Overview of Hazards for Those Working in Agriculture

Scott Prince

Key words: job task, hazards, injury, illness, allergy, stress

Despite a dramatic shift in agricultural production methods in the developed nations over the past several decades, agricultural work remains one of the most hazardous occupations. In the United States during the 10 years from 1992 to 2002, the annual rate of fatal occupational injuries in agriculture (including forestry and fishing) declined 5%, from 23.9 to 22.7 per 100,000 workers. During the same time period, the rate among those employed in the private sector declined by 21% and, by the end of that period, was 4.2 per 100,000 workers, over five times lower than in agriculture. Injury and illness rates, which are more difficult to estimate, also are significantly elevated for farmers compared to workers in the private sector, though the difference is less pronounced (1-3).

The number of U.S. agricultural workers has been relatively stable over the past decade at approximately 3.3 million, though farming populations, particularly migrant workers, are difficult to count accurately. Whatever the exact number, these workers comprise only a small percentage of the population, which is similar to the situation in other industrialized nations. This is in sharp contrast to the preindustrial age, and the current situation in much of the world, where overall 70% of all workers farm. Fewer farmers means that fewer people are directly aware of the risks of agriculture. With the shift of the population to cities, most people tend to have a romanticized view of rural life and farming as peaceful and healthy. Even the health care providers who care for farmers may not be uniformly aware of the increased risks associated with their patients' occupation (3-6).

The ability to dramatically increase farming productivity, accomplished primarily through mechanization and use of chemicals, is also a significant contributor to the risks faced by those who remain in agriculture. More productivity does not necessarily translate into lower risk for the farmer, particularly for fatal and disabling injuries. While hand tilling and walking behind an animal-powered plow have certain associated hazards, those activities do not have the same risk for sudden, catastrophic injury present in operating mechanized farm equipment, especially earlier models that had little or no safety engineering. Similarly, pest control and the use of fertilizer in the prein-dustrial, prechemical age may have been inefficient, but it gave rise to a narrower range of serious hazards than the substances and methods in use today.

Just as agriculture is possibly the most diverse occupational classification in terms of the wide variation in products, methods, and job tasks, agricultural hazards are present in a multitude of ways—obvious or subtle, acute or chronic. Table 3.1 lists job tasks and associated hazards to provide a brief overview of the most common risks faced by farmers. It is not meant to be as detailed as the discussions in the following chapters but outlines categories of risk by general farm activities and exposures.

Table 3.1. Common agricultural hazards by job task.

Job task

Hazards

Outcomes

Primarily crop-related Field preparation, cultivation, harvesting Handling pesticides, herbicides

Handling fertilizer Working in grain elevators

Working in silos Handling cotton Harvesting tobacco

Primarily animal-related Contact with animals in general (10-13)

Working with large animals Working in animal confinement buildings (including manure pits) (12)

Inorganic dust (silica) (7)

Allergens

Chemical exposure

Ammonia

Organic dust (7) (allergens, endotoxins, irritants) Oxygen displacement Entrapment Nitrogen oxides Cotton dust/endotoxin Nicotine

Bites, scratches, stings Allergens Infectious agents Feed additives Pesticides

Being stepped on/ pinned

Organic dust Hydrogen sulfide Ammonia Methane Disinfectants Carbon dioxide Inhalation of manure

Silicosis

Dermatitis, respiratory effects Acute: toxicity Chronic: neuropathy

(organophosphates) Possible: cancer, adverse reproductive events (4,8) Burns, respiratory damage Allergies, other respiratory diseases Asphyxia Trauma, asphyxia Silo-fillers' lung Byssinosis

Green tobacco illness (9)

Trauma, infection, envenomation Dermatitis, respiratory effects Zoonoses

Dermatitis, other toxicity Acute/chronic toxicity

(see above) Trauma, crush injuries

Allergies, other respiratory disease

Asphyxia, pulmonary edema Respiratory irritation, disease Asphyxia, explosion Dermatitis, respiratory disease Asphyxia

Asphyxia, pneumonia

Table 3.1. Common agricultural hazards by job task. (continued)

Job task

Hazards

Outcomes

Handling hay/straw/feed

Moldy dusts

Farmers' hypersensitivity

Veterinary

Anesthetic gases/

pneumonitis (7)

treatment (11,12)

medications

Acute systemic toxicity,

Ionizing radiation

dermatitis

Laser

Burns, tissue damage, cancer

Burns

Primarily machinery-related

Loud processes (common

Noise

Hearing loss, increased risk of

in machinery tasks)

injury (loss of situational

awareness)

Operating electrical

Electrical shock

Burns, electrocution

equipment

Fire

Burns, smoke inhalation

Operating gasoline/diesel

Heat

Burns

equipment

Fire

Burns, smoke inhalation

Carbon monoxide

Carbon monoxide poisoning

Diesel fumes

Respiratory irritation

Driving tractor/other

Rollover

Trauma

vehicle

Falling from seat

Trauma

Collisions (MVA)

Trauma

Chronic vibration

Hip arthritis

(posture)

Operating field implements

Entrapment

Trauma

Operating hydraulic

Wet surfaces: falls

Trauma

systems/pressure

High pressure fluid

Injection injury, infection

washers (14)

Welding

Welding fumes

Acute: welding fume fever

Ultraviolet (UV) light

Chronic: metal toxicity/lung

Heat/fire

disease

Acute: UV keratitis/flash burns

Chronic: cataracts

Burns, smoke inhalation

Other general tasks/exposures

Strenuous physical work

Ergonomic stress

Cumulative trauma syndrome

Outdoor work

UV radiation

Acute: sunburn

Heat

Chronic: skin damage/cancer,

Cold

cataracts

Lightning

Dehydration, cramps,

Noncrop plants

hyperthermia

Frostbite, hypothermia

Burns, electrocution

Allergy, dermatitis

Work at heights

Falls

Trauma

Using tractors and other vehicles, operating power equipment, and working with large animals are the primary farm activities associated with traumatic injury. The majority of agricultural fatalities involve tractor-related injuries, and the annual rate of fatal injuries per tractor has remained around

8 per 100,000 for the most recent decade for which there are data. Tractor rollovers account for 50% to 60% of these fatalities. This is particularly troubling since the majority of these deaths could be prevented with the use of rollover protective structures (ROPS) and seat belts. Runovers accounted for approximately another quarter of the tractor-related fatalities, with children, either nearby or as extra passengers, at particular risk (3,4,6,7,15-18).

Farm machinery and equipment also require maintenance and repair, much of which is performed by the farmer. Because this is an occasional activity, the skill, understanding of hazards, and use of engineering controls or personal protective equipment may be lower for the farmer than for someone who performs these same jobs full-time. However, the farmer is also less likely to become complacent about performing hazardous tasks or to suffer effects associated with chronic exposure.

While causing fewer fatalities than machinery, contact with animals, in particular cattle, horses, sheep, and hogs, is a leading factor in total agricultural injuries. Animal handlers also face increased risk of zoonotic infection. These diseases are usually specific to certain types of animals and/or exposure circumstances and may be transmitted by bite, scratch, inhalation, ingestion, or skin contact. Certain zoonotic infections, such as brucellosis and orf, are associated with farm animals; others, such as rabies and Lyme disease, are associated simply with working outdoors (1,11,13,19).

The increased use of high-density animal confinement buildings increases risk for several of the zoonoses and also elevates the risk for other toxic exposures and allergic conditions. Both animal and crop-related organic material cause a wide spectrum of allergic conditions. The division of allergic cause by either plant or animal becomes somewhat arbitrary, as grain dust contains insect parts, animal dander, and feces, while feeds and bedding material from plant sources may cause allergies in animal handlers. Molds and bacteria in the farm environment also can be allergenic, especially in the high levels encountered in grain or animal confinement enclosed settings (7,10).

Chemical toxicity can result from animal care activities involving feeds, pesticides, animal wastes, and veterinary care. Pesticides, herbicides, fertilizers, silica, endotoxins, and decomposition gases are common crop-related chemical exposures. These exposures affect a variety of organs, especially the skin and lungs, and may result in acute and chronic diseases. Research has also begun to focus on the use of agrochemicals and possible associations with both cancer and adverse reproductive outcomes (8).

Factors affecting the health of those in agriculture extend beyond the physical, biological, and chemical hazards listed in Table 3.1. Stress remains a significant problem for rural areas in general and for farmers in particular. Strenuous working conditions, the financial uncertainty inherent in agriculture, and a relative social isolation with a lack of support services are a few of the stressors that can contribute to psychological pathology. Access to health care for farm workers can be limited by geography, cultural issues, or financial considerations. Special population groups common in agriculture—

children, the elderly, migrant workers, and others—have greater risks for certain farm-related health problems. As the multiple components of agricultural health and safety become more fully understood, modifications to current prevention efforts should improve the health of this population (4,20-22).

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