to well over 50 important programs in many different 10 states across the country, including Iowa. The initiative along with the growing AgriSafe Network provided the impetus that led to the legislation for ICASH. Based on consultation with representative Osterberg, a bill was produced to establish ICASH.  Representatives Josephine Gruhn (D-Spirit Lake) and Wendell Pellett (R-Atlantic) were floor managers of the I-CASH bill, along with co-author, David Osterberg. The legislation passed and became effective July 1, 1990. An ad hoc committee of representatives from Iowa State University, The University of Iowa, the Iowa Department of Public Health, the Iowa Agriculture Department, and other at-large representatives worked together to develop the processes that would be adopted to implement I-CASH.

Although not specified in the legislation, I-CASH was supportive in reestablishing the Agricultural Safety Extension and allocated $50,000 per year to support an Agricultural Extension Safety Extension Specialist at Iowa State University.  The Agricultural Safety Specialist was advertised, and Charles V. Schwab was hired to fill that position on May 25, 1990.

Major accomplishment of the I-CASH legislation was to establish a working collaboration between UI, ISU, the Department of Agriculture, and the Department of Public Health, together with a very diverse group of private agricultural health and safety organizations.  I-CASH aim was to keep this collaboration going with the common goal of saving lives and preventing injuries to farmers. I-CASH is unique, as it is the only legislative-based collaborative agricultural health and safety organization in the world. Working among organizations with diverse

cultures, funding streams, and alliances, some with inherent competition and barriers, I-CASH has done well to keep the organization functioning to meet the needs of the agricultural community. The following are some of the major I-CASH accomplishments:

  • Facilitated and promoted the development of Farm Safety 4 Just Kids;
  • Promoted the continuation and advancement of the program of agricultural health and injury surveillance at the Iowa Department of Public Health;
  • Facilitated and promoted the development of Sharing Help Awareness United Network (SHAUN);
  • Development of the AgriSafe Network, a group of some 24 hospitals, health clinics, and county health departments that provide community-based preventive occupational health services for the farm community.
  • Founded and fostered the development of the Farm Safety Day Camp.
  • Developed the Farm Safety Walkabout Program;
  • Initiated the Tractor Risk Abatement and Control program;
  • Initiated research and programming regarding occupational and community health associated with swine and poultry confinement production;
  • Developed the Agricultural Occupational Health Nurse Certificate Program.
  • Trained and certified approximately 90 nurses and other health care providers in agricultural occupational health.
  • Led a 1995 national conference regarding the health and environmental consequences of large-scale swine production;
  • Led the 1997 conference “Tractor Risk Abatement and Control: The Policy Conference”;
  • Supported the development of the National Education Center for Agricultural Safety on the Peosta campus of Northeast Iowa Community College;
  • Developed and initiated the Certified Safe Farm Program;
  • Accomplished dissemination of $50,000 in grants for prevention of illnesses and injuries to farm youth in over 15 communities in Iowa;
  • Developed interactive hands-on training materials for agricultural youth;
  • Developed web-based information dissemination packages for the agricultural population;
  • Achieved incorporation of goals to reduce agricultural injuries and illness in the Healthy Iowans 2010;
  • Conducted a strategic planning process 2000 for I-CASH to rejuvenate I-CASH to meet the demands of the next decade;
  • Witnessed a true reduction of deaths and injuries over the past decade.

The last accomplishment is by far the most important. Since the beginning of I-CASH in 1990, there has been a 40% observed reduction injuries and fatalities (rates per number of farms).  This observed reduction can at least partially be attributed to the totality of interventions from the state and private affiliates of I-CASH.

Appendix G: Keokuk County Rural Health Study Collaborators


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