agricultural occupational health and safety: farming families presenting a challenge to wellness

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Agricultural occupational health and safety: farming families presenting a challenge to wellness

Desley Hegney

The Australian Journal of Rural Health © Volume 1 Number 3, May 1993

Agticultural occupational health

and safety: farming families presenting a challenge to wellness by DESLEY HEGNEY

ABSTRACT: Occupational health and safety has become the right of all workers. This right was recognised formally in New South Wales and other Australian States by the introduction of legislation in the form of the Occr~parional Health and Safety Act. Farm (agricultural) occupational health and safety differs from other workplace issues, in that the farm is also the home. Thus occupational exposure affects not only the farmer, but the family living on the farm. This article examines the current state of agricultural occupational health and safety (farm safety) in Australia. Farm hazards such as agricultural chemicals, dusts and zoonoses are discussed in an attempt to ex- amine whether farmers are aware of these health hazards, and whether the introduction of workplace legislation has had the same effect on the health, safety and welfare of farmers.

In discussions about a ‘fair go’ in terms of health,

little was heard, until recently, by those who live in relative isolation from capital cities. Yet, as Emmett states, there is no industry more vital to the Australian economy than the rural industry. ’

Agricultural production is one of the most hazardous occupations in Australia. A study of work-related deaths from 1982 to 1984 revealed the occupational category ‘farming, fishing, hunting and timbergetting’ as having the third highest incidence of work-related fatalities after ‘mining and quarrying’ and ‘transport and communication’ .2 This survey found that the average farm fatality incidence was 19.4 per 100 000, twice the rate for all occupations (8.1 per 100 000). The majority of these were male? as are the majority of all occupational categories. Parton stated that the Hospitals and Health Service Commission in 1983 found that a male agricultural worker has a 50 per cent higher probability of being killed in an industrial accident than the average male worker.3 In the USA, agriculture is one of the most

27

Desley Hegney is a senior lecturer and acting director of the Nursing Research and Teaching

Unit, School of Health, University of New England, Tamworth.

hazardous occupations with no improvement in

the last 30 years.4 Farming, as an occupation, differs from most

in that there is a close relationship between work and lifestyle. As Emmett states - farm people truly live their work.’ Additionally, the place of work is very different from most urban settings in that there may be extreme environmental conditions (floods? droughts) as has been the case in many areas of NSW in the 1991-92 period.5 Other hazards particular to farming are ‘natural’ and introduced contamination of water and soil (eg tetanus and chemical residues), contamination of the air with respiratory hazards (eg grain dust and farm chemical vapours) and hazards from animal handling (eg trauma, zoonoses).

THE FARMING FAMILY

Employment and Hours of Work A typical farmer in Australia is a person who has been born in Australia, is male and self-employed. He is usually assisted by a wife and children5 Employment profiles show that the number of women employed in agriculture has increased since 1983, whereas the number of maIes has decreased by about 5 per cent (see Table 1).

ABS figures also indicate that farm employees work longer hours than other employees in

28 The Australian Journal of Rural Health

Table 1: A profile of male and female employees in agriculture, 1983-1990

Year Males Females

n % n %

290 200 75.41 94 100 24.49

279 300 74.86 93 800 25.14 287 400 72.85 107 100 27.15 278 400 71.3 112 100 28.70 300 400 72.1 116 700 27.98 284 000 70.52 118 700 29.48 269 000 70.70 111 100 29.30

Total

‘000

384.3

373.1 394.5 390.6 417.1 402.7 380.1

1983

1984 1985 1986 1987 1988 1990

Source: ABS, 1991:441

Table 2: Employment profile of agricultural workers, 1985-1987 (‘000)

Employment Category

1985 1986 1987

n % n % n %

Employer male female

Self-employed male female

Employee+ male

female

Helpers male female

38.9 13.5 32.4 11.6 36.2 13.3

15.4 14.4 15.0 13.4 16.0 15.6

150.5 52.4 147.3 52.9 136.4 50.0

59.6 55.7 61.4 54.8 55.5 53.9

92.3 32.1 86.1 30.9 87.6 32.1

26.4 24.6 24.5 21.9 21.9 21.2

5.7 2.0 12.5 4.5 12.6 4.6

5.7 5.3 11.1 9.9 9.6 9.3

Source: ABS, 1988

Australia. For example, farm employees worked an average of 49.3 hours per week in 1990, eight hours a week more than the second highest category, mining. Additionally, farmer’s working hours are increasing, where most other workers’ hours are decreasing.6,7

A striking feature of the agricultural workforce is the large number of self-employed people (see

Table 2) and the rising number of female ‘helpers’. The latter are considered to be a reflection of the current economic situation on farms.

EDUCATION Few farmers have had any formal tertiary education in farming as the farm has been ‘handed on’

from father to son. Most training, therefore, is by experience gained ‘on the job’ rather than through formal channels. A few farmers, and the number is growing, have tertiary education or trade skills in farm work.4

FARMER ATTITUDES TO OCCU- PATIONAL HEALTH AND SAFETY Most farmers are relatively remote from health

services, and, therefore, farm accidents pose special problems. For example, treatment by an ambulance can be more than 45 minutes away, with hospital treatment delayed for one and one-half hours after the ambulance is called. Regardless of the delay in treatment it appears that farmers

Volume 1, Number 3 - May 1993 29

do not rate health and safety as highly as urban dwellers. Studies of farmers’ attitudes to agricultural health and safety in Australia, New Zealand and the USA indicate that, in most cases, farmers place a higher priority on farm production than on safety.8*9,10Despite this, Kendall et al. in a study of farmers in three states of the USA, found that

farmers consider their occupation a dangerous and stressful one.8

Stanford, in a study of Colorado farmers, suggested that farmers are either not aware of the hazards of farming, or consider that hazards are a natural and acceptable risk of their occupation9 Both Hegney and Webster” and Hiscock-Corneylo, who studied farmers in New South Wales and Victoria, found that most of the farmers in the study had a limited knowledge of agricultural occupational health and safety. Emmett also felt that farmers did not rate occupational health issues highly.’ He felt that farmers, when faced

with a choice of damage to their health or pro- ductivity, would choose the latter. All authors felt that farmers had a high acceptance of occupational injury and disease, often wishing to be seen

as ‘hardy’. This ‘hardiness’ may be a result of the

necessity to keep working and may be unique to farmers. It may also be a reflection of the perception of farmers towards health care and health services. Recent studies have shown that farmers often view hospitals and medica! services as a place to visit as a last resort.!

CHALLENGES TO WELLNESS

Influences of Economic Factors on Farm Safety In any industry economic pressures tend to have adverse consequences for occupational health and safety, as less attention is given to safety and there is a tendency to cut corners.’ The current rural crisis brought about by high interest rates, poor seasonal conditions, high farm on-costs and decreased returns: has not only increased stress and stress related illnesses, but has increased the workload for both male and female farmers.‘-:? Additionally, farm women face considerable

pressures as they try to maintain the traditional domestic family role, while being forced to play a greater part in the Iess traditional aspects such as manual work.” The role of a woman as a farm

‘helper’ has increased by 4 per cent since 1983 (see Table 2).

Farm men and women have to work harder and longer to replace the hired help they can no longer afford.12 Additionally, farm women are required to perform more manual work than ever before as most farmers can no longer afford to hire casual labour for routine manual tasks. The manual work which is required has been described by Emmett as extremely hazardous especially as mechanisation has left few safe manual handling tasks.’ Thus mechanisation has increased the hazards of farming and the severity of accidents.

The extra hours that farm men and women work are also seen as increasing occupational risk. These extra hours can lead to fatigue and result in a greater number of accidents. Low, in her study of farmers in the New England Region of NSW, found that the more hours people worked, the more likely they were to have an accident.13

FARM INJURIES AND ILLNESSES

Emmett states that of the 174 000 farms in Aus- tralia in 1987,60 per cent were family operated.’

As was shown in Table 1, the number of people

employed on farms has decreased.6s7 The high proportion of family operated farms,

or self-employed farmers, makes it near to impossible to ascertain the level of agricultural injuries and illnesses, as data on occupational illness and injuries are only available from workers’ compensation figures. The latter are only available for farm employees because of cover- age provisions, thus excluding aImost two-thirds of the farm workforce. The majority of workers (the -self-employed) cannot claim workers’ compensation (as they are not employees), and, therefore, any injuries or illnesses which do occur are not recorded in the formal workers’ compensation system.

The National Occupational Health and Safety Commission’s (Worksafe) study of work related fatalities between January 1982 and December 1984 reported that 34 children were killed on farms in this period. The major causes of child deaths occurred when the children were either

riding on farm machinery or playing in a work area (eg submerged by grain while playing in open silos). Additionally, 210 males and 14 females died from farm accidents. Of the adult deaths,


88 (approximately 40 per cent) involved tractors and/or attached machinery. Another 67 deaths were caused by powered machinery including farm vehicles (27 caused by being drawn into machinery like hay bailers, 40 from machinery

roll overs). Of those who died, 122 were farmers or farm managers and 102 were farm workers.14,15 Worksafe also found that fatalities were more likely to occur in elderly farmers (44 per cent in farmers aged 60 years and over). The reasons for this are unknown, but it appears that farm injury patterns which show a high proportion of the older age group injuries, differ from other injury patterns.

Davidson stated that in 1985-86 there were 9 700 lost-time injuries in the rural sector in NSW. He postulated that as these were only rep- resentative of 36 per cent of the workforce, a possible 27 080 lost-time injuries occurred in NSW during this time. l6 The cost of the 9 700 injuries in 1985-86 was $40 million. Therefore,

a minimum cost in 1985-86 for lost-time injuries which includes the self-employed would have been $111 million.16 McCulloch used NSW Workers’ Compensation figures 1986-87 and ABS Statis- tics on the farm workforce. She stated that in 1986 87 the cost of agricultural injuries in Australia was $400 million which was equal to ‘4.3 per cent of the gross value of farm production in Australia, 1986-87’.17 However, as Davidson

himself points out, it is difficult, and risky, to assume that self-employed people will have the same injury and/or illness pattern as employed workers.16 Additionally, Hegney and Webster found that wage and salaried farm workers had more time off with an injury than self-employed farmers.”

Low, in her study of New England farmers, estimated that the total cost of injuries which occurred over the twelve months, 1990-91, was $102 000 or 205 days (nine hour days) lost to production.13 Emmett found that in NSW in

1985-86, the injury rate for farm workers was 69: 1 000 which is higher than the average of 47:

1 000. In contrast, the illness rate for farm workers was lower than the NSW state average - 6.7: 1 000 in comparison to 8.4: 1 000.’ Addi- tionally, the cost of occupational disease amongst agricultural workers in NSW is higher than that of other occupational groups. In 1989-90, the

WorkCover Authority of New South Wales estimated that the average cost per claim from agricultural workers was $5 200, which is con- siderably higher than the average cost per injury of $3 300.‘* This implies that although the illness

rate is lower, the severity of compensated illness reported by farmers is significantly greater than most other occupational groups.

The causes of farm injuries and disease are relatively well-known by occupational health professionals. Emmett, Clarke, Davidson and Worksafe have identified seven major influences on agricultural health and safety.1~5~16,1g These are:

1. Traumatic injury Traumatic injuries can occur as a result of injuries/death from tractors, machinery, non- mechanised equipment, animals, aircraft, slips, falls and flying objects.’ A study of deaths by Frommer in 1982-83 found that of the 265 farm deaths, 91 were caused by tractors.14 A further 14 deaths resulted from entanglement in machinery.’

2. Ergonomic design of agricultural machinery The design of equipment, sheds, etc in agriculture is reported to be poor.*O This poor design can result in ahigher level of farm accidents than would occur if the machinery were ergo- nomically designed. For example, Low found a higher accident rate in left-handed farmers.13 This may be caused, she feels, by the fact that most agricultural equipment is designed for right-handed people.

3. Biological Farmers are at risk from insects (stings, bites and infestations), have a high risk of tetanus (if not fully immunised) and are exposed to organic dusts which can lead to Farmer’s Lung Disease and asthma. A study by Emanuel4 in the USA found that 8-10 per cent of farmers are serologically positive to Farmer’s Lung Disease. Clarke states that respiratory disease is noted to result in higher than average deaths

in a number of rural regions of NSW.‘l She states that health workers require education on the understanding and management of occupational asthma relating to organic dusts. Zoonoses also pose a problem for farmers. Clarke states that Hydatid disease and


Leptospirosis are particular problems in some climate could be of significance when con-

rural areas.?’ trasting NSW and New Zealand orchardists.

Physical 6. Climatic The most commonly recognised physical hazards are electricity, noise and vibration. Clarke, reporting on the results of hearing screening services for farmers in the New England Region of New South Wales, states that over 60 per cent of farmers have signifi- cant noise induced hearing loss associated with on-farm noise.*l

Chemical exposure Poisoning (either acute or chronic) can occur from agricultural chemicals (pesticides, herbicides, veterinary products and fertilisers)

and other industrial chemicals. Chemicals are extensively used in modern agriculture. For example, Emanuel states that 1 billion pounds of pesticides are used in the USA annually.4 Of this, herbicides account for two-thirds.

Hazards from thermal stress, fire, floods, and solar radiation pose threats to farmer’s health. Solar radiation and the associated risks of skin cancers are a major threat to rural workers in Australia. Bryant states that Australian rural workers are at greater risk from sun induced cancers than any other rural worker in the world. He states that at any one time 125 000 Aus- tralians have some form of skin cancer.23

Rural workers in Australia have been found to wear a minimum amount of clothing, thus increasing the risk of sun related cancers.23

The majority of chemical related illnesses are moderate and chronic rather than severe or acute

poisoning. EmanueI estimates that only one per cent of all pesticide related illnesses are reported in the USA.” The reason for thi,s is

that most farmers do not have regular blood examinations to detect poisoning. The Aus- tralian experience appears to be similar to that of the USA.

7. Psychological, attitudinal and lifestyle factors Farmers have been described as being in-

dependent, hard working people who seldom comp1ain.l The health and safety problems of increasing stress and long hours have been discussed previously. The lifestyle of farmers not only affects general levels of health but can have a direct impact on farmers’ occupa-

tional health and safety.

Hiscock-Corney in her study of Victorian famrers found that none of the 25 workers in the study had ever had a blood test for possible blood chemical or pesticide levels.1° In New Zealand, Stoke found that 28 per cent of those regularly using organophosphates reported symptoms suggestive of poisoning at some time during their working lives.” In NSW in 1984, 156 people were admitted to hospital with poisoning from agricultural chemicals.”

Preventive measures are poorly adhered to as Hegney and Webster found in their study of orchardists in NSW. None of the orchardists in the study regularly used protective equipment during spraying.:’ In contrast: Briggs, in a study of New Zealand farmers, found that 79 per cent of orchardists wear protective equipment when they should.” It is possible that knowledge, availability of equipment or

For example, Brotherhcod states that less than 25 per cent of rural Australians are adequately fit for the work they perform. Mechanisation, he suggests, is largely responsible for falling levels of fitness, because it has taken the ‘healthy, safe aerobic work from many occupations leaving the risky manual handling jobs unmechanised’ .24 However, physical hard work remains a requirement in many rural occupations .

THE LAW AND AGFUCULTURAI, OC- CUPATIONAL HEALTH AND SAFETY

All farmers whether self-employed, employers, helpers, or employees are bound by the various occupational health and safety legislation in each state and territory of Australia, as it is applicable to the ‘occupier’ of the premises.“j This legislation, enacted in 1983 in NSW, aims to increase

the level of occupational health and safety at work by self-regulation. However, as Creighton states, it is only likely to be effective ‘in workplaces where

there is a substantial number of employees and where there are trade unions [which] have a clear


and positive attitude to occupational health and safety’. In the rural sector, he suggests, self- regulation is not a viable option.25

The application of occupational health and safety legislation on farms presents many challenges to the regulators. Isolation alone makes enforce- ment of the legislation costly and difficult.25 Additionally, as Clarke rightly points out, it is difficult to develop regulations for the manufac- turing industries and make them appropriate to farmers.5 Some of the reasons for this, she states,

are:

there is a large diversity of tasks;

the changing and extreme climatic conditions;

the farmers and the family live on the farm (the farm is the home);

farm work, on the whole, is performed alone;

work is affected by seasonal factors; and

the irregularity of the hours worked.5

There appears to be a general consensus that

legal regulation is only a partial solution to health and safety problems facing agricultural workers.25

OPTIONS FOR INCREASING OCCUPATIONAL HEALTH AND SAFETY ON FARMS

Occupational health and safety on farms has been shown to be a complex issue. It appears that there are many solutions which could be introduced at a local level, rather than from gov- ernment intervention. The ministerial advisory group on farm safety has recommended that the national strategy to improve farmer health and safety involve the development of Farm Safety Action Groups at a local or regional level to mobilise local resources.26 A network of Farm Safety Groups has been established across rural Australia, under the guidance of the National Farmsafe Secretariat (Moree), with community health staff and general practitioners playing key roles in this movement.*l

Private practitioners are beginning to work in the area of agricultural occupational health and safety. An example of this is Stocksense, a private farm safety consultancy, which aims to train farmers, universities, schools, producers and

trade organisations in the safe use of livestock handling.27

The organisation of Farmsafety Action Groups and Committees helps to overcome the geographic disadvantage of rural people. Anderson stated at the Farmsafe ‘88 conference in Armidale, New South Wales, that ‘legislation is not the basis for farm safety, rather . . . the industry itself should develop a self-regulatory approach’.28

Another strategy is to involve farm women as agents of change. Clarke suggests that farm women can be used in this capacity to promote and increase awareness of farm health and safety.5

A study by Kendall et al. has found that farmers in the USA wanted occupational health and

safety services available to them in the form of ‘hot lines’, screenings, preventative programs on pesticides, drinking water analysis and identifi- cation of respiratory conditions8 These farmers suggested that farm magazines and agricultural

extension services be used to ‘spread the message’ as well as the more traditional forms of information from medical and health personnel.

CONCLUSION

Farmers and farm workers have been shown to have a high occupational risk. Compounding the problem is the lack of reliable statistics on farm related injuries and illnesses. Although concern about the dangerous nature of farming has been expressed, farmers themselves appear to be more interested in production than health and safety. This may be a reflection of a lack of awareness by farmers of the hazards of their work. On the other hand, it may be an indication of the influ- ence exerted by economic factors, particularly in times of rural crisis.

Legislation which was introduced to improve occupational health and safety practices has not totally corrected the health and safety problems on farms. In fact, many of the farmers who may be aware of the legislation may not be aware of their obligations. Legislation, it appears, is not the sole answer. The emergence of Farmsafety Groups, formed at the regional and local level but coordinated by the National Farmsafe Secre- tariat, should have some effect on agricultural occupational health and safety. The use of the media by these groups may have the desired effect of increasing awareness about health and safety on


farms. The use of ‘local’ input, now used extensively by the Department of Agriculture and Fisheries in NSW, has been shown to increase the acceptance of change in farming areas.

Regardless of what is done, it is obvious that certain disadvantages of rural people will not be overcome quickly or easily as the problem is compounded by poor access to health care and limited workers’ compensation common ‘rights’, things taken for granted by the majority of urban employees. It appears that for some considerable

time, farmers and farm workers will present a challenge to wellness.

REFERENCES

1.

2.

3.

4.

5.

6. 7. 8.

Emmett E. Occupational health and safety in the primary industries -perspectives and problems. Trans. Farmsafe 88, University of New England, Armidale. 26-29 June 1988:2&27. Harrison JE, Frommer MS, Ruck EA, Blythe FM. Deaths as a result of work-related injury in Australia, 1982-1984. MJA 1989:150. Patton K. Cost-benefit aspect of health, occupational health and safety in the primary industries, Trans. Farmsafe 88, University of New England, Armidale. 26-29 June 1988:135-44. Emanuel DA. A case for medical, environmental and safety

screening. American Journal of Industrial Medicine 1990;18:413-19. Clarke LJ. The nature of farm work and the delivery of occupational health services - the experience of the agricultural health unit, Moree. Trans. Farmsafe 88. University ofNew England, Armidale, 26-29 June 1988: 208-19. Australian Bureau of Statistics, 1990. Australian Bureau of Statistics, 1991. Kendall T, Donham KJ, Yoder D, Ogilvie L. The farm fam ily perception of occupational health: amultistate survey of knowledge, attitudes, behaviours and ideas. American Journal of Industrial Medicine 1990:18:427-31.

9. Sanford D. Reaching the difficult audience: an experi-

ment to provide occupational health services to farmers and ranchers in Colorado, USA. American Journal of Industrial Medicine 1990;18:395-403.

lO.Hiscock-Corney LS. Health and safety issues for Victo-

rian farmworkers. The Australian Journal of Advanced Nursing 1989;6:25-28.

1 l.Hegney DG, Webster MED. Health and safety practices of orchardists in the Richmond River Valley of NSW. Trans. 22nd Conference of the Ergonomics Society of Australia, Toowoomba, 1985:30-38.

12.Greaney J. The role of women in alleviating occupational stress on the family farm, Trans. Farmsafe 88, University of New England, Armidale, 26-29 June 1988:317-322.

13.Low J. The incidence of farm injury: results from a pilot survey (in press).

14. Worksafe Australia. Farm Safety. 1991. 15. Worksafe Australia. Farming: the third most dangerous

occupation in Australia. 1991. 16. Davidson B. Deficiencies of workers’ compensation based

statistics and options for improved data collection, Farmsafe 88, University of New England, Armidale, 26-29 June 1988:242-253.

17,McCulloch J. Farm accidents -causes and costs. Trans. Farm Safety Symposium: National Agricultural Resources Outlook Conference, 1991:1-7.

18,WorkCoverAuthority. Workers Compensation Statistics 1989-90, 1991.

19.WorksafeAustralia.FarmSafetyResourceManual. 1991. 20.Bath PR, Webster MED, Lush PD. Pattern and frequency

of work associated illness and injury among dairy and poultry farmers in five regions of NSW. Trans. 22nd Conference of the Ergonomics Society of Australia, Toowoomba, 1985:60-77.

21,Clarke LJ. Personal communication, 1990.

22.Stoke J. Safer use of agricultural chemicals, Trans. Farmsafe 88, University of New England, Armidale, 26-29 June 1988:157-67.

23, Bryant S. The sun, skin cancer and the rural worker, Trans. Farmsafe 88, University of New England, Armidale, 26-29 June 1988:185-94.

24,Brotherhood JR. Physical fitness and rural industry, Trans. Farmsafe 88, University of New England, Armidale, 26-29 June 1988:174-84.

25. Creighton B. Legislative initiatives and improved health and safety. Trans. Farmsafe 88, University of New England, Armidale. 26-29 June 1988:9-19.

26.Worksafe Australia. Ministerial Advisory Group of Farm Safety Report 1989.

27.Todd B. People are animals but animals are not people. Liverpool, NSW: Posh Printing, 1988.

28,Anderson B. Covemote. Trans. Farmsafe 88, University of New England, Armidale, 26-29 June 1988:48.

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