A survey of expert opinion on the effects of occupational exposures to trunk rotation and whole-body vibration

We present a review of current expert opinion on the effects of combined exposures to trunk rotation and whole-body vibration (WBV), commonly experienced by operators of agricultural machinery. We evaluate the level of agreement between academic experts in the field of ergonomics, human response to WBV and agricultural operators, on the effects of exposure to WBV and trunk rotation. A total of 83 individuals responded to the paper-based questionnaire, which included questions on risk levels from individual and combined exposures, discomfort development, exposure duration limits and tasks within agriculture. The results showed that all groups considered exposure to WBV and trunk rotation as risk factors for the development of back pain. The experts were not in consensus regarding acceptable exposure durations, areas of discomfort experienced or recommendations for cab developments.

Agricultural workers and urinary bladder cancer risk in Egypt

The authors examined the associations between farming and the risk for squamous cell (SCC) or urothelial cell (UC) carcinoma of the urinary bladder among Egyptians. The authors used data from a multicenter case-control study (1,525 male and 315 female cases, and 2,069 male and 547 female age- and residence-matched, population-based controls) to calculate adjusted odds ratios (AORs) and 95% confidence intervals (CIs). Men in farming and who never smoked had increased risk for either SCC or UC (AOR [95% CI]: 4.65 [2.59-8.36] and 6.22 [3.82-10.15], respectively). If they ever smoked, their risks were 2.27 (1.75-2.95) and 1.93 (1.58-2.35), respectively. Women in farmer households were at increased risk for SCC (1.40 [0.93-2.09] and UC [1.25 (0.82-1.89]), although not statistically significant. Occupational and environmental exposures to farming increased the risk for bladder cancer among Egyptians.

Occupational illnesses related to physical strains in apple harvesting

INTRODUCTION

Special strains are an occupational hazard often due to physical loads and inadequately designed work equipment.

OBJECTIVE

The aim of this pilot study was to determine occupational illnesses related to physical strains through an experimental design that assesses the associated working postures and oxygen uptake in apple harvesting.Three methods were applied to define the physical stress provoked by apple farming tasks.

MATERIAL AND METHODS

The experiments considered 5 labourers - 3 women and 2 men. The physical fatigue was assessed through oxygen consumption and heartbeat frequency according to UNI EN ISO 8996 standards. Measurements were conducted using a portable metabolimeter(COSMED). Working postures were determined according to Ovako Working Posture Analysis System(OWAS). An interview was conducted to record the labourers' subjective estimate of the stress.

RESULTS

The interview results demonstrated neck and dorsal pains and fatigue causes for each operator. The VO₂ was equal to 82.33 ± 27.40 lO₂/h for women and 67.00 ± 27.60 lO₂/h for men, meaning that it was tiring for some men but for all women. The heart rates were of 115 ± 6.00 bpm for women and 113 ± 5.65 bpm for men. The VCO₂ was of 63.81 ± 21.45 lCO₂/h for women and 45.10 ± 25.53 lCO₂/h for men, while energetic equivalent and body surface area were similar for both genders, about 5.60W × h/l O₂ and 1,80 m(2) on average. Women's metabolic rate had a very high value - over 290W × m(-2), although for the men it was between 200-260W × m(-2). According to OWAS, low apple picking was ranked in class 2, high apple picking in class 1, and apple transportation belonged to class 3. conclusion. Related to VO₂ and VCO₂ consumption and the identified negative body postures, it is necessary to improve working conditions.

Agricultural work exposures and pulmonary function among hired farm workers in California (the MICASA study)

Despite California's dependence on hired farm labor, scarce research has been conducted on the respiratory health of hired farm workers. Agricultural exposures to inorganic and organic dusts can adversely affect an individual's respiratory health and differ by farm type and job task. The purpose of the present analysis was to examine associations between agricultural work exposures and pulmonary function among 450 California farm workers. Data were collected as part of the Mexican Immigration to California: Agricultural Safety and Acculturation (MICASA) study, a prospective cohort study examining occupational risk factors and health of hired farm worker families in Mendota, California. Time-weighted self-reported average (TWSRA) dust scores were calculated from assessments of past-12-month agricultural work history. Other dust exposure indicator variables included months worked in agriculture in the past 12 months and years worked in agriculture. Multiple linear regression modeled FEV1 (forced expiratory volume in 1 second), FEF(25-75%) (forced midexpiratory flow rate), FVC (forced vital capacity), FEV6, FEV1/FVC, and FEV1/FEV6 separately. Seventy-six percent of participants had worked in agriculture in the past year. In models conducted for crops and tasks separately, high TWSRA dust score was associated with better FEV6. Crop and task models showed associations between greater months worked in agriculture in the past year and better FEV1, FEF(25-75%), and FEV6. Both models also found greater years worked in agriculture to be associated with worse FEV1/FEV6. Results were generally in the opposite direction as expected given past research but not uncommon. Future research should investigate relationships between pulmonary function and agricultural dust exposure over a lifetime and changes in pulmonary function over time.

[Professional risk assessment for modern pesticides during their application in the horticulture]

The work conditions on application of modern pesticides Masai, Regalis and Bellis for apple orchards protection have been researched. We show that total risk of hazard influence of tebufenpyrad, prohexadione-calcium, pyraclostrobin and boscalid on agricultural workers under condition of complex entry in body through skin and respiratory tracts is permissible. We proved that application of studied preparations is not dangerous for workers in case of abidance of agrotechnical and hygienic regulations.

WHO Framework Convention on Tobacco Control in China: barriers, challenges and recommendations

AIM

The aim of this study was to analyze the barriers in the implementation of the Framework Convention on Tobacco Control (FCTC) in China and present recommendations on ways to address these challenges in tobacco control in China.

METHODS

We review the available literature on progress and explore the barriers and challenges that impede a speedier pace in the adoption of the effective tobacco control measures, and present recommendations based on in-depth knowledge of decision-making process on the implementation of FCTC in China.

RESULTS

The pace of progress in China is too slow. China faces intractable political, structural, economic and social barriers in tobacco control, which make the whole-hearted implementation of FCTC measures a painstaking process.

DISCUSSION

The authors recommend a comprehensive approach to speed up the implementation of tobacco control measures. This includes strong political leadership from the top, structural changes to the tobacco industry and government oversight of the tobacco industry, as well as advocacy and support for tobacco control from civil society at the grassroots level.

[IgE mediated anaphylaxis in a patient with systemic mastocytosis]

BACKGROUND

Anaphylaxis is a severe, generalized, life-threatening reaction of rapid onset. We report the case of a patient presenting several systemic anaphylactic reactions over many years, initially ascribed to a cereals allergy but which finally proved to be due to systemic mastocytosis hidden for a long time.

PATIENTS AND METHODS

A 53-year-old man consulted for an eruption consisting of monomorphic pigmented maculopapular lesions on the trunk associated with itching and urticaria. He was a farmer and presented severe sensitivity to cereals, with anaphylaxis, which continued despite withdrawal of these allergens. Skin and bone marrow infiltration, abnormal mast cells, positivity for c-kit 816 mutation and the persistent elevation of serum tryptase enabled a diagnosis of indolent systemic mastocytosis to be made.

DISCUSSION

In systemic mastocytosis anaphylaxis is an expected complication relating to the proliferation of mast cells and a massive increase in mediator release (non-immunological mechanism). All patients with severe and recurrent anaphylaxis should be analyzed for underlying mastocytosis by careful physical examination and assay of baseline tryptase.

[Human exposure to livestock pollutants]

The paper describes the sources and characteristics of the particulate matter (PM) generated in pig and poultry facilities. PM origins from the food, the peeling of the skin, loss of fur or feathers, from feces and litter, if present. The PM concentrations measured during the day change due to the management of the litter, the distribution of the food and the cleanliness of the shelters. There are several methods to protect the welfare of animals and stockmen, among which the ventilated ceilings are today the most innovative choice.

Agricultural work and chronic musculoskeletal pain among Latino farm workers: the MICASA study

BACKGROUND

Agriculture poses varied dangers to hired farm workers in the U.S., but little information exists on occupational risks for chronic musculoskeletal pain. We examined common work positions, such as kneeling, carrying heavy loads, and repetitive motion that may increase the risk for chronic musculoskeletal pain.

METHODS

MICASA is a population-based study of occupational exposures and health in hired farm workers in California. This analysis includes 759 participants, 18-55 years old, engaged in farm work and residing in Mendota, CA. Chronic pain was defined as pain lasting 6 weeks or longer at specific body sites (back, knee, hip, etc.) over the entire farm work career.

RESULTS

Mean age was 37.9 years. Sixty-five percent participants were born in Mexico, 27.7% were born in El Salvador, and 4.2% were U.S-born. Chronic pain was associated with older age and female sex. After adjustment for age, years working in agriculture, and smoking, stooping/bending >30 hr/week among both men (OR = 2.49, 95% CI: 1.03-5.99) and women (OR = 2.15, 95% CI: 1.04-4.46) was associated with chronic hip pain. Driving tractors or other heavy farm equipment >60 hr/week was associated with increased odds of chronic hip pain (OR = 2.16, 95% CI: 1.02-4.54) among men. We also observed significant associations with kneeling or crawling >35 hr/week among women for both chronic back pain (OR = 2.96, 95% CI: 1.27-6.93) and knee pain (OR = 3.02, 95% CI: 1.07-8.50), respectively.

CONCLUSIONS

Chronic musculoskeletal pain is prevalent among farm workers and is associated with common work positions. Further research should focus on developing preventive interventions for tasks associated with increased pain risk. These interventions should be targeted to specific types of agricultural tasks.

Work-related musculoskeletal disorders among Irish farm operators

BACKGROUND

To establish prevalence, risk factors, and impact of work-related musculoskeletal disorders (WMSDs) among farmers in Ireland.

METHODS

In summer 2009, a questionnaire was appended to the Teagasc (Irish Agricultural and Food Development Authority) National Farm Survey (n = 1,110) to obtain data on the prevalence, risk factors and impact of WMSDs amongst farm operators in Ireland. Data were collected by trained recorders and analyzed using chi-square tests, t-tests, Mann-Whitney's U-tests and logistic regression models.

RESULTS

The prevalence of WMSDs in the previous year was 9.4% (n = 103), with the most commonly affected body region being the low back 31% (n = 32). Nearly 60% (n = 57) of farmers reported missing at least a full day's work as a consequence of their WMSD. Personal factors evaluated using binary regression analysis, were found not to influence whether or not a farmer experienced a WMSD. However, work-related factors such as larger European Size Units (ESUs, OR: 1.007, CI: 1.002-1.012), greater number of hectares farmed (OR: 2.501, CI: 1.208-4.920), higher income (OR: 1.859, CI: 1.088-3.177), dairy enterprise (OR: 1.734, CI: 1.081-2.781), and working on a full-time farm (OR: 2.156, CI: 1.399-3.321) increased the likelihood of experiencing a WMSD. Working on a full-time farm was the only factor found to independently predict WMSDs in the multiple regression analyses.

CONCLUSIONS

This study suggests that the prevalence of WMSDs can be reduced by the application of improved farm management practices. A more detailed examination of the risk factors associated with WMSDs is required to establish causality and develop effective interventions.

Acute pulmonary function change associated with work on large dairies in California

OBJECTIVE

To study whether dairy workers in California have lower baseline and greater cross-shift decrements in lung function than control employees.

METHODS

A cross-sectional study of 210 dairy and 47 control workers who completed questionnaires and spirometry before and after the work shift.

RESULTS

Dairy work was associated with mean baseline differences of -0.132 L (P = 0.07) and -0.131 L (P = 0.13) in forced expiratory volume in 1 second and forced vital capacity, respectively, compared with control employees, adjusting for age, height, smoking status, and days back at work since last day off. Dairy work was associated with a mean cross-shift difference of -65.2 mL (P = 0.02) and -103.1 mL (P < 0.01) in forced expiratory volume in 1 second and forced vital capacity, respectively, adjusting for smoking status and work-shift time.

CONCLUSIONS

Dairy work in California was associated with mild acute airway obstruction. The unclear long-term effect of dairy work in California merits further investigation.

Agricultural exposures and stroke mortality in the Agricultural Health Study

Exposures associated with common agricultural activities may increase risk of stroke. The authors evaluated associations between self-reported agricultural activities including pesticide use and handling of crops and stroke mortality among 51,603 male pesticide applicators enrolled in the Agricultural Health Study (AHS). Vital status was obtained through 2008. Stroke mortality was defined by underlying or contributing cause of death (ICD-9 430-438, ICD-10 I60-I69). Information regarding lifetime pesticide use, working with crops or animals, engagement in other agricultural activities, and potential confounders was self-reported at enrollment. Cox proportional hazards models, with age as the time scale, were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) adjusted for state of residence, smoking status, and alcohol consumption. Median follow-up time was 13 yr, during which 308 stroke deaths occurred. No measure of overall or specific pesticide use was positively associated with mortality due to stroke. Stroke mortality was inversely associated with handling hay, grain, or silage at least once each year as reported at enrollment (HR: 0.75; 95% CI: 0.58, 0.98). There was no evidence of an association between pesticide use and stroke mortality. The inverse association between handling of hays and grains and stroke mortality may be due to (1) those engaging in such activities being healthier than those who did not or (2) exposure to some biological agent present in hays and grains. Further investigation of incident stroke, rather than stroke mortality, as well as stroke subtypes, is needed to determine the full role of agricultural exposures and stroke.

Burnt sugarcane harvesting - cardiovascular effects on a group of healthy workers, Brazil

BACKGROUND

Brazil is the world's largest producer of sugarcane. Harvest is predominantly manual, exposing workers to health risks: intense physical exertion, heat, pollutants from sugarcane burning.

DESIGN

Panel study to evaluate the effects of burnt sugarcane harvesting on blood markers and on cardiovascular system.

METHODS

Twenty-eight healthy male workers, living in the countryside of Brazil were submitted to blood markers, blood pressure, heart rate variability, cardiopulmonary exercise testing, sympathetic nerve activity evaluation and forearm blood flow measures (venous occlusion plethysmography) during burnt sugarcane harvesting and four months later while they performed other activities in sugar cane culture.

RESULTS

Mean participant age was 31 ± 6.3 years, and had worked for 9.8 ± 8.4 years on sugarcane work. Work during the harvest period was associated with higher serum levels of Creatine Kinase - 136.5 U/L (IQR: 108.5-216.0) vs. 104.5 U/L (IQR: 77.5-170.5), (p = 0.001); plasma Malondialdehyde-7.5 ± 1.4 µM/dl vs. 6.9 ± 1.0 µM/dl, (p = 0.058); Glutathione Peroxidase - 55.1 ± 11.8 Ug/Hb vs. 39.5 ± 9.5 Ug/Hb, (p<0.001); Glutathione Transferase- 3.4±1.3 Ug/Hb vs. 3.0 ± 1.3 Ug/Hb, (p = 0.001); and 24-hour systolic blood pressure - 120.1 ± 10.3 mmHg vs. 117.0 ± 10.0 mmHg, (p = 0.034). In cardiopulmonary exercise testing, rest-to-peak diastolic blood pressure increased by 11.12 mmHg and 5.13 mmHg in the harvest and non-harvest period, respectively. A 10 miliseconds reduction in rMSSD and a 10 burst/min increase in sympathetic nerve activity were associated to 2.2 and 1.8 mmHg rises in systolic arterial pressure, respectively.

CONCLUSION

Work in burnt sugarcane harvesting was associated with changes in blood markers and higher blood pressure, which may be related to autonomic imbalance.

The Upper Midwest Health Study: industry and occupation of glioma cases and controls

BACKGROUND

Understanding glioma etiology requires determining which environmental factors are associated with glioma. Upper Midwest Health Study case-control participant work histories collected 1995-1998 were evaluated for occupational associations with glioma. "Exposures of interest" from our study protocol comprise our a priori hypotheses.

MATERIALS AND METHODS

Year-long or longer jobs for 1,973 participants were assigned Standard Occupational Classifications (SOC) and Standard Industrial Classifications (SIC). The analysis file includes 8,078 SIC- and SOC-coded jobs. For each individual, SAS 9.2 programs collated employment with identical SIC-SOC coding. Distributions of longest "total employment duration" (total years worked in jobs with identical industry and occupation codes, including multiple jobs, and non-consecutive jobs) were compared between cases and controls, using an industrial hygiene algorithm to group occupations.

RESULTS

Longest employment duration was calculated for 780 cases and 1,156 controls. More case than control longest total employment duration was in the "engineer, architect" occupational group [16 cases, 10 controls, odds ratio (OR) 2.50, adjusted for age group, sex, age and education, 95% confidence interval (CI) 1.12-5.60]. Employment as a food processing worker [mostly butchers and meat cutters] was of borderline significance (27 cases, 21 controls, adjusted OR: 1.78, CI: 0.99-3.18).

CONCLUSIONS

Among our exposures of interest work as engineers or as butchers and meat cutters was associated with increased glioma risk. Significant associations could be due to chance, because of multiple comparisons, but similar findings have been reported for other glioma studies. Our results suggest some possible associations but by themselves could not provide conclusive evidence.

Work organization and occupational health: perspectives from Latinos employed on crop and horse breeding farms

BACKGROUND

Agriculture is hazardous and increasingly dependent on Latino workers, a vulnerable population. However, little research has studied how work organization influences Latino farmworker health.

METHODS

Using a work organization framework, this cross-sectional study describes and compares the work organization and occupational health characteristics of a sample of Latino crop (n = 49) and horse production (n = 54) workers in Kentucky.

RESULTS

Crop workers experienced more physical demands, work-related and environmental stressors, and musculoskeletal and ill-health symptoms. Significantly more crop workers indicated work-related illness or missed work due to work-related illness/injury, though one-fourth of both groups reported work-related injury in the past year. A majority of both groups cited exposure to toxic chemicals, a minority of whom received training on their use.

CONCLUSION

Further surveillance is needed to understand the rate and precursors of illness/injury in these populations, as is research on the relationship between supervisory practices, psychosocial stressors, and occupational health.

[Asbestos and agriculture: new perspectives of risk]

The presence of ophiolites in areas of Basilicata, where there have been reports of mesothelioma in farmers, is known. This study evaluates the increased risk of exposure to tremolite in carrying out agricultural activities. Cases of mesothelioma occurred in farmers with unknown exposure to asbestos have been selected and assessed the employment in areas contaminated by tremolite. Personal samplings were conducted in a group of farmers employed in these areas and a group of subjects used in activities that do not involve contact with the ground. For the 5% of cases of mesothelioma in the lucan register emerged exposure to asbestos exclusively in farming activities in areas at tremolite risk. The analysis of the samples showed the presence of personal fibers of tremolite in 2/3 of the cases. In 60% there was an overcoming of the natural limit of 2 ff/l, with a peak up to 23.6 ff/l. The study shows that the risk of exposure to tremolite in agriculture is significantly higher than natural exposure.

Epidemiologic investigation of an occupational illness of tobacco harvesters in southern Brazil, a worldwide leader in tobacco production

OBJECTIVES

As part of smoking surveillance, the authors conducted an epidemiologic investigation in southern Brazil to identify the occurrence of Green Tobacco Sickness and risk factors for illness and to recommend control and prevention measures.

METHODS

A 1:2 case-control study matched by subjects' smoking habits. The study population was residents of Candelária, Rio Grande do Sul state, who farm tobacco and provided a urine sample for cotinine measurement by high-performance liquid chromatography. Confirmed cases were persons with compatible clinical presentation (headache, nausea, vomit, dizziness or weakness) and cotinine level >10 ng/ml. Controls were persons without compatible signs or symptoms. The association measure was the matched OR with 95% CIs and p<0.05.

RESULTS

Of 33 confirmed cases, 64% were men, average age was 33 years (SD ± 11.8 years) and 57% were landowners. Cases have had similar illness in the past and were likelier to be workers hired by farmers-landowners than controls. Multivariate analysis yielded independent association between these variables and illness, controlled for age and sex. Contact with pesticides and working with wet tobacco leaves were not associated with illness.

CONCLUSIONS

The authors confirmed Green Tobacco Sickness in southern Brazil; the authors recommend investigation of its prevalence in tobacco-growing regions and monitoring of and education about the disease and its prevention by occupational health authorities.

Health, environment and working conditions in tobacco cultivation: a review of the literature

This study presents a review of the literature published between 1979 and 2010 on health and working conditions in tobacco cultivation, with particular emphasis on the Brazilian context. A review of computerized databases (PubMed, Scopus, WilsonWeb and Bireme/PAHO Virtual Health Library - Public Health) was carried out using the following search terms: tobacco, agricultural worker health, agricultural worker disease, working conditions, unsafe working conditions, occupational risk, occupational disease, and labor force. Articles published in English, Spanish and Portuguese were analyzed. Thirty-seven articles were selected from 214 references that were initially identified. Thirty-four additional publications (reports, etc.) were also analyzed. Among the many effects described in the literature, especially noteworthy are "green tobacco sickness," respiratory disorders, musculoskeletal injuries, mental disorders, and a negative environmental impact. Very few studies have been carried out in Brazil.

Environmental health impacts of tobacco farming: a review of the literature

OBJECTIVE

To review the literature on environmental health impacts of tobacco farming and to summarise the findings and research gaps in this field.

METHODS

A standard literature search was performed using multiple electronic databases for identification of peer-reviewed articles. The internet and organisational databases were also used to find other types of documents (eg, books and reports). The reference lists of identified relevant documents were reviewed to find additional sources.

RESULTS

The selected studies documented many negative environmental impacts of tobacco production at the local level, often linking them with associated social and health problems. The common agricultural practices related to tobacco farming, especially in low-income and middle-income countries, lead to deforestation and soil degradation. Agrochemical pollution and deforestation in turn lead to ecological disruptions that cause a loss of ecosystem services, including land resources, biodiversity and food sources, which negatively impact human health. Multinational tobacco companies' policies and practices contribute to environmental problems related to tobacco leaf production.

CONCLUSIONS

Development and implementation of interventions against the negative environmental impacts of tobacco production worldwide are necessary to protect the health of farmers, particularly in low-income and middle-income countries. Transitioning these farmers out of tobacco production is ultimately the resolution to this environmental health problem. In order to inform policy, however, further research is needed to better quantify the health impacts of tobacco farming and evaluate the potential alternative livelihoods that may be possible for tobacco farmers globally.

Studies of farmers' annual exposure to whole body vibration on selected family farms of mixed production profile

The objective of the study was to recognize and evaluate the annual exposure of private farmers to whole body mechanical vibration on selected family farms of mixed production profile (plant-animal). The scope of study covered the carrying out of time schedules of agricultural activities, and measurements of the frequency weighted vibration acceleration (m/s(2)), expressed as effective values (r.m.s.) for each of three spatial directions on the seat surface within the period of the whole year. The basic vibration parameter was vibration dose (d). The following values were determined: total monthly vibration dose, mean equivalent daily vibration dose, and mean equivalent daily vibration acceleration. The highest values of the total monthly vibration dose (d) were observed in April and August (55.3-56.7 m(2)/s(4).h). The mean equivalent of daily vibration acceleration showed the highest values in four months of the year: April, August, September and October (0.49-0.60 m/s(2)); the average value of this parameter for the whole year reached the level of 0.44 m/s(2) - below the standard. Due to the occurrence in agricultural vehicles of mechanical shocks (mean values of maximum vibration acceleration: 0.82-1.00 m/s(2); exceeding the standard), and exceeding of the daily exposure action value, proper steps should be undertaken with respect to the protection of private farmers against risk resulting from exposure to mechanical vibration while performing work activities.

The safe home project

The Thai Health Promotion Foundation supported the Improvement of Quality of Life of Informal Workers project in Ban Luang District, Amphur Photaram, Ratchaburi Province. There were many informal workers in Ban Luang District. Sweet-crispy fish producers in Ban Luang were the largest group among the sweet-crispy fish producers in Thailand. This project was aimed at improving living and working conditions of informal workers, with a focus on the sweet-crispy fish group. Good practices of improved living and working conditions were used to help informal workers build safe, healthy and productive work environments. These informal workers often worked in substandard conditions and were exposed to various hazards in the working area. These hazards included risk of exposure to hot work environment, ergonomics-related injuries, chemical hazards, electrical hazards etc. Ergonomics problems were commonly in the sweet-crispy fish group. Unnatural postures such as prolonged sitting were performed dominantly. One hundred and fifty informal workers participated in this project. Occupational health volunteers were selected to encourage occupational health and safety in four groups of informal workers in 2009. The occupational health volunteers trained in 2008 were farmers, beauty salon workers and doll makers. The occupational health and safety knowledge is extended to a new informal worker group: sweet-crispy fish producer, in 2009. The occupational health and safety training for sweet-crispy fish group is conducted by occupational health volunteers. The occupational health volunteers increased their skills and knowledge assist in to make safe home and safe community through participatory oriented training. The improvement of living and working condition is conducted by using a modified WISH, Work Improvement for Safe Home, checklist. The plans of improvement were recorded. The informal workers showed improvement mostly on material handling and storage. The safe uses and safe storage of chemicals were introduced among farmers. The awareness of healthcare using personal protective equipments is increased in all groups especially in farmers. Safe home by local occupational health volunteer is proposed to be one effective measure for improvement of quality of life.

Harvest of need: addressing health and safety challenges on North Carolina's farms

Agriculture is North Carolina's leading source of revenue and its most dangerous industry. This issue brief, along with the commentaries and sidebars in the associated policy forum, addresses the complexity of agricultural health and safety in North Carolina and concludes that the following activities are crucial to reducing the incidence of agricultural illness, injury, and death in the state: (1) positive promotion of safe and healthy farms, (2) increased funding for existing programs, (3) creation of a task force to develop a dedicated, comprehensive surveillance system for agricultural illness, injury, and fatality, (4) increased emphasis on and funding for training of health care professionals and emergency response personnel in agricultural health and safety, (5) funding to expand farm health and safety programs to all 100 counties, and (6) strong collaborations to further develop and strengthen a seamless, holistic system for addressing the state's agricultural health and safety needs.