PART I: INTRODUCTION

A.                Context

It is widely recognised that farms are dangerous places to work.  Farmers are constantly at risk from occupational health problems such as farmers’ lung, arthritis, hearing loss and skin cancer.  They are also at risk from accidents with chemicals and machinery.  But these risks extend further: to the farmers’ families, their neighbours and, in some cases, to the wider community visiting the countryside for recreational activities.

For example, in the United Kingdom and Ireland, agriculture is regarded as an industry with one of the worst track records for work related accidents and deaths.  In the UK, statistics show that in 2001/2002 there were 9 fatalities for every 100,000 workers employed in agriculture and in the ten year period 1992/1993 to 2001.2002, 497 people died in agriculture accidents.  Put another way, 50 people a year or almost one person a week dies in an agricultural accident.  Deaths from accidents with machinery account for almost half of these numbers.  A similar pattern is seen in Ireland.

And yet farmers still take unacceptable risks.  On 15^th June 2001 a farmer in County Clare, Ireland, was prosecuted for not properly guarding a number of power-take-off- shafts in his farm machinery.  This: in spite of the fact that in the previous year 16 people died in Ireland by becoming entangled in power-take-off-shafts.

One of the difficulties facing farmers is the fact that the Countryside can still attract people onto farmland who have little understanding of the dangers of the farm.  They are ignorant of the fact that crops are often sprayed, or the way in which animals may behave towards them.  Even campers can be at risk from micro-organisms such as E-coli 0157 which can persist on the ground where animals have left droppings.

Farms have also always been a major attraction for young children, who can wander onto land, or into working farm yards without realising the risks that they can be facing.

It has to be said that we cannot predict the behaviour of fools, but we can do a lot to protect ourselves from the hazards on our farms and to warn visitors of the dangers of our industry.  In the following sections of the Youth Farm Course, we try to give you some practical tips, guidance and the necessary technical information to make your farm a safer place.

B.    Accidents on Farms

Earlier, we mentioned the UK statistics for fatalities in farming.  If we analyse the 497 people killed in the last 10 years, we see that:

• 173 were farm employees
• 253 were self employed farmers
• 71 were members of the public.

A frightening statistic is 42 of these were also children under 16 years old.  The main causes of death continue to include:

• transport related (vehicles overturning, people being run down) – 33%
• falling from height (working on fragile roofs or in trees etc.) – 18%
• being hit by falling objects (bales, trees, branches etc.) – 14%
• contact with moving or unguarded machinery – 10%
• livestock related accidents – 8%
• electrocution – 7%

C.    Health Risks on Farms

One of the biggest concerns for farmers in modern agriculture is the effects of pesticides and sprays on their long term health.  But long term health risks are also experienced from several unexpected sources:

• Farmers lung comes from breathing in mould spores shaken out of a bale or old hay.
• Toxic gases can result in permanent health problems or sudden death.  Manure storage and silo gases are often found on farms as the result of manure decomposition or crop storage.  These gases can result in asphyxiation, irreversible lung damage and lingering respiratory problems.
• Researchers have documented an increased incidence of skin cancer among farmers who work in the sun for prolonged periods without the benefit of protective clothing or sun screens.
• Research has shown that farm work can result in permanent joint and ligament injury.  These injuries predispose farmers to arthritic conditions which can seriously affect their mobility when performing farm chores.
• Farmers have increased levels of hearing loss when compared to other occupations.  Hearing loss is prevalent among farmers who are exposed to loud and continuous noise from machinery and equipment which has not been properly maintained or when proper hearing protection is ignored.
• Farmers who raise livestock in confinement housing often suffer from Organic Dust Toxic Syndrome (ODTS).  These ailments area caused by toxins and dusts in livestock confinement facilities.
• Agriculture pesticides and anhydrous ammonia are among the chemicals which can cause serious acute or chronic health problems.  Many agriculture workers fail to wear personal protective equipment when handling agricultural chemicals.
• E coli 0157 is a particular bacterium that lives in the guts of animals including cattle, sheep, deer, goats and wild birds.  The toxins that it produces have serious effects on human ranging from diarrhoea to kidney failure and even death.

D.    You Can’t be Too Careful

 

The image of agricultural work is that of a healthy pursuit, far from congested and polluted cities, that provides an opportunity for plenty of fresh air and exercise.  In some ways, this is true.  US farmers, for example, have a lower mortality rate for ischemic heart disease and cancer as compared with other occupations.

However, agricultural work is associated with a variety of health problems.  An overview of the main hazards is provided in section 1.8 below.  But by way of explaining just how important it is to be careful when carrying out routine farm duties just think about this: when spraying agricultural pesticides you need to bear in mind that it is highly likely that some of the active ingredients will be left on the spray equipment and may build up over time.  So, without thorough cleaning, anyone subsequently using or handling the machinery could be inadvertently exposed to the pesticide residues.  Those most at risk include spray contractors and maintenance workers as well as farm workers and their families.

Recently the UK Government Health and Safety Executive (HSE) decided to assess the real risks to workers by measuring the levels of residues that typically build up on farm equipment.  The HSE asked their research laboratories, HSL, in collaboration with the Cranfield Centre for Eco-Chemistry, to do this for a range of commonly used pesticides on spray equipment.  The residue build up was related to the way in which the spraying was done, and to any cleaning regimes used.

An initial survey of 250 farmers identified the type of spraying equipment used and the most commonly applied pesticides.  Fourteen farms then agreed to take part in the field study, which involved two visits to each farm to coincide with the main spraying periods of the year in late spring/summer and autumn/winter.  Samples of surface build-ups were taken from specific locations on the delivery system such as the nozzles, spray tank and boom and elsewhere on the tractor including windscreens and doors. Seven locations of a fixed size were sampled on each occasion. In addition, cotton gloves were worn by the farmers.  These rubbed onto the surfaces of the machinery in normal use, and the amount of build up transferred on to them was used to assess the probable exposure of the workers during typical working practices such as: entering the cab, using controls, mounting equipment and changing oil filters.  Each sample collected was tested for thirteen of the most commonly applied pesticides.

It was clearly shown that the residue build-ups were at levels that are agreed by experts to have health implications.  And these farms were not run by bad farmers. They all cleaned their equipment.  Nevertheless, any worker handling the equipment in the trials with an open wound, or skin complaint could have been absorbing dangerous levels of chemicals into their bodies without knowing it.

Occupational exposure to airborne hazardous substances is usually discussed in terms of the risk of inhalation, or breathing them in.  In general, occupational exposure limits are normally developed with a view to controlling this route.  However, it is now widely accepted that certain toxic substances can pass through the skin, contributing to the overall “body burden” (although the extent varies considerably between different chemicals).  In the UK the HSE has investigated the extent to which absorption through the skin takes place using vapours from a range of substances with different physicochemical parameters.  Tests were conducted on a small group of volunteers in a controlled atmosphere room using four chemicals - toluene, xylene, 1-methoxy-2-propanol and 2-butanone - which represent a range of substances which might pass through the skin.  These are “active ingredients” in a wide range of products typically used in Agriculture and Farm and Machinery maintenance.

The uptake of the vapour by the body was assessed by monitoring the levels of the chemicals produced by the body as it tries to break these toxins down.  The volunteers wore T-shirts and jeans, and for one experiment the inhalation route was excluded by asking the volunteers to wear air-fed masks.  The exposures were for four hours each at the appropriate occupational exposure limit.

The tests confirmed that for some substances the uptake of solvent vapour through the skin can contribute significantly to the body burden.  Further work using the solvent 2-butoxyethanol has shown that, as temperature and humidity increase, the dermal exposure route becomes more significant (so if you work harder in warm weather you increase your risk!).  It is also important to realize that wearing overalls made little difference to uptake of the solvent.

Now this doesn’t mean that it isn’t safe to use these products.  Just that your body will need time to “recover” and flush any toxins absorbed from your system.  So it is important to work in ventilated areas and to use the safety equipment and procedures recommended in the information provided by the supplier on the MSDS.

Most farm accidents and related injuries arise when people aren’t taking proper care.  They are in a hurry and so they don’t fetch the right equipment, or they have become “over-confident” and think that they don’t need to wear the proper protective clothing.  In the Table below we present a summary of the type of farming accidents typically seen on Cyprus.  All of them are avoidable!

	Incident / Accident brief description	Cause (Examples)	Potential Results	Do	Don’t
1	Overturning of tractor while driving down slope.	Brakes not used properly.	The driver – farmer may injure or kill himself due to an overturned incident of the tractor.	Drive carefully Check normal operation (i.e. brake fluids).	Don’t drive tractors with unnecessary load on dangerous ground.
2	Falling of a worker from a working agricultural vehicle.	Not properly seated.  Inappropriate use of vehicle.	Body injured.	Carry passengers only as and when allowed by the manufacturer.	Carry passengers unless appropriate seats and safety are provided.
3	Falling from height.	Insufficient support provided as per regulation when working at over 2 m height.	Body injured.	Make sure all safety precautions are available.	Work in heights when necessary supports and precautions are not available.
4	Falling from ladder.	Inappropriate support of ladder. Damaged ladder in use.	Body injured.	Make sure ladder is well positioned on ground.	Use ladders only when well fitted.
5	Arm injured in moving belt.	Non-proper clothing use.	Body injured.	Make sure moving parts are well protected and suitable clothing is being used.	Work in environments with unprotected moving parts.
6	Explosion of liquid battery.	Non-properly disconnection applied.	Eye damage.	Follow safety precautions.
7	Snake bite.	Non-properly safety boots were used.	Body injured.
8	Fire.	Fire use for cleaning the ground.	Uncontrolled fire.	Avoid fire for cleaning the field.

E.     Keeping Children Safe on Farm

Throughout Europe and the major Agricultural Economies there is growing concern for the safety of children and young adults on farms.  As such it is an area that needs to be assessed separately, because many of the fatalities and deaths that occur happen to outsiders and visitors.  In the UK there have been initiatives targeted at children for many years.  Books and videos can be ordered (in English) from the web site of the UK Health and Safety Executive (HSE).  There are also activity based courses organised form children in the UK (see for example, http://www.northernrural.co.uk/farmesefety.htm

F.     Managing Farm Safety

Safety on a farm works best if the person or people in charge take a leading role in managing safety and health.  Many business enterprises have proven that good safety management leads to increased productivity, and the same works for farms.  By having a good safety management program, you can avoid not only farm injuries, but also unplanned incidents that are costly, time consuming, stressful and inconvenient. This makes good economic sense.

How to start

To assess safety management on your farm, check whether you have:

• Regular hazard spotting surveys of plant, equipment, substances and tasks.
• A system of recording injuries, near misses and identified hazards.
• Safe procedures for farm tasks.
• Safety training and supervision for new and young employees.
• Protective clothing and equipment.
• Safety training and practice for each new item of plant and equipment.
• Safety discussions between employers, contractors and employees.
• Safety information readily available for plant, equipment and hazardous substances.
• Copies of the Occupational Safety and Health Act and Regulations.

Develop a plan

Draw up a safety management plan covering the points listed above. Preferably, put your plan in writing, and keep it with other safety information about plant, equipment and substances on the farm.

Discuss it with others on the farm during development, and ensure their safety concerns are met. Make sure the plan allows for ongoing safety consultation with others, the provision of information and training, and a system for hazard identification, risk assessment and risk control.

Then make sure employees and others on the farm are familiar with the plan, safe work procedures, and current legal safety and health requirements.

The plan should cover providing farm workers with safety information, induction for new employees, safety training with new plant and procedures, special safeguards for young workers, and keeping a record of injuries, near misses and potential hazards.

Consultation

Consultation means discussion - talking about and reaching agreement on safety and health problems and solutions with others doing the work. Here are some guidelines:

• Allow others on the farm to discuss and contribute to the safety management plan.
• Make sure everyone on the farm knows and understands the safety rules you have agreed to, and is aware of the relevant workplace safety laws.
• Involve others in safety planning for new plant or equipment before it is ordered.
• Discuss unfamiliar or potentially risky farm tasks beforehand, and plan an agreed safe procedure.
• During shared tasks, communicate with one another continually to avoid risky situations.

• As far as possible, keep to agreed safety plans for each job.
• Following any injury or near-miss incident, no matter how minor, discuss and agree on a safer way to continue the work.
• Be prepared to stop work until suitable safety improvements can be made.

Spot the hazard

The best safety outcomes on farms are achieved by a 24-hour approach to spotting and dealing with hazards. A hazard is any situation, activity, procedure, plant, equipment or animal that may result in injury or harm to a person. Hazards may be identified in:

• Environments (light, noise, rain, heat, sun),
• Substances (pesticides, fuels, dusts),
• Workplace layout (work space, bench height, storage heights),
• Work organisation (unnecessary manual handling),
• Equipment (ladders, silos, chainsaws, angle grinders),
• Farm animals (that bite, kick, butt, crush, toss, infect),
• Heights (roofs, silos, windmills),
• Electricity (switches, cables, leads, power tools, connections).

How to spot hazards

• Observation - use your senses of sight, hearing, smell and touch - combined with common sense, knowledge and experience.
• Material safety data sheets (MSDSs) - obtain them from manufacturers and suppliers. Read them carefully to identify possible harm from hazardous substances, and precautions that need to be taken.
• Hazard and risk surveys - conduct hazard spotting surveys of main work areas. Talk to others about their safety concerns; check injury and incident records.
• Children and visitors - include in your surveys areas and activities in which children or visitors could be at risk.
• Discussion groups - are useful for identifying hazards and recommending solutions.
• Safety audits - consider hiring a consultant to investigate safety and help prepare a management plan.
• Information - keep informed of hazards in the industry through the latest available information.
• Record analysis - keep records of identified hazards, near misses, injuries and workers' compensation claims, to help identify possible trends.
• Consumer information - carefully read and follow consumer guidelines on equipment and substances.
• Act and Regulations - become familiar with the Occupational Safety and Health Act and Regulations.

Assess the Risk

Once a hazard has been identified, the likelihood and possible severity of injury or harm will need to be assessed, before determining how best to minimise the risk. High risk hazards will need to be addressed more urgently than low risk situations.

You may decide that the same hazard could lead to several different possible outcomes. For each hazard consider how likely each possible outcome is, and record the highest priority you come up with. The following list may help your decision.

Make the changes

Consider the following control measures, listed in order of importance:

• a) Remove the hazard at the source - e.g. get rid of the plant or substance.

• b) Substitute it with a less hazardous plant or substance.

• c) Isolate the hazardous process, plant or substance from people.

• d) Add engineering controls, such as safety barriers or exhaust ventilation.

• e) Adopt safe work procedures, training and supervision to minimise the risk.

• f) Where other means are not sufficient or practicable, provide personal protective equipment.

• g) Implement and monitor the controls you decide upon.

One or more of the controls recommended above should be agreed upon, and the changes made as soon as possible, before the hazard causes an injury.

Checking the changes

To make sure risk has been minimised, and a further hazard has not been created, the new safety measures may need to be carefully tested before people are allowed back onto a worksite or before work recommences. Consultation between the employer and others at the workplace will help to reach a safe decision.

In some cases, a new set of safe work procedures may be necessary, possibly even another period of training and supervision, until the improvement can be shown to be working safely.

Safety improvements should be reviewed periodically, to make sure they continue to be effective.

G. Your Legal Duties

Self-employed farmers, farm managers, employers and employees all have legal responsibilities to make the farm safe. This includes people running the family business or working their own property.

 

Manufacturers, importers, suppliers and installers of substances, materials, buildings, plant and equipment, and other people in control of farming workplaces can also have legal responsibilities relating to workplace safety on farms.

Act and Regulations

Every employer is required by law to make available a copy of the Occupational Safety and Health Act and the Occupational Safety and Health Regulations , to any employee who asks to see them.

People who live on or visit farms are also covered by these laws, whether they work there or not.

Employers

Employers must take all practicable steps to ensure employees are not exposed to hazards. Their responsibilities include:

• Maintaining work areas, machinery and equipment in a safe condition.
• Organising safe systems of work.
• Providing adequate information, instruction, training and supervision to enable employees to work safely.
• Ensuring employees are aware of potential hazards.
• Providing adequate protective clothing and equipment (e.g. ear plugs, goggles, respirators, etc) where other measures to eliminate or control risks are impracticable or inadequate.
• Consulting with employees on safety and health matters.
• Making sure equipment and materials are used, stored, transported and disposed of safely.
• Identifying hazards, assessing risks and controlling hazards on the farm.

Employees

Employees must take reasonable care to protect their own safety and health and the safety and health of others. These responsibilities include:

• Following safety instructions.
• Using and looking after protective equipment as instructed.
• Informing the employer of hazards.
• Cooperating with the employer on safety and health matters.

Employers and self-employed persons

Employers and self-employed persons have a responsibility to take reasonable care to ensure their own safety and health at work. They must also ensure, as far as practicable, that the safety and health of other people is not at risk through their actions or the actions of their employees.

Contractors

If you engage contractors or sub-contractors, for example shearers, you have the same responsibilities to them and their employees as if you were their employer.  This applies only to matters which are, or should be, under your control. Contractors and subcontractors also have responsibilities as employers to their employees.

Manufacturers

Where machinery is used in a workplace, those who design, manufacture, import, supply, erect or install the machinery must make sure that operators are not exposed to hazards when they are using the machinery properly.

Adequate information on safe use, safe maintenance and potential hazards must be provided when equipment is supplied and, later on, whenever requested.

Regulations

The Occupational Safety and Health Regulations For Agriculture apply to farming.

Hazardous substances

Occupational Safety and Health Regulations - Hazardous Substances - is relevant to chemicals used commonly on farms.

A person who manufactures, imports or supplies any substance for use at a workplace must ensure, as far as practicable, that adequate data about toxicity, safe use, handling, processing, storage, transportation and disposal of the substance is provided:

• a) when the substance is supplied and

• b) thereafter whenever requested.

This information should be available in the form of labels, a register of hazardous substances, safety assessments, monitoring reports and material safety data sheets.

Work buildings

Any person who manages or controls a workplace is required to make it safe. People must be able to work there and to enter and leave the workplace safely.  Architects, designers and builders of workplace buildings have responsibilities to make sure people who may work in these buildings are not exposed to hazards.

Consultation and cooperation

Cooperation and discussion are the keys to safety and health at work. Employers and employees must consult one another to resolve safety and health problems.  Where there are a number of employees at a workplace, they or the employer may ask for a safety and health representative to be elected. The election process must then begin.  The employer may establish a safety and health committee, or an employee can ask for one to be established.

Role of representatives and committees

The functions of a safety and health representative are to:

• a) Inspect the workplace as agreed with the employer. (If the workplace has not been inspected in the preceding 30 days, it may be inspected at any time, after providing reasonable notice to the employer.)

• b) Promptly investigate accidents, dangerous incidents or serious risk situations.

• c) Keep up with current safety and health information.

• d) Report hazards and potential hazards to the employer.

• e) Refer matters to the safety and health committee.

• f) Consult and co-operate with the employer on safety and health.

• g) Liaise with employees on safety and health matters.

The functions of a safety and health committee are to:

• a) Provide information to safety and health representatives.

• b) Consult with representatives on intended changes to the workplace.

• c) Enable representatives to perform duties and attend training.

Resolving issues

The Occupational Safety and Health Act says safety and health issues should be resolved through consultation between employers and employees or their elected safety and health representatives. Both parties should agree on procedures for resolving issues.

If all attempts to resolve a safety or health issue at the workplace fail, an inspector from OSHA can be called.

Refusal to work in an unsafe situation

Employees may refuse to do work which they believe would expose them or others to the risk of serious and imminent injury or illness. An employee refusing unsafe work must notify the employer and the safety and health representative if there is one. The employee must remain available to do reasonable alternative duties while the issue is addressed.

Discussion to resolve the problem must then take place. While the problem is being addressed an employee may be given reasonable alternative work, and he or she remains entitled to the same pay and other benefits.

Accidents

Work accidents which result in certain kinds of injuries or cause an employee to be absent must be reported. Failure to do so is an offence. Certain work-related diseases must also be reported. <

H.      Common Hazards and Long Term Health Threats in Farming

Agricultural workers are at a high risk for particular cancers, respiratory diseases and injuries.  Because of the remote location of much of this work, emergency health services are lacking, and agromedicine has been viewed as a vocation without high social status.  The work environment involves exposure to the physical hazards of weather, terrain, fires and machinery; toxicological hazards of pesticides, fertilizers and fuels; and health insults of dust.

Respiratory Hazards: Agricultural workers are subject to several pulmonary diseases related to exposures at work as shown in table 1 below.

Table 1. Respiratory hazards

Exposures	Health effects
Cereal grain pollen, livestock dander, fungal antigens in grain dust and on crops, dust mites, organophosphorus insecticides	Asthma and rhinitis: Immunoglobin E-mediated asthma
Organic dusts	Nonimmunologic asthma (grain dust asthma)
Specific plant parts, endotoxins, mycotoxins	Mucous membrane inflammation
Insecticides, arsenic, irritant dust, ammonia, fumes, grain dust (wheat, barley)	Bronchospasm, acute and chronic bronchitis
Fungal spores or thermophilic actinomycetes released from mouldy grain or hay, antigens of less than 5 mm in diameter	Hypersensitivity pneumonitis
Thermophilic actinomycetes: mouldy sugar cane	Bagassosis
Mushroom spores (during clean-out of beds)	Mushroom worker’s lung
Mouldy hay, compost	Farmer’s lung
Fungi: mouldy maple bark	Maple bark stripper’s disease
Anthropoids: infested wheat	Wheat weevil disease
Plant debris, starch granules, moulds, endotoxins, mycotoxins, spores, fungi, gram-negative bacteria, enzymes, allergens, insect parts, soil particles, chemical residues	Organic dust toxic syndrome
Dust from stored grain	Grain fever
Mouldy silage on top of silage in silo	Silo unloader’s syndrome
Decomposition gases: ammonia, hydrogen sulphide, carbon monoxide, methane, phosgene, chlorine, sulphur dioxide, ozone, paraquat (herbicide), anhydrous ammonia (fertilizer), oxides of nitrogen	Acute pulmonary responses
Nitrogen dioxide from fermenting silage	Silo filler’s disease
Welding fumes	Metal fume fever
Oxygen deficiency in confined spaces	Asphyxiation
Soil dust of arid regions	Valley fever (coccidiomycosis).  Endemic to USA & South America only
Mycobacterium tuberculosis	Tuberculosis (migrant workers)

Exacerbation of asthma by specific allergens and nonspecific causes has been associated with airborne dust. Several farm antigen exposures can trigger asthma, and they include pollen, storage mites and grain dust. Mucous membrane inflammation is a common reaction to airborne dust in individuals with allergic rhinitis or a history of atopy. Plant parts in grain dust appear to cause mechanical irritation to the eyes, but endotoxin and mycotoxin exposure may also be associated with the inflammation of the eyes, nasal passages and throat.

Chronic bronchitis is more common among farmers than among the general population. The majority of farmers with this illness have a history of exposure to grain dust or work in swine confinement buildings. It is believed that cigarette smoking is additive and a cause of this illness. In addition, acute bronchitis has been described in grain farmers, especially during grain harvest.

Hypersensitivity pneumonitis is caused by repeated antigen exposures from a variety of substances. Antigens include micro-organisms found in spoiled hay, grain and silage. This problem has also been seen among workers who clean out mushroom bed houses.

Organic dust toxic syndrome was originally associated with exposure to mouldy silage and was, thus, called silage unloader’s syndrome. A similar illness, called grain fever, is associated with exposure to stored grain dust. This syndrome occurs without prior sensitization, as is the case with hypersensitivity pneumonitis. The epidemiology of the syndrome is not well defined.

Farmers may be exposed to several different substances that can cause acute pulmonary responses. Nitrogen dioxide generated in silos can cause death among silo workers. Carbon monoxide generated by combustion sources, including space heaters and internal combustion engines, can cause death of agricultural workers exposed to high concentrations inside of buildings. In addition to toxic exposures, oxygen deficiency in confined spaces on farms is a continuing problem.

Many agricultural crops are causative agents for pulmonary diseases when they are processed. These include hypersensitivity pneumonitis caused by mouldy malt (from barley), paprika dust and coffee dust. Byssinosis is caused by cotton, flax and hemp dusts. Several natural products are also associated with occupational asthma when processed: vegetable gums, flax seed, castor bean, soybean, coffee bean, grain products, flour, orris root, papain and tobacco dust (Merchant et al. 1986; Meridian Research, Inc. 1994; Sullivan et al. 1992).

Dermatological Hazards: Farmers are exposed to several skin hazards, as shown Table 2, below. The most common type of agriculture-related skin disease is irritant contact dermatitis. In addition, allergic contact dermatosis is a reaction to exposures to sensitizers including certain plants and pesticides. Other skin diseases include photo-contact, sun-induced, heat-induced, and arthropod-induced dermatoses.

The skin can be burned in several ways. Burns can result from dry fertilizer, which is hygroscopic and attracts moisture (Deere & Co. 1994). When on the skin, it can draw out moisture and cause skin burns. Liquid anhydrous ammonia is used for injecting nitrogen into the soil, where it expands into a gas and readily combines with moisture. If the liquid or gas contacts the body—especially the eyes, skin and respiratory tract—cell destruction and burns can occur, and permanent injury can result without immediate treatment.

Tobacco croppers and harvesters can experience green tobacco sickness when working with damp tobacco. Water from rain or dew on the tobacco leaves probably dissolves nicotine to facilitate its absorption through the skin. Green tobacco sickness is manifested with complaints of headache, pallor, nausea, vomiting and prostration following the worker’s contact with wet tobacco leaves. Other insults to the skin include arthropod and reptile stings and bites, and thorn punctures, which can carry diseases.

Table 2. Dermatological hazards

Exposures	Health effects
Ammonia and dry fertilizers, vegetable crops, bulb plants, fumigants, oat and barley dust, several pesticides, soaps, petroleum products, solvents, hypochlorite, phenolic compounds, amniotic fluid, animal feeds, furazolidone, hydroquinone, halquinol	Irritant contact dermatitis
Mites	Grain itch
Sensitizing plants (poison ivy or oak), certain pesticides (dithiocarbamates, pyrethrins, thioates, thiurams, parathion, and malathion)	Allergic contact dermatitis
Handling tulips and tulip bulbs	Tulip finger
Creosote, plants containing furocoumarins	Photo-contact dermatitis
Sunlight, ultraviolet radiation	Sun-induced dermatitis, melanoma, lip cancer
Moist and hot environments	Heat-induced dermatitis
Wet tobacco leaf contact	Nicotine poisoning (green tobacco sickness)
Fire, electricity, acid or caustic chemicals, dry (hygroscopic) fertilizer, friction, liquified anhydrous ammonia	Burns
Bites and stings from wasps, chiggers, bees, grain mites, hornets, fire ants, spiders, scorpions, centipedes, other arthropods, snakes	Arthropod-induced dermatitis, envenomation, Lyme disease, malaria
Punctures and thorn pricks	Tetanus

Toxic and Neoplastic Hazards: The potential for toxic substances exposure in agriculture is great, as can be seen Table 3 below. Chemicals used in agriculture include fertilizers, pesticides (insecticides, fumigants and herbicides) and fuels. Human exposures to pesticides are widespread in developing countries as well as in the developed countries.

Table 3. Toxic and neoplastic hazards

Exposures	Possible health effects
Solvents, benzene, fumes, fumigants, insecticides (e.g., organophosphates, carbamates, organochlorines), herbicides (e.g., phenoxy-aliphatic acids, bipyridyls, triazines, arsenicals, acentanilides, dinitro-toluidine), fungicides (e.g., thiocarbamates, dicarboximides)	Acute intoxication, Parkinson’s disease, peripheral neuritis, Alzheimer’s disease, acute and chronic encephalopathy, non-Hodgkin lymphoma, Hodgkin’s lymphoma, multiple myeloma, soft-tissue sarcoma, leukaemias, cancers of the brain, prostrate, stomach, pancreas and testicle, glioma
Solar radiation	Skin cancer
Dibromochloropropane (DBCP), ethylene dibromide	Sterility (male)

The United States has registered more than 900 different pesticides with more than 25,000 brand names.  About 65% of the registered uses of pesticides are for agriculture.  They are primarily used to control insects and to reduce crop loss.  Two-thirds (by weight) of the pesticides are herbicides.  Pesticides may be applied to seed, soil, crops or the harvest, and they may be applied with spray equipment or crop dusters.  After application, pesticide exposures can result from off-gassing, dispersion by the wind, or contact with the plants through skin or clothing.  Dermal contact is the most common type of occupational exposure.  A number of health effects have been associated with pesticide exposure.  These include acute, chronic, carcinogenic, immunologic, neurotoxic and reproductive effects.

Farmers experience a higher risk for some site-specific cancers.  These include brain, stomach, lymphatic and haematopoietic, lip, prostrate and skin cancer.  Solar and pesticide (especially herbicide) exposure have been related to higher cancer risks for farm populations (Meridian Research, Inc. 1994; Popendorf and Donham 1991; Sullivan et al. 1992).

Injuries Hazards: Studies have consistently shown that agricultural workers are at increased risk of death due to injury.  In the United States, a study of work-related fatalities for 1980 to 1989 reported rates in agricultural production of 22.9 deaths per 100,000 workers, as compared to 7.0 deaths per 100,000 for all workers.  The average fatality rate for males and females, respectively, was 25.5 and 1.5 deaths per 100,000 workers.  The leading causes of death in agricultural production were machinery and motor vehicles.  Many studies report the tractor as the leading machine involved in fatalities, frequently from tractor rollovers.  Other leading causes of death include electrocutions, caught in, flying objects, environmental causes and drowning.  Age is an important risk factor related to agricultural fatalities for males.  For example, the fatality rate for agricultural workers in the US over the age of 65 was over 50 per 100,000 workers, more than double the overall average (see Figure 1).

Figure 1: Agricultural workers fatality rates, US, 1980-89     

A 1993 survey of farm injuries in the United States found the major injury sources to be livestock (18%), machinery (17%) and hand tools (11%).  The most frequent injuries reported in this study were sprain and strain (26%), cut (18%) and fracture (15%). Males represented 95% of the injuries, while the highest concentration of injuries occurred among workers 30 to 39 years of age.

Table 4   shows the source and nature of injury and the activity during injury for four major crop production categories.  The National Safety Council estimated a US rate of 13.2 occupational injuries and illnesses per 100 crop production workers in 1992.  More than half of these injures and illnesses resulted in an average of 39 days away from work.  In contrast, the manufacturing and construction sectors had an injury and illness incidence rate of, respectively, 10.8 and 5.4 per 100 workers.

In another study in the United States, investigators determined that 65% of all farm injuries required medical attention and that machinery other than tractors caused nearly half of the injuries that resulted in permanent disability (Meridian Research, Inc. 1994; Boxer, Burnett and Swanson 1995).

Table 4. Injury hazards

Exposures	Health effects
Road vehicle crashes, machinery and vehicles, struck by objects, falls, oxygen depletion, fires	Fatalities
Tractors	Crushing of the chest, extravasation (escape of fluids—e.g., blood—and surrounding tissue), strangulation/asphyxia, drowning
Augers	Hypovolemia (loss of blood), sepsis and asphyxia
Electricity	Electrocutions
Machinery and vehicles, draught animal kicks and assaults, falls	Nonfatal injuries: injury infection (e.g., tetanus)
Hay balers	Friction burns, crushing, neurovascular disruption, avulsion, fractures, amputation
Power take-offs	Skin or scalp avulsion or degloving, amputation, multiple blunt injury
Corn pickers	Hand injuries (friction burns, crushing, avulsion or degloving, finger amputation)
Fires and explosions	Serious or fatal burns, smoke inhalation,

Mechanical and Thermal Stress Hazards: As discussed above, sprains and strains are a significant problem among agricultural workers, and as shown in Table 5 below, agricultural workers are exposed to several mechanical and thermal stresses that result in injury.  Many of these problems result from handling heavy loads, repetitive motion, poor posture and dynamic motion.  In addition, agricultural vehicle operators are exposed to whole-body vibration.  One study reported the prevalence of low-back pain to be 10% greater among tractor drivers.

Table 5. Mechanical and thermal stress hazards

Exposures	Health effects	Interventions
Tendon overuse, stretching; excessive force	Tendon-related disorders (tendinitis, tenosynovitis)	Ergonomic design, vibration dampening, warm clothing, rest periods
Repetitive motion, awkward wrist posture
Vibration of the hands	Raynaud’s syndrome
Repetition, high force, poor posture, whole-body vibration	Degenerative changes, low-back pain, intervertebral disk herniation; peripheral nerve and vascular, gastrointestinal and vestibular system injuries
Motor and machinery noise	Hearing loss	Noise control, hearing protection
Increased metabolism, high temperatures and humidity, limited water and electrolytes	Heat cramps, heat exhaustion, heat stroke	Drinking water, rest breaks, protection from the sunshine
Low temperatures, lack of dry clothing	Frost nip, chilblains, frostbite, systemic hypothermia	Dry, warm clothing, heat generation from activity

Noise-induced hearing loss is common among agricultural workers.  One study reported that farmers more than 50 years of age have as much as 55% hearing loss.  A study of rural students found that they have two times greater hearing loss than urban students.

Agricultural workers are exposed to temperature extremes.  They may be exposed to hot, humid environments in work in the tropical and subtropical zones, and during the summer in the temperate zones.  Heat stress and stroke are hazards under these conditions.  Conversely, they may be exposed to extreme cold in the temperate zones in the winters and possible frostbite or death from hypothermia (Meridian Research, Inc. 1994).

I.        So How Do You Comply With All of These Requirements?

There are guidance documents, leaflets and pamphlets produced by the authorities responsible for Health and Safety on farms in your Country.  These can be obtained from your Governmental Departments, and often through the internet.  Some examples are provided in the “bibliography” for this Course Module (see section 7).

Sections 2 to 7 also contain useful guidance taken from documents prepared from farmers around the world.  Whilst the information presented is certainly compliant with “best practice” it cannot be guaranteed that following these guidelines will enable you to comply with your own local legislation.  Some of the methods presented may also be inappropriate in your geographical location.  You should therefore use the information provided to enable you to ask the right sorts of questions and get appropriate no none-sense answers from local experts and those authorities in your Country charged with policing Health and Safety on farms.  At the end of the day, we cannot tell you how to run your farm.  That is for you to do.  But we can help you to spot and prevent possible accidents and long term health risks, and help you to avoid them.

Help is provided in Section 7 and on the Course CD to enable to obtain further information and contact appropriate organizations that can help you