Identifying Farmer Workplace Injury Risk Factors in Ireland Using Farm Accounts Data.

Identification of occupational workplace injury risk factors is dependent on gaining sufficient and reliable data on both injury occurrence and associated workplace factors. Assessing workplace injury risk factors associated with farming is challenged by non-collection, non-reporting, or under-reporting by farmers, particularly those operating family farms in a self-employed manner. A supplementary (or add-on) farm operator (FO) workplace injury survey was undertaken in association with the Irish National Farm Survey (NFS), which is responsible for provision of Irish farm-level data to the European Commission (EC) Farm Accountancy Data Network (FADN). Data from this add-on survey were analyzed in association with farm and socio-economic data routinely collected by NFS as a component of the FADN. The combined data-set was analyzed using both descriptive and inferential statistical techniques including multivariate logistic regression to identify risk factors for occurrence of farm operator workplace injuries (FOWI). FOWI levels were significantly higher on farms where both the FO and their spouse engaged in Off Farm Employment (OFE). More generally, FO injury levels were associated with farm workload and investment levels. The study demonstrates how FADN farm and socio-economic data can be combined with additional FO workplace injury data to identify workplace injury risk factors. The study identifies a risk factor for FOWI occurrence where both FO and spouse engaged in OFE. More generally, it indicates that farm workplace injuries are associated with farm management-related factors.

The impact of a workplace cardiovascular health screening programme 'Farmers Have Hearts' on health behaviour change among Irish farmers.

BACKGROUND: Irish farmers are a high-risk group for cardiovascular disease (CVD) which imposes not only a risk to their health but has more far-reaching implications for occupational health and safety. OBJECTIVE: This study assessed the impact of a workplace health screening and health behaviour change programme among a sub-group of male Irish farmers. METHODS: Data were collected from male livestock farmers (n = 310) who attended health screenings at livestock marts. Participating farmers also received lifestyle advice to prompt health behaviour change. Health behaviour change was tracked by two phone questionnaires at Week 1 (n = 224) and Week 12 (n = 172). All data were entered into SPSS v22 and analysed using chi-square and regression techniques. RESULTS: At Week 12, 48% reported having changed at least one health behaviour. The majority of farmers were referred to their GP and by Week 12, 32% had acted on this advice. Participants most in need of health behaviour change based on adverse health screening results were, paradoxically, the least likely to contemplate or engage in health behaviour change. CONCLUSIONS: Findings demonstrate that whilst workplace health screenings can be a catalyst for behaviour change for some farmers, more follow-up supports are needed to encourage sustainable behaviour change.

From training to practice: the impact of ENGAGE, Ireland's national men's health training programme.

Ireland's National Men's Health Policy recommended developing training programmes tailored to the needs of those working in health and allied health professionals and ENGAGE was developed to meet that recommendation. This study evaluated the impact of ENGAGE on frontline service providers' self-reported knowledge, skills, capacity and practice up to 5-months post training. Between 2012 and 2015, ENGAGE Trainers (n = 57) delivered 62 1-day training programmes to 810 participants. This study was conducted on a subset of those training days (n = 26) and participants. Quantitative methodologies were used to collect pre (n = 295), post (n = 295) and 5-month post (n = 128) training questionnaire data. Overall, participants were highly satisfied with the training immediately post training (8.60 ± 1.60 out of 10) and at 5-month follow up (8.06 ± 1.43 out of 10). Participants' self-reported level of knowledge, skill and capacity in identifying priorities, engaging men and influencing practice beyond their own organisation increased immediately following training (P < 0.001) and, with the exception of improving capacity to engage men and influencing practice beyond their organisation, these improvements were sustained at 5-month post training (P < 0.001). The vast majority of service providers (93.4%) reported that ENGAGE had impacted their work practice up to 5-month post training. The findings suggest that ENGAGE has succeeded in improving service providers' capacity to engage and work with men; improving gender competency in the delivery of health and health related services may increase the utilisation of such services by men and thereby improve health outcomes for men.

Farmers Have Hearts: The Prevalence of Risk Factors for Cardiovascular Disease Among a Subgroup of Irish Livestock Farmers.

OBJECTIVES: Despite international findings that farmers have better health outcomes than other occupation groups, Irish farmers are found to be a high-risk group for cardiovascular disease (CVD). Early detection of CVD through preventive health measurements, such as screening of high-risk groups, can contribute to a reduction of CVD cases. Farmers, however, represent a "challenging" group in terms of engaging in preventive health behaviors. This study examined the prevalence of cardiovascular risk factors among male Irish livestock farmers who participated in heart screening as part of a workplace health intervention. METHODS: In this cross-sectional study, data were collected from a convenience sample (N = 310) of farmers. Consent included permission to analyze the heart screening results and to participate in two follow-up questionnaires by phone at Week 1 (n = 224) and Week 12 (n = 172). All data were entered onto the Statistical Package for the Social Sciences (SPSS version 22) and both descriptive and inferential statistics were compiled. RESULTS: Almost one in two (46%; n = 140) farmers had high blood pressure (≥140/≥90 mm Hg), and 46% (n = 140) had elevated total cholesterol. One third of farmers were found to be obese (35%; n = 110). The vast majority (83%; n = 255) had at least four risk factors for CVD based on the outcomes of the heart screening. CONCLUSION: The study findings in relation to obesity and the prevalence of multiple risk factors for CVD are a particular cause of concern and shed considerable light on the current excess burden of CVD among farmers in Ireland.

Staying Fit for Farming-A Health Booklet Designed for Irish Farmers.

The objectives of this study were to design a health booklet specifically targeted to farmers with clear and understandable messages through the use of simple terminologies, pictures, agricultural references, and farmer-related case studies; and to maximize the profile and reach of the booklet to empower farmers to take increased control of their own health. Seven focus groups were carried out with farmers and professionals from the agricultural sector to explore the health needs of farmers and their attitudes and behaviors in relation to their health. Findings from these focus groups informed the content and design of the booklet "Staying Fit for Farming-A Health Booklet for Farmers." This booklet was launched on 25 September 2013 and received widespread publicity in both print and broadcast media. A high-quality print resolution of the booklet was made available nationally (approximately 70,500 print circulation sales) through the Irish Farmers Journal on 25 January 2014. The journal included a feature on the booklet, encouraging farmers to see the booklet as an important resource for their health and as a long-term source of health information. The booklet has been adopted by the Irish Heart Foundation as a resource for its "Farmers Have Hearts-Heart Health Checks" program. The booklet has helped push farmers' health into the forefront identifying health as a key driver of "staying fit for farming." The approach taken to consult with farmers and farm organizations helped ensure maximum buy-in from the target group to hopefully motivate farmers to take increased responsibility for their own health.

Comparison of uptake of colorectal cancer screening based on fecal immunochemical testing (FIT) in males and females: a systematic review and meta-analysis.

BACKGROUND: Colorectal cancer is the third most common cancer in males and the second in females worldwide. Incidence and mortality are higher in men than women. Colorectal cancer screening is effective in reducing mortality. Internationally, fecal immunochemical testing (FIT) is increasingly being recommended as the primary screening test. This systematic review and meta-analysis aimed to determine whether uptake of FIT screening differs between men than women. METHODS: We searched PubMed and Embase for peer-reviewed articles published in English during 2000-2013 for randomized controlled trials (RCT) or observational studies of screening using FIT that quantified numbers invited and participating by gender. Meta-analysis was performed using a random effects model. RESULTS: Six hundred and eighty-five citations were identified, 19 meeting the inclusion criteria. Random effects meta-analysis found male uptake was significantly lower than female uptake [odds ratio (OR), 0.84; 95% confidence interval (CI), 0.75-0.95; P < 0.01]. This generally persisted throughout subgroup analysis of study design (RCTs vs. observational studies and study quality), screening organization (methods of invitation, number of samples, age range of screening, recommendations, and reminders), and setting. CONCLUSIONS: Meta analysis of FIT screening studies indicates significantly lower uptake among men. IMPACT: Further investigation is required into factors influencing acceptability and participation of FIT screening in both sexes.

The lived experience of low back pain among Irish farmers: case studies.

Low back pain (LBP) is the most commonly reported musculoskeletal disorder (MSD) among farmers. There is limited researching regarding the lived experience of LBP among farmers. Video interviews were conducted with three dairy farmers who reported having a significant episode of LBP. The interview data were transcribed and analyzed, and results were presented in relation to the constructs explored. The farmers experienced their first significant episode of LBP in their late 20s or early 30s and all attributed their LBP to farm work or a farm-related incident. Hours worked per day ranged from 9 to 13 hours. Tasks identified by farmers that they were unable to do due to LBP included physical work, working with sheep, building work, and "certain jobs." Work changes made due to LBP included getting help, slowing down, avoiding strenuous work, carrying smaller loads, mechanizing the farm, using the tractor more, and wearing a back belt for certain jobs. Each farmer had his own way of preventing or managing his LBP, including a mix of active self-management and passive coping strategies such as swimming, using ice, spinal manipulation, and taking medication. The farmers were unable to quantify how much their LBP had cost them directly or indirectly. The case studies illustrate farmers engaging in ongoing work despite significant pain. All of the farmers have adapted at work and engaged in self-management strategies to reduce the occurrence of LBP. Given the rich data produced by these case studies, future case studies are recommended to gain greater insights into farmers' experiences concerning LBP.

Work-related musculoskeletal disorders among Irish farm operators.

BACKGROUND: To establish prevalence, risk factors, and impact of work-related musculoskeletal disorders (WMSDs) among farmers in Ireland. METHODS: In summer 2009, a questionnaire was appended to the Teagasc (Irish Agricultural and Food Development Authority) National Farm Survey (n = 1,110) to obtain data on the prevalence, risk factors and impact of WMSDs amongst farm operators in Ireland. Data were collected by trained recorders and analyzed using chi-square tests, t-tests, Mann-Whitney's U-tests and logistic regression models. RESULTS: The prevalence of WMSDs in the previous year was 9.4% (n = 103), with the most commonly affected body region being the low back 31% (n = 32). Nearly 60% (n = 57) of farmers reported missing at least a full day's work as a consequence of their WMSD. Personal factors evaluated using binary regression analysis, were found not to influence whether or not a farmer experienced a WMSD. However, work-related factors such as larger European Size Units (ESUs, OR: 1.007, CI: 1.002-1.012), greater number of hectares farmed (OR: 2.501, CI: 1.208-4.920), higher income (OR: 1.859, CI: 1.088-3.177), dairy enterprise (OR: 1.734, CI: 1.081-2.781), and working on a full-time farm (OR: 2.156, CI: 1.399-3.321) increased the likelihood of experiencing a WMSD. Working on a full-time farm was the only factor found to independently predict WMSDs in the multiple regression analyses. CONCLUSIONS: This study suggests that the prevalence of WMSDs can be reduced by the application of improved farm management practices. A more detailed examination of the risk factors associated with WMSDs is required to establish causality and develop effective interventions.

Risk factors for musculoskeletal disorders among farm owners and farm workers: a systematic review.

BACKGROUND: A systematic review was undertaken to establish risk factors for the development of musculoskeletal disorders (MSDs) among farmers. METHODS: Comprehensive electronic searches of Pubmed, Web of Science, CINAHL, SCOPUS, EMBASE, Agris Database, and Cochrane Library were carried out using a battery of key words for MSDs and farmers. The studies methods quality was assessed using a standardized checklist. RESULTS: Thirty-three studies fulfilled the inclusion criteria. The median method score was 65% of the maximum attainable score, resulting in 15 studies of higher methodological. Risks were categorized into: Work characteristics (n = 11), personal characteristics (n = 5), and psychosocial factors (n = 5). Spinal MSD risk factors include exposure to working in tree crops, vibration, postural load, being an owner operator, age, education beyond high school, suffering from asthma or depression, having <8 hr nightly sleep, bad quality sleep, and geographic location. Upper extremity MSD risk factors include being an owner operator, dust with pig workers, numbness and coldness in younger milkers and numbness in milkers >43 years, age, and body height in dairy farmers. Lower extremity MSD risk factors include, duration of farming ≥10 years, working >5 hr daily in animal barns, milking >40 cows, years as a dairy farmer, farm work, age, body mass, and female gender. CONCLUSIONS: In exploring risk factors the spine was the most researched body region, followed by lower and upper extremity. Given the variance between studies, it is recommended that future studies focus on specific types of farmers and should explore specific exposures for specific body parts using standardized case definitions.

Prevalence of musculoskeletal disorders among farmers: A systematic review.

OBJECTIVE: To determine the prevalence of musculoskeletal disorders (MSDs) among farmers and to establish the most common regional MSDs reported. METHODS: Comprehensive electronic searches of Pubmed, Web of Science, CINAHL, SCOPUS, EMBASE, Agris Database, and Cochrane Library were carried out using keywords for MSDs and farmers. Pooled estimates of prevalence with 95% confidence intervals were calculated for overall MSD prevalence and the most common regional MSDs reported. RESULTS: Twenty-four studies fulfilled the inclusion criteria and were incorporated into this review. From these studies, life-time prevalence of any form of MSD among farmers was 90.6% while 1-year MSD prevalence was 76.9% (95% CI 69.8-82.7). The majority of studies focused on spinal MSDs with low back pain (LBP) the most frequently investigated. Life-time LBP prevalence was 75% (95% CI 67-81.5) while 1-year LBP prevalence was 47.8% (95% CI 40.2-55.5). The next most common regional MSDs reported were upper (range 3.6-71.4%) and lower extremities (range 10.4-41%). CONCLUSIONS: The systematic review identified the prevalence of MSDs by body region in farmers and established that LBP was the most common MSD, followed by upper and then lower extremity MSDs. Reported trends suggest that the prevalence of MSDs in farmers is greater than in non-farmer populations. Case-definition uniformity among MSD researchers is warranted. More studies are needed regarding upper and lower extremity MSDs, gender, workplace, and task context of MSDs.