Association of immunotoxicological indices with lung cancer biomarkers in poultry, grape, and rose farming workers.

Exposure to occupational hazards like dust, pesticides, diesel emission particles, or physical hazards in the agricultural sector is known to cause adverse health effects on farm workers. Our study aimed at addressing the association of immunomodulatory status with plasma levels of lung cancer biomarkers in farming population, attempting to recognition of vulnerable farming group. Blood samples from apparently healthy 51 chicken husbandry, 19 grape orchard, and 21 rose greenhouse workers were subjected to evaluate plasma levels of two representative lung cancer biomarkers, pro-gastrin releasing peptide (Pro-GRP) and cytokeratin fragment 19 (CYFRA 21-1). Peripheral blood mononuclear cells obtained from farmers were used for natural killer (NK) cell phenotyping and cytokines (interferon-gamma, IFN-γ and interleukin-13, IL-13) profiling in the culture supernatant. Compared to the rose greenhouse farmers, the grape orchard and chicken husbandry workers revealed a significantly upregulated plasma Pro-GRP and CYFRA 21-1 level. A low proportion of NK cells was observed among the female grape orchard workers and a lowered IFN- γ:IL-13 ratio was seen in the grape and chicken husbandry workers than the rose workers. Our findings imply that grape orchard and chicken husbandry workers have more disturbed immune homeostasis implicated with augmentation in the levels of lung cancer biomarkers than the rose greenhouse workers.

Association Between Ergonomic Burden Assessed Using 20-Item Agricultural Work-Related Ergonomic Risk Questionnaire and Shoulder, Low Back, and Leg Pain in Korean Farmers.

OBJECTIVES: This study aimed to determine the agricultural ergonomic burden in Korean farmers and to analyze its correlation with musculoskeletal pain. METHODS: In total, 1001 farmers (525 females and 476 males; mean age, 59.6±7.5years) who owned or rented a farm and belonged to an agricultural cooperative unit were recruited. Ergonomic burdens were assessed using a 20-item Agricultural Work-related Ergonomic Risk Questionnaire (20 agricultural works). The presence of musculoskeletal pain (shoulder, low back, and leg/foot), Farm Stressor Inventory, subjective stress index, and agricultural workload (low, moderate, somewhat hard, or hard) were collected using structured questionnaires. RESULTS: Factor analysis of the Agricultural Work-related Ergonomic Risk Questionnaire revealed a four-factor solution: neck and upper limb, trunk and push - pull, machine and heavy lifting, and repetitive trauma. Cronbach's alpha was greater than 0.65. For 18 of the 20 items, there was a significant association with the Farm Stressor Inventory, subjective stress index, and agricultural workload. The most frequent ergonomic burdens were squatting (51.2%), highly repetitive wrist movements (53.5%), shoulder flexion at 45-90° (51.2%), and trunk flexion or twisting at≥45° (48.8%). Ergonomic burdens were significantly different in 13 items between sexes. The musculoskeletal pain was associated with increased agricultural burdens in 10 items in male farmers and 14 items in female farmers. CONCLUSION: Increased agricultural ergonomic burdens were associated with musculoskeletal pain. Ergonomic burden showed different patterns between male and female farmers, with female farmers appearing to be more affected by ergonomic burden than male farmers.

Incidence Rates of Agricultural Machine-Related Injuries in South Korea.

Although agricultural machines are the leading cause of agricultural injury, there are few comparative studies on the injury risks associated with different types of agricultural machines. Therefore, we compared the injury rates and risks of various agricultural machine types in South Korea using data from comprehensive agricultural machine insurance, which is partially paid for by the government. Specifically, we conducted a retrospective cross-sectional study using 2014-2019 data on subscriptions and 2014-2020 data on compensation for personal bodily injury from comprehensive agricultural machine-related insurance coverage. We calculated the agricultural machine-related injury rate for each machine type and analyzed the factors affecting the injury using logistic regression. Between 2014 and 2020, 2061 recorded agricultural machine-related injuries occurred for 338,418 comprehensive agricultural machinery insurance subscriptions. The annual average number of injuries per 1000 agricultural machines was 6.1, showing an annual increase. Multivariate logistic regression analysis revealed that the risk of injury increased with age, which was 2.3 times higher for tillers and power carts than for tractors. There is thus a need for legal safety measures, particularly related to high-risk agricultural machines (e.g., power tillers) and individuals (e.g., older drivers), as well as specific driving licenses and regular inspections of agricultural machinery.

Evaluation of Heat Stress Levels Inside Greenhouses during Summer in Korea.

Farmers working inside greenhouses during summer are at risk of heat-related illness. In this study, we compared the dry-bulb temperatures (DTs) and the wet-bulb globe temperature (WBGT) index inside and outside greenhouses. We then determined the criteria for appropriate working and resting times inside greenhouses. The measurements were performed during the hottest period in 2020 and 2021 for two greenhouses, representative of those commonly found in rural areas. A direct-reading WBGT index meter was used for these measurements, and Automated Synoptic Observing System (ASOS) data were used to obtain regional DT data. DTs inside the greenhouses were significantly higher than the ASOS DTs (p < 0.001). In addition, the August WBGT index inside was significantly higher than that outside the greenhouses (p < 0.001). We found that the temperature during the period between 08:00 and 19:00 exceeded the international threshold of 28 °C for heat-acclimatized workers performing moderate-intensity work, above which heat stress becomes a concern. Our results revealed that the thermal index inside can be significantly higher than that found outside greenhouses. Therefore, when work is required inside greenhouses during the summer, stricter standards and safety measures should be considered.

Ergonomic Improvements to Agricultural Harvest Baskets to Reduce the Risk of Musculoskeletal Disorders among Farmers.

Typical harvesting baskets (TB) are used in various agricultural workplaces; however, no study to date has reported their effect on the musculoskeletal system. Therefore, this study aimed to evaluate the effects of a novel basket with attached rotational handles (RHB) to help alleviate the work-related physical burden of farmers. We analyzed the surface electromyograms (EMGs) of seven muscles, evaluated the subjective discomfort levels and locally perceived discomfort (LPD) scores to investigate the discomfort in the whole body and seven hand muscles, respectively. The EMGs showed that muscle activity decreased in five muscles (flexor carpi ulnaris, extensor carpi radialis, lateral triceps, middle deltoid, and upper trapezius) and increased in two (biceps brachii and erector spinae) when the RHB was used (p < 0.05). The subjective discomfort score for the RHB decreased compared to that for TB (p < 0.001). The LPD scores also decreased, and the RHB and TB scores ranged from 1.25-1.40 and 3.1-3.25, respectively. The use of the RHB may prevent wrist bending, and reduce the activity of certain muscles while increasing the activity of other muscles. Therefore, it is necessary to conduct training and to evaluate the working posture while considering the affected muscles.

Comparison of Overall Immunity Levels among Workers at Grape Orchard, Rose Greenhouse, and Open-Field Onion Farm.

Background: Occupational hazards in crop farms vary diversely based on different field operations as soil management, harvesting processes, pesticide, or fertilizer application. We aimed at evaluating the immunological status of crop farmers, as limited systematic investigations on immune alteration involved with crop farming have been reported yet. Methods: Immunological parameters including plasma immunoglobulin level, major peripheral immune cells distribution, and level of cytokine production from activated T cell were conducted. Nineteen grape orchard, 48 onion open-field, and 21 rose greenhouse farmers were participated. Results: Significantly low proportion of natural killer (NK) cell, a core cell for innate immunity, was revealed in the grape farmers (19.8 ± 3.3%) in comparison to the onion farmers (26.4 ± 3.1%) and the rose farmers (26.9 ± 2.5%), whereas cytotoxic T lymphocyte proportion was lower in the grape and the onion farmers than the rose farmers. The proportion of NKT cell, an immune cell implicated with allergic response, was significantly higher in the grape (2.3 ± 0.3%) and the onion (1.6 ± 0.8%) farmers compared with the rose farmers (1.0 ± 0.4%). A significantly decreased interferon-gamma:interleukin-13 ratio was observed from ex vivo stimulated peripheral blood mononuclear cells of grape farmers compared with the other two groups. The grape farmers revealed the lowest levels of plasma IgG1 and IgG4, and their plasma IgE level was not significantly different from that of the onion or the rose farmers. Conclusion: Our finding suggests the high vulnerability of workplace-mediated allergic immunity in grape orchard farmers followed by open-field onion farmers and then the rose greenhouse farmers.

Occupational Safety and Health Education Experience and Prevention Service Needs among South Korean Farmers: A National Survey.

OBJECTIVE: Objective data on farmers' awareness of occupational safety and health are needed for the development of national policy measures. Yet, relevant research is lacking in South Korea. METHODS: This study investigated occupational safety and health education experience, perceived needs for prevention services, and factors affecting these among South Korean farmers. The data are from a personal-visit survey conducted on 9,970 sample farms nationwide. RESULTS: While 69.9% of the farmers felt the need for agricultural health and safety education and 60.6% were willing to receive it, only 30.3% had at least one educational experience. A total of 51.9% felt the need for professional on-farm services. By group, education experience and perceived need for prevention services were consistently low among women, people aged 70 or older, low-income individuals, or farmers with a farming career duration of less than five years. Experience of safety and health education increased the desire for other prevention services: people who had received safety and health education were 6.4 times more likely to feel the need for education, 5.5 times more willing to participate in education, 2.0 times more likely to feel the need to improve their work environments, and 1.7 times more likely to feel the need for professional on-farm services. CONCLUSION: Despite the high desire for injury prevention services, farmers have had very limited opportunities to receive safety education; measures are also needed for groups whose safety education has been neglected. Further studies on education methods and on-farm services tailored to South Korean farmers are needed.

Analysis of checklists for agricultural safety management.

INTRODUCTION: The current health and safety management system under the Occupational Health and Safety Act has avoided agriculture in Korea. It is important to consider the various safety systems used in agricultural health and safety to develop effective regulations. OBJECTIVE: The aims were to classify and review the items from various checklists using safety systems, such as design, training, etc., ultimately aimed at proposing directions for improving the health and safety of farmers. MATERIAL AND METHODS: Among the retrieved checklists with Google, four were chosen for this study, based on criteria such as the Checklist developed by an international organization, as well as others. Each item on the checklist was categorized using criteria concerning safety systems, developed based on previous studies. RESULTS: The total number of analyzed items was 573, which is 36 more than the actual number of checklist items (537). The proportion of items belonging to the training/procedures system was the highest (32.5%); the second-highest was for the mitigation system - 18.2%.; the third-largest proportion of items was maintenance/inspection - with 14.3%. Items related to the design and human factor systems were 8.2% and 5.6%, respectively. The safety system with the lowest proportion was the warning/notification system - 4.2% of the total items. The proportion of items that could not be classified into safety systems was found to be 16.1%. CONCLUSIONS: A large number of items belonging to the training/procedures system reported as occasionally not effective in prevention of injury were found in the checklists. It appears important to develop checklist items proposing the supplementation of various safety systems, rather than presenting items that are biased towards certain safety systems.

Agricultural injuries among farm and non-farm children and adolescents in Alberta, Canada.

BACKGROUND: Understanding of the specific risk of agricultural injury sustained by different populations of children and adolescents is needed for effective safety intervention. OBJECTIVE: To compare the rates and patterns of agricultural injury incidence (fatal and non-fatal injury) between farm and non-farm children less than 18 years of age in Alberta, Canada. METHODS: A total of 115 378 children (five subgroups: two groups of farm children and three groups of non-farm children) in Alberta were followed from 1999 to 2010 to examine injury incidence using the linkage of three administrative health databases. A recurrent event survival analysis using Cox proportional hazards regression was carried out. RESULTS: A total of 1 849 agricultural injury episodes (1 616 emergency department visits, 225 hospitalizations, and 8 deaths) were identified from 1999 to 2010. The age- and gender-adjusted rate (per 100 000 person years) of agricultural injury was 672.3 for rural-living farm children, 369.4 for urban-living farm children, 180.2 for rural non-First Nations (FN) children, 64.4 for rural FN children, and 23.7 for urban children in descending order. CONCLUSION: Specific strategies for different children's populations to prevent agricultural injuries and to extend agricultural injury controls to non-farming populations are needed.

Agricultural injuries in Korea and errors in systems of safety.

INTRODUCTION: Agriculture is known to be a dangerous industry in Korea, as well as in other countries. According to earlier studies, the root cause of occupational injury can be identified with errors in the various systems of safety, and such identification is helpful for the prevention of occupational injury. OBJECTIVE: The aims of this study were to examine the root causes of cases of agricultural injury in Korea, based on insurance claims and identification of errors in systems of safety. MATERIALS AND METHOD: Using the Korean Mutual Aid Insurance's injury claim database, 277 injury cases were identified, of which 68 were contacted. Root causes were categorized, using the logic tree diagramming method and the systems of safety described in the literature. RESULTS: Seventy-five percent of all injuries were attributable to falls, strangulation, amputation and collision from flying and falling objects. 194 root causes were found for all injuries. The percentages of errors in all the systems of safety for each root cause were 24.7% - training/procedure, 20.3% - design, 11.9% - mitigation, 9.3% - human factor, 6.2% - maintenance/inspection, and 1.0% - warning/notification. The percentage of root causes which could not be categorized due to a shortage of information was 18.6%. CONCLUSIONS: It was found that most agricultural injuries were caused by a complex layer of root causes which were classified as errors in the systems of safety. This result indicates that not only training and personal protective equipment, but also regulation of safety design, mitigation devices, inspection/maintenance of workplaces, and other factors play an important role in preventing agricultural injuries. The identification of errors will help farmers to implement easily an effective prevention programme.

Farm Work-Related Injuries and Risk Factors in South Korean Agriculture.

Agriculture is known to be a risk-filled industry in South Korea, as it is worldwide. The aims of this study were to identify the magnitude of farm work-related injuries and evaluate the association between injury and possible risk factors. Farmers, including farm members (N = 16,160), were surveyed. After excluding 7 subjects with missing data in questions about injury, 16,153 farmer responses were used for the analysis. Of the 16,153 farmers, 3.6% answered having at least one farm work-related injury requiring outpatient treatment or hospitalization during 2012. The proportion of injured men (4.3%) was 1.5 times higher than women (2.9%). From an age perspective, the proportion was 1.3% of those aged 49 or below, 2.7% of those aged 50-59, 4.2% of those aged 60-69, 4.2% of those aged 70-79, and 3.1% of those aged 80 or above. We used a multivariate logistic regression analysis with a stepwise model (forward) for risk factors (gender, age, farm ownership, farm type, work years in agriculture, work months during 2012, night work experience, and work experience under the influence of alcohol). The increased risk of farm work-related injuries significantly remained associated with age, farm ownership, and experience of night work. Further studies should be conducted to consistently identify injury characteristics, especially for old farmers, considering the crop cultivation in Asian countries.

Identifying risk factors of musculoskeletal disorders on Korean farms.

BACKGROUND: Farming is known to pose musculoskeletal disorder risk factors, although how risk factors differ between farmers in various countries is largely unknown. OBJECTIVE: To identify ergonomic risk factors through a qualitative assessment of common tasks performed by South Korean farmers. METHODS: A convenience sample of Korean farmers was videotaped performing typical jobs on farms that produced rice, fruits and vegetables, or raised animals. Ergonomists identified poor ergonomic risk factors that may lead to musculoskeletal disorders including poor postures of the shoulders, wrists, neck, low back, and knees. RESULTS: Severe flexion and lifting of heavy loads was common across farms. While many of the concerning risk factors identified were similar to those in other parts of the world, one was unique in this population - deep knee flexion while weeding, harvesting, and sorting. CONCLUSIONS: Given the Korean farm population is aging at an alarming rate and remains dominated by small farms, many of these potential risk factors may have a continued or increased role in the development of musculoskeletal disorders. While the current study provided the first observational assessment of ergonomic demands on Korean farms, more quantitative and rigorous investigations are needed to establish actual risk factors.

Estimated rate of agricultural injury: the Korean Farmers' Occupational Disease and Injury Survey.

OBJECTIVES: This study estimated the rate of agricultural injury using a nationwide survey and identified factors associated with these injuries. METHODS: The first Korean Farmers' Occupational Disease and Injury Survey (KFODIS) was conducted by the Rural Development Administration in 2009. Data from 9,630 adults were collected through a household survey about agricultural injuries suffered in 2008. We estimated the injury rates among those whose injury required an absence of more than 4 days. Logistic regression was performed to identify the relationship between the prevalence of agricultural injuries and the general characteristics of the study population. RESULTS: We estimated that 3.2% (±0.00) of Korean farmers suffered agricultural injuries that required an absence of more than 4 days. The injury rates among orchard farmers (5.4 ± 0.00) were higher those of all non-orchard farmers. The odds ratio (OR) for agricultural injuries was significantly lower in females (OR: 0.45, 95% CI = 0.45-0.45) compared to males. However, the odds of injury among farmers aged 50-59 (OR: 1.53, 95% CI = 1.46-1.60), 60-69 (OR: 1.45, 95% CI = 1.39-1.51), and ≥70 (OR: 1.94, 95% CI = 1.86-2.02) were significantly higher compared to those younger than 50. In addition, the total number of years farmed, average number of months per year of farming, and average hours per day of farming were significantly associated with agricultural injuries. CONCLUSIONS: Agricultural injury rates in this study were higher than rates reported by the existing compensation insurance data. Males and older farmers were at a greater risk of agriculture injuries; therefore, the prevention and management of agricultural injuries in this population is required.

The Relationship between Injury and Socioeconomic Status in Reference to the Fourth Korean National Health and Nutrition Examination Survey.

OBJECTIVES: This study aims to investigate the relationship between the total injury experience rate and socioeconomic status based on the fourth Korea National Health and Nutrition Examination Survey (KNHANES). METHODS: By analyzing data from the fourth KNHANES conducted from 2007 to 2009, we estimated the injury experience rate according to socioeconomic status, including the occupational characteristics of 11,837 subjects. Setting the injury experience rate as a dependent variable and socioeconomic status as an independent variable, we performed logistic regression to calculate odds ratios reflecting the likelihood of injury according to socioeconomic status while controlling for relevant covariates. RESULTS: In 797 subjects who had injury experience over the past 1 year, 290 persons (36.4%) had a work-related injury. As their income, home value, and educational status increased, their injury experiences decreased. Among occupational groups, the craft, equipment, machine operating, and assembling workers showed the highest rate (10.6%) of injury experience, and the lowest rate (5.7%) was found in the unemployed group. After adjusting for the confounding variables, the experience of injury was significantly related to several socioeconomic factors: high income (OR = 0.54; 95% CI: 0.34-0.86), high home value (OR = 0.65; 95% CI: 0.43-0.96), low education status (OR = 1.28; 95% CI: 1.07-1.52), and specific occupations such as craft, equipment, machine operating, and assembling work (OR = 1.99; 95% CI: 1.60-2.47), skilled agriculture, forestry and fishery work (OR = 1.43; 95% CI: 1.02-2.01), and simple labor (OR = 1.38; 95% CI: 1.04-1.82). CONCLUSIONS: The injury experience rate differed depending on the socioeconomic status. A negative correlation was found between the injury experience rate and income, low home value, and education level. Moreover, a higher rate of injury experience was found in occupation groups and physical worker groups in comparison to the unemployed group and white-collar worker groups. This study would be useful in selecting appropriate priorities for injury management in Korea.

The Relationship between Waist Circumference and Work-related Injury in Reference to the Fourth Korea National Health and Nutrition Examination Survey.

OBJECTIVE: This study aims to investigate the relationship between waist circumference and work-related injury in reference to the fourth Korea National Health and Nutrition Examination Survey. METHODS: By analyzing data from the fourth Korea National Health and Nutrition Examination Survey conducted from 2007 to 2009, we estimated the rate of injury experience according to socioeconomic status, including occupational property, of 8,261 subjects. We performed logistic regression analysis with work-related injury experience rate as dependent variable and waist circumference as an independent variable, Odds ratios (OR) were calculated, which reflect the likelihood of work-related injury experience rate, and 95% confidence interval (95% CI) while controlling for relevant covariates with stratifying by sex, age, nature of injury, site of injury and occupational group. RESULTS: Among 797 persons who had injury experience over the past 1 year, 293 persons (36.8%) had work-related injury experience. After adjusting the confounding variables, the work-related injury was related to abnormal waist circumference (OR = 1.35; 95% CI: 1.02 ~ 1.78). In subgroups, ORs were higher in men (OR = 1.42; 95% CI: 1.02 ~ 1.98), professional, manager, and administrator (OR = 2.41; 95% CI: 1.10 ~ 5.28). Higher rate of injuries were noted in back and waist (OR = 2.92; 95% CI: 1.49 ~ 5.73), and transport accident had increased risk (OR = 1.60; 95% CI: 1.13 ~ 2.28). CONCLUSIONS: Work-related injury rate differed depending on the waist circumference. The abdominal obesity was associated with higher risk of work-related injury. This study would be useful in selecting appropriate priorities for work-related injury management in Korea.