Farm work, dust exposure and respiratory symptoms among farmers

OBJECTIVE: Environmental working conditions in rural areas, notably exposure to organic and mineral dusts, have been associated with increases in respiratory diseases. The objective of this study was to evaluate the prevalence of respiratory symptoms among farmers and the associations of these with occupational risk factors. METHODS: This cross-sectional study was undertaken in 1996 with 1,379 farmers from Southern Brazil. Sociodemographic and farming-production parameters were collected, as were levels of exposure to organic and mineral dusts. Respiratory symptoms were assessed by a modified version of American Thoracic Society-Division of Lung Disease questionnaire. Multiple logistic regression analysis was used in analyses, controlling for confounding factors. RESULTS: The majority (52%) of interviewees worked in activities with intense exposure to dust. Workers on farms with better economic indicators had a lower prevalence of respiratory symptoms. Poultry workers showed more symptoms of chronic respiratory disease (OR=1.60; 95% CI: 1.05-2.42). Farmers exposed to high concentrations of dust had more than 70% higher risk of asthma symptoms (OR=1.71; 95% CI: 1.10-2.67) and chronic respiratory disease symptoms (OR=1.77; 95% CI: 1.25-2.50). CONCLUSIONS: The rural workers studied herein were exposed to high levels of organic and mineral dusts. Those exposed to higher dust concentrations, such as poultry workers, showed an increased risk of work-related respiratory symptoms. The implementation of respiratory protection programs is recommended, emphasizing workers involved with poultry production.     

Socioeconomic Status and Injury in a Cohort of Saskatchewan Farmers

Purpose: To estimate the strength of relationships between socioeconomic status and injury in a large Canadian farm population. Methods: We conducted a prospective cohort study of 4,769 people from 2,043 farms in Saskatchewan, Canada. Participants reported socioeconomic exposures in 2007 and were followed for the occurrence of injury through 2009 (27 months). The relative hazards of time to first injury according to baseline socioeconomic status were estimated via Cox proportional hazards models. Findings: Risks for injury were not consistent with inverse socioeconomic gradients (adjusted HR 1.07; 95% CI: 0.76 to 1.51 for high vs low economic worry; adjusted HR 1.72; 95% CI: 1.23 to 2.42 for completed university education vs less than high school). Strong increases in the relative hazard for time to first injury were identified for longer work hours on the farm. Conclusions: Socioeconomic factors have been cited as important risk factors for injury on farms. However, our findings suggest that interventions aimed at the prevention of farm injury are better focused on operational factors that increase risk, rather than economic factors per se.     

Impact of Long Farm Working Hours on Child Safety Practices in Agricultural Settings

Objectives: To characterize working hours of adult farm owner-operators and their spouses by season, and to examine associations between working hours and farm safety practices affecting children. Methods: We conducted a secondary analysis of cross-sectional survey data collected as part of an existing study of injury and its determinants. Results: Owner-operators reported a median of 60 to 70 hours of farm work per week during warm weather months, with declines in hours over the winter. Spouses reported similar seasonal patterns, although their median reported hours were much lower. Longer farm working hours by owner-operators were marginally associated with increased exposure of teenagers to farm work hazards. Exposures of young children to worksite hazards rose in association with longer farm working hours by spouses. Conclusion: Exposures of children to farm worksite hazards and demands may be consequences of adult long working hours.     

Severe farm injuries among New York farmers.

BACKGROUND: Data from the telephone interview portion of the New York State Farm Family Health and Hazard Surveillance were used to study the incidence and predictors of severe farm injury. METHODS: One thousand seven hundred and six participants completed two telephone interviews in which they reported all injuries over a 12-month period. RESULTS: Nine percent of participants reported at least one severe farm injury. Using logistic regression the significant risk factors for sustaining at least one severe farm injury are younger age, the presence of hearing loss or joint trouble, working more hours per day, being the owner/operator of the farm, and being from a farm with higher gross sales. CONCLUSIONS: There needs to be continuing education of all farmers as to the risks of injury. However, when resources are limited, we recommend that injury education and interventions in this farming population should target younger farmers, those who work longer hours, owner/operators, farmers from higher grossing farms, with special attention to farmers who have physical impairments.     

Trends of ATV use and associated injury on Saskatchewan farms

Purpose: All-terrain vehicles (ATV's) are a hazardous source of injury in many contexts and geographical regions, but to date have not been investigated in Saskatchewan.

Methods: Baseline surveys from the Saskatchewan Farm Injury Project were examined at two time points in terms of: (1) rates and correlated characteristics of reported ATV use; and (2) qualitative content analysis of injury events involving ATVs. The sample of eligible farmers was 2,972 in 2007 and 1,702 in 2013.

Findings: Self-reported ATV use increased on Saskatchewan farms over the five-year period, both in terms of the number of individuals using ATV's on the farm and the days per year of operation. ATV use is significantly more common on farms with livestock, among male farmers, and among younger farmers. Farmers with low back pain were also more likely to report ATV use. Qualitative content analysis of farmers' reported “most serious injury” on the farm revealed themes related to: (1) tasks undertaken with ATV's at the time of the incident (e.g., stock work and personal transport); (2) contributing factors (vehicle, environmental and driver); and (3) safety reflections.

Conclusion: The apparent trends of increasing ATV use on Saskatchewan farms and serious nature of the injury incidents reported indicate that this is an issue worthy of further investigation.     

Technical workshop report: Working Group II: agricultural occupational health and safety services for farmers and ranchers

This work group felt that there is compelling evidence that effective occupational health services are essential to improve the serious occupational safety and health problems in agriculture. Program initiatives may be stimulated by federal and state governments, but development and implementation must involve the grassroots farm community and local resources. Other countries (Sweden, Finland, Canada) are far ahead of the United States in this area and serve as examples. Developing services should be comprehensive and should include clinical, technical, and educational efforts. Marketing programs to the public must include grassroots involvement. Surveillance and program evaluation are essential in any new program efforts. Funding such programs must be shared by federal, state, local, and private resources. Regulatory options should be a minimal part of such a program, but mandatory rollover protective devices and mandatory reporting seems to be one feasible regulatory option.     

Trauma in Hispanic Farm Workers in Eastern North Carolina

Abstract

Context: In spite of the attention directed at the problem of occupational injuries within the farm environment and at the general health status of migrant farm workers in the United States, there have been no studies focusing on the risk for traumatic injury in general for this disadvantaged group.

Purpose: Trauma affecting Eastern North Carolina Hispanic farm workers was quantified and certain risk factors were found.

Methods: Through chart review and retrieval of trauma registry information, patient occupational history, injury patterns, treatment variables as well as outcome and hospital charges were determined and compared with data for Hispanic construction workers and other service area males.

Findings: Two hundred fifty-six Hispanic farm workers were admitted to the trauma center from July1992 to June 2002, which is comparable to the risk (0.1%) of being admitted to the trauma center for an age-matched service area male. Only 5% of injuries occurred during farm work, 21% were penetrating injuries, and in 66% ofcases (compared to 51% for other age-matched males) alcohol was involved.

Conclusion: Most trauma affecting Hispanic farm workers in Eastern North Carolina is not directly occupational and happens in conjunction with recreational activity, where alcohol is an important risk factor. The human and financial cost resulting from such injuries is of such magnitude that it deserves consideration by everybody who is involved in shaping policies in agriculture, immigration and rural public health.     

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.     

Pain, medication, and injury in older farmers

BACKGROUND: Agricultural work continues to be a dangerous occupation. Older farmers experience high risks for work-related injury. The purpose of this research was to determine if there is a relationship between medication use and injury among older male farmers in Alberta. METHODS: Using probabilistic linkage between an Alberta Agriculture government registry of farm operators and the Alberta Health Plan registry file, older farmers (aged 66 and older) were identified. Farm related injuries were identified using an E-code search of both hospitalization and emergency department separations for a 3-year period. Cases were matched to controls on age, geographic health region, and index injury date at a ratio of 1:5. Co-morbidity and medication use for each of the cases and controls were derived from population based health system utilization files. Conditional logistic regression was used to determine which medications were related to injury. RESULTS: Overall, a total of 282 farm related injuries were suffered by the linked group. Controlling for co-morbidity, farmers who had stopped taking narcotic pain killers (OR = 9.37 [95% CI:4.95, 17.72]) and non-steroidal anti-inflammatories (OR = 2.40 [95% CI:1.43, 4.03]) 30 days prior to the date of injury were at risk of injury. Those farmers taking sedatives up until the date of injury were also at risk (OR = 3.01 [95 CI:1.39, 6.52]). In addition, those suffering from incontinence/urinary tract disorders (OR = 2.95 [95% CI:1.30, 6.71]), and prior injury (OR = 1.42 [95% CI:1.04, 1.95]) were also at greater risk of injury. CONCLUSIONS: The relationship of medication use and injury in this population is different from those observed in studies of falls in older persons. We hypothesize that distraction from either pain or co-morbidity may play an important role in the etiology of injuries suffered in this active older working population. Further investigations in this area are required to confirm these findings.     

Farm injury hospitalisations in New South Wales (2010 to 2014)

Objective: To examine gender differences in the characteristics, treatment costs and health outcomes of farm injuries resulting in hospitalisation of New South Wales (NSW) residents. Method: A population‐based study of individuals injured on a farm and admitted to hospital using linked hospital admission and mortality records from 1 January 2010 to 30 June 2014 in NSW. Health outcomes, including injury severity, hospital length of stay (LOS), 28‐day readmission and 30‐day mortality were examined by gender. Results: A total of 6,270 hospitalisations were identified, with males having a higher proportion of work‐related injuries and injuries involving motorbikes compared to females. Females had a higher proportion of equestrian‐related injuries. There were no differences in injury severity, with around 20% serious injuries, in mean LOS or 28‐day hospital re‐admission. Treatment costs totalled $42.7 million, with males accounting for just under 80% of the total. Conclusions: There are some gender differences in the characteristics of farm injury‐related hospitalisations. Farm injury imposes modest, but nonetheless relatively considerable, financial costs on hospital services in NSW. Implications for public health: Continued efforts to ameliorate these injuries in a farm environment, which are mainly preventable, will have personal and societal benefits.     

Relationship Between Sleep Loss and Economic Worry Among Farmers: A Survey of 94 Active Saskatchewan Noncorporate Farms

ABSTRACT

Farm work involves seasonal peak busy periods with long hours of work and potential sleep loss. Social, technological, and economic changes, and depressed commodity prices, have resulted in financial stress. There may be a relationship between sleep loss and worry about economic conditions. The objective of this study was to examine the association between hours of sleep and worry associated with cash flow shortages and worry associated with debt among a population of farmers and their family members. One hundred and ninety-five persons from 94 active farms in two rural municipalities in west central Saskatchewan were interviewed by questionnaire. Logistic regression analyses were used to quantify associations between sleep patterns and economic concerns during peak seasons and nonpeak seasons. During peak agricultural seasons, 31.6% of owner/operators reported less than 6 hours of sleep per night compared to 6.3% during the nonpeak season (p < .01). A significant relationship (odds ratio [OR] 3.59, confidence interval [CI] 1.58–8.13) was observed between daily cash flow worry and impaired sleep during peak busy seasons. A large proportion of farmers surveyed suffered severe sleep deprivation during peak seasons, and this sleep loss appeared related to worries about cash flow that were not observed during nonpeak seasons. It is possible that sleep loss during peak busy seasons may be related to impaired judgment, as shown by differential worry habits, and might also be related to the high injury rates observed in farmers during peak busy seasons.     

The Bassett Farm Safety and Health Project

The Bassett Farm Safety and Health Project was started in 1980 when Drs. May and Pratt made clinical observations on respiratory illnesses in farmers. The initial work involved the investigation of clinical syndromes associated with dust exposures and, from there, environmental dust studies. The current scope of work of The Farm Safety and Health Project includes three major components: research, education, and patient care. The research activities currently include studies into the analysis of injuries on farms, hearing loss in a randomly selected population, and estimating the annual incidence of Silo Filler's Disease in New York State. Educational activities currently include a statewide hearing conservation project, and the provision of numerous education materials for farmers and farm workers. The clinical activities include the establishment of an occupational medicine clinic in the fall of 1988, designed specifically for evaluation and treatment of agricultural workers with occupation-related illness and injuries.     

#65 Medication use,co-morbidity and injury in older male farmers

PURPOSE: The purpose of this research was to determine if there is a potentially causal relationship between medication use and injury among older male farmers in Alberta.METHODS: Using probabilistic linkage between an Alberta Agriculture government registry of farm operators and the Alberta Health Plan registry file, older farmers (aged 66 and older) were identified. Farm related injuries were identified using an E-code search of both hospitalization and emergency department separations for a 3-year period. Cases were matched to controls on age, geographic health region, and index injury date at a ratio of 5:1. Co-morbidity and medication use for each of the cases and controls were derived from population based health system utilization files. Conditional logistic regression was used to determine which medications were related to injury.RESULTS: Over a 3-year period, a total of 282 farm related injuries were suffered by the linked group. Controlling for co-morbidity, farmers who had stopped taking narcotic pain killers (OR = 9.85[95%CI:5.14,18.86]) and non-steroidal anti-inflammatories (OR = 2.36[95%CI:1.40,3.98]) 30 days prior to the date of injury were at increased risk. Those farmers taking sedatives and hypnotics right up until the date of injury were also at increased risk (OR = 3.12[95CI:1.41,6.89]).. In addition, those suffering from incontinence (OR = 3.71[95%CI:1.60,8.59]) and osteoporosis (OR = 4.78[95%CI:1.34,16.99]) were also at increased risk.CONCLUSION: The relationship of medication use and injury in this population is different from those observed in studies of falls in older persons. These data indicate that distraction from either pain or co-morbidity may play a factor in injuries suffered in this active older working population.     

Health Care for Family Farmers and Women Involved in Farm Economics (WIFE)

ABSTRACT

This article describes safety and health issues confronting American farmers. Factors that contribute to a lack of well-being and nonoptimal health care coverage for farming families are presented. These include the common considerable distance of farms from health care providers, the shortage of health professionals in rural areas, the inherent health and safety hazards of farming, the lack of health and accident insurance, and the stresses placed on farming families in holding multiple job responsibilities. Women Involved m Farm Economics (WIFE) a nonprofit organization, was formed initially to improve the financial status of farmers. Activities of WIFE in improving the health and safety of American farmers are described.     

Farm Safety Research to Practice: The Long Road From the Laboratory to the Farm

ABSTRACT

Research to Practice is a critically important component in the Centers for Disease Control and Prevention/National Institute for Occupational Safety and Health (CDC/NIOSH) mission of conducting applied research in support of worker health and safety. All of the excellent research in the world will not help workers if the products of that research are not effectively integrated into widespread use in industry. For this reason, Research to Practice has been a major program emphasis within NIOSH. Although success stories can be found, few come from agriculture, the authors maintain, because of a range of unique economic and regulatory factors present in this sector. The purpose of this commentary is to discuss the major factors standing in the way of bringing proven agricultural safety innovations into commercial production, and to outline a range of possible solutions to these structural challenges.     

Farm Safety Practices and Farm Size in New South Wales

Objective: There is some evidence to suggest that safety on small-area farms may not be high priority due to economic constraints and lack of knowledge. This has important ramifications for injury and economic burden. The objective of this research was to conduct a pilot study to investigate whether small- to medium-area farms implement fewer safety practices than large-area farms. Methods: Farmers were recruited from farm safety training days, field days, and produce stores in rural New South Wales (NSW), Australia. Small- and medium-area farms less than 500 ha (1235 acres) in size were aggregated for analysis and compared with large-area farms (≥500 ha) for survey items, including safety equipment owned and used, safety practices protecting children, barriers to improving safety, and causes of injury. Results: Overall, small/medium-area farms were found to own less safety equipment and to employ less safety practices than large-area farms. In particular, fewer tractors were fitted with rollover protection structures, there was less signage, less hearing protection, and fewer machinery guides. Injury rates were slightly less for small/medium-area farms, particularly involving vehicles. Small- and medium-area farmers were more likely to report lack of skills as barriers to making safety improvements. Conclusion: This pilot study found some evidence that small/medium-area farms implement fewer safety practices than large-area farms. A larger study is warranted to investigate this further, with particular focus on barriers and ways to overcome them. This could have important ramifications for government policies supporting struggling farmers on small/medium-area farms.