Health and Safety in Australian Agriculture - Linking Research,Data and Action

ABSTRACT

Almost every week the rural media provide farming communities around Australia with information about health and safety hazards on farms. The results of the increasing research and data collection are being made broadly available. But are we just adding yet another worry to already stressed farmers, farm workers and farm families by this approach?

Until recently, there was little information or support available to farmers to assist them to identify the hazards on their own workplace, to assess the relative risk to health and safety of the many hazards identified, or to plan adoption of effective solutions to reduce risk based on the cash flow of the farming enterprise.

Managing Farm Safety is a program which has been developed through integration of data findings, research findings, farmer responsibilities under OHS Occupational Health and Safety legislation, farm management practicalities, farm cash flow and farmer aspirations. The program will be incorporated into rural education, training and extension services.

The services to farmers and farm families include access to training in farm OHS management, provision of a management tool or kit which includes and on-farm audit, record of education and training for employees, record of farm chemicals usage, and information about risk reduction solutions are available, their relative effectiveness and the cost of each option. The program will be provided in commodity specific format as more of the major industry groups in Australian agriculture move to adopt the approach.

This paper describes the data flow system used in the development and maintenance of this program.     

On fertile ground: An initial evaluation of green care farms in the United States

ABSTRACT

Green care farms (GCF) provide unique opportunities to persons with disabilities to engage in meaningful and therapeutic activities in farm settings. In this pilot study, the researchers examined the feasibility and impact of the first GCF in the United States. Qualitative interviews (N = 19) and thematic analysis were conducted. GCF participants and family members were enthusiastic about participation and identified benefits such as respite and improved mood. Administrators and farmers indicated that GCF challenged the status quo of funding, programming, and farming. Administrators speculated that the future success of GCF relies upon administrative expertise, local relationships, and managing risk and liability.     

Injury and Illness Costs in the Certified Safe Farm Study

CONTEXT: The Certified Safe Farm (CSF) intervention program aims to reduce occupational injuries and illnesses, and promote wellness to reduce health care and related costs to farmers, insurers, and other stakeholders. PURPOSE: To evaluate the cost effectiveness of CSF. METHODS: Farms (316) located in a 9-county area of northwestern Iowa were recruited and randomized into intervention and control cohorts. Intervention farms received occupational health screenings, health and wellness screening, education, on-farm safety reviews, and performance incentives. For both cohorts, quarterly calls over 3 years were used to collect self-reported occupational injury and illness information, including costs to the farmers and their insurers. FINDINGS: Annual occupational injury and illness costs per farmer paid by insurers were 45% lower in the intervention cohort ($183) than in the control cohort ($332). Although out-of-pocket expenses were similar for both cohorts, combined costs of insurance and out-of-pocket expenses were 27% lower in the intervention cohort ($374/year per farmer) compared to the control cohort ($512/year per farmer). Within the cohort of intervention farmers, annual occupational injury and illness cost savings were directly associated with on-farm safety review scores. Reported health care costs were $237 per farmer in the safest farms (those farms scoring in the highest tertile) versus $485 per farmer in the least safe farms (lowest tertile). CONCLUSIONS: Results suggest that farmers receiving the intervention had lower health care costs for occupational injuries and illnesses than control farmers. These cost savings more than cover the cost of providing CSF services (about $100 per farm per year).     

Occupational health and safety in hospitals accreditation system: the case of Lebanon

Introduction: Hospital accreditation can be an incentive to improve occupational health and safety (OHS) performance.

Objective: This study assesses the relationship between status of accreditation among private Lebanese hospitals and compliance with OHS accreditation standards.

Methods: A survey was administered to 68 private Lebanese hospitals to assess accreditation status and specific indicators related to each of the 9 OHS codes in the Lebanese accreditation manual. Chi-square, Fisher’s exact test, and independent sample t-tests compared the OHS standards between accredited and non-accredited hospitals.

Results: Fifty-six percent of participating private hospitals were accredited. Accredited hospitals reported statistically better OHS performance than non-accredited hospitals based on the standards outlined in the accreditation manual. However, there was inconsistent performance on numerous OHS indicators among participating hospitals.

Conclusion: The gaps in OHS performance suggest the need for strengthened OHS guidelines in the national accreditation process to safeguard workers’ health. Strategies to fortify OHS performance include tying service reimbursement to OHS compliance and linking OHS standards with national labor legislation.     

Erythrocyte cholinesterase activity levels in desert farm workers

In this study we have examined 532 migrant farm workers engagedmainly in the cultivation of vegetable crops, in both greenhousesand openfarms, and an equal number of controls. Erythrocyteacetylcholinesterase activity (AChE) was measured to determinethe degree of toxicity due to exposure to organophosphate andcarbamate pesticides in the farm workers employed either asforemen (41.5%) or farmers (58.5%). The mean ages of the farmworkers and controls were 35.2±7.4 (mean±SD) yearsand 34.6±7.1 years. AChE activity of the farm workersand controls was 3.89±0.64 Ul/ml (mean±SD) and4.15±0.29 Ul/ml. The haemoglobin adjusted erythrocytecholinesterase activity (HAChE) was 29.96±4.14(mean±SD)for farm workers and 32.10±2.26 for controls. AChE activitywas very highly significantly lower for the foremen (3.76±0.69)compared to farmers (3.98±0.59) (Student's t-test=4.13,p=0.0001). HAChE was also very highly significantly lower forforemen (29.24±4.37) compared to farmers (30.46±3.88)(Student's t-test=3.64, p=0.0001). The poorly controlled useof pesticides in the farms appeared to have caused sub-clinicalintoxication in the farm workers and indicated the need fortraining and implementation of hygiene practices.     

United Airway Disease Among Crop Farmers

Although there are observed relationships between agriculture and respiratory health problems, little attention has been given to relationship between lower and upper airway problems among farmers in the United States. The objective was to investigate the possible relationship between occupational risk factors and “united airway disease” among farmers in eastern North Carolina. Farmers and farm workers were selected from eastern North Carolina by using a cluster sampling method. A total of 180 farmers and farm workers completed the questionnaire. Data analyses were conducted to test associations and correlations between working conditions and symptoms. Lower airway symptom prevalence was 35%, and 66% had upper airway symptoms. Only 1% of farmers had physician-diagnosed rhinitis. Self-reported rhinitis and asthma symptoms were significantly correlated (r = .228, P = .003) among farmer/farm workers. Upper airway diseases are prevalent yet overlooked among farmer/farm workers. Early management of upper airway symptoms may prevent severe lower airway diseases, which will lead to increased productivity in the agricultural workforce.     

Inhalable and Respirable Particulate and Endotoxin Exposures in Kentucky Equine Farms

ABSTRACT

Adverse respiratory health effects in the agricultural industry have been linked to particulate endotoxin exposure. However, whether the endotoxin concentration is significantly correlated to the size of the particle remains an open question. To date, limited research has been conducted to assess particulate endotoxin exposures in the agricultural industry in general or the equine industry in particular. A task-based exposure assessment was conducted to characterize the endotoxin levels of inhalable and respirable particles on four Kentucky farms during the summer season. We conducted personal sampling of respirable and inhalable particles (n = 75) across all four farms and particulate endotoxin (n = 58) on two of them. Simultaneously, we collected real-time area samples across all four farms by task – horse care, filing hooves, cleaning stalls, cleaning barns, cleaning dry lots, and cleaning trucks. The endotoxin concentration of inhalable particles (geometric mean: 50.2–1,024 EU/m³) was ~50 times higher than that of respirable particles (geometric mean: 1.72–19.0 EU/m³). Horse care generated the lowest endotoxin concentrations for both particle sizes, while cleaning tasks tended to produce higher concentrations. There was no significant correlation between the endotoxin and particle concentrations for each size fraction based on tasks by farm (R² = 0.069 for inhalable; 0.214 for respirable). The equine workers in this study were exposed to higher endotoxin concentrations than workers in other industries, such as the swine industry. Providing exposure control guidelines and recommendations to the equine industry is necessary to reduce long-term endotoxin exposure and to prevent adverse respiratory symptoms.     

Job Resources and Work Engagement among Finnish Dairy Farmers

Objectives: The aims of this study were to examine job resources, work engagement and Finnish dairy farmers’ preferences concerning methods to enhance overall well-being while working on farms.

Methods: A postal survey yielded 265 completed questionnaires from 188 dairy farms. The sample was assessed as representative of Finnish dairy farmers. Exploratory factor analysis and a linear mixed model were utilized during the data analyzing process.

Results: The variables lowering work engagement were stressors related to the workload and problems with health. Elevated work engagement was associated with the factors work with farm animals and family. The most important resource variables were “child or children,” “own family,” and “animal health.” Female dairy farmers considered resource variables related to the family, love, and work with cattle as significantly more important than male dairy farmers. Male dairy farmers experienced higher work engagement and, concerning the dimensions, especially higher dedication and absorption than male respondents in a reference sample of workers in difference occupations. A sustainable farm economy and the possibility to have a holiday period were the most important methods to improve overall well-being on dairy farms.

Conclusion: The results indicate that the family, working with cattle, healthy farm animals, a reasonable workload, and a sustainable farm economy have the capacity to create positive impacts on well-being among dairy farmers. Well-being on farms is a part of sustainable food production.     

Cattle Farmer Awareness and Behavior Regarding Prevention of Zoonotic Disease Transmission in Senegal

ABSTRACT

Livestock farmers are known to be at high risk of exposure to zoonosis. A convenience survey to assess Senegalese traditional cattle farmers’ knowledge and attitudes regarding zoonotic diseases with reference to bovine brucellosis was conducted. A total of 222 cattle farmers were interviewed. Just over a quarter (30.1%) of the study participants knew or had heard of zoonotic diseases, whereas 6.8% knew at least one mode of transmission. Rabies was the most named zoonotic disease by farmers who knew zoonosis. Meanwhile, no farmer had heard of bovine brucellosis. Identification of zoonotic disease varied significantly by farmer’s main activity. All farmers reported that they drink milk produced on their cattle farms, and 95.0% drank fresh milk without prior heat treatment. A majority of farmers (70.3%) regularly assist animals during parturition and abortion without protective gloves. Farmers were less likely to assist animals if they had attended formal education. This study reports low knowledge of zoonotic infections and low compliance to control practices. Investigations on possible zoonotic infections, tailored zoonotic disease control programs including disease awareness creation and improved farm management are strongly recommended.     

Comparison of Farmers in the Agricultural Health Study to the 1992 and 1997 Censuses of Agriculture

Abstract

Context: The Agricultural Health Study (AHS) is a large, prospective cohort study in the states of Iowa and North Carolina that has been developed to better understand how pesticides and other agricultural exposures relate to the occurrence of cancer and other diseases.

Purpose: This report compares the characteristics of AHS farmers to the Census of Agriculture to evaluate the generalizability of AHS findings.

Methods: We restricted the AHS to private pesticide applicators who enrolled in Iowa (n = 31,065) and in North Carolina (n = 17,239) between 1993 and 1997, and who identified themselves as living or working on a farm. We compared their self-reported data with data from the 1992 and 1997 Censuses of Agriculture.

Findings: AHS farmers in Iowa are younger; live or work on larger farms; more frequently apply herbicides, insecticides, and fungicides; and are more likely to raise beef cattle and swine, and grow corn, soybeans, hay, and oats. AHS farmers in North Carolina are also younger, live or work on larger farms, more frequently reported growing crops commonly seen in the state, and are more frequent pesticide users. However, animals raised are similar to those in the North Carolina Census of Agriculture.

Conclusions: AHS farmers likely represent the higher end of pesticide usage in both states in part because AHS farmers have larger farms. Since the health effects of pesticides are best ascertained among pesticide users with the greatest exposure, the AHS cohort should prove to be a valuable resource for health effects research.     

Asthma among Household Youth on Racial Minority Operated Farms—United States, 2008

Objectives: Youth on farms are at risk for injuries and illnesses, including asthma, which continues to disproportionately affect minority groups.

Methods: For this study, the 2008 Minority Farm Operator Childhood Agricultural Injury Survey (M-CAIS) data were used to estimate the prevalence of asthma among youth aged 0–19 years living on racial minority-operated farms. Youth were considered to have a lifetime diagnosis of asthma based on an affirmative response to the question “Has he/she ever been diagnosed as having asthma by a health professional?”

Results: In 2008, of the estimated 37,400 youth (0–19 years) who lived on racial minority operated farms, 11% had asthma. Asthma prevalence was highest among males (13%) and youth 10–19 years of age (12%). Asthma prevalence among youth varied by race, ranging from 13% among household youth living on Black/African American operated farms to 7% among youth living on Asian/Native Hawaiian/Pacific Islander operated farms. In 2008, nearly half (46%) of household youth (0–19 years) worked on the farm. The odds of having asthma were higher among working youth compared with non-working youth (POR, 1.5; 95% CI: 1.3–1.8).

Conclusion: Disparities in asthma among youth living or working on racial minority-operated farms were observed. These findings may assist agricultural safety and health researchers, practitioners, and educators in identifying and designing targeted interventions to reduce asthma burden among youth on racial minority-operated farms.     

Intervening to Improve Health Indicators Among Australian Farm Families

ABSTRACT

The Sustainable Farm Families project (http://www.sustainablefarmfamilies.org.au/) was a 3-year demonstration and education project designed to influence farmer behavior with respect to family health and well-being among cropping and grazing farmers in Victoria, New South Wales, and South Australia, Australia. The project was conducted by the Western District Health Service, Hamilton, Australia, in partnership with farmers; Farm Management 500 (peer discussion group); the Victorian Farmers Federation; Royal Melbourne Institute of Technology; and Land Connect. During the 3 years of the project, 128 farmers—men (70) and women (58)—were enrolled. The project utilized a combination of small group workshops, individualized health action plans, and health education opportunities to encourage farm safety and health behavior changes and to elicit sustained improvements in the following health indicators: body mass index (BMI), total cholesterol, fasting blood glucose, and blood pressure. Mean changes in these health indicators were analyzed using repeated measures analysis of variance (ANOVA) and McNemar's test compared the proportion of individuals with elevated indicators. Among participants with elevated values at baseline, the following average reductions were observed: BMI 0.44 kg/m² (p = .0034), total cholesterol 48.7 mg/dl (p < .0001), blood glucose 10.1 mg/dl (p = .0016), systolic blood pressure 12.5 mm Hg (p < .0001), and diastolic blood pressure 5.0 mm Hg (p = .0007). The proportion of participants with elevated total cholesterol at baseline decreased after 24 months (p < .001). Such findings suggest that proactive intervention by farmer associations, rural health services, and government agencies may be an effective vehicle for promoting voluntary farm safety and health behavior change while empowering farm families to achieve measurable reductions in important health risk factors.     

Fatal agricultural injuries in North Carolina by race and occupation, 1977–1991

Medical examiner reports and death certificates were reviewed for all fatal agricultural injuries (n = 228) that occurred on-the-job in North Carolina between 1977 and 1991. Data were collected on the decedents' age, gender, race, date and time of injury, means of injury, and occupation. Annual workforce estimates were derived from the 1980 and 1990 US Census of the Population. Overall, 54% of the fatal injuries were due to tractors. Farmers who suffered fatal injuries tended to be older (median age = 56 years) and Caucasian (87%), while farm workers who died on the job were younger (median age = 35 years) and more often African-American (60%). The crude mortality rate for farmers was 38 per 100,000 worker-years; the crude rate for farm laborers was 16 per 100,000 worker-years. Age-adjusted fatal injury rates were 2.5 times higher among African-American farmers than among Caucasian farmers; furthermore, between 1977 and 1991 the rate of fatal injury among African-American farmers increased an estimated 14.7% per year. African-American farmers in North Carolina have experienced rising rates of fatal injuries at a time when employment in the industry is declining due to consolidation of farm ownership and foreclosures of African-American owned farms. In order to address the growing racial disparity in farm fatalities, efforts need to be made to improve the conditions under which African-American farmers are working. Am. J. Ind. Med. 31:452–458, 1997. © 1997 Wiley-Liss, Inc.     

Caregiver Reported Oral Health-Related Quality of Life in Young American Indian Children

American Indian/Alaska Native (AI/AN) children experience high rates of dental decay, yet their pediatric oral health-related quality of life (POQL) has not been described. We measured POQL in AI children and compared it in children with reported excellent/very good/good versus fair/poor oral health status (OHS) and assessed association of OHS, child’s age, dental service utilization, and dental insurance on POQL scores. Caregivers of 143 AI (100 %), young (mean age 25.1 months) children reported their POQL score as 4.2 (scale 0–100, lower score indicates better POQL); OHS as excellent (35 %), very good (27 %), good (21 %), fair (14 %), and poor (3 %); and utilization of urgent dental services (12 %). Worse POQL was associated with worse OHS (p = 0.01). After adjustment, worse POQL was associated with increased reported use of urgent dental services (p = 0.004). POQL of young AI children was generally favorable but worsened with increased utilization of urgent dental services.     

Hospital support services and the impacts of outsourcing on occupational health and safety

Background: Outsourcing labor is linked to negative impacts on occupational health and safety (OHS). In British Columbia, Canada, provincial health care service providers outsource support services such as cleaners and food service workers (CFSWs) to external contractors.

Objectives: This study investigates the impact of outsourcing on the occupational health safety of hospital CFSWs through a mixed methods approach.

Methods: Worker’s compensation data for hospital CFSWs were analyzed by negative binomial and multiple linear regressions supplemented by iterative thematic analysis of telephone interviews of the same job groups.

Results: Non-significant decreases in injury rates and days lost per injury were observed in outsourced CFSWs post outsourcing. Significant decreases (P < 0.05) were observed in average costs per injury for cleaners post outsourcing. Outsourced workers interviewed implied instances of underreporting workplace injuries.

Conclusions: This mixed methods study describes the impact of outsourcing on OHS of healthcare workers in British Columbia. Results will be helpful for policy-makers and workplace regulators to assess program effectiveness for outsourced workers.     

Impact of Training Bolivian Farmers on Integrated Pest Management and Diffusion of Knowledge to Neighboring Farmers

Teaching farmers integrated pest management (IPM) in farmer field schools (FFS) has led to reduced pesticide use and safer handling. This article evaluates the long-term impact of training farmers on IPM and the diffusion of knowledge from trained farmers to neighboring farmers, a subject of importance to justify training costs and to promote a healthy and sustainable agriculture. Training on IPM of farmers took place from 2002 to 2004 in their villages in La Paz County, Bolivia, whereas dissemination of knowledge from trained farmer to neighboring farmer took place until 2009. To evaluate the impact of the intervention, self-reported knowledge and practice on pesticide handling and IPM among trained farmers (n = 23) and their neighboring farmers (n = 47) were analyzed in a follow-up study and compared in a cross-sectional analysis with a control group of farmers (n = 138) introduced in 2009. Variables were analyzed using χ² test and analysis of variance (ANOVA). Trained farmers improved and performed significantly better in all tested variables than their neighboring farmers, although the latter also improved their performance from 2002 to 2009. Including a control group showed an increasing trend in all variables, with the control farmers having the poorest performance and trained farmers the best. The same was seen in an aggregated variable where trained farmers had a mean score of 16.55 (95% confidence interval [CI]: 15.45–17.65), neighboring farmers a mean score of 11.97 (95% CI: 10.56–13.38), and control farmers a mean score of 9.18 (95% CI: 8.55–9.80). Controlling for age and living altitude did not change these results. Trained farmers and their neighboring farmers improved and maintained knowledge and practice on IPM and pesticide handling. Diffusion of knowledge from trained farmers might explain the better performance of the neighboring farmers compared with the control farmers. Dissemination of knowledge can contribute to justify the cost and convince donors and governments in low-income countries to prioritize farmers training.     

Mortality patterns of Australian male farmers and farm managers

Objective: To compare the all‐cause and specific‐cause death rates of Australian male farmers and farm managers aged 25–74 years, with other Australian men. Methods: Data were extracted from the Australian Bureau of Statistics Death Registration Collection covering the calendar years of 1999–2002. Denominator data for male farmers and farm managers were drawn from the 2001 Australian Population Census. Direct age‐standardized death rates were calculated and compared with the general Australian male population. Results: The 4025 male farmers or farm managers who died in this period represented 3.35% of all male deaths in the 25–74 year age range. The all‐cause death rate for farmers and farm managers (730/100 000) was 33% higher than that of the Australian male population of the same age (549/100 000) (standardized mortality ratio (SMR) = 1.33). Causes of death related to neoplasms (SMR = 1.37), circulatory disease (SMR = 1.40) and all external causes (SMR = 1.37), were all statistically higher than the comparison population. Within these groupings, ischaemic heart disease (SMR = 1.39), other circulatory disease (SMR = 1.42), prostate cancer (SMR = 2.40), lymphohaematopoietic cancer (SMR = 1.80) and transport injuries (SMR = 2.06), were all significantly higher. Conclusion: These data indicate that Australian male farmers and farm managers are a disadvantaged group in terms of health status. The elevated rates of all‐cause and specific‐cause mortality compared with the Australian comparison population, illustrate both the need and scope for further investigation of these issues.