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Acute and Chronic Disability Among US Farmers and Pesticide Applicators:

Acute and Chronic Disability Among US Farmers and Pesticide Applicators: The National Health Interview Survey O Gómez-Marín, D Zheng, W LeBlanc, D Lee, LE Fleming, F Ma, T Pitman, D Jane (University of Miami School of Medicine, Miami, FL, 33136) Acknowledgements :

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Acute and Chronic Disability Among US Farmers and Pesticide Applicators:

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  1. Acute and Chronic Disability Among US Farmers and Pesticide Applicators: The National Health Interview Survey O Gómez-Marín, D Zheng, W LeBlanc, D Lee, LE Fleming, F Ma, T Pitman, D Jane (University of Miami School of Medicine, Miami, FL, 33136) Acknowledgements: Data: Inter-University Consortium for Political & Social Research, US Dept of Health & Human Services, National Center for Health Statistics Funding: National Institute of Occupational Safety & Health (NIOSH)-funded R01 0H03915-01; National Institute of Occupational Safety & Health (NIOSH)-funded Deep South Agricultural Center (University of South Florida) Abstract Background: To establish and apply a methodology to assess predictors of health status and acute and chronic disability for farmers and pesticide applicators compared to all other US workers using the 1986-1994 National Health Interview Surveys (NHIS). Methods: After adjustment for sample weights and design effects using SUDAAN, several measures of acute and chronic disability and health status were modeled using multiple logistic regression. Results: Farmers were, on average, significantly older than the rest of the US workforce. After adjusting for age, gender, race-ethnicity, and education, compared to all other US workers (n = 453,219), farmers (n = 9576) and pesticide applicators (n = 180) were more likely to be male, White, Hispanic, and less well educated; farmers were significantly less likely to report acute and chronic disability and poor health, while pesticide applicators were more likely to report chronic disability and poor health. Conclusions: Given the cross sectional nature of the data and the significant job demands of farming, both leading to a relative healthy worker effect, the present results indicate that at any point in time, compared to other US workers, farmers are in general healthier, whereas, despite the small numbers, pesticide applicators have similar or poorer health. Methods The Study Objectives were to evaluate the Acute and Chronic Disability and the Health Status of pesticide exposed workers (e.g. farmers and pesticide applicators) compared to all other US workers during the same time period using pooled NHIS annual Cross Sectional data. The National Health Interview Survey (NHIS) is an annual probability sampling of the US civilian population. Between 1986-1994, 450,000 US workers > 18 yrs reported employment during the 2 weeks prior to the interview. Morbidity conditions, as well as multiple demographic variables were available including: age, gender, race, ethnicity, education, family income, and geographic region. For these analyses, Acute Disability (<2 Weeks) was defined in terms of: Days Restricted Activity, Days in Bed, Days Lost Work; Chronic Disability (<12 Months) in terms of: Doctor Visits, Hospitalizations; and Health Status in terms of: Reported Health Condition and Self Rated Health. Analyses were performed using the multiple logistic regression procedure in SUDAAN to adjust for sample weights and design effects as well as covariates. Proxy information and interactions were evaluated. • Conclusions • The NHIS population-based sample of US workers is appropriate for assessing acute and chronic morbidity issues as well as the healthy worker effect and other biases. • Compared to all other US workers, acute and chronic disability analyses showed that these pesticide-exposed workers had a higher proportion of males, Whites, Hispanics, and were less well educated. However, farmers in general were significantly less likely to report acute and chronic disability and poor health (although self reported Health Assessment was poor), while pesticide applicators were more likely to report chronic disability and poor health. Of note, Non Hispanic Older Female Workers of Lower Education were the most at risk for both Acute and Chronic Disability. • Limitations: Self Report and Proxy information; Access to Care and Self Employment (Disability); Lack of individual exposure measures; Cross Sectional data; and Confounding.

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