Even though considerable attention has been given to the size of the disability community in the United States, few data sources definitively capture either the prevalence or nature of disability, especially within rural areas. There is also considerable ambiguity over the terminology used. One data source, for example, defines a disability as being off work for at least 1 day, while other sources use vague terms such as "total" and "partial" to categorize disability types. Terms such as "rural," "farm," and "agricultural worker" are also not uniformly defined. Consequently, estimating the prevalence of disability within the agricultural work force becomes more of an art form than a science.
Approximately 2.13 million farms and ranches in the United States are responsible for the production of most of the food and fiber consumed and utilized in the United States. These farms and ranches are primarily operated by families that consist of 3.12 million operators and 3.49 million operator household members, many of whom provide both paid and unpaid labor to the operation. In addition, approximately 1.2 million hired agricultural workers are employed in agricultural production on a full-time or seasonal basis. This relatively small proportion of the population has a significant responsibility given the dependency of the entire population on the agricultural products they produce (1,2).
Farm-related injury data have shown that those engaged in agriculture-related activities are especially susceptible to disabling injuries. The National Safety Council has historically classified agriculture as one of the three most hazardous occupations. If injuries involving children in the agricultural workplace were included, agriculture's injury rate would be even higher. Approximately 5% of nonfatal farm injuries that occur each year are severe enough to prevent the farmer from continuing to farm due to a serious permanent disability. Approximately 1300 individuals sustained such injuries in 2003. A greater, though undocumented, number of farmers and ranchers continue to farm following a serious injury in spite of their inability to perform essential work-related tasks due to a permanent disabling condition. Approximately 2% of the full-time farm operators and workers who participated in the National Safety Council's multistate agricultural injury survey had suffered permanent disabling injuries while performing farm-related work (3-5).
According to the United States Bureau of Labor Statistics, as reported by the National Safety Council, for agriculture, fishing, and forestry (not including logging), approximately 130,000 disabling injuries occurred per year in 2000 and 2001. Although frequently used to represent the number of disabling farm-related injuries each year, the definition for disabling injury in these reports included any workers requiring medical treatment or having lost work for more than half a day. The National Institute for Occupational Safety and Health (NIOSH) estimated that the rate of disabling injuries for agricultural workers to be 500 per day and stated that approximately 5% of these injuries result in permanent disability (2,5,6).
For example, farm-related amputations accounted for 2.6% of all reported workplace amputations in 1999 and 11% of all serious farm-related injuries. For the period 1992 to 1999, 344 farm-related amputations were reported per year, which included only those documented by the state departments of labor and reported to the Bureau of Labor Statistics (7,8).
Farmers and agricultural workers are also disabled as the result of non-farm-related or non-work-related injuries. Of the severely disabled farmers and ranchers who contacted the Breaking New Ground Resource Center at Purdue University over the period 1990 to 2000, motor vehicle and recreational-related injuries each accounted for more disabilities than farm-related mishaps.
In addition to disabilities caused by injuries, farmers, ranchers, and other agricultural workers are also affected by health-related disabilities or a combination of disabilities that restrict their ability to perform their jobs and participate fully in daily living activities. A study of Indiana farm operators completed at Purdue University in 1981 revealed that 66% were affected by at least one physical impairment. Over 30% cited musculoskeletal impairments; 25% indicated hearing impairments; 24% cited cardiovascular impairments; and 22% reported respiratory impairments. Over 17% responded that there were work-related tasks on their farms that they were no longer able to perform due to their disabilities, and over 19% said that they were hindered or limited in their ability to perform necessary tasks. Nineteen percent also stated that they required assistance from a neighbor, employee, or family member to perform necessary tasks in their farm operations (9).
A comparison of general and farm population data concerning the nature and scope of physical disabilities suggested that rural and farm populations have a greater proportion of persons with disabilities. Early studies by the National Center for Health Statistics reported that 16.4% of the farm population had experienced some limitation of activity due to chronic conditions, whereas only 10.5% of the total labor force encountered such problems. Back problems were more prevalent among the farm population: 17.7 people per 1000 had displaced intervertebral disks compared to 13.5 people per 1000 for the nonfarm population. The farm population was more severely plagued by arthritis with 130.7 cases per 1000 as compared with 109.2 cases per 1000 for nonfarm people. The Missouri Farmers and Arthritis Project confirmed the earlier findings when it found that one third of farmers surveyed reported that arthritis inhibits some of their activities, and one third said they had reduced their physical level of labor due to arthritis. The Arthritis Foundation-Indiana Chapter stated that farmers are at an increased risk for arthritis-related disability and that the impact can be quite profound in regard to reducing physical strength and ability to perform routine chores (10-12).
Kirkhorn and Schenker (13) noted that the reporting system for occupational illnesses is still inadequate, which makes it almost impossible to accurately track trends in chronic illnesses that are a consequence of agricultural occupational exposure. Despite lower rates of smoking, farmers have an increased prevalence of several acute or chronic respiratory diseases, and there is increasing evidence that endotoxins, which are found in organic dusts from both grain storage and confined animal feeding operations, are significant contributors to these conditions (see Chapter 19). The authors reported that over 700,000 workers spent part of each day working in confined animal feeding operations. The impact of long-term disability due to respiratory diseases is largely undocumented within the agricultural work force, especially with respect to the ability of those affected to continue engaging in productive agricultural work (13).
Apart from injuries and occupation-related diseases, many farm and rural families are affected by congenital or birth defects at levels comparable to the general populations. Farmers and ranchers are diagnosed with such diseases as multiple sclerosis and retinitis pigmentosa, and thousands of rural children are also born each year with developmental disabilities such as cerebral palsy and Down syndrome.
Previous rough estimates of the total number of workers with disabilities participating in agricultural work in the United States range from an unpublished figure of 288,000 to 500,000 reported by the U.S. Department of Agriculture's AgrAbility Program. The U.S. Department of Agriculture (USDA) also reported that over 13 million Americans living in rural areas have chronic or permanent disabilities. These data are considered conservative considering the increased risk of injury for those employed in agriculture (14).
Using the most recent Census of Agriculture data (2002) and applying a conservative value of 20% of the farm and ranch population having a disability that restricts daily living, it is currently estimated that approximately 1.36 million individuals who own, operate, live on, or work on United States farms and ranches are impacted by disability (1,2,9).
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