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Mortality and Morbidity in Agriculture in the United States – Policy Implications

Mortality and Morbidity in Agriculture in the United States – Policy Implications. Risto H. Rautiainen, MS, Stephen J. Reynolds, PhD, CIH Great Plains Center for Agricultural Health, . Aims. Characterize trends since Ag at Risk, 1998 in Agriculture Agricultural populations

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Mortality and Morbidity in Agriculture in the United States – Policy Implications

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  1. Mortality and Morbidity in Agriculture in the United States – Policy Implications Risto H. Rautiainen, MS, Stephen J. Reynolds, PhD, CIH Great Plains Center for Agricultural Health,

  2. Aims Characterize trends since Ag at Risk, 1998 in • Agriculture • Agricultural populations • Prevalence and incidence of • Fatal occupational injuries • Non-fatal occupational injuries • Work related diseases Conclusions Recommendations

  3. Trends in Agriculture • Rapid decrease in farms and farm workforce in early and mid part of the 20th century • Relatively slow changes since 1970’s • Part time farming has increased • Large scale farming has increased

  4. Fatal Injuries in Agriculture

  5. Sources of Information • National Safety Council (NSC) • NIOSH National Traumatic Occupational Fatalities (NTOF) • Bureau of Labor Statistics (BLS), Census of Fatal Occupational Injuries (CFOI)

  6. ROPS in Relation to SUV Tire Separation Problem

  7. Nonfatal Injuries Sources • National Safety Council • Bureau of Labor Statistics (workers on farms with >10 hired workers) • California Workers Compensation (hired farm workers) • Studies and surveys

  8. Work Related Illness Definitions: • Occupational disease • Work related illness • Work related symptoms Sources: • Bureau of Labor Statistics (hired workers) • National Safety Council

  9. Work Related Illnesses BLS (NSC Injury Facts 2000) • Workers on farms with >10 employees • 30.9 illnesses / 10,000 workers • 56% skin disorders • 14% repeated trauma • 13% respiratory disease • 17% other

  10. Respiratory Disease • Thorne et al: swine confinement workers: occup. asthma 20%, chronic bronchitis 25%, ODTS 33% • Reynolds et al: association with work exposure and respiratory symptoms in turkey barn workers • Wilkins et al: cash grain farmers, chronic caugh 9%, phlegm 11%, dysphnea 16%, wheeze 8% • NIOSH: fatalities from hypersensitivity pneumonitis • Causes: organic dust, endotoxin, ammonia

  11. Cancer Overall cancer rates are typically lower in agriculture compared to general population. PMRs: NIOSH 0.89, Finland 0.82, Sweden 0.80 • Blair et al: overall cancer rate lower but certain cancers elevated: Hodgkin’s disease, multiple myeloma, leukemia, skin melanomas, and cancers of the lip, stomach, and prostate

  12. Hearing Loss • Becker et al, NY: 72% of farmers had high frequency hearing loss • Mudipalli et al, IA: 50% of females, 86% of males with farming history had hearing loss, respectively 50% and 80% when no farm history; 47% of young males had hearing loss

  13. Skin Disorders • BLS: 17/10,000 workers in 1999. • Finland 16/10,000 farmers in 1996 • California: 2% contact dermatitis • California, causes: plants (52%), chemicals (20%), food products (22%)

  14. Zoonoosis Thomas et al, England. Antibodies found for: • Q-fever (29.2%), toxoplasma (50.2%), • lyme disease (0.2%), leptospira (0.2%), • brucella (0.7%), • hantavirus (seroprevalence 4.7%), • orthopox virus (0.7%), parapox virus (4.5%), Bartonella spp. (2.0%), • Ehrlichia Chaffeensis (0.2%), • human granulocytic ehrlichiosis agent (2.0%), • Echinococcus Granulosis (1.5%)

  15. Stress • US, some studies show higher Relative Risk for suicide for farmers (~1.1) • Canada: lower risk for farmers • Center for Epidemiologic Studies Depression Scale; Depressive symptoms • Ohio 8%, • Colorado 8% males, 11% females • IA, Keokuk County males 17%, females 25% • Kidd et al, Thu et al: injury-stress association

  16. Repeated Trauma • BLS: second most common work related illness in farm workers • California: back (24%), upper back (19%), wrist problems (18%) • Musculoskeletal problems in dairy farmers: Sweden (82-86%), Australia (57%), Colorado (43%)

  17. Ag at Risk Recommendations • Mandate reporting of diseases and injuries through state health departments. • Complete agricultural/rural National Health Interview and Examination Survey • Develop model surveillance programs for occupational disease and injuries • Complete National Occupational Hazard Survey for Agriculture. • Enhance NTOF database for causes of agricultural deaths. • Continue NSC survey to provide continuity to estimate traumatic deaths and injuries.

  18. Conclusions • No progress in fatalities • No progress in tractor fatalities • Some progress regionally • Some progress in childhood fatalities • Some progress in non-fatal injuries for employed workers • No progress in surveillance • Some progress in research based knowledge of injuries, illnesses, and risk factors

  19. Recommendations • Develop a National database for non-fatal injuries and illnesses. • Enhance NTOF, CFOI fatality surveillance. • Expand in-depth FACE fatality investigations to most states and include agricultural fatalities as priority. • Include info on farm family members and farm residents in Census of Ag and labor surveys. • Utilize existing knowledge to develop a National Agricultural Injury and Illness Prevention Agenda

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