A rapid review of leading indicators to measure Australian farm safety culture.

Agriculture accounts for over half of Australia's land use therefore the farmers managing this land need to be safe at work. This paper offers measuring farm safety culture as a way to overcome the stagnation in the trend of fatal farm injury burden. To work towards achieving a way to measure farm safety culture, this research reviewed the leading indicators of safety. Following PRISMA guidelines, we screened for globally significant literature in the field of methodologies to measure safety climate and safety culture. We performed a rapid review of literature resulting in nineteen articles that add to our understanding of how to create and re-adapt existing questionnaires and produce validated metrics. The leading indicators were grouped into 8 dimensions where we found a translational disconnect between safety for organisational structures and safety for family farm businesses. This paper provides recommendations for government, safety regulators, policymakers, and industry of the leading indicators that may be applicable for measuring farm safety culture for Australian farmers.

Modelling the risk of Japanese encephalitis virus in Victoria, Australia, using an expert-systems approach.

Predictive models for vector-borne diseases (VBDs) are instrumental to understanding the potential geographic spread of VBDs and therefore serve as useful tools for public health decision-making. However, predicting the emergence of VBDs at the micro-, local, and regional levels presents challenges, as the importance of risk factors can vary spatially and temporally depending on climatic factors and vector and host abundance and preferences. We propose an expert-systems-based approach that uses an analytical hierarchy process (AHP) deployed within a geographic information system (GIS), to predict areas susceptible to the risk of Japanese encephalitis virus (JEV) emergence. This modelling approach produces risk maps, identifying micro-level risk areas with the potential for disease emergence. The results revealed that climatic conditions, especially the minimum temperature and precipitation required for JEV transmission, contributed to high-risk conditions developed during January and March of 2022 in Victora. Compared to historical climate records, the risk of JEV emergence was increased in most parts of the state due to climate. Importantly, the model accurately predicted 7 out of the 8 local government areas that reported JEV-positive cases during the outbreak of 2022 in Victorian piggeries. This underscores the model's potential as a reliable tool for supporting local risk assessments in the face of evolving climate change.

Some differences but all at risk: Improving farm safety for young people-An Australian experience.

A significant portion of on-farm deaths and injuries in Australia occur among young people working on the farm. Since most Australian farms are still family owned and operated, young people are an integral part of everyday operations and the farm is a place where these young people live, work and play. This paper describes how the international Gear Up for Ag Health and Safety™ program, originally developed in North America, was further developed for a younger Australian audience (ages 12-19) enrolled in agricultural programs at secondary or vocational schools. In addition, we share insight on demographics, self-reported farm safety behaviours, and the most common farm tasks being performed by program participants utilising a pre-survey originally developed for program customisation. Of particular importance were the most common farming tasks reported by this group. The most common tasks performed on Australian farms included a large variety of vehicle use (farm vehicles, motorbikes, and quadbikes) and handling livestock. Females reported operating vehicles and other farm equipment at the same rates as males. Males were more likely to be working with large heavy machinery and driving trucks, while females were more likely to be working with livestock and using horses for stockwork. Both males and females reported low use of PPE and poor safety habits. In future Australian programs, it will be important to address the conspicuous use of motor vehicles, quadbikes, motor bikes and machinery at early ages, and to target gender-specific tasks to reduce risks on the farm.

Child Farm-Related Injury in Australia: A Review of the Literature.

Children on farms have been identified as a population vulnerable to injury. This review seeks to identify child farm-related injury rates in Australia and to determine the key hazards and contributing risk factors. This critical review utilised the PRISMA guidelines for database searching. Research from the year 2000 onward was included as well as earlier seminal texts. Reference lists were searched, and the relevant research material was explored. Our primary focus was on Australian peer-reviewed literature with international and grey literature examples included. Evidence suggests that there is limited Australian research focusing on child farm-related injuries. Child representation in farm-related injuries in Australia has remained consistent over time, and the key hazards causing these injuries have remained the same for over 20 years. The factors contributing to child rates of farm injury described in the literature include child development and exposure to dangerous environments, the risk-taking culture, multi-generational farming families, lack of supervision, child labour and lack of regulation, limited targeted farm safety programs, underuse of safe play areas, financial priorities and poor understanding and operationalisation of the hierarchy of control. It is well known that children experience injury on farms, and the key hazards that cause this have been clearly identified. However, the level of exposure to hazards and the typical attitudes, behaviours and actions of children and their parents around the farm that contribute to chid injury remain unexplored.

Agricultural health and medicine education-Engaging rural professionals to make a difference to farmers' lives.

OBJECTIVE: Despite continued higher rates of workplace injuries, earlier morbidity and mortality and challenging climatic environments, few formal programs focus on the health, well-being and safety of farmers. The agricultural health and medicine unit, developed in 2010, was designed to increase cultural competence and empower rural professionals to improve the health, well-being and safety outcomes of farming populations in Australia. This study aimed to understand the extent to which graduates (2010-2018) use the knowledge and skills gained in their current occupations and identify barriers and enablers faced in implementing them. DESIGN: Mixed-methods descriptive study. SETTING: Graduates were invited to complete an online survey. Following the survey, graduates participated in a phone interview until saturation was reached. PARTICIPANTS: Forty-one graduates completed the survey (31% response rate), and eleven interviews were conducted. INTERVENTIONS: Education in agricultural health and medicine. MAIN OUTCOME MEASURES: Graduates use of knowledge and skills gained from the course and the barriers and enablers they experienced in implementation. RESULTS: The most represented occupations were nursing, medicine and agriculture (farming). Of respondents, 76% agreed their ability to diagnose, treat or prevent agricultural occupational illness or injury had improved. Positively, 42% use course content professionally at least weekly. Fifty-one per cent experienced barriers in implementing their new knowledge, and little evidence of career advancement was observed. CONCLUSION: This study informs the continuous development of the agricultural health and medicine curriculum and highlights the importance of a collaborative and multidisciplinary approach to improving the health, well-being and safety of farming populations. Despite engaged graduates, the continued high workplace mortality, preventable non-communicable disease and challenging climatic conditions highlight the need for strategic prioritisation of farmers' health across health, agriculture and policy settings.

Organophosphate exposure and the chronic effects on farmers: a narrative review.

INTRODUCTION: Organophosphates are a class of insecticides used globally by the agricultural industry for insect control. Acute consequences of organophosphate exposures are well known, while there has been limited research on their long-term effects. The objective of this review was to discuss the health effects of chronic organophosphate exposure in farmers. METHODS: Medline, Scopus and Web of Science were searched to find the relevant articles. Articles published only in English and until December 2018 were reviewed. The selected articles were then categorised as neurological (neurobehaviour, neurodevelopmental, neurological signs and symptoms) or non-neurological subheadings. RESULTS: A total of 53 articles for neurological effects and 17 articles for non-neurological effects were identified. Chronic organophosphates exposure was associated with deficits in the neurobehaviour subsets of attention and short-term memory, increased incidence of neurodegenerative diseases and effects on peripheral nerves and neurodevelopment. However, research to support non-neurological effects such as respiratory symptoms, increased cancer risk, endocrine disruption, cardiac issues, chronic fatigue and infertility was limited. CONCLUSION: Chronic organophosphate exposure was found to affect four of the five areas of described neurological effects in the literature. A large proportion of the research in this area was not methodologically strong, therefore few recommendations can be conclusively made. Future research is warranted to investigate the non-neurological effects of chronic exposure to ensure the occupational risks of low-level chronic exposure are clearly communicated to farmers and farm workers.

A Pest to Mental Health? Exploring the Link between Exposure to Agrichemicals in Farmers and Mental Health.

The current literature acknowledges that occupational exposures can adversely affect mental health. This review seeks to elucidate the current understanding of the effect of agrichemical exposure on mental health in the agricultural sector, including low-dose, chronic pesticide exposure. This scoping review adopted a snowballing and saturation approach. The review highlights inconsistencies in linking poor mental health and pesticide use. While some studies specifically showed that both high- and low-dose pesticide exposure were associated with poor mental health, consistent and rigorous research methods are lacking. The review also proposes terms to delineate exposure types described in the literature. The review outcomes direct efforts to protect the health, wellbeing and safety of farming communities across the globe.

Cholinesterase research outreach project (CROP): point of care cholinesterase measurement in an Australian agricultural community.

BACKGROUND: Australian farmers are routinely exposed to a wide variety of agrichemicals, including herbicides and insecticides. Organophosphate (OP) insecticides are widely used for agricultural production, horticulture and animal husbandry practices. Symptoms of OP toxicity are the results of inhibition of the enzyme acetylcholinesterase (AChE) which is found in many types of conducting tissue in human bodies such as nerve and muscle, central and peripheral tissues, motor and sensory fibres. Cholinesterase can be measured in red blood cells/erythrocytes (AChE) and plasma (PChE). This study aims to explore integration of AChE monitoring into routine health checks for those at risk and also to examine any association between AChE activity and agrichemical use in a Victorian farming community in Australia. METHODS: This was a prospective cohort study, where farmers and non-famers were compared on the levels of AChE at four time points of baseline, 3-4 weeks, 6-weeks and at 9-weeks. Study participants (N = 55) were residents from South West Victoria, aged between 18 and 75 years, spoke English, and had not had a previous known acute chemical accident. A total of 41 farming (had been farming for more than 5 years) and a convenience sample of 14 non-farming individuals met the inclusion criteria. Testing of AChE was repeated for all participants with a maximum of three times over 10 weeks. RESULTS: The integration of AChE monitoring was very well accepted by all participants. There was no significant difference in average AChE activity between farming and non-farming participants (one-way ANOVA p > 0.05) in this study. There was no significant difference between personal use of agricultural chemicals on farm and the levels of AChE at baseline (measurement 1) or any of the follow up periods (p > 0.05). However, the mean activity of AChE was significantly lower within follow up periods [F (2.633, 139.539) = 14.967, p < 0.001]. There was a significant reduction of AChE between the follow up at 3-weeks and 6-weeks period (p = 0.015). CONCLUSIONS: The routine monitoring of AChE may allow for early recognition of chronic low-level exposure to OPs when they are used by farmers, provided a reasonable estimate of baseline AChE is available. This work provides an evidence for recommending the integration of AChE monitoring into point of care (POC) procedures in rural health clinics and quantifying pesticide exposure and personal protection both on the farm and in the home. Farmer engagement is crucial to the successful integration of AChE monitoring into rural health clinics in Australia. TRIAL REGISTRATION: ACTRN12613001256763 .

Cholinesterase Research Outreach Project (CROP): measuring cholinesterase activity and pesticide use in an agricultural community.

BACKGROUND: Australian farmers and their workers are exposed to a wide variety of pesticides. Organophosphate (OP) insecticides are a widely used class of pesticide used for animal husbandry practices (Naphthalophos for sheep dipping, jetting and drench), crop production for pest control (Dimethoate) and in public health (Maldison for head lice). Acute poisonings with this class of insecticide are reported among agricultural workers and children around the globe, due to the inhibition of acetylcholinesterase (AChE). Less is known about chronic exposures. Regular monitoring of erythrocyte AChE will enable farmers to identify potential exposure to organophosphate insecticides and take action to reduce exposures and improve their health and safety practices. This study aims to assess and improve the integration of AChE monitoring into routine point of care health clinics, and provide farming and non-farming people with a link between their AChE activity and their household chemical and agrichemical use. METHODS/DESIGN: The research will target individuals who work on mixed farming enterprises and routinely using OPs (n = 50) and non-farmers (n = 30). Baseline data are collected regarding demographic, health conditions and behaviours, Kessler 10 (K10) scores, chemical use and personal protection. Baseline anthropometric measures include height, weight, hip and waist circumference, body fat analysis and, biochemical analysis of fasted total serum cholesterol, triglycerides, low-density cholesterol (LDL), high-density cholesterol (HDL) and blood glucose. Analysis of erythrocyte cholinesterase (EAChE) activity is also conducted using a finger prick test. Testing of EAChE is then repeated in all participants every 3 weeks for a maximum of three times over a period 10 weeks. Participants are provided with full feedback and counselling about their EAChE activity after each reading and a detailed summary provided to all participants at the completion of the study. Data will be analysed using repeated measures within a general linear model. DISCUSSION: This work will provide an evidence base and recommendations for the integration of EAChE monitoring into Australian rural health clinics, leading to research which will further quantify pesticide exposure both on the farm and in the home, highlighting the importance of sustaining and providing a safe work and home environment for farming communities. TRIAL REGISTRATION: ACTRN12613001256763.