title: Effectiveness of roll-over protective structures in reducing farm tractor fatalities.
abstract: OBJECTIVE
  The purpose of this systematic review was to evaluate the effectiveness of roll-over protection structures (ROPS) as an engineering control for prevention of fatalities from farm tractor roll-overs.
  
  
  METHODS
  Using a systematic approach to literature searching, relevant studies from peer-reviewed journals, technical and government reports, and unpublished reports were retrieved. Studies meeting initial criteria for possible inclusion were screened to determine whether they addressed the review topic (ROPS), included comparison data and included outcomes data such as injury or fatality. Articles that evaluated the use and impact of ROPS on operators of agricultural tractors were reviewed. Outcomes included two primary categories: implementation of ROPS and fatalities.
  
  
  RESULTS
  Of a total 207 citations reviewed, 53 met initial screening criteria and 21 studies were included in this review. Farm tractor roll-overs result in approximately 200 fatalities per year in the United States. ROPS or crush-proof cabs, which are designed to protect the farmer during a roll-over incident, are currently used on only about 50% of the estimated 4.8 million tractors in the United States. A significant proportion of tractors built after 1985 (when manufacturers began implementing a voluntary ROPS standard) have had ROPS removed. Evidence from Sweden and other Northern European countries clearly demonstrates that ROPS can essentially eliminate roll-over fatalities. In the United States, the only fatalities associated with roll-overs of ROPS-equipped tractors occurred when farmers did not use a seatbelt to hold them within the protective envelope of the ROPS. Estimates of costs of programs to retrofit older tractors with ROPS range from approximately $500,000 to $900,000 per life saved, which is comparable to other accepted life-saving interventions.
  
  
  CONCLUSIONS
  Future research efforts should include the development of collapsible and telescoping ROPS that can be used in low clearance areas such as dairy barns and fruit orchards. ROPS retrofits also need to be developed for many older tractor models. Effective educational and incentive programs need to be developed to increase the acceptance and use of ROPS among U.S. farmers. A national policy should be implemented to ensure that all tractors operated in the United States are equipped with ROPS or crush-proof cabs.
authors.affiliation: Great Plains Center for Agricultural Health, University of Iowa, Iowa City, Iowa 52242, USA. stephen-reynolds@uiowa.edu
authors.forename: S J
authors.initials: SJ
authors.lastname: Reynolds
authors.forename: W
authors.initials: W
authors.lastname: Groves
mesh_terms: D000062:Accidents, Occupational / Q000191:economics / Q000401:mortality* / Q000517:prevention & control*; D000382:Agricultural Workers' Diseases / Q000401:mortality* / Q000517:prevention & control; D002423:Cause of Death; D003257:Consumer Product Safety; D003362:Cost-Benefit Analysis; D004867:Equipment Design; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007484:Iowa; D008297:Male; D016272:Occupational Health; D015541:Off-Road Motor Vehicles / Q000191:economics; D014947:Wounds and Injuries / Q000401:mortality* / Q000517:prevention & control