Farm activities associated with eye injuries in the Agricultural Health Study.

Farmers are at risk for work-related eye injuries, some of which can be very serious. This study describes the farm activities that were related to eye injury in a group of 36 Iowa farmers in the Agricultural Health Study who sustained 40 farmwork-related eye injuries requiring medical advice or treatment. Farm activities of grinding or cutting metal accounted for 11 (27.5%) of the eye injuries, welding for 3 (7.5%), and drilling for 2 (5%). The other 24 eye injuries were related to diverse farm activities. One injury was caused by an animal. Only one injury was caused by a chemical exposure. Foreign body in the eye was the most frequent type of eye injury overall, accounting for 32 (80%) of the eye injuries. Of those, 20 were metallic foreign bodies. Although none of the injuries required hospitalization, 10 eye injuries (25%) resulted in the farmer missing 1 to 5 days of work. At least three injuries occurred while farmers were wearing safety glasses/goggles. These results suggest that farmers are at risk for eye injury from activities such as grinding and cutting metal, welding, and drilling and from other diverse activities on the farm for which eye hazards may not have been anticipated. In addition, these findings have implications for use of appropriate eye protection during all farm activities.

Occupational injuries among workers with diabetes: the National Health Interview Survey, 1997-2005.

OBJECTIVE: To assess associations between diabetes and occupational injury. METHODS: Data from the 1997 to 2005 National Health Interview Survey comprised a sample of 195,284 adult workers. Multivariate logistic regression analysis assessed associations between diabetes and occupational injuries, adjusting for age, sex, race, and education. Additional logistic regression analysis examined the effect of medical therapy and duration of diabetes with occupational injury. RESULTS: There was no significant association between diabetes and occupational injury (adjusted OR = 1.18; 95% CI = 0.86 to 1.61). Subgroups of diabetics who reported no current diabetes therapy (OR = 1.87; 95% CI = 1.01 to 3.47) or duration of diabetes longer than 12 years (OR = 1.83; 95% CI = 1.05 to 3.18) were at increased risk for occupational injury. CONCLUSION: The finding of no overall increased risk for occupational injury among workers with diabetes provides nationally representative results that may be useful to policymakers. Increased risk for occupational injury among untreated diabetics or those with long duration of disease may lead to focused efforts to prevent occupational injuries.

Characteristics of crashes with farm equipment that increase potential for injury.

CONTEXT: Crash fatality and injury rates are higher on rural roadways than other roadway types. Although slow-moving farm vehicles and equipment are risk factors on rural roads, little is known about the characteristics of crashes with farm vehicles/equipment. PURPOSE: To describe crashes and injuries for the drivers of farm vehicles/equipment and non-farm vehicles involved in an injury crash. Passengers are not included in this analysis. METHODS: Injury crashes were included that involved a farm vehicle/equipment and at least one non-farm vehicle reported in Iowa Department of Transportation crash data from 1995 to 2004. Odds ratios were calculated through logistic regression to identify increased odds for injury among drivers of non-farm vehicles and farm vehicles/equipment. We examined frequently occurring crash characteristics to identify crash scenarios leading to the highest odds for injury. FINDINGS: Non-farm vehicle drivers were 5.23 times more likely to be injured than farm vehicle/equipment drivers (95% CI = 4.12-6.46). The absence of restraint use was a significant predictor of injury for both farm vehicle/equipment drivers (OR = 2.85; 95% CI = 1.14-7.13) and non-farm vehicle drivers (OR = 2.53; 95% CI = 1.54-4.15). Crash characteristics increasing the odds of injury for non-farm vehicle drivers included speeding, passing the farm vehicle/equipment, driving on a county road, having a frontal impact collision, and crashing in darkness. Ejection was the strongest predictor of injury for the farm vehicle/equipment driver. CONCLUSION: Non-farm vehicle drivers were much more likely to be injured than farm vehicle/equipment drivers, suggesting that farm vehicle/equipment crash prevention should be a priority for all rural road users. Prevention strategies that reduce motor vehicle speed, assist in safe passing, increase seat belt use, and increase conspicuousness of the farm vehicle/equipment are suggested.

Sleep quantity and quality as a predictor of injuries in a rural population.

This study aimed to assess the association of sleep disturbance and injuries in a rural population of Iowa. Study participants were 1345 adults who were enrolled in the KCRHS. Sleep problems were assessed based on self-reports at the beginning of the study. Injury information was collected by telephone interviews an average of every 6 months from August 1999 to June 2004. Sleeping for less than 7.5 hours increased the risk for injuries by 61% (rate ratio, 1.61; 95% confidence interval, 1.21-2.15) compared with sleeping for 7.5 to 8.5 hours (reference). Snoring frequency/severity and daytime fatigue/sleepiness were not significant in predicting the risk for injuries. Alcohol consumption of 1 to 2 or more drinks per day increased the risk for injuries among those who had sleep problems. Having adequate hours of sleep is important in preventing injuries. Avoiding alcohol consumption would be especially helpful in reducing injuries among people with sleep disturbance.

Hearing loss as a risk factor for agricultural injuries.

BACKGROUND: Previous studies suggested that hearing impairment based on self-report might increase the risk of agricultural injuries. However, self-reported hearing measures may be subject to inaccuracy and subjective perception. We assessed the association of agricultural injuries with hearing loss and other hearing characteristics using measured hearing. METHODS: Study subjects were 150 farmers who participated in the Iowa Certified Safe Farm study. Injury information was collected by telephone interviews at 2-5 month intervals from September 1999 to October 2002. Hearing levels were measured annually using the pure tone audiometry from 1998 to 2002. Adjusted rate ratios of injuries were calculated using the multivariate Poisson regression model. RESULTS: Hearing loss in the better ear (RR = 1.62), hearing asymmetry (RR = 1.67), and fair/poor self-reported hearing (RR = 1.96) were significantly associated with the risk of agricultural injuries. It is notable that self-reported hearing might be a stronger predictor of injuries than pure tone audiometry (PTA). Exposure to noise elevated the risk of injuries in those farmers with hearing loss or hearing asymmetry. The occasional use of hearing protection was significantly associated with agricultural injuries. CONCLUSIONS: This study adds substantial evidence that hearing loss acts as a risk for agricultural injuries. Prevention of hearing loss and noise exposure may be important in reducing the burden of agricultural injuries.

A comparison of self-reported hearing and pure tone threshold average in the Iowa Farm Family Health and Hazard Survey.

BACKGROUND: Self-reported hearing measures are useful for surveying hearing loss in a population because they are short, and easy to administer by either questionnaire or telephone. This study aims to assess the performance of several self-reported hearing measures to identify hearing loss in a group of Iowa farmers. METHODS: The study subjects were 98 male farmers who participated in the Iowa Farm Family Health and Hazard Survey. We tested three self-reported hearing measures; the hearing screening questions, the Rating Scale for Each Ear (RSEE), and the Health, Education and Welfare-Expanded Hearing Ability Scale (HEW-EHAS), which were originally developed and implemented in the National Health Interview Survey. The sensitivity and specificity of the self-reported hearing measures were assessed by comparing them with pure tone threshold averages. These sensitivity and specificity measures were compared between younger and older age groups. RESULTS: The sensitivities of the screening questions, RSEE, and HEW-EHAS were 73.0%, 66.7%, and 53.3%, respectively. The specificities of the self-reported hearing measures were similar, which ranged from 81.4% to 84.8%. The sensitivities of the self-reported hearing measures were higher in the younger age group while the specificities were higher in the older age group. CONCLUSIONS: The results of this study support the use of simple screening questions in identifying hearing loss among farmers.

Risk factors for falls among Iowa farmers: a case-control study nested in the Agricultural Health Study.

BACKGROUND: Farmers are at increased risk for fall-related injury compared with other occupations. Little is known about risk factors for non-fatal falls on the farm. This case-control study, nested within the Agricultural Health Study, aimed to assess risk factors for work-related falls among Iowa farmers. METHODS: A screener questionnaire sent to 6,999 farmers in 1998 identified 79 farmers who reported a fall-related farm injury that required medical advice or treatment in the previous year. Multivariable logistic regression analysis was used to assess several possible risk factors for injury among these farmers compared with 473 farmers with no injury in the previous year. RESULTS: There were significant associations between fall-related farm injury and age between 40 and 64 years (OR = 2.21; 95% CI = 1.20-4.07), doctor-diagnosed arthritis/rheumatism (OR = 2.05; 95% CI = 1.11-3.79), difficulty hearing normal conversation (even with a hearing aid, in the case of those who used one) (OR = 1.82; 95% CI = 1.07-3.08), and taking medications regularly (OR = 1.80; 95% CI = 1.02-3.18). CONCLUSIONS: Aging and health impairments, such as arthritis and hearing difficulties, are risk factors for which accommodations and preventive strategies can be devised to prevent fall-related injuries on the farm.

Workplace accommodations for people with disabilities: National Health Interview Survey Disability Supplement, 1994-1995.

As American workers age, workers with impairments and functional limitations make up a larger percentage of our workforce. This investigation presents data from the National Health Interview Survey Disability Supplement 1994-1995 (NHIS-D) describing the nature of workplace accommodations in the American workforce and factors associated with the provision of such accommodations. Of a nationally representative sample of workers aged 18 to 69 years with a wide range of impairments, 12% reported receiving workplace accommodations. Males (odds ratio (OR) 0.64: 95% confidence interval (CI) 0.53-0.78) and Southerners (OR 0.57; 95% CI = 0.47-0.70) were less likely than others to receive workplace accommodations. Those with mental health conditions were less likely than others to receive accommodations (OR 0.56; 95% CI = 0.44-0.70). College graduates (OR 1.53; 95% CI = 1.22-1.91), older workers, full time workers (OR 3.99; 95% CI = 2.63-3.87), and the self-employed (OR 1.76; 95% CI = 1.28-2.41) were more likely than others to receive accommodations.

Risk factors for animal-related injury among Iowa large-livestock farmers: a case-control study nested in the Agricultural Health Study.

CONTEXT: Although farmers are at risk for injuries from contact with large livestock, few previous studies have examined risk factors for animal-related injuries. PURPOSE: This case-control study, nested in the Agricultural Health Study, aimed to assess risk factors for animal-related injury among Iowa large-livestock farmers. METHODS: A screener questionnaire sent to 6999 farmers identified 116 farmers with large livestock who had an animal-related injury requiring medical advice/treatment in the previous year. Several possible risk factors for injury were assessed by comparing these farmers with 342 farmers who had livestock but were not injured in the previous year. FINDINGS: A multiple logistic regression analysis showed significant associations between animal-related injury and the use of a hearing aid (odds ratio [OR] = 5.4 [95% CI, 1.6 to 18.0]), doctor-diagnosed arthritis or rheumatism (OR = 3.0 [95% CI, 1.7 to 5.2]), education beyond high school (OR = 1.8 [95% CI, 1.1 to 2.8]), and a younger age. Farmers engaged in off-farm work were less likely to sustain animal-related injuries (OR = 0.4 [95% CI, 0.2 to 0.8]). CONCLUSIONS: This is the first study to show associations between animal-related injury and a younger age, hearing difficulties, and doctor-diagnosed arthritis. Hearing loss and arthritis, which are more common among farmers than among other workers, may be particularly important risk factors to address in future preventive studies.

Health risk factors among Iowa farmers.

This study compares the prevalence of the health risk factors for chronic disease and injury among farmers with their prevalence among other workers, using data from the Iowa Behavioral Risk Factor Surveillance System. From January 1999 to December 1999, there were 3,620 adults who participated in the survey. This report focuses on the 2,140 subjects who reported they were working. We calculated the percentage with each health risk factor, the adjusted odds ratio (OR) and the associated 95% confidence interval (CI), comparing the prevalence of health risks among farmers and other workers. Most health conditions and risk factors were similar among farmers and other workers. However, we found that farmers had some protective behaviors. They had better oral health (OR = 0.34, 95% CI 0.20-0.57) and were less likely to smoke (OR = 0.14, 95% CI 0.06-0.29) than other workers. In contrast, we found that farmers reported some high-risk behaviors compared to other workers. They were less likely to have smoke detectors at home (OR = 0.39, 95% CI 0.18-0.82), or to have had stool blood screening for colorectal cancer (OR = 0.41, 95% CI 0.1 7-1.00). These results suggest areas for future research to define targeted preventive interventions in farm communities.

Workforce participation by persons with disabilities: the National Health Interview Survey Disability Supplement, 1994 to 1995.

Using the National Health Interview Survey Disability Supplement of 1994 to 1995, we examined the factors associated with employment among Americans with disabilities. Persons with disabilities who were more educated were more likely to be working. Married men were more likely to work than unmarried men (odds ratio [OR], 1.58). Blacks were less likely to work than whites (OR, 0.56). Persons with disabilities related to cardiovascular disease (OR, 0.23), musculoskeletal disease (OR, 0.37), and respiratory disease (OR, 0.23) were less likely to work than other Americans with disabilities. Among persons with psychiatric disorders, there was considerable variety in the propensity to work. Persons with schizophrenia (OR, 0.24) and paranoid delusional disorder (OR, 0.34) were markedly less likely to work; persons with bipolar disorder (OR, 0.60) and major depression (OR, 0.69) were also less likely to work. Lastly, persons with self-reported alcohol abuse (OR, 1.30) were more likely to work, and persons with self-reported drug abuse (OR, 0.93) were not less likely to work, than others in our study population of Americans with disabilities.