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

Jill StocksCentre for Occupational and Environmental HealthUniversity of Manchester

Not reported by specialist

Seen by a general practitioner (GP)

No medical consultationSWI

THOR-GP

THOR specialist

The work-related ill health Surveillance Pyramid

THOR cases

Occupational physicianOPRA

Population changes in agricultural workers (Labour Force Survey,UK)

LFS

F&M BSE ban lifted

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 rate3510 (2580-4430) per 100 000 workers

(2009-2012)

•Average incidence rate1430 (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 work2. Use of tools/heavy machinery3. Animal related—not accidental4. Accidents

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

1. Hay/straw2. Seeds/grains3. Birds/animals4=. Fungal agents 4=. Agricultural chemicals5. Plants

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

1. Plants2. Wet and dirty work3. Nickel and/or chromates4. Rubber found in boots, gloves and milking equipment5. Soap/detergents/disinfectants6. Colophony (pine resin)

•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

Method for analysing trends in incidence

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

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

Estimated annual change0.92 (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 change0.94 (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

Work-related infectious diseases in agricultural workers (UK)

NCP

FSA

Trends in incidence of campylobacter in agricultural and food sectors

FSA

JWG

Trends in incidence of reports of Trends in incidence of reports of diarrhoea and vomiting by occupationdiarrhoea and vomiting by occupation

Thanks to all the THOR team

Raymond AgiusRoseanne McNameeMelanie CarderLouise HusseySue Turner