Blood lipid levels in a rural male population.

OBJECTIVES: Farmers have a low risk for cardiovascular disease, which may be related to a favourable blood lipid profile. In order to study the blood lipid levels and evaluate the effect of other cardiovascular risk factors on the blood lipid profile, this cross-sectional study was made. MATERIAL AND METHODS: A total of 1013 farmers and 769 non-farming rural men in nine different Swedish counties were examined, interviewed, and replied to questionnaires. The inter-relationships between different risk factors were analysed using a multivariate linear regression model. RESULTS: The farmers had a significantly more favourable blood lipid profile than the non-farmers although the total cholesterol levels were almost the same for the two groups. In the total study population there were significant positive relationships between total cholesterol level and body mass index (BMI), diastolic blood pressure and smoking. The high-density lipoprotein (HDL) level was positively related to physical workload and alcohol consumption, and negatively related to BMI, waist/hip ratio and smoking. Triglyceride levels showed a positive relationship to BMI, waist/hip ratio and blood pressure. Differences between farmers and other rural males were seen, especially with respect to the effect of physical activity and psychosocial factors. Among the farmers, a negative correlation between the Karasek-Theorell authority over work index and total cholesterol, the low-density lipoprotein (LDL)/HDL ratio and triglyceride levels was observed. CONCLUSIONS: This study indicated that diet is of minor significance for the blood lipid profile, whereas factors such as physical activity, body weight and the waist/hip ratio, smoking, alcohol consumption, and perhaps psychosocial working conditions are major independent factors affecting the blood lipid profile most prominently among farmers, but also among non-farming rural men.

A prospective study of morbidity and mortality rates among farmers and rural and urban nonfarmers.

Farmers are known to have lower morbidity and mortality rates than the mean for other occupational groups in the general population. Whether this is due to the urban-rural health gradient or to occupational factors related to farming is not clear. To explore this issue, we conducted a prospective study of farmers and matched rural and urban referents. Official hospital admission and mortality data for the years 1989-1996 were obtained. The relative risk of being admitted to hospital were 10% higher among rural and urban referents than among the farmers. The biggest differences were seen for mental and cardiovascular disorders. The odds of dying during follow-up did not differ between the two rural groups but were doubled among urban referents. In conclusion, the lower morbidity and mortality rates among farmers are partly due to the urban-rural health gradient but in addition salutogenic factors linked to farming seem to be active.

Psychosocial conditions and access to an occupational health service among farmers.

To determine whether membership in an occupational health service program varies with correlation with psychosocial risk factors, this study was carried out among farmers in connection with a larger investigation of salutogenic factors. The study was based on information collected via questionnaires (answered on location) and standardized interviews. The material consists of 364 farmers or persons engaged in agriculture who had occupational health care and 548 without it. There were clear differences in psychosocial patterns between the groups. Those with occupational health care were less often single and had more education and more social contacts than did those without such care. Eating times were more regular and meals were better in those with occupational health care. Karasek-Theorell's indices for psychological demands and decision latitude at work were also higher in this group. Better-educated farmers and those with larger farms were more often members of an occupational health care program. In addition, this group had fewer psychosocial risk factors.

Differences in the use of health care facilities and patterns of general risk factors in farmers with and without occupational health care programs.

To investigate whether differences in the use of health care facilities and the distribution of risk factors were related to the accessibility of occupational health services, 912 farmers in a large research project were studied. Information was collected from nine different localities in rural areas, using questionnaires, standardized interviews, physical examinations, and blood tests. The results showed that there was hardly any difference in the use of general health care facilities between the groups. Those with occupational health services generally had more medical visits, but also had fewer diagnoses of cardiac disease. Known risk factors were present more often in the group without occupational health services. The work of the occupational health care service and the individual's interest in health questions appeared to be of significance in the way the risk factors were distributed.

Reported health status among farmers and nonfarmers in nine rural districts.

Farmers appear to have a lower morbidity and mortality rate than other occupational groups. Whether this better health is due to exposure to farming or to the well-known fact that rural populations have better health than urban ones, irrespective of occupation, is not clear. To explore this problem, all male farmers in nine administrative areas and age-matched nonfarmers from the same rural areas were sampled and invited to participate in a survey. 1782 (76%) men responded. We found that farmers had somewhat lower rates of outpatient health care utilization for causes other than trauma and fewer hospital admissions. These differences were independent of the urban-rural factor and could not be explained by traditional determinants of health and health care utilization. Other factors, linked to farming or to farmers' lifestyles, are probably involved.

Prevalence of antibodies specific to Puumala virus among farmers in Sweden.

OBJECTIVES: The Puumala virus is the causative agent of nephropathia epidemica, a European form of hemorrhagic fever with a renal syndrome. From its reservoir in bank voles, the virus is spread by airborne transmission to humans. Occupational risks for the acquisition of nephropathia epidemica are not well defined. The prevalence of serum antibodies to Puumala virus was determined for Swedish farmers. From a comparison of the prevalence among farmers from various parts of the country, the assumption that Puumala virus occurs endemically only in the northern and central parts of Sweden was also tested. METHODS: Serum samples from 910 farmers and 663 referents living in various rural parts of Sweden were tested with an enzyme-linked immunosorbent assay, using a recombinant nucleocapsid protein of Puumala virus as the antigen. RESULTS: North of a latitude of 59 degrees N, the prevalence of Puumala virus antibodies was significantly higher among farmers (12.9%) than among referents (6.8%). In the southern areas, antibodies to Puumala virus were rare, and altogether only 2 of 459 persons had antibodies. Seropositive persons did not differ from seronegative ones with regard to blood pressure, and they did not comprise cases of chronic renal disease. CONCLUSIONS: Serological evidence confirmed that the exposure of humans to Puumala virus is firmly restricted to the northern and central parts of Sweden. In addition the evidence indicated that, in this region, farming is associated with an increased risk of contracting hantavirus infection.