Sources of Hazards and Health Risks

Two health specialty areas dealing with agriculture are worth noting. Agricultural medicine refers to the subdivi­sion of public health and/or occupational medicine included in the training and practice of health profes­sionals. Agromedicine refers to a specialty partnership between agricultural and medical professionals invested in reducing illness and deaths related to agriculture.

Agromedicine has focused on core health areas of trau­matic injury, pulmonary exposures, and agrochemical injury. Table 1 provides a general guide to these agricul­ture-related health risks. Rather than serving as a com­plete guide, the table is designed to highlight the principal exposures and possible manifestations that public health practitioners should be aware of when designing programs to improve health and safety in the agricultural environ­ment (Zejda et al., 1993).

Table 1 Public health practitioners’ guide to health risks in agriculture

Adapted from Zejda JE, McDuffie HH, and Kosman JA (1993) Epidemiology of health and safety risks in agriculture and related industries. Practical applications for rural physicians. Western Journal of Medicine 158: 56-63, amended with permission from the BMJ Publishing Group

Fatal and Nonfatal Injuries. Disabling injuries and accidental deaths represent one of the most disturbing aspects of safety risks in agriculture. Globally 170 000 agricultural workers die each year from traumatic injuries and the fatal injury rate in agriculture is twice that of other industries. Injuries on the farm involve tractor rollovers, machine injuries, animal injuries, and farmyard injuries. An estimated 38 000 children under the age of 20 years who lived on, worked on, or visited farms and ranches were injured in 1998, and approxi­mately 100 unintentional injury deaths occur annually among children and adolescents on U.S. farms (Myers and Hendricks, 2001).

Children account for about 20% of all U.S. farm fatalities and a higher proportion of the total number of nonfatal farm injuries. Farm machinery (including tractors) is the leading cause of fatality to farm youth less than 20 years of age in the United States. Thirty percent of farm machinery-related deaths are among children less than 5 years of age. Drowning is the second leading cause of death on farms with children less than 5 years of age accounting for 32% of the deaths.

The most common injury resulting in death is to the head or brain, accounting for nearly two-thirds of the total. The leading sources of nonfatal injuries are surfaces, animals, and nonindustrial off-road vehicles; and the leading causes of these injuries are falls, off-road transportation accidents, and being struck by objects. The parts of the body most commonly injured are hands, head, and legs and the most frequent types of injury are lacerations, fractures, and scrapes or abrasions.

For all workers, but especially for field workers, fatigue increases the risk of injury. Long hours, early morning hours, and work in very hot conditions all increase fatigue, as does the heavy physical labor entailed in most agricul­tural work. The relative inexperience of young workers also increases their risk of accidents and injury.

Farmers identify stress and overwork as a main reason for forgoing pesticide safety practices and rushing is a well-established risk factor for machine-related injury in a variety of settings. A study of farm injuries in over 1000 U.S. farmers showed that younger age, the presence of hearing loss or joint trouble, and working more hours per day were among the strongest predictors of severe injury (Hwang etal, 2001).