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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 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 The work-related ill health Surveillance Pyramid THOR cases OPRA Occupational physician
Population changes in agricultural workers (Labour Force Survey,UK) BSE ban lifted F&M LFS
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
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
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)
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
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)
Summary of self-reported WRI in agricultural workers (UK) Significantly raised incidence of injuries and prevalence of MSD but take little time off work.
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
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
WRI in agricultural workers reported by clinical specialists (males, UK, 2002-2008)
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
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
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
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)
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
Trends in work-related allergic respiratory diseases in agricultural workers (UK) Estimated annual change 0.92 (0.86-0.99)
Trends in work-related allergic respiratory diseases in agricultural workers (UK) and autumn rainfall
Trends in work-related MSD in agricultural workers (UK) Estimated annual change 0.94 (0.85 - 1.04)
EU Zoonoses Directive 2003/99/EC • EU Zoonoses Regulation 2160/2003/EC • Directive EC646/2007
Targets agreed with DEFRA, FSA, poultry industry and retailers – reduce campylobacter and salmonella - 2001 • Salmonella National control programme in poultry - 2007
Trends in incidence of campylobacter in agricultural and food sectors FSA JWG
Thanks to all the THOR team Raymond Agius Roseanne McNamee Melanie Carder Louise Hussey Sue Turner