Julie Depczynski

Mortality patterns of Australian male farmers and farm managers

OBJECTIVE To compare the all-cause and specific-cause death rates of Australian male farmers and farm managers aged 25-74 years, with other Australian men. METHODS Data were extracted from the Australian Bureau of Statistics Death Registration Collection covering the calendar years of 1999-2002. Denominator data for male farmers and farm managers were drawn from the 2001 Australian Population Census. Direct age-standardized death rates were calculated and compared with the general Australian male population. RESULTS The 4025 male farmers or farm managers who died in this period represented 3.35% of all male deaths in the 25-74 year age range. The all-cause death rate for farmers and farm managers (730/100,000) was 33% higher than that of the Australian male population of the same age (549/100,000) (standardized mortality ratio (SMR)=1.33). Causes of death related to neoplasms (SMR=1.37), circulatory disease (SMR=1.40) and all external causes (SMR=1.37), were all statistically higher than the comparison population. Within these groupings, ischaemic heart disease (SMR=1.39), other circulatory disease (SMR=1.42), prostate cancer (SMR=2.40), lymphohaematopoietic cancer (SMR=1.80) and transport injuries (SMR=2.06), were all significantly higher. CONCLUSION These data indicate that Australian male farmers and farm managers are a disadvantaged group in terms of health status. The elevated rates of all-cause and specific-cause mortality compared with the Australian comparison population, illustrate both the need and scope for further investigation of these issues.

Patterns of alcohol use for farm and non-farm residents in New South Wales

The annual NSW Population Health Survey uses random digit dialling to complete computer assisted telephone interviewing. Full details on the methodology including weighting procedures and results are available elsewhere. Questions relating to personal alcohol consumption are contained within the survey. Additionally, for 2008 a new question was included – Do you live on a farm or rural property? Responses were compared by gender between farm and non-farm groups for the selected variables based on 95% confidence intervals (CI) and Rao-Scott c. A total of 10 296 survey respondents completed the 2008 NSW Population Health Survey, with 1117 (10.8%) of the sample being farm residents (628 women : 489 men). The farm sample had higher proportions of subjects in the 45–74 years (men) and 30–44 years (women) cohorts, with fewer in the 30–44 years (men) and 75+ years (women) age groups.

Changes in the hearing status and noise injury prevention practices of Australian farmers from 1994 to 2008

Abstract This study compares the hearing status and behaviors of Australian farmers from 1994–2001 with those from 2002–2008. Over this period the authors found (1) there was a 12.5% overall improvement in the proportion of farmers with normal hearing in left ears, with the likelihood of a screening participant having normal hearing improving by almost 9% each year; (2) significant improvements in the mean hearing threshold of both ears from 1 to 6 kHz; (3) significantly higher mean hearing thresholds for 35- to 44-year-old farmers exposed to firearms, chainsaws, workshop tools, heavy machinery, and tractors with cabins compared to nonexposed groups; (4) nonuse of hearing protection devices by young farmers (15 to 24 years old), was associated with hearing loss for those using uncabined tractors. Despite a reduction in noise injury, further adoption of noise reduction strategies for specific agricultural work practices is required.

Stage of diagnosis of prostate, breast and colorectal cancer in farm residents compared with other rural and urban residents in New South Wales

OBJECTIVE To determine if stage at diagnosis of prostate, breast and colorectal cancers differs between farm, rural non-farm and urban residents. DESIGN Data linkage of baseline survey information from a large cohort study, with state cancer registry records from 2006 to 2009. SETTING New South Wales, Australia. PARTICIPANTS New South Wales residents enrolled in the 45 and Up Study cohort. MAIN OUTCOME MEASURES Adjusted odds ratio of non-localised cancer stage was modelled using binary logistic regression, controlling for commonly known cancer risk factors. RESULTS Overall differences in the odds ratios for later stage prostate, breast and colorectal cancer diagnosis in farm men and women compared with rural non-farm and urban counterparts were not statistically significant, although farm men had twice the odds of either group of being diagnosed at later stage colorectal cancer. The odds of later stage prostate cancer for farm and urban men were similar, but rural non-farm men were significantly less likely than urban men to be diagnosed at later stage. Higher household income was associated with later stage breast and prostate cancer; and private health insurance with extras was negatively associated with later stage prostate cancer. CONCLUSIONS Differences in stage of cancer diagnosis, particularly between farm and rural non-farm men, remain unexplained but were not statistically significant. Farm men may be at higher risk of later stage colorectal cancer diagnosis, which if confirmed has implications for research on possible reasons, and for the delivery of appropriate cancer diagnostic services in rural areas.

Comparison of cancer incidence in Australian farm residents 45 years and over, compared to rural non-farm and urban residents - a data linkage study

BackgroundIt is not known if the incidence of common cancers in Australian farm residents is different to rural non-farm or urban residents.MethodsData from farm, rural non-farm and urban participants of the 45 and Up Study cohort in New South Wales, Australia, were linked with state cancer registry data for the years 2006–2009. Directly standardised rate ratios for cancer incidence were compared for all-cancer, prostate, breast, colorectal cancer, melanoma and non-Hodgkin Lymphoma (NHL). Proportional hazards regression was used to generate incidence hazard ratios for each cancer type adjusted for relevant confounders.ResultsFarm women had a significantly lower all-cancer hazard ratio than rural non-farm women (1.14, 1.01–1.29). However, the lower all-cancer risk observed in farm men, was not significant when compared to rural non-farm and urban counterparts. The all-cancer adjusted hazard ratio for combined rural non-farm and urban groups compared to farm referents, was significant for men (1.08,1.01–1.17) and women (1.13, 1.04–1.23). Confidence intervals did not exclude unity for differences in risk for prostate, breast, colorectal or lung cancers, NHL or melanoma. Whilst non-significant, farm residents had considerably lower risk of lung cancer than other residents after controlling for smoking and other factors.ConclusionsAll-cancer risk was significantly lower in farm residents compared to combined rural non-farm and urban groups. Farm women had a significantly lower all-cancer adjusted hazard ratio than rural non-farm women. These differences appeared to be mainly due to lower lung cancer incidence in farm residents.

Farmers’ knowledge of Q fever and prevention approaches in New South Wales

OBJECTIVE To identify what New South Wales (NSW) farmers know about Q fever to inform preventive approaches. DESIGN Thematic analysis of qualitative data gathered through semi-structured individual interviews, focus groups and a community meeting. SETTING Rural communities in NSW, Australia. PARTICIPANTS A total of 25 farmers participated in individual interviews (n = 4) or three focus groups, each with seven participants (n = 21). A further 27 persons, were involved in a community meeting. MAIN OUTCOME MEASURES Themes derived from the interviews, focus groups and community meeting. RESULTS Knowledge variations regarding Q fever risk and transmission highlight a need for improved risk communication. Vaccination was viewed as the preferred prevention approach; barriers were raised including time, costs, access to screening/vaccination and General Practitioner (GP) knowledge about Q fever. Local vaccination initiatives were supported. CONCLUSIONS Strengthening existing GP knowledge and services leading to expanded provision of screening/vaccination could improve the coverage of Q fever vaccine in endemic NSW farming and rural communities.

Safe play areas on farms in New South Wales

OBJECTIVE To assess the prevalence and security of fenced house yards on NSW farms and rural properties with a view to providing information to increase the development of safe play areas on farms. DESIGN A cross-sectional stratified study using computer-assisted telephone interviewing. SETTING Interviews were conducted in the four rural Area Health Services throughout February to December 2008. PARTICIPANTS Randomly selected sample of 1117 adults living on a farm or rural property in the study areas. MAIN OUTCOME MEASURES Self-reported issues involving fenced house yards or safe play areas for children. RESULTS Overall, 79.8% of farm respondents reported that they had a fenced house yard or safe play area. For those respondents with a fenced house yard, 66.6% reported that it was secure enough to prevent /make it difficult for a young child to wander away unsupervised. Based on these figures, it is estimated that only 53.1% of all farms or rural properties have a secure fenced house yard or safe play area. There were statistically significant variations between geographic locations, with the North Coast (37.7%) being lower. CONCLUSIONS This study illustrates a need across rural NSW to further promote, install or upgrade secure fenced house yards or safe play areas. While all geographic regions of the state could improve provision to protect children, there may also be some that are in need of more intensive intervention programs to enhance compliance. Such a proposition may also be relevant on a national level.

Hearing screening program impact on noise reduction strategies

The objective of this study was to determine the impact of the New South Wales Rural Hearing Conservation Program on the implementation of personal hearing protection (PHP) and noise management strategies among farmers who had participated in this program in New South Wales, Australia. A follow-up survey of a random sample of people screened through the New South Wales Rural Hearing Conservation Program was linked to their baseline data. The use of PHP at baseline was compared to use at follow-up in four specific scenarios: use with non-cabbed tractors, with chainsaws, with firearms, and in workshops. For non-cabbed tractors, the net gain in PHP use was 13.3%; the net gain was 20.8% for chainsaws, 6.7% for firearms, and 21.3% for workshops. Older farmers and those with a family history of hearing loss were less likely to maintain or improve PHP use. Those with severe hearing loss, males, and participants reporting hearing problems in situations where background noise was present were more likely to maintain or improve PHP use. Forty-one percent of farmers had initiated other strategies to reduce noise exposure beyond the use of PHP, which included engineering, maintenance, and noise avoidance solutions. The early (hopefully) identification of hearing deficit in farmers and farm workers can help promote behavior change and help reinforce a farm culture that supports hearing conservation. The continuation and expansion of hearing screening programs such as these should be encouraged as basic public health strategy in farming communities.