title: Does the small farm exemption cost lives?
abstract: BACKGROUND
  Congress has exempted farms with fewer than 11 employees from enforcement of the Occupational Safety and Health Act. Three states (California, Oregon, and Washington) do not observe the exemption.
  
  
  METHODS
  We compared rates of fatal occupational injury in agriculture, by year, in 1993-2007, in California, Oregon, and Washington (aggregated), and the remaining states (as two aggregated groups): those with, and those without, state-designed occupational safety and health programs.
  
  
  RESULTS
  Fatality rates were approximately 1.6 to 3 times as high in both groups of states observing the small farm exemption as in the group of three states not observing it. Comparisons excluding the agriculture industry showed weaker differences.
  
  
  CONCLUSIONS
  The three states' opting out of the small farm exemption may have had substantial direct effects. They may also reflect and/or encourage a generally more effective approach to occupational health and safety. Although alternative explanations must be considered, the stakes are high in terms of injury and loss of life; further investigation seems urgently indicated.
authors.affiliation: Epidemiologist Alaska Pacific Regional Office, National Institute for Occupational Safety and Health, Anchorage, Alaska 99508, USA. gjx7@cdc.gov
authors.forename: Philip D
authors.initials: PD
authors.lastname: Somervell
authors.forename: George A
authors.initials: GA
authors.lastname: Conway
mesh_terms: D000062:Accidents, Occupational / Q000401:mortality / Q000706:statistics & numerical data; D000383:Agriculture / Q000706:statistics & numerical data*; D016001:Confidence Intervals; D033161:Government Regulation; D006801:Humans; D009026:Mortality / Q000639:trends*; D009784:Occupational Diseases / Q000453:epidemiology / Q000401:mortality; D016273:Occupational Exposure / Q000331:legislation & jurisprudence* / Q000517:prevention & control / Q000706:statistics & numerical data; D016272:Occupational Health / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D040242:Risk Reduction Behavior; D014481:United States / Q000453:epidemiology; D014489:United States Occupational Safety and Health Administration