title: Lighting and marking policies are associated with reduced farm equipment-related crash rates: a policy analysis of nine Midwestern US states.
abstract: OBJECTIVE
  To evaluate the effectiveness of roadway policies for lighting and marking of farm equipment in reducing crashes in Illinois, Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, South Dakota and Wisconsin.
  
  
  METHODS
  In this ecological study, state policies on lighting and marking of farm equipment were scored for compliance with standards of the American Society of Agricultural and Biological Engineers (ASABE). Using generalized estimating equations negative binomial models, we estimated the relationships between lighting and marking scores, and farm equipment crash rates, per 100 000 farm operations.
  
  
  RESULTS
  A total of 7083 crashes involving farm equipment was reported from 2005 to 2010 in the Upper Midwest and Great Plains. As the state lighting and marking score increased by 5 units, crash rates reduced by 17% (rate ratio=0.83; 95% CI 0.78 to 0.88). Lighting-only (rate ratio=0.48; 95% CI 0.45 to 0.51) and marking-only policies (rate ratio=0.89; 95% CI 0.83 to 0.96) were each associated with reduced crash rates.
  
  
  CONCLUSIONS
  Aligning lighting and marking policies with ASABE standards may effectively reduce crash rates involving farm equipment.
authors.affiliation: Department of Occupational and Environmental Health, College of Public Health, The University of Iowa, Iowa City, Iowa, USA.
authors.forename: Marizen
authors.initials: M
authors.lastname: Ramirez
authors.affiliation: Department of Occupational and Environmental Health, College of Public Health, The University of Iowa, Iowa City, Iowa, USA.
authors.forename: Ronald
authors.initials: R
authors.lastname: Bedford
authors.affiliation: Department of Biostatistics, College of Public Health, The University of Iowa, Iowa City, Iowa, USA.
authors.forename: Hongqian
authors.initials: H
authors.lastname: Wu
authors.affiliation: Department of Emergency Medicine, Carver College of Medicine, The University of Iowa, Iowa City, Iowa, USA.
authors.forename: Karisa
authors.initials: K
authors.lastname: Harland
authors.affiliation: Department of Biostatistics, College of Public Health, The University of Iowa, Iowa City, Iowa, USA.
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Cavanaugh
authors.affiliation: Department of Occupational and Environmental Health, College of Public Health, The University of Iowa, Iowa City, Iowa, USA.
authors.forename: Corinne
authors.initials: C
authors.lastname: Peek-Asa
mesh_terms: D000062:Accidents, Occupational / Q000517:prevention & control* / Q000706:statistics & numerical data; D000063:Accidents, Traffic / Q000517:prevention & control* / Q000706:statistics & numerical data; D000383:Agriculture; D004867:Equipment Design / Q000379:methods*; D000072480:Farms; D006291:Health Policy; D006293:Health Promotion; D006801:Humans; D008029:Lighting; D015146:Midwestern United States; D015233:Models, Statistical; D018986:Motor Vehicles / Q000331:legislation & jurisprudence; D017751:Safety Management / Q000379:methods*