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


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    1. Incidence and trends in work-related ill-health in UK agricultural workers Jill Stocks Centre for Occupational and Environmental Health University of Manchester

    2. 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

    3. Population changes in agricultural workers (Labour Force Survey,UK) BSE ban lifted F&M LFS

    4. 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

    5. 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

    6. 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)

    7. 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

    8. 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)

    9. Summary of self-reported WRI in agricultural workers (UK) Significantly raised incidence of injuries and prevalence of MSD but take little time off work.

    10. 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

    11. 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

    12. WRI in agricultural workers reported by clinical specialists (males, UK, 2002-2008)

    13. 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

    14. 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

    15. 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

    16. 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)

    17. 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

    18. Trends in work-related skin diseases in agricultural workers (UK)

    19. Trends in work-related allergic respiratory diseases in agricultural workers (UK) Estimated annual change 0.92 (0.86-0.99)

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

    21. Trends in work-related MSD in agricultural workers (UK) Estimated annual change 0.94 (0.85 - 1.04)

    22. EU Zoonoses Directive 2003/99/EC • EU Zoonoses Regulation 2160/2003/EC • Directive EC646/2007

    23. Targets agreed with DEFRA, FSA, poultry industry and retailers – reduce campylobacter and salmonella - 2001 • Salmonella National control programme in poultry - 2007

    24. Work-related infectious diseases in agricultural workers (UK) FSA NCP

    25. Trends in incidence of campylobacter in agricultural and food sectors FSA JWG

    26. Trends in incidence of reports of diarrhoea and vomiting by occupation

    27. Thanks to all the THOR team Raymond Agius Roseanne McNamee Melanie Carder Louise Hussey Sue Turner