Risk factors for low back injury among farmers in Iowa: A case-control study nested in the agricultural health study

Agricultural Injuries: Risk Factors and Severity by Affected Body Part among US (Midwest) Farmers

OBJECTIVES

Statistics from the United States Bureau of Labor Statistics indicate that agriculture consistently ranks as the most hazardous industry in the US. To identify specific targets for prevention, we investigated injury risk factor profiles separately for each injured body site. We also characterized the severity of agricultural injuries by injured body site using the type of medical care and lost work time due to injury.

METHODS

We used the Central States Center for Agricultural Safety and Health (CS-CASH) surveillance data for 2018 to perform descriptive statistics and regression modeling.

RESULTS

We found that 12% (513/4351) of the participants experienced one or more injuries in the previous 12 months. Compared to female operators, male operators had 3.53 (95% CI: 1.17-10.68) times higher odds of back injury. Operators in livestock production had 2.77 times (95% CI:1.12-6.82), 2.28 times (95% CI:1.25-4.14), and 1.69 times (95% CI:1.10-2.59) higher odds of injury to the chest/trunk, finger, and leg/knee/hip, respectively, compared to operators in crop or mixed production. After adjusting for age and gender, operators who worked full time (vs. part-time) on the farm/ranch had 2.11 times (95% CI:1.03-4.34) higher odds of back injury. Arm/shoulder and leg/knee/hip injuries were more frequent in older age groups.

CONCLUSIONS

Prevention measures should be tailored considering specifically livestock producers with emphasis on trainings on proper livestock handling, such as being gentle, establishing routine, keeping distance, and avoiding sudden and loud noise when handling animals. Applying these techniques avoid startling the animals and reduce the risk of injuries.

"We're Lucky to Have Doctors at All"; A Qualitative Exploration of Australian Farmers' Barriers and Facilitators to Health-Related Help-Seeking

This study aimed to explore barriers and facilitators that impact on farmers' help-seeking behaviours for health and mental health concerns. Fifteen semi-structured interviews were conducted with farmers (12 male; age 51.7 ± 12.6 years) from three rural regions in South Australia. Interviews explored demographic and farm-related characteristics, perceptions of individual (and where relevant family) health and mental health concerns and experiences, and perceived barriers of health support-seeking. Thematic analysis was used to identify key themes. Four key themes were identified relating to help-seeking; personal attitudes and beliefs, farm-related barriers, health system barriers and the provision of support from family and friends. Dominant personal attitudes included valuing independence, strength and privacy. Farm related barriers included the 'farm comes first' and the fact that 'farm work is never done'. Health system barriers included issues relating to availability of choice and access, professionals (lack of) understanding of farm life, and time and financial costs of accessing care. Provision of support from family and friends involved informal help and advice, including facilitating access to professional support. Multiple attitudinal, structural, and farm-related issues affect farmers' help-seeking. Professionals who understand farm work practices and routines are valued by farmers and this is likely to facilitate access to care. Workforce development programs and community programs that involve farmers' perspectives as consumers and co-designers, using evidence-based strategies, may assist in strengthening these relationships.

Occupational health and safety in agriculture. A systematic review

Introduction: The prevalence of occupational diseases in the agricultural sector is higher than in other industries, since agricultural workers are at higher risk of exposure to different chemicals and pesticides, and are more prone to occupational accidents.Objective: To conduct a review of recent literature on occupational health and risk in agriculture.Materials and methods: A literature search was conducted in PubMed, SciencieDirect and Scopus using the following search strategy: type of articles: original research papers; language: English; publication period: 2006-2016; search terms: "agricultural health", "agrarian health", "risk factors", "epidemiology", "causality" and "occupational", used in different combinations ("AND" and "OR").Results: The search yielded 350 articles, of which 102 met the inclusion criteria. Moreover, 5 articles were found in grey literature sources and included in the final analysis. Most research on this topic has been conducted in the United States, which produced 91% (97/107) of the articles included.Conclusions: Most studies on health and safety in agriculture focused primarily on the harmful effects of occupational exposure to agrochemicals and pesticides, and the consequences of occupational accidents. However, since more than 90% of these studies come from the United States, a more comprehensive approach to health in agriculture is required, since what is reported here may be far from the reality of other regions, especially Latin America.

Diagnosed Chronic Health Conditions Among Injured Workers With Permanent Impairments and the General Population

OBJECTIVE

To profile chronic health conditions of an injured worker sample before and after workplace injury and compare injured workers to a matched community sample.

METHODS

Logistic regression analyses compared risk of certain chronic health conditions for permanently disabled injured workers in the pre- and post-injury periods to comparator subsamples from the Canadian Community Health Surveys 2003 and 2009/2010.

RESULTS

There were notable health differences between the injured worker and comparator samples for the post-injury period. Injured men and women were more likely to report arthritis, hypertension, ulcers, depression, and back problems than the comparator sample. Injured women were also more likely to report migraine headaches and asthma.

CONCLUSIONS

The observed differences suggest that permanently impaired injured workers experience more rapidly accelerated health declines than other aging workers, and this outcome is gendered.

A systematic review of socioeconomic status measurement in 13 years of U.S. injury research

OBJECTIVE

The purpose of this review was to assess the impact of socioeconomic status (SES) on injury and to evaluate how U.S. injury researchers have measured SES over the past 13years in observational research studies.

DESIGN & METHODS

This systematic review included 119 US injury studies indexed in PubMed between January 1, 2002 and August 31, 2015 that used one or more individual and/or area-level measures of SES as independent variables. Study findings were compared to the results of a previous review published in 2002.

RESULTS

Findings indicate SES remains an important predictor of injury. SES was inversely related to injury in 78 (66%) of the studies; inverse relationships were more consistently found in studies of fatal injury (77.4%) than in studies of non-fatal injury (58%). Approximately two-thirds of the studies (n=73, 61%) measured SES along a gradient and 59% used more than one measure of SES (n=70). Studies that used a gradient measure of SES and/or more than one measure of SES identified significant relationships more often. These findings were essentially equivalent to those of a similar 2002 review (Cubbin & Smith, 2002).

CONCLUSIONS

There remains a need to improve measurement of SES in injury research. Public health training programs should include best practices for measurement of SES, which include: measuring SES along a gradient, selecting SES indicators based on the injury mechanism, using the smallest geographic region possible for area-level measures, using multiple indicators when possible, and using both individual and area-level measures as both contribute independently to injury risk. Area-level indicators of SES are not accurate estimates of individual-level SES.

PRACTICAL APPLICATIONS

Injury researchers should measure SES along a gradient and incorporate individual and area-level SES measures that are appropriate to the injury outcome under study.

Identification of influential demographic and work-related risk factors associated to lower extremity pain perception among rice farmers

BACKGROUND

A high prevalence of musculoskeletal disorders and abnormal alignments of the lower extremities (LE) was found for rice farmers. It is important to investigate demographic and work-related risk factors associated with LE pain prior to developing intervention strategies addressing the problematic factors of the highest-risk task.

OBJECTIVE

To identify factors associated with LE pain in rice farmers for every stage of the cultivation process.

METHODS

Thirty experienced farmers (age of 45.9±6.21 (mean±SD)) rated LE pain experienced before and after each cultivation stage using the Standardized Nordic Questionnaire. Risk factors of pain were characterized based on expert risk assessment of tasks due to force, posture and motion, in addition to a conventional survey of demographic and other work-related information.

RESULTS

Ergonomic risk factors were found to be the strongest predictors of knee and foot pain perception, which induced a substantial increase of pain perception (up to 4.6 times) with varying extent for individual cultivation stages. The highest risk and pain perception was found during the planting performance. Age exhibited significantly positive association with foot pain during planting and harvesting. However, more experienced farmers perceived less foot pain, presumably by developing effective movement strategies.

CONCLUSIONS

The findings suggest that the planting process should be subject of further intervention development, especially for older farmers, with focus on reducing force, awkward posture and repetitive movement to minimize risk of LE pain.

Review and Meta-analysis of Emerging Risk Factors for Agricultural Injury

Agricultural injury is a significant public health problem globally. Extensive research has addressed this problem, and a growing number of risk factors have been reported. The authors evaluated the evidence for frequently reported risk factors earlier. The objective in the current study was to identify emerging risk factors for agricultural injury and calculate pooled estimates for factors that were assessed in two or more studies. A total of 441 (PubMed) and 285 (Google Scholar) studies were identified focusing on occupational injuries in agriculture. From these, 39 studies reported point estimates of risk factors for injury; 38 of them passed the Newcastle-Ottawa criteria for quality and were selected for the systematic review and meta-analysis. Several risk factors were significantly associated with injury in the meta-analysis. These included older age (vs. younger), education up to high school or higher (vs. lower), non-Caucasian race (vs. Caucasian), Finnish language (vs. Swedish), residence on-farm (vs. off-farm), sleeping less than 7-7.5 hours (vs. more), high perceived injury risk (vs. low), challenging social conditions (vs. normal), greater farm sales, size, income, and number of employees on the farm (vs. smaller), animal production (vs. other production), unsafe practices conducted (vs. not), computer use (vs. not), dermal exposure to pesticides and/or chemicals (vs. not), high cooperation between farms (vs. not), and machinery condition fair/poor (vs. excellent/good). Eighteen of the 25 risk factors were significant in the meta-analysis. The identified risk factors should be considered when designing interventions and selecting populations at high risk of injury.

Noise and neurotoxic chemical exposure relationship to workplace traumatic injuries: A review

INTRODUCTION

More than 5,000 fatalities and eight million injuries occurred in the workplace in 2007 at a cost of $6 billion and $186 billion, respectively. Neurotoxic chemicals are known to affect central nervous system functions among workers, which include balance and hearing disorders. However, it is not known if there is an association between exposure to noise and solvents and acute injuries.

METHOD

A thorough review was conducted of the literature on the relationship between noise or solvent exposures and hearing loss with various health outcomes.

RESULTS

The search resulted in 41 studies. Health outcomes included: hearing loss, workplace injuries, absence from work due to sickness, fatalities, hospital admissions due to workplace accidents, traffic accidents, hypertension, balance, slip, trips, or falls, cognitive measures, or disability retirement. Important covariates in these studies were age of employee, type of industry or occupation, or length of employment.

DISCUSSION

Most authors that evaluated noise exposure concluded that higher exposure to noise resulted in more of the chosen health effect but the relationship is not well understood. Studies that evaluated hearing loss found that hearing loss was related to occupational injury, disability retirement, or traffic accidents. Studies that assessed both noise exposure and hearing loss as risk factors for occupational injuries reported that hearing loss was related to occupational injuries as much or more than noise exposure. Evidence suggests that solvent exposure is likely to be related to accidents or other health consequences such balance disorders.

CONCLUSIONS

Many authors reported that noise exposures and hearing loss, respectively, are likely to be related to occupational accidents. Practical applications: The potential significance of the study is that findings could be used by managers to reduce injuries and the costs associated with those injures.

Double Jeopardy

The purpose of this study was to determine the prevalence and characteristics of tinnitus and assess the relationship between tinnitus and hearing loss among firefighters and operating engineers, who are exposed to noise on-the-job. The study analyzed existing data from two different populations (154 firefighters and 769 operating engineers) who completed a survey and audiometric tests as part of a hearing loss prevention intervention study. Approximately 40% of both groups reported tinnitus; 34% of firefighters and 59% of operating engineers showed hearing loss at noise-sensitive frequencies (4 kHz and 6 kHz). Firefighters with high frequency hearing loss (odds ratio [OR] = 2.31; 95% confidence interval [CI] = [1.05, 5.11]) and those with perceived impaired hearing status (OR = 3.53; 95% CI = [1.27, 9.80]) were significantly more likely to report tinnitus. Similarly, operating engineers who had hearing loss at both low (OR = 2.10; 95% CI = [1.40, 3.15]) and high frequencies (OR = 2.00; 95% CI = [1.37, 2.90]), and perceived impaired hearing status (OR = 2.17; 95% CI = [1.55, 3.05]) were twice as likely to report tinnitus. This study demonstrated that tinnitus is a considerable problem for noise-exposed workers. Workers with hearing loss demonstrated significantly higher rates of tinnitus. Comprehensive workplace hearing conservation programs should include tinnitus management for noise-exposed workers, along with other key elements such as noise control and hearing protection.

Prevalence of low back pain and associated factors among farmers during the rice transplanting process

[Purpose] The aim of this study was to investigate the prevalence of low back pain and associated factors in Thai rice farmers during the rice transplanting process. [Subjects and Methods] Three hundred and forty-four farmers, aged 20–59 years old, were asked to answer a questionnaire modified from the Standard Nordic Questionnaire (Thai version). The questionnaire sought demographic, back-related, and psychosocial data. [Results] The results showed that the prevalence of low back pain was 83.1%. Farmers younger than 45 years old who worked in the field fewer than six days were more likely to experience low back pain than those who worked for at least six days. Farmers with high stress levels were more likely to have low back pain. [Conclusion] In the rice transplanting process, the low back pain experienced by the farmers was associated with the weekly work duration and stress.

Characteristics of Work- and Non-work-Related Farm Injuries

PURPOSE

Farm-related injuries are an important public health problem in agriculture because of their impact on individuals, families, and farm operations. While surveillance programs such as the Census of Fatal Occupational Injuries is available to track fatal agricultural injuries, more work is needed to examine the burden of nonfatal agricultural injuries.

METHODS

Data involving agricultural injuries were collected from the Iowa Trauma Registry from January 1, 2005, through December 31, 2011. A total of 2,490 trauma patients were found to have been classified as having a farm-related injury. These nonfatal farm-related injuries were compared by work-relatedness, injury severity score, length of hospital stay, and hospital discharge status. Also reported are the age and gender of the trauma patients, as well as the population of the county in which the injury occurred.

RESULTS

In our analysis, we found that work- versus nonwork-relatedness had little effect on injury severity, but that work-related injuries did result in longer average hospital stays. Injuries occurring in counties of lower population size tended to be slightly more severe and be more likely to have nonroutine discharges.

CONCLUSIONS

Farm environments pose hazards which are persistent for those working and living on the farm, regardless of whether or not they are engaged in work-related activities. Public health prevention approaches that consider work and nonwork farm environments may be helpful in designing interventions to reduce injury.

Impact of excessive daytime sleepiness on the safety and health of farmers in Saskatchewan

BACKGROUND

Sleep disorders may negatively impact the health and well-being of affected individuals. The resulting sleepiness and impaired cognitive functioning may also increase the risks for injury.

OBJECTIVE

To examine the relationship between daytime sleepiness, defined as an Epworth Sleepiness Scale score >10, and self-reported sleep apnea, as potential determinants of farming-related injury and self-perceived physical health.

METHODS

Phase 2 of the Saskatchewan Farm Injury Cohort Study (2013) involved a baseline survey that included 2849 individuals from 1216 farms. A mail-based questionnaire was administered to obtain self-reports regarding sleep, demographics, farm injuries and general physical health. Multilevel logistic regression was used to quantify relationships between excessive daytime sleepiness and health.

RESULTS

The prevalence of excessive daytime sleepiness was 15.1%; the prevalence of diagnosed sleep apnea was 4.0%. Sleepiness was highest in the 60 to 79 (18.7%) and ≥80 (23.6%) years of age groups, and was higher in men (19.0%) than in women (9.3%). Injuries were reported by 8.4% of individuals, and fair or poor health was reported by 6.2%. Adjusting for confounding, individuals with excessive daytime sleepiness appeared more likely to experience a farming-related injury (OR 1.34 [95% CI 0.92 to 1.96]) and were more likely to report poorer physical health (OR 2.19 [95% CI 1.45 to 3.30]) than individuals with normal daytime sleepiness.

CONCLUSION

Excessive daytime sleepiness, a potentially treatable condition, appeared to be common in farmers and to negatively affect their health. Sleep disorder diagnosis and treatment programs did not appear to be used to their full potential in this population.

The effects of arthritis, mobility, and farm task on injury among older farmers

The current study was conducted by performing secondary analysis of data drawn from a study of sustained work indicators of older farmers. The primary outcome variable was the reported occurrence or non-occurrence of injuries because of farm work in the past year. There were three explanatory variables of interest: (1) whether respondents reported ever having been diagnosed with arthritis/rheumatism by a medical doctor; (2) whether participants reported having mobility problems; and (3) a farm task injury risk index. Additional explanatory variables included the estimated number of days spent on farming activities in the past year, as well as demographic characteristics such as age, sex, and race. Institutional review board approvals were obtained for the original study prior to data collection, and for the current study prior to secondary analysis of data. Descriptive statistics were calculated for the outcome and explanatory variables. Initial multivariable longitudinal models for the occurrence of injuries were fitted with the explanatory variables. Odds ratios for the effects of interest were calculated using the final models. A longitudinal model was fitted using data in waves 1, 3, and 5, with a farm task injury risk index as outcome variable and wave, sex, age, race, and estimated number of days spent on farming activities in the past year as explanatory variables for exploration of the relationship between the farm task injury risk index and these variables. In this group of older farmers, aging was protective for injury, and was associated with decreased farm task injury risk index. Arthritis/rheumatism was associated in our study with occurrence of injury because of farm work across all four waves. Our results indicated that farmers with mobility problems were twice as likely to experience injuries because of farm work compared to farmers with no mobility problems. Increased farm task injury risk index was associated with a 40% increase in odds for the occurrence of injury due to farm work. In this study of older farmers, the type of work, and not the amount of work was significantly associated with injury risk. Implications for future studies of farm injury include the need for nurse researchers and others to incorporate objective validated measures of mobility and health care provider diagnoses of arthritis, and arthritis type. Nurse researchers should proceed with ongoing evaluation of the farm task injury risk index to determine its validity, reliability, and usefulness as a predictor of farm injuries. In the practice setting, nurses may apply findings from this study to provide injury prevention teaching to older farmers and their families. For example, discussions of the more risky farm tasks, injury prevention strategies, and treatment modalities including those that promote improved mobility should be targeted to older farmers with arthritis and actual or potential mobility issues. Ultimately, these nursing research and practice efforts may lead to preservation of function, and decreased injury risk and severity among older farmers.

Risk factors for musculoskeletal disorders among farm owners and farm workers: a systematic review

BACKGROUND

A systematic review was undertaken to establish risk factors for the development of musculoskeletal disorders (MSDs) among farmers.

METHODS

Comprehensive electronic searches of Pubmed, Web of Science, CINAHL, SCOPUS, EMBASE, Agris Database, and Cochrane Library were carried out using a battery of key words for MSDs and farmers. The studies methods quality was assessed using a standardized checklist.

RESULTS

Thirty-three studies fulfilled the inclusion criteria. The median method score was 65% of the maximum attainable score, resulting in 15 studies of higher methodological. Risks were categorized into: Work characteristics (n = 11), personal characteristics (n = 5), and psychosocial factors (n = 5). Spinal MSD risk factors include exposure to working in tree crops, vibration, postural load, being an owner operator, age, education beyond high school, suffering from asthma or depression, having <8 hr nightly sleep, bad quality sleep, and geographic location. Upper extremity MSD risk factors include being an owner operator, dust with pig workers, numbness and coldness in younger milkers and numbness in milkers >43 years, age, and body height in dairy farmers. Lower extremity MSD risk factors include, duration of farming ≥10 years, working >5 hr daily in animal barns, milking >40 cows, years as a dairy farmer, farm work, age, body mass, and female gender.

CONCLUSIONS

In exploring risk factors the spine was the most researched body region, followed by lower and upper extremity. Given the variance between studies, it is recommended that future studies focus on specific types of farmers and should explore specific exposures for specific body parts using standardized case definitions.

A review of pesticide exposure and cancer incidence in the agricultural health study cohort

We reviewed epidemiologic evidence related to occupational pesticide exposures and cancer incidence in the Agricultural Health Study (AHS) cohort. Studies were identified from the AHS publication list available on a Medline/PubMed database search in March 2009. Findings related to lifetime-days and/or intensity-weighted lifetime-days of pesticide use are the primary focus of this review, because these measures allow for the evaluation of potential exposureresponse relationships. Most of the 32 pesticides examined were not strongly associated with cancer incidence in pesticide applicators. Increased rate ratios and positive exposureresponse patterns were reported for 12 pesticides currently registered in Canada and/or the United States. Exposure misclassification is also a concern in the AHS and may limit the analysis of exposureresponse patterns. Epidemiologic evidence outside the AHS remains limited with respect to most of the observed associations, but animal toxicity data support the biological plausibility of relationships observed six pesticides. Continued follow-up is needed to clarify associations reported to date. In particular, further evaluation of registered pesticides is warranted.

The association of nutritional status and gender with cross-sectional area of the multifidus muscle in establishing normative data

Despite recognized evidence for the importance of the multifidus muscle in stabilizing the lumbar spine, identifying subjects at risk for injury and subsequent loss of intrinsic spinal stabilization remains difficult. Previous research has failed to associate multifidus muscle size and height, weight, or body mass index (BMI). The purpose of this study was to begin to establish normative data for the multifidus muscle cross-sectional area (CSA) at the L5 level and to identify factors associated with size. Twenty-five participants (17 female), with a mean age of 32.5 (SD 11.6) years without history of LBP were considered for inclusion. Participants' height and weight were recorded and BMI calculated. Ultrasound imaging was used to obtain a CSA in cm(2) of the subjects' multifidus muscles at the L5 level bilaterally; testing was done by two trained testers. Prior to testing, intra- and inter-tester reliability were determined. Percent body fat was determined using a three-site skinfold caliper measurement, also using two trained testers. Mean BMI was 24.18 and mean body fat (%) was 22.88 for all participants. As expected, age and BMI were moderately correlated. Left and right multifidus muscle CSA were highly correlated (r = 0.92, p < 0.001). The mixed model ANOVA indicated a significant main effect for gender as males exhibited larger CSA than females. Participants without history of low back pain present with symmetrical multifidus muscle CSA at the L5 level. Clear gender differences in CSA show that males tend to have larger multifidus muscles at the L5 level, indicating a need to establish gender-specific norms for clinicians examining the L5 multifidus muscle.

A review of pesticide exposure and cancer incidence in the Agricultural Health Study cohort

OBJECTIVE

We reviewed epidemiologic evidence related to occupational pesticide exposures and cancer incidence in the Agricultural Health Study (AHS) cohort.

DATA SOURCES

Studies were identified from the AHS publication list available at http://aghealth.nci.nih.gov as well as through a Medline/PubMed database search in March 2009. We also examined citation lists. Findings related to lifetime-days and/or intensity-weighted lifetime-days of pesticide use are the primary focus of this review, because these measures allow for the evaluation of potential exposure-response relationships.

DATA SYNTHESIS

We reviewed 28 studies; most of the 32 pesticides examined were not strongly associated with cancer incidence in pesticide applicators. Increased rate ratios (or odds ratios) and positive exposure-response patterns were reported for 12 pesticides currently registered in Canada and/or the United States (alachlor, aldicarb, carbaryl, chlorpyrifos, diazinon, dicamba, S-ethyl-N,N-dipropylthiocarbamate, imazethapyr, metolachlor, pendimethalin, permethrin, trifluralin). However, estimates of association for specific cancers were often imprecise because of small numbers of exposed cases, and clear monotonic exposure-response patterns were not always apparent. Exposure misclassification is also a concern in the AHS and may limit the analysis of exposure-response patterns. Epidemiologic evidence outside the AHS remains limited with respect to most of the observed associations, but animal toxicity data support the biological plausibility of relationships observed for alachlor, carbaryl, metolachlor, pendimethalin, permethrin, and trifluralin.

CONCLUSIONS

Continued follow-up is needed to clarify associations reported to date. In particular, further evaluation of registered pesticides is warranted.

Farm work exposure of older male farmers in Saskatchewan

BACKGROUND

The average age of farmers in North America is increasing each year. Research has determined that age and health status are both related to increased risk of injury. The purpose of this research was to determine the association of health and medication factors with exposure to farm work in older male farmers.

METHODS

As part of a cohort study to study determinants of injury on Saskatchewan farms, 5,502 farm people associated with 2,386 Saskatchewan farms were surveyed by mail questionnaire during the winter of 2007. The primary dependent variable was average hours per week of farm work. Independent variables included illnesses, age, and medication use.

RESULTS

The mean number of hours worked per week by farmers aged 55 years and older was 48. There was a significant relationship between age and hours worked with each year of age accounting for about 0.85 hr less work per week. Medication use was related to a reduction in weekly work hours during the busy fall season but was not related to work exposure averaged over the whole year. In multivariable linear regression analysis, the main contributing variables to farm work exposure were: retired status (-), working off farm (-), and age (-).

CONCLUSION

The amount of hours older farmers work on the farm is considerable compared to any other occupational category. While there is a declining trend in the amount of work, a 75-year-old farmer still works, on average, about 34 hr per week. Some farmers do appear to self-limit during busy times of the year if they are taking medication.

Leg Strength Comparison between Younger and Middle-age Adults

Although a risk of occupational musculoskeletal diseases has been identified with age-related strength degradation, strength measures from working group are somewhat sparse. This is especially true for the lower extremity strength measures in dynamic conditions (i.e., isokinetic). The objective of this study was to quantify the lower extremity muscle strength characteristics of three age groups (young, middle, and the elderly). Total of 42 subjects participated in the study: 14 subjects for each age group. A commercial dynamometer was used to evaluate isokinetic and isometric strength at ankle and knee joints. 2 × 2 (Age group (younger, middle-age, and older adult groups) × Gender (male and female)) between-subject design and Post-hoc analysis were performed to evaluate strength differences among three age groups. Post-hoc analysis indicated that, overall, middle-age workers' leg strengths (i.e. ankle and knee muscles) were significantly different from younger adults while middle-age workers' leg strengths were virtually identical to older adults' leg strengths. These results suggested that, overall, 14 middle-age workers in the present study could be at a higher risk of musculoskeletal injuries. Future studies looking at the likelihood of musculoskeletal injuries at different work places and from different working postures at various age levels should be required to validate the current findings. The future study would be a valuable asset in finding intervention strategies such that middle-age workers could stay healthier longer.

Hearing problems among a cohort of nationally certified EMS professionals

PURPOSE

The objectives of this study were to estimate the prevalence of hearing problems among a national cohort of emergency medical service (EMS) professionals, determine factors associated with hearing problems, and estimate the percentage of EMS professionals who utilize hearing protection.

METHODS

Utilizing results from a questionnaire, individuals who reported hearing problems were compared to individuals who had not. Multivariable logistic regression was performed to identify variables associated with hearing problems. Finally, items regarding use of hearing protection were assessed to estimate the percentage of usage among EMS professionals.

RESULTS

In total, 1,058 (57%) participants responded to the questionnaire. Of those, 1,024 (97%) who completed the hearing problems question were utilized for analysis. There were 153 (14.9%) cases of self-reported hearing problems. The final logistic regression model included lifetime occupational noise exposure 0.99 (95% CI = 0.9997-1.0002), report of previous back problems (odds ratio (OR) = 2.74, 95% CI = 1.8340-4.1042), large community size (OR = 1.67, 95% CI = 1.1211-2.4843), and minority status (OR = 0.61, 95% CI = 0.3719-0.9867). Finally, 213 (20.8%) individuals reported utilizing some form of hearing protection at their main EMS job.

CONCLUSION

The results from this analysis are the first national estimates of the prevalence of self reported hearing problems among EMS professionals. This study was also the first to estimate the percentage of EMS professionals who self reported the utilization of hearing protection.

Back problems among emergency medical services professionals: the LEADS health and wellness follow-up study

OBJECTIVE

Describe work-life and demographic characteristics associated with reporting recent back pain, and estimate back pain severity among Emergency Medical Services (EMS) professionals.

METHODS

A 58-item postal questionnaire was used to collect relevant health and wellness information from a national sample of EMS professionals. The outcome variables were self-reported pain in the back or legs, and severity of recent back pain as indicated by the Aberdeen Back Pain Scale (ABPS).

RESULTS

There were 470/930 (50.5%) participants who reported one or more days of pain in the back or legs over a 2-week period. The variables most strongly associated with recent back pain and pain severity were prior back problems, self-reported health, and job satisfaction.

CONCLUSION

This study indicated that work-life, health, and demographic characteristics of EMS professionals were associated with reporting recent back pain.

Health, medication use, and agricultural injury: A review

BACKGROUND

Agricultural work in the United States and Canada continues to be one of the most dangerous vocations. Surveillance evidence suggests that older farmers (>60 years of age) are at greater risk of serious injury than their younger counterparts. The purpose of this article was to outline illnesses and medications that may contribute to older farmers' increased risk of agricultural injury and to determine a minimum set of health-related covariates that could be used in farm injury studies.

METHODS

A review of English language literature in Medline, CINAHL, and NIOSH databases was conducted examining disease and medication factors related to farm injury.

RESULTS

Health- and disease-related factors most commonly reported as significantly contributing to agricultural injury included previous injury, hearing problems, depression, arthritis, and sleep deprivation. The use of "any medication" was identified as a significant risk factor for injury in a number of studies. The use of sleep medication was significantly related to injury in two studies.

CONCLUSIONS

Based on the findings, it is recommended that at a minimum, researchers collect information on the prevalence of previous injury, hearing problems, depression, arthritis/muscular-skeletal problems and sleep disturbance as these have been identified as significant risk factors in a number of studies. In addition, where subjects that identify any of these afflictions, further information should be sought on any medications used in their treatment which can add data on disease severity. More research and surveillance activities need to be focused on the older farm worker. This population is critical to the maintenance of the agricultural base in North America and health and safety research initiatives need to address this. By integrating research from the fields of gerontology, occupational health and safety, and injury prevention, innovative interventions could be constructed to assist the aging farmer in the continuation of safe farming.

Self-reported back pain among farm women in southeast Louisiana

This cross-sectional survey details the incidence and predictors of self-reported back pain among farm women from southeastern Louisiana. The sample was obtained from a preexisting data set of a cross-sectional randomized sample of farm women who participated in the Louisiana Farm Family Injury Prevention and Health Initiative research project. The Haddon Injury Model was used as the conceptual framework. Approximately one fourth of the women in the sample reported back pain in the past year. The major findings from logistic regression analysis were that women reported back pain if they were hauling animals to market and had physical health conditions. Implications for nursing practice include assessing the risk of back pain among farm women and providing client education that includes the importance of compliance with recommended health screenings for early detection and treatment of physical health conditions associated with back pain.

Self-Reported Back Pain among Farm Women in Southeast Louisiana

This cross-sectional survey details the incidence and predictors of self-reported back pain among farm women from southeastern Louisiana. The sample was obtained from a preexisting data set of a cross-sectional randomized sample of farm women who participated in the Louisiana Farm Family Injury Prevention and Health Initiative research project. The Haddon Injury Model was used as the conceptual framework. Approximately one fourth of the women in the sample reported back pain in the past year. The major findings from logistic regression analysis were that women reported back pain if they were hauling animals to market and had physical health conditions. Implications for nursing practice include assessing the risk of back pain among farm women and providing client education that includes the importance of compliance with recommended health screenings for early detection and treatment of physical health conditions associated with back pain.

Risk factors for serious injury in Finnish agriculture

BACKGROUND

Previous studies indicate 20% of injuries represent 80% of injury costs in agriculture. To help prevent the most costly injuries, we aimed to identify characteristics and risk factors associated with serious injuries.

METHODS

We analyzed insurance records of 93,550 self-employed Finnish farmers. We ranked injury causes by claim cost and used multiple logistic regressions to identify risk factors for (any) injury and serious injury (injuries exceeding claim costs of 2000 euros).

RESULTS

A total of 5,507 compensated injuries occurred in 2002 (rate 5.9/100 person-years), and 1,167 or 21% of them (rate 1.25/100 person-years) were serious. The causes/sources resulting in highest average claim costs were motor vehicles; stairs, scaffoldings, and ladders; trailers and wagons; floors, walkways, and steps; other structures and obstacles; augers, mills, and grain handling equipment; horses; combines and harvesting equipment; tractor steps; and uneven and slippery terrain. Older age, male gender, higher income level, greater field size, residing on the farm, Finnish language (vs. Swedish), occupational health service (OHS) membership, and animal production were risk factors for injury. The risk factors for serious injury were similar; however, the effects of age, income level, and the raising of horses were more prominent. Language, residence, ownership status, and OHS membership were not risk factors for serious injury.

CONCLUSIONS

Cost-effective prevention efforts should address the following risk factors: older age, male gender, larger income and operation size, livestock production (particularly dairy, swine, and horses), motor vehicle incidents, falls from elevation, and slips, trips and falls.