Incidence and trends in work-related
ill-health in UK agricultural workers
Jill Stocks
Centre for Occupational and Environmental Health
University of Manchester
The work-related ill health
Surveillance Pyramid
THOR
cases
Not reported
by specialist
OPRA
THOR
specialist
Occupational physician
Seen by a general practitioner (GP)
No medical consultation
THOR-GP
SWI
Population changes in agricultural
workers (Labour Force Survey,UK)
F&M
BSE ban lifted
LFS
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 rate
3510 (2580-4430) per 100 000 workers (2009-2012)
• Average incidence rate
1430 (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 work
2. Use of tools/heavy machinery
3. Animal related—not accidental
4. Accidents
Ranking of causes of asthma and allergic alveolitis
in agricultural workers (UK, all physicians)
1. Hay/straw
2. Seeds/grains
3. Birds/animals
4=. Fungal agents
4=. Agricultural chemicals
5. Plants
Ranking of causes of contact dermatitis in
agricultural workers (UK, all physicians)
1. Plants
2. Wet and dirty work
3. Nickel and/or chromates
4. Rubber found in boots, gloves and
milking equipment
5. Soap/detergents/disinfectants
6. Colophony (pine resin)
Method for analysing trends in incidence
•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
Trends in work-related skin diseases in
agricultural workers (UK)
Trends in work-related allergic respiratory
diseases in agricultural workers (UK)
Estimated annual change
0.92 (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 change
0.94 (0.85 - 1.04)
• 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)
FSA
NCP
Trends in incidence of campylobacter
in agricultural and food sectors
FSA
JWG
Trends in incidence of reports of diarrhoea
and vomiting by occupation
Thanks to all the THOR team
Raymond Agius
Roseanne McNamee
Melanie Carder
Louise Hussey
Sue Turner