Tractor Driving Among Kentucky Farm Youth: Results from the Farm Family Health and Hazard Surveillance Project

This article documents the extent of children\u27s involvement in tractor operations among a representative sample of Kentucky children living and working on family farms. Specifically, we describe children\u27s exposures to tractor-related work activities, profile their use of the tractor (number of days worked), and assess compliance with generally recommended safety measures, such as using tractors equipped with ROPS (rollover protective structures), avoiding riding as passengers on tractors, and operating tractors on public roadways. Data for this study were collected in 1994 and 1995 as part of the NIOSH-sponsored Farm Family Health and Hazard Surveillance Project (FFHHSP). Despite recognition in the health and safety community of the hazards associated with operating tractors without ROPS on public roadways and with extra riders, these practices remain common among youth on Kentucky farms. Farms with annual incomes greater than $10,000, particularly with livestock commodities, appear to use youth for a greater number of days of tractor operation than other farms. Such farms may be an appropriate target for intervention

Suicides Among Farmers in Three Southeastern States, 1990-1998

Several studies have documented higher rates of suicide among farmers in comparison to other occupational groups, both in the U.S. and internationally. The purpose of this study is to describe the epidemiology of farmer suicides in three southeastern states (Kentucky, North Carolina, and South Carolina) during the nine-year period 1990-1998. Electronic death certificate data were obtained from the National Center for Health Statistics. Over the nine-year period, there were 590 deaths related to suicide (E-codes: 950-959) among farmers (occupation codes: 473, 474, 475, 477, and 479) in the states of Kentucky, North Carolina, and South Carolina. The results of this study confirm the increased rate of suicide mortality among white male farmers in comparison to the total white male population in these three southern states. The increased rate of suicide was significantly elevated among farmers age 25-34 years (RR: 2.07; 95% CI: 1.61-2.67) and among those age 75-84 (RR: 2.04; 95% CI: 1.70-2.45) and age 85 years and older (RR: 2.67; 95% CI: 2.02-3.54) in comparison to the total white male population.The use of a firearm was the primary mechanism of death for the majority (86%) of the cases. Farmer suicide mortality rates in the southeastern U.S. are higher than in Midwestern states. The elevated rate of white male farmer suicides in North Carolina over this time period (35% higher age-adjusted suicide rate in comparison to South Carolina) suggests a need for further investigation to assess the individual, social, and economic factors that may explain this elevated rate. Interventions for the prevention of suicide need to be directed to older male farmers who consistently have higher suicide rates than similar males in other occupations

Farm Work Injuries Among a Cohort of Children in Kentucky, USA

Children residing on farms with livestock may be at an increased risk for work-related injuries, compared to children who work on other commodity farms. This study characterizes children\u27s work tasks on Kentucky farms and assesses whether children who work on beef cattle farms are at an increased risk for farm work injuries. The results of a cohort study of children aged 5-18 years (N=999 at baseline) working on family farms in Kentucky, followed for two consecutive years after an initial enumeration five years previously, found that 70% of the children were involved in animal-related chores. Across all age groups, children on beef cattle farms devoted a greater number of hours per week to farm work, compared to children living on other commodity farms, especially during the school year. For all children in the study, working more than 180 days per year, performing farm work independently, and working on a beef cattle farm (compared to other commodity farm), increased the risk of a farm work injury. However, none of these associations were statistically significant. For male children only, the performance of work tasks independently was significantly associated with a 2.4-fold increased risk (OR = 2.41; 95% CI: 1.15-5.06; P=0.02) for a farm work injury, after controlling for days of working, age, period of data collection, and commodity type of the farm

Preventing Cardiovascular Disease in Kentucky: Epidemiology, Trends, and Strategies for the Future

Cardiovascular disease (CVD) is the leading cause of death in the United States despite dramatic improvements in the treatment of heart disease in recent years. Kentucky leads the nation in the prevalence of several individual risk factors for cardiovascular disease, the prevalence of multiple risk factors, and in cardiovascular mortality. While trends in the prevalence of some of these cardiac risk factors have shown improvement, others have remained unchanged or have worsened. The increased prevalence of obesity and diabetes, especially among young persons, is one of the most worrisome trends. The prevalence of smoking in Kentucky remains high, and has not declined substantially in the past fifteen years. As a consequence of poverty, low educational levels, a high unemployment rate, and often limited access to medical care, select populations in the Appalachian region of the state have among the highest rates of cardiovascular disease in the developed world. In the 2004 Behavioral Risk Factor Surveillance System (BRFSS) report of the Centers for Disease Control and Prevention, Kentucky had met none of the stated objectives related to cardiovascular risk for Healthy Kentuckians 2010. Public health initiatives and interventions directed toward the prevention of CVD in Kentucky must address Kentucky\u27s unique challenges if progress is to be made

Farmwork-Related Injury Among Farmers 50 Years of Age and Older in Kentucky and South Carolina: A Cohort Study, 2002-2005

Farmers in the U.S. are becoming more diverse; the average age of the farmer is increasing, as is the number of women and minority farm operators. There is limited research on injury risk factors in these special populations of farmers. It is especially important to study the risk factors for injury in these growing and at-risk groups. A longitudinal survey was conducted of farmers (n = 1,394) age 50 and older who resided in Kentucky and South Carolina. The questionnaire was administered by telephone and mail surveys four times between 2002 and 2005 to the fixed cohort of farmers, obtained by convenience sample. Approximately half of the cohort was female, and the majority of the cohort worked less than 40 hours per week. This cohort reported a crude, non-fatal injury rate of 9.3 injured farmers per 100 per year. Farmers reporting chronic bronchitis/emphysema (estimated odds ratio [EOR] = 1.57), back problems (EOR = 1.37), arthritis (EOR = 1.31), 3 to 4 restless nights in the past week (EOR = 2.02), or 5 to 7 restless nights in the past week (EOR = 1.82) were at significantly higher odds of sustaining a farmwork-related injury as calculated by the generalized estimating equations (GEE) regression method Farmers operating equipment on highways (EOR = 1.51) or climbing higher than eight feet (EOR = 1.69) were at significantly higher odds of sustaining a farmwork-related injury, and females were at higher risk of injury when performing animal-related tasks (EOR = 3.00) or crop-related tasks (EOR = 2.21). Identified factors associated with farmwork-related injury should better inform agricultural health policies and guidelines for older farmers, such as policies governing the allowable number of hours worked per week and rest breaks, guidelines that advise appropriate types of farm tasks, and ergonomic engineering advances on farming equipment

The Hidden Work of the Farm Homemaker

Despite women’s involvement in agricultural production, the work role of women residing in farm households has not been thoroughly examined. Data collected in 1994-1995 as part of the NIOSH-sponsored Farm Family Health and Hazard Surveillance Project were used to address task issues and health status of farm women in Kentucky. In 1996, the farm woman component of the Kentucky study was replicated in five counties in west Texas, allowing an examination of farm women in two large agricultural states. The Kentucky study employed a two-stage cluster design;the Texas study was based on a systematic quota sample of farms. Both studies selected a sample of women aged 18 years and older living in farm households. A total of 992 women in Kentucky (response rate = 85%) and 665 women in Texas completed a structured 30-min telephone interview on work roles, health status, injuries, and demographics. The results indicated that although 46.4% of the Kentucky respondents and 46.3% of the Texas respondents characterized themselves as farm homemakers, they regularly engaged in farmwork. Reported tasks included work with animals, tobacco-related chores, field irrigation, farm equipment operation, and farm management. Further, women who characterized themselves as homemakers reported rates of farm injuries that were comparable with women who classified themselves in other roles such as full agricultural partners. Role definition may influence the woman’s perception of risk on the farm, preclude participation in farm safety programs, and prevent an accurate occupational medical history. This two-state descriptive study highlights the hidden work role of the farm woman—a role that remains invisible to the farm woman herself—and emphasizes the important occupational exposures that farm women encounter

Missed Work Due to Occupational Illness Among Hispanic Horse Workers

Occupational illnesses are inadequately reported for agriculture, an industry dominated by a vulnerable Hispanic population and high fatal and nonfatal injury rates. Work-related illnesses can contribute to missed work, caused by a combination of personal and work factors, with costs to the individual, employer, and society. To better understand agricultural occupational illnesses, 225 Hispanic horse workers were interviewed via community-based convenience sampling. Descriptive statistics, bivariate analyses, and log binomial regression modeling were used to: (1) describe the prevalence of missed work due to work-related illnesses among Hispanic horse workers, (2) examine work-related and personal factors associated with missed work, and (3) identify health symptoms and work-related characteristics potentially associated with missed work. Key findings reveal that having at least one child (PR = 1.71, 95% CI = 1.03, 2.84), having poor self-reported general health (PR = 0.72, 95% CI = 0.48, 1.08), experiencing stress during a typical workday (PR = 2.58, 95% CI = 1.25, 5.32), or spending less time with horses (PR = 1.87, 95% CI = 1.15, 3.05) are significant predictors of missing work. Interventions can be designed to identify workers most susceptible to missing work and provide resources to reduce absenteeism. Future research should examine work-related illness in agricultural horse production, including personal and work-related factors, in order to diminish occupational health disparities among these workers, who are more likely to be employed in hazardous agricultural work

Different Types of Housing and Respiratory Health Outcomes

Evidence has shown that housing conditions may substantially influence the health of residents. Different types of housing have different structures and construction materials, which may affect indoor environment and housing conditions. This study aimed to investigate whether people living in different types of housing have different respiratory health outcomes. The data from the 1999–2006 National Health and Nutrition Examination Survey were used for the analyses. The types of housing included houses, townhouses, apartments, and mobile homes. Respiratory symptoms included wheezing, coughing, sputum, and dyspnea; respiratory diseases included asthma, chronic bronchitis, emphysema, and chronic obstructive pulmonary disease (COPD). Multiple logistic regression was used to calculate odds ratio (OR) and 95% confidence interval (CI) after adjustment for potential confounding factors. A total of 11,785 participants aged 40 years and older were included in the analyses. Compared with those living in single family houses, participants living in mobile homes were more likely to have respiratory conditions, the OR (95% CI) was 1.38 (1.13–1.69) for wheezing, and 1.49 (1.25–1.78) for dyspnea; whereas participants living in apartments were less likely to have respiratory conditions, the OR (95% CI) was 0.58 (0.36–0.91) for chronic bronchitis, and 0.69 (0.49–0.97) for COPD. Compared with living in single family houses, living in mobile home was associated with worse, whereas living in apartments was associated with better, respiratory health outcomes. Further research is needed to better understand the underlying mechanisms and prevent adverse respiratory effects associated with living in mobile homes

Farm Tractor Safety in Kentucky, 1995

Objective: Tractor rollovers are a major cause of farm injuries and fatalities. The authors used data from a statewide surveillance study to estimate the prevalence of safety features such as rollover protective structures, seat belts, and power take-off shields on farm tractors in Kentucky. Methods: Using data from the Farm Family Health and Hazard Surveillance Project, the authors report on the prevalence of farm tractor safety features by size of farm, by region of the state, by number of tractors per farm, and by tractor age and estimate the prevalence of tractors equipped with rollover protection by region and for the state as a whole. Results: Of the estimated 85,446 family-owned farms in Kentucky with at least one tractor, an estimated 55.6%, or 47,515 farms, do not have a tractor equipped with a rollover protective structure. Few tractors that are 10 years old or older were found to be equipped with seat belts; no tractors that were more than 20 years old were equipped with seat belts. Conclusions: Kentucky, with an estimated 25 to 30 tractor-related fatalities each year, may contribute up to 20% of the total number of farm tractor fatalities in the nation. The overall prevalence of rollover protective structures on tractors in Kentucky is lower than estimates for other states as reported in national survey data. The study\u27s findings suggest the need to target smaller farms with one or two tractors for retrofitting of rollover protective structures and for tractor safety programs

Triazine Herbicide Exposure and Breast Cancer Incidence: An Ecologic Study of Kentucky Counties

The incidence of breast cancer in the United States has steadily increased for the past three decades. Exposure to excess estrogen, in both natural and synthetic forms, has been implicated as a risk factor for the development of this disease. Considerable interest has been focused on organochlorines, such as the triazine herbicides, and their possible role in the initiation or promotion of human breast cancer. To explore this relationship, an ecologic study of Kentucky counties was designed. Exposure to triazines was estimated by use of water contamination data, corn crop production, and pesticide use data. A summary index of triazine herbicide exposure was developed to classify counties into low, medium, or high exposure levels. Data on county breast cancer rates were obtained from the state registry. A Poisson regression analysis was performed, controlling for age, race, age at first live birth, income, and level of education. Results revealed a statistically significant increase in breast cancer risk with medium and high levels of triazine exposure [odds ratio (OR) = 1.14,p\u3c0.0001 and OR = 1.2, p\u3c0.0001, respectively]. The results suggest a relationship between exposure to triazine herbicides and increased breast cancer risk, but conclusions concerning causality cannot be drawn, due to the limitations inherent in ecologic study design