The principal causes of ill health in farming were associated with manual handling, lung problems, infections and noise. Of farmers with occupational ill health, 50% suffer from chronic back pain. Regarding personal health, farmers have been identified as a group with a poor personal health profile (O’Shea, 1997). Male farmers between the ages of 15 and 64 have a death rate much higher than that of most other workers.
The HSA has provided the following advice.
Avoid slips and trips by keeping the farmyard and farm buildings tidy at all times. Provide adequate lighting in the farmyard and buildings
- Have a regular health check to monitor your general health and physical well-being
- Regular checks can identify and start appropriate treatments for health issues early
- Discuss your concerns with a close friend, family member or health professional. If stressed or anxious always seek help through your family or G.P.
- It is important to recognise signs of stress and seek professional help
- Give your health adequate attention
A range of serious illnesses can be caught from animals and contaminated materials. There are over 20 such diseases in this country, including brucellosis, tuberculosis, tetanus, Weil's disease and toxoplasmosis.
- If it is necessary to communicate by shouting at another person at a distance of two metres, the noise level is likely to be above the legal action level of 85 decibels (dB (A)).
- The best way to solve a noise problem is to identify the source and reduce either the noise level or exposure time as much as possible
- Purchase equipment with low noise levels
- Keep tractor doors shut and maintain silencers on equipment such as tractors or chainsaws
- Isolate or enclose equipment with noise above 85 decibels
- Use mechanical or automatic feeding systems to reduce the need to enter pig or poultry houses during feeding
- Move away from the noise source
- Ear defenders must be worn if the noise level remains above 80 decibels
The Farmers Have Hearts (FHH) programme was founded in 2005 in County Roscommon where a multidisciplinary team of the Health Service Executive (HSE) carried out free heart health checks. These heart health checks measured cholesterol, blood glucose and blood pressure levels as well as height, weight and waist measurements. In addition lifestyle advice was offered to the participating farmers. The aim of the programme was to address cardiovascular health of rural men.
As part of the ‘Farmers Have Hearts’ initiative established by Irish Heart Foundation supported by the HSE, here are some of the main findings 2013/2014 Evaluation Report:
- The majority (82.1%) of farmers reported being aware of a family history of heart disease and/or stroke or diabetes.
- Almost half of farmers (46.0%) had high blood pressure (≥ 140/90 mmHg). Specifically 44.0% had elevated systolic blood pressure (≥140 mmHg) and 25.9% had raised diastolic pressure levels (≥90 mmHg).
- Almost half of farmers (46.1%) had raised total cholesterol levels (≥5.0 mmol/L), 44.4% had elevated LDL levels (>3.0 mmol/L) and, of these 3.9% had LDL levels ≥4.5 mmol/L.
- The vast majority of participating farmers were found to be overweight or obese. Based on BMI measurements, 86.4% of farmers exceeded recommended BMI levels (BMI kg/m2 25.0) and of them 35.6% were classified as obese (BMI kg/m2 30.0+). Similarly, for waist circumference, 79.5% of farmers exceeded recommended waist measurements (≥ 37 inches) and of them 37.8% were classified as ‘at high risk’ (40+ inches).
- In relation to self-reported health measures, one third of participating farmers (35.5%) reported not physically active for 5 days or more a week and 34.5% reported not active for 30 minutes on physically active days. The majority of farmers (64.2%) reported experiencing stress ‘sometimes’ and 16.2% reported feeling stressed ‘most of the time’. A minority of farmers (17.8%) reported smoking, of whom 64.7% reported smoking more than 10 cigarettes a day. Almost half of farmers (46.4%) reported that they drank alcohol on a regular basis and 25.0% of ‘drinkers’ reported drinking >17 standard drinks a week.
- Majority of farmers (77.7%) were found to have three or more CVD risk factors based on objective measured health outcomes from the heart health checks. In relation to non-measured self-reported health (79.7%) of farmers had one or more risk factors for 6 CVD. Combined measured and non-measured health outcomes, the majority (80.7%) of famers had four or more CVD risk factors.
- The majority of farmers (79.2%) were advised to visit their GP by the IHF nurse on the basis of the heart health check results. At Week 1, 11.0% of farmers who were advised to see their GP, reported having visited their GP. At Week 12, an additional 20.8% of advised farmers had visited their GP since Week 1. Thus, about a third (31.8%) of those who were advised to visit their GP as a result of the heart health check actually followed through and visited their GP.
- Overall, most respondents reported a positive experience of the heart health check and rated it as ‘very good’ or ‘excellent’ in relation to the approach of the IHF staff (86.2%), the convenience of the location (79.9%), the explanation of the results by the nurse (84.8%), and the feeling that they could talk openly to the nurse during the heart health check (87.5%).
- At Week 1, the majority of farmers (74.1%) reported that they were thinking of making changes to their lifestyle. At Week 12, almost half of farmers (48.3%) reported that they had made some changes to their lifestyle. The main reported changes were in relation to increased levels of physical activity (92.7%) and /or diet (89.1%).
- Overall, farmers felt that heart health checks at marts were a good initiative for a number of reasons. Almost half of farmers (41.9%) said that they ‘would not have had a health check otherwise’; 14.0% said that it raised health awareness; while 12.8% stated that ‘meeting the IHF at the mart broke the ice and helped to overcome fears of getting a health check done’.
- Farmers suggested that future engagement with farmers in health promotion interventions should consider; ‘health checks at marts’ (29.7%) and ‘meeting farmers at workplace settings’ such as marts, farm walks and farmers meetings (22.1 %).
- There should be an increased focus on the workplace (such as the mart or a farming event) as an ideal and effective setting in which to engage farmers in health promotion and preventive health interventions.
- There should be a nationwide expansion of health promotion interventions, such as the FHH programme, that targets farmers as a specific population group.
- Effective health consultations with farmers revolve around building rapport, talking their language and showing understanding of their profession; all of which pave the way for more open dialogue.
- Targeted health promotion activities, such as the FHH programme, contribute to farmers being more proactive about their health: specifically in terms of follow-up use of GP services and making certain lifestyle behaviour change. It is important to increase the focus of intervention measures that target the reduction of high risk drinking and smoking cessation among farmers. Furthermore, more research is needed to identify the factors that contribute to high stress levels among farmers and on effective interventions and practical tips to support farmers to deal with stress.