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Incidence and trends in work-related ill-health in UK agricultural workers. Jill Stocks Centre for Occupational and Environmental Health University of Manchester. THOR specialist. Not reported by specialist. Seen by a general practitioner (GP). No medical consultation. THOR-GP. SWI.

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slide1

Incidence and trends in work-related ill-health in UK agricultural workers

Jill Stocks

Centre for Occupational and Environmental Health

University of Manchester

slide2

THOR specialist

Not reported by specialist

Seen by a general practitioner (GP)

No medical consultation

THOR-GP

SWI

The work-related ill health Surveillance Pyramid

THOR cases

OPRA

Occupational physician

slide4

Self-reported work-related ill health in agricultural workers (England and Wales)

  • Average days lost per worker per year (3 year average):
  • All industries 0.81days
  • Agriculture 0.41 days*
  • Residential care activities+ 2.16 days
  • Wholesale trade 0.31
  • Professional, scientific and technical activities: 0.33
  • *significantly lower than all industries

+ Residential care for learning disabilities, mental health and substance abuse

Estimated days (full-day equivalent) off work and average days lost per (full-time equivalent) worker due to self-reported illness caused or made worse by current or most recent job, by industry, for people working in the last 12 months, averaged 2009/10 - 2011/12

slide5

Self-reported work-related ill health in agricultural workers (England and Wales)

  • All work-related ill health
  • Average prevalence rate
  • 3510 (2580-4430) per 100 000 workers (2009-2012)
  • Average incidence rate
  • 1430 (830-2040) per 100 000 workers (2006-2009)*
  • Not significantly different to all sectors
  • *too few to estimate since 2009
slide6

Self-reported work-related ill health in agricultural workers (England and Wales)

  • MSD
  • Average prevalence rate
  • 2630(1840-3420) per 100 000 workers (2009-2012)
  • Significantly higher than all sectors
  • Incidence - insufficient reports
  • Stress/anxiety
  • Prevalence and incidence - insufficient reports
  • (inconsistent with suicide rates)
slide7

Self-reported work-related injuries in agricultural workers (England and Wales)

  • Work related injury in last 12 months
  • Incidence
  • 3840 (2790-4890) per 100 000 workers (2009-2012)
  • Significantly higher than all other sectors
  • Average days lost per worker per year due to injury
  • 0.24 (0.084-0.40)
  • Not significantly different to all sectors
slide8

Fatal injuries in agriculture (England and Wales)

  • 41 fatalities (2011-2012)
  • (6 non-workers; investigated by the HSE)
  • Worst fatal accident rate of all sectors
  • 15-20% fatal accidents (1.5% population)
slide9

Summary of self-reported WRI in agricultural workers (UK)

Significantly raised incidence of injuries and prevalence of MSD but take little time off work.

slide10

The Health and Occupation Reporting Network (THOR)

  • Reports of work-related ill-health
  • Dermatologists, Respiratory specialists, Psychiatrists, Rheumatologists, GPs, OPs, Infectious disease specialists
  • Core and sample reporters
  • Denominators – GP, OPRA, LFS
  • Standardised incidence rate ratios mitigate the uncertainty in the exact population covered by THOR
slide11

WRI reported by GPs in agricultural workers (2006-2012, UK) to THOR

  • 3 year average incidence per 100, 000 workers
  • All WRI - 2800 (SWI - 1430)
  • MSD - 2035
  • Mental ill-health - 121
slide13

WRI in agricultural workers reported by clinical specialists (UK)

  • Significantly relative to all work related disease
  • Skin cancer
  • Allergic contact dermatitis
  • Asthma
  • Allergic alveolitis
  • MSD
  • Significantly relative to all work related disease
  • Long latency respiratory disease
  • Irritant contact dermatitis
  • No significant difference
  • Mental ill-health
  • Infectious diseases
slide14

Ranking of causes of MSD in agricultural workers (UK, all physicians)

1. Lifting/bending/digging/manual work

2. Use of tools/heavy machinery

3. Animal related—not accidental

4. Accidents

slide15

Ranking of causes of asthma and allergic alveolitis in agricultural workers (UK, all physicians)

1. Hay/straw

2. Seeds/grains

3. Birds/animals

4=. Fungal agents

4=. Agricultural chemicals

5. Plants

slide16

Ranking of causes of contact dermatitis in agricultural workers (UK, all physicians)

1. Plants

2. Wet and dirty work

3. Nickel and/or chromates

4. Rubber found in boots, gloves and milking equipment

5. Soap/detergents/disinfectants

6. Colophony (pine resin)

slide17

Method for analysing trends in incidence

  • Two-level longitudinal negative binomial regression model with random effects1
  • Outcome variable (dependant) = no of cases per reporter per month
  • Main predictor = time
  • Adjusted for seasonality, first month of reporting, population offset
  • Incidence rate ratios relative to base year
  • Controlled ITS used to evaluate interventions

1McNamee R et al OEM 2008: 65; 808-814

slide19

Trends in work-related allergic respiratory diseases in agricultural workers (UK)

Estimated annual change

0.92 (0.86-0.99)

slide20

Trends in work-related allergic respiratory diseases in agricultural workers (UK) and autumn rainfall

slide21

Trends in work-related MSD in agricultural workers (UK)

Estimated annual change

0.94 (0.85 - 1.04)

slide22

EU Zoonoses Directive 2003/99/EC

  • EU Zoonoses Regulation 2160/2003/EC
  • Directive EC646/2007
slide23

Targets agreed with DEFRA, FSA, poultry industry and retailers – reduce campylobacter and salmonella - 2001

  • Salmonella National control programme in poultry - 2007
slide27

Thanks to all the THOR team

Raymond Agius

Roseanne McNamee

Melanie Carder

Louise Hussey

Sue Turner