Mortality and Morbidity in Agriculture in the United States

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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,

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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

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Trends in Agriculture

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

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Fatal Injuries in Agriculture
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Sources of Information

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

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ROPS in Relation to SUV Tire Separation Problem
Problem Tractor Overturn Tire Tread Separation
Fatalities 150/y, gt6,000 total 174 total
Number of units 4.8M Tractors 6.5M Tires
Solution ROPS New tires
Cost per unit / total 500 / 2.4B (1.4B for remaining non-ROPS tractors) 100 / 0.65B
Intervention initiated gt40 years 7 months
Corrected, Feb 01 40 95

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Nonfatal Injuries

• Sources
• National Safety Council
• Bureau of Labor Statistics (workers on farms with
  gt10 hired workers)
• California Workers Compensation (hired farm
  workers)
• Studies and surveys

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Work Related Illness

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

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Work Related Illnesses

• BLS (NSC Injury Facts 2000)
• Workers on farms with gt10 employees
• 30.9 illnesses / 10,000 workers
• 56 skin disorders
• 14 repeated trauma
• 13 respiratory disease
• 17 other

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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

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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 Hodgkins disease,
  multiple myeloma, leukemia, skin melanomas, and
  cancers of the lip, stomach, and prostate

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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

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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)

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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)

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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

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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)

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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.

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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

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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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