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