Anxiety and Depression Symptoms Among Farmers: The HUNT Study, Norway

Exploring longitudinal associations between farmer health and well-being and dairy herd subclinical mastitis prevalence and productivity: The HUNT Study, Norway

The health and well-being of farmers is one aspect of the sustainability of agriculture, as is the health and productivity of livestock. Previous research suggests a possible association between the two, but the complexity of the relationships between farmers and their livestock can hamper research efforts. This observational study uses high quality existing survey and register data from a cohort of Norwegian dairy enterprises to explore possible longitudinal associations between farmer health and well-being (general health, chronic disease or condition, chronic pain, anxiety or depression symptoms, or poor life satisfaction) and changes in dairy herd udder health (estimated by the proportion of milk tests with a high somatic cell count [SCC%]) or milk yield (kg/cow-year Eq). We found evidence of a general trend toward increased SCC% with poor farmer health or well-being. If the farmer had poor self-reported general health, the odds ratio (OR) for a 1-yr increase in SCC% at the enterprise was 1.51 (95% CI: 0.76, 2.99) and 1.80 (0.71, 4.51) after adjustment for possible effect modifiers, compared with those with good health, and for poor life satisfaction the OR was 1.50 (0.71, 3.15) and 2.61 (0.92, 7.39) after adjustment. We also find evidence that enterprises where a farmer was experiencing poor health or well-being tended to have lower odds of a decrease in milk yield than other enterprises. The OR for a 1-yr decrease in milk yield with any chronic disease or condition was 0.42 (0.24, 0.76), and with symptoms of anxiety or depression the OR was 0.56 (0.23, 1.34). Potential confounders and effect modifiers are discussed and explored. These results suggest that further longitudinal research to unravel the relationships between farmer health and well-being, and livestock health and productivity is needed.

Validation of visual analog scales of mood and anxiety at the workplace

The Hospital Anxiety and Depression Scale (HADS) is commonly used to detect depressive or anxious states, but its 14-item questionnaire is time-consuming. Visual analog scales (VAS) are easy to use and quick to implement. Although the VAS has been validated to assess pain and occupational stress, VAS scores for anxiety and mood have never been evaluated in the workplace. We aimed to validate the use of visual analog scales (VAS) for anxiety and mood compared to HADS in workers. A HADS self-reported questionnaire associated with VAS assessing perceived anxiety and mood on a horizontal line of 100 mm was administered to 182 workers, with a second test (retest) proposed one week later. Sociodemographic, characteristics of work, sleep, well-being, and stress were also assessed. VAS anxiety and mood correlated with the HADS sub-scores (0.70 and 0.65, respectively). The test-retest reliability was good. Optimal VAS cut-offs were ≥ 60/100 for anxiety and ≤ 60/100 for mood, to define at-risk patients. The VAS is quick to perform, easy to use, and reliable for screening depression and anxiety in occupational medicine. We recommend validated questionnaires for at-risk patients.

TRIAL REGISTRATION

CLINICALTRIALS

gov: NCT02596737. Available at: https://www.

CLINICALTRIALS

gov/ct2/show/NCT02596737.

Sowing seeds of awareness: a cross-sectional analysis of mental health literacy and help-seeking in Irish farmers

BACKGROUND

Farmers around the world are at risk of depression, anxiety, and suicidal ideation yet many avoid seeking help. In Ireland, farmers' mental health is a national concern, as farmers face barriers of masculine norms around help-seeking. This study aimed to examine the prevalence and relationship between mental health literacy and mental health help-seeking in the Irish farming community. It also aimed to identify if mental health literacy or mental health help-seeking differed depending on gender, age, education, health status and income level.

METHODS

We conducted a cross-sectional assessment of 351 Irish farmers' mental health literacy and help-seeking using validated psychometric measures: the Mental Help Seeking Intention Scale (MHSIS), the Attitudes Toward Seeking Professional Psychological Help Short Form (ATSPPH-SF), and the Multicomponent Mental Health Literacy Measure (MMHL).

RESULTS

Irish farmers' mental health literacy and help-seeking scores were interrelated. Though low, farmers' scores were comparable to the general population and higher than some European samples. Despite broadly favourable attitudes towards seeking professional mental health help, Irish farmers perceived significant barriers to accessing care and exhibited stoic health attitudes. Farmers with less education and men were particularly at risk.

CONCLUSION

Irish farmers' stoic attitudes may be a response to their perceived lack of services. Interventions providing mental health literacy education and improving access to existing mental health services are particularly important for this population of farmers.

Creating an Age-Friendly Environment in Farming - The Farmer's Yards Approach

With demographic trends highlighting an inversion of the farming community age pyramid, with those aged 65 years and over constituting the fastest growing subgroup of the farming population globally, this article highlights a social initiative for older farmers called Farmer's Yards, embodying values, and aspirations pertinent to farmers in their later years, that is helping to create an age-friendly environment in farming in line with World Health Organisation (WHO) guidelines. By providing older farmers with a platform for sustained social engagement and inclusion within the farming community, this social initiative aligns with principles promoting active and healthy aging, thereby contributing positively to their mental health and wellbeing in later life. In doing so, Farmer's Yards is helping to address recent calls by the European Commission for an increased emphasis on the delivery of creative mechanisms that enhance the quality of life of older farmers through social policy. The pilot phase of this social initiative outlined in this article, held in a Livestock Mart (Auction Market) setting in the west of Ireland, demonstrates how Farmer's Yards can strengthen Mart's long-standing position and reputation as centres of social activity within rural areas by helping older farmers maintain legitimate social connectedness, collegiality, and comradeship with their peers in advancing age in their respective regions, and in turn, combat social isolation and loneliness in later life. Recommendations for future research and on the expansion of Farmer's Yards are subsequently outlined.

The role of OsBZR4 as a brassinosteroid-signaling component in mediating atrazine and isoproturon degradation in rice

Development of a biotechnological system for rapid degradation of pesticides is important to mitigate the environmental, food security, and health risks that they pose. Degradation of atrazine (ATZ) and isoproturon (IPU) in rice crops promoted by the brassinosteroid (BR) signaling component BRASSINAZOLE RESISTANT4 (OsBZR4) is explored. OsBZR4 is localized in the plasma membrane and nucleus, and is strongly induced by ATZ and IPU exposure. Transgenic rice OsBZR4-overexpression (OE) significantly enhances resistance to ATZ and IPU toxicity, improving growth, and reducing ATZ and IPU accumulation (particularly in grains) in rice crops. Genetic destruction of OsBZR4 (CRISPR/Cas9) increases rice sensitivity and leads to increased accumulation of ATZ and IPU. OE plants promote phase I, II, and III metabolic reactions, and expression of corresponding pesticide degradation genes under ATZ and IPU stress. UPLC-Q-TOF-MS/MS analysis reveals increased relative contents of ATZ and IPU metabolites and conjugates in OE plants, suggesting an increased OsBZR4 expression and consequent detoxification of ATZ and IPU in rice and the environment. The role of OsBZR4 in pesticide degradation is revealed, and its potential application in enhancing plant resistance to pesticides, and facilitating the breakdown of pesticides in rice and the environment, is discussed.

Farmers' Mental Health: The Mediating Role of Chronic Fatigue

The agricultural environment is known to be particularly harmful to farmers' psychological health. To better understand how its impact is modulated, this study mainly focuses on the mediating role of chronic fatigue between A) loneliness at work, autonomy, workload, government regulations and policies and financial hardship, and B) life satisfaction, positive affect and psychological distress. The study is based on a sample of 453 Canadian dairy farmers. Structural equation modeling analyses confirmed the mediating role of chronic fatigue in the relationships between the factors studied, with the exception of financial hardship. Implications for research and the psychological burden affecting agricultural workers are discussed.

Introducing the Role of Genotoxicity in Neurodegenerative Diseases and Neuropsychiatric Disorders

Decades of research have identified genetic and environmental factors involved in age-related neurodegenerative diseases and, to a lesser extent, neuropsychiatric disorders. Genomic instability, i.e., the loss of genome integrity, is a common feature among both neurodegenerative (mayo-trophic lateral sclerosis, Parkinson's disease, Alzheimer's disease) and psychiatric (schizophrenia, autism, bipolar depression) disorders. Genomic instability is associated with the accumulation of persistent DNA damage and the activation of DNA damage response (DDR) pathways, as well as pathologic neuronal cell loss or senescence. Typically, DDR signaling ensures that genomic and proteomic homeostasis are maintained in both dividing cells, including neural progenitors, and post-mitotic neurons. However, dysregulation of these protective responses, in part due to aging or environmental insults, contributes to the progressive development of neurodegenerative and/or psychiatric disorders. In this Special Issue, we introduce and highlight the overlap between neurodegenerative diseases and neuropsychiatric disorders, as well as the emerging clinical, genomic, and molecular evidence for the contributions of DNA damage and aberrant DNA repair. Our goal is to illuminate the importance of this subject to uncover possible treatment and prevention strategies for relevant devastating brain diseases.

Farming, finance and family: factors associated with anxiety, depression and stress among Western Australian farmers

Farming is a challenging, stressful and rewarding occupation involving many factors that are beyond farmers' control. The aim of this study was to investigate correlates associated with the anxiety, depression and stress of farmers in Western Australia. Farmers and farm residents (N = 124) completed an online survey assessing anxiety, depression, stress, farming stressors, social supports, coping strategies and sense of belonging. Higher financial/external trade and societal pressures, family/relationship tension, use of coping strategies such as self-blame, venting, disengagement and planning, lack of succession planning and considering selling the farm, and lower social support and sense of belonging, were associated with higher anxiety, depression and/or stress. The findings highlight the specific impacts of financial and family pressures on poorer mental health status among farmers. Clinical and community interventions that build on naturally occurring strengths, such as family support and community connectedness, are needed.

Cohort profile: The FarmMERGE project-Merging human and animal databases to investigate the relationship between farmer and livestock health and welfare. The HUNT Study

Stockmanship is an important determinant for good animal welfare and health. The goal of the FarmMERGE project is to investigate the associations between farmer health and work environment, and the health, productivity and welfare of their livestock. We merged several livestock industry databases with a major total population-based health study in Norway (The Trøndelag Health Study 2017-2019 (HUNT4)). This paper describes the project's collection and merging of data, and the cohort of farmers and farms that were identified as a result of our registry merge. There were 56,042 participants of HUNT4 (Nord-Trøndelag County participants only, participation rate: 54.0%). We merged a list of HUNT4 participants whose self-reported main occupation was "farmer" (n = 2,407) with agricultural databases containing production and health data from sheep, swine, dairy and beef cattle from 2017-2020. The Central Coordinating Register for Legal Entities was used as an intermediary step to achieve a link between the farmer and farming enterprise data. We identified 816 farmers (89.5% male, mean age 51.3 years) who had roles in 771 farming enterprises with documented animal production. The cohort included 675 unique farmer-farm combinations in cattle production, 139 in sheep, and 125 in swine. We linked at least one HUNT4 participant to approximately 63% of the dairy farms, 53% of the beef cattle farms, 30% of the sheep farms, and 38% of the swine farms in Nord-Trøndelag County in the 2017-2019 period. Using existing databases may be an efficient way of collecting large amounts of data for research, and using total population-based human health surveys may decrease response bias. However, the quality of the resulting research data will depend on the quality of the databases used, and thorough knowledge of the databases is required.

Depression in Brazilian farmers: prevalence and associated factors

BACKGROUND

The unique characteristics of rural areas and agricultural work can contribute to the genesis of diseases, including mental disorders such as depression.

AIMS

To estimate the prevalence of and factors associated with depression symptoms in Brazilian farmers.

METHODS

A cross-sectional epidemiological study involving 784 farmers of the state of Espírito Santo/Brazil was carried out. Depression was identified using the Mini-International Neuropsychiatric Interview. Hierarchical logistic regression was used to assess the associated factors.

RESULTS

The prevalence of depression symptoms among farmers was 16.8% (n = 132). Of those experiencing symptoms, 6.1% (n = 48) we're currently experiencing a depressive episode, and 10.7% (n = 84) a recurrent depressive episodes. The associated factors were: female gender (OR 1.63; 95% CI 1.04-2.54), not owning the land (OR 1.79; 95% CI 1.11-2.89), professional dissatisfaction (OR 1.99; 95% CI 1.18-3.35), previous pesticide poisoning (OR 2.87; 95% CI 1.45-5.67), complex multimorbidity (OR 1.95; 95% CI 1.15-3.31) and occurrence of previous depressive episodes (OR 9.83; 95% CI 4.39-21.99).

CONCLUSIONS

A high prevalence of depression symptoms was identified among rural workers. Sociodemographic, occupational, clinical, and professional dissatisfaction factors were associated with a higher risk of depression symptoms in this population.

Improving the mental health of farmers: what types of remote support are acceptable, feasible, and improve outcomes? A feasibility RCT

BACKGROUND

The farming community have high rates of poor mental health, and are relatively 'hard to reach' with mental health services. The aim of this study was therefore to undertake a feasibility RCT, based on two mental health interventions. These were (1) CBT based 'Living Life to the Full for Farming Communities' (LLTTF-F; www.llttf.com ), and (2) a holistic social and emotional support service delivered by the Royal Scottish Agricultural Benevolent Institution (RSABI). The feasibility was supplemented by process evaluation.

METHODS

This feasibility study aimed to recruit 40 individuals from the farming community who were experiencing a common health problem defined as a score of >  = 8 on PHQ-9. A snowball approach was used to recruit interested individuals who had an association with farming. An initial telephone call screened for eligibility and obtained consent to randomisation to the two specified interventions, or to a thirdly group receiving a combination of both LLTTF-F and 'Social and emotional support'. Participants were permitted to override the randomised option if they expressed a strong preference before the interventions began.

RESULTS

Thirty-two participants provided baseline and three-month data. All three interventions showed positive improvements on PHQ-9 scores as follows: the 'combined intervention' mean baseline score was 18.1 compared to 12.0 at 3-month follow-up (mean change 6.1). 'Social and emotional support' mean baseline score was 11.3 compared to 6.7 at 3-month follow-up (mean change 4.6). 'LLTTF-F CBT-based intervention only' mean baseline score was 11.8 compared to 4.5 at 3-month follow-up (mean change 7.3). The retention rate was 81% at three months. In a sub-group of the LLTTF-F CBT-based intervention online materials were supplemented by telephone guided support. This approach received very positive feedback.

CONCLUSIONS

Recruitment from the farming community required intense effort, and good engagement can then be retained for at least three months. There is evidence that the interventions used were feasible, and tentative evidence that they had a demonstrable effect on mental wellbeing, with the LLTTFF providing the largest effect on PHQ-9 scores. Trial Registration Number ISRCTN27173711, submitted 25/08/2023, confirmed 22/092023.

One Welfare: Assessing the Effects of Drought and the COVID-19 Pandemic on Farmers' Well-Being and Their Perception of Goats' Welfare

Considering the interconnections between human well-being, animal welfare, and the environment, this study aimed to investigate the impacts of drought and the COVID-19 pandemic on small-scale goat farmers' well-being and their perception of goats' welfare following the One Welfare framework. Using a telephone survey, close-ended questions, and Likert scales, we assessed the impacts of drought and the COVID-19 pandemic on human well-being and animal welfare in the Coquimbo region of Chile. The DASS-21 questionnaire was used to evaluate farmers' mental health. Goat farmers perceived the scarcity of water and food for animals as factors that negatively affected animal productivity and welfare and caused an increase in farmers' stress levels. Farmers who had not been visited by a veterinarian showed higher levels of stress than those who received one visit during the year (M = 10 vs. 2, p = 0.025). Additionally, farmers who perceived better welfare of their animals showed lower levels of depression (rs = -0.17, p = 0.048), anxiety (rs = -0.21, p = 0.016), and stress (rs = -0.33, p < 0.001). These findings emphasize the importance of addressing farmers' mental health and veterinary support as crucial aspects to ensure both goat welfare and farm productivity.

A Cross-Sectional Study of Farmer Health and Wellbeing in Norway: The HUNT Study (2017-2019)

OBJECTIVES

Obtain a broad impression of the health and wellbeing of working farmers in a representative population.

METHODS

A cross-sectional study using data from a large, general population-based survey, The HUNT Study, Norway (HUNT survey 4, 2017-2019, response rate 54%). The study included 24,313 occupationally active participants aged 19 to 76 years, including 1,188 farmers. Prevalences are estimated for outcomes covering musculoskeletal, respiratory, and mental health as well as general health and life satisfaction, with adjustment for worker age and sex. The estimates for farmers are compared to skilled white collar workers and skilled manual workers.

RESULTS

Farmers had a higher estimated prevalence of poor overall health (prevalence ratio [PR] 1.56 [95%CI 1.34,1.82]), chronically impaired mobility (PR 1.83 [1.53, 2.20]), long-standing musculoskeletal pain or stiffness (PR 1.29 [1.21, 1.37]), work-related respiratory attack (PR 4.32 [3.67, 5.08]), depression symptoms (PR 1.30 [1.04, 1.61]) and symptoms of psychological distress (PR 1.23 [1.04, 1.47]) than skilled white collar workers. The estimated prevalence of poor overall health (PR 1.19 [1.00, 1.41]) and work-related respiratory attacks (PR 1.44 [1.24, 1.67]) was also higher for farmers than skilled manual workers, after adjustment for age and sex. Farmers had greater odds of rating themselves less satisfied with life in general than skilled white collar workers (adjusted OR 1.17 [1.04, 1.31]).

CONCLUSIONS

These results are consistent with previous research and add evidence that farm work is associated with high prevalences of a broad range of adverse health outcomes. The associations with chronically impaired mobility, long-standing musculoskeletal pain, and poor self-rated health were strong. The adjusted PRs for work-related respiratory attacks relative to both comparison groups were particularly high. More research is needed to identify and evaluate interventions that can improve farmer health.

Overage labor, intergenerational financial support, and depression among older rural residents: evidence from China

Background

Depression is a major factor affecting the happiness of older rural residents. With the increasing aging of the Chinese population, overage labor is becoming more prevalent in rural areas of China. This study aimed to assess whether, and if so, how, overage labor affects depression status in older rural residents.

Methods

Using data from the China Health and Retirement Longitudinal Study, this study explored the association between overage labor and depression among older rural residents by using ordinary least squares and moderated mediation models.

Results

The results show that overage labor significantly reduced levels of depression in older rural residents. This result remained robust after using propensity score matching and double machine learning. Furthermore, the improvement of older rural residents' depression via overage labor is mainly achieved through work income, but this mediating effect is negatively moderated by intergenerational financial support. This implies that in traditional Chinese rural society, intergenerational financial support from children plays an important role in reducing depression among older rural residents.

Conclusion

Our findings have potential policy implications for China and other developing countries in terms of addressing issues related to aging and depression in older adults.

Overage labor, value perceptions, and happiness in urban older adults' lives: Empirical evidence from China

Background

Over the past four decades, China has seen a rapid increase in the level of urbanization, along with an increasing number of older adults. How to promote active aging in the midst of rapid urbanization has become a new challenge for the Chinese government and all sectors of society. This study attempts to verify the relationship between overage labor and happiness in life, and further explore the possible mediating role of multidimensional value perceptions.

Method

Based on 5010 valid samples from the 2011, 2013, 2015, and 2018 China Health and Aging Tracking Survey datasets (CHARLS), the study explored and tested the differences in happiness in life between older adults with overage labor and retired older adults. In addition, this study further examined the mediating role of multidimensional value perceptions using a mediation model.

Results

(1) Urban older adults with overage labor had significantly higher levels of happiness in life compared to urban retired older adults. (2) The higher level of life happiness of urban older adults with overage labor depends on their perceptions of different values; (3) Specifically, the realization of value perceptions in personal, family and social dimensions through labor contributes to the life happiness of urban older adults with overage labor.

Conclusion

There is a significant difference between urban old adults with overage labor and urban retired old adults in terms of happiness in life. At the same time, the study confirmed that all three aspects of value perceptions, such as personal, family and social, are the mediating mechanisms between overage labor and urban old adults in terms of happiness in life.

Psychological Morbidity in the Farming Community: A Literature Review

The mental health of the farming community across industrialised nations has long been a major concern. Using an adapted procedure for a systematic literature review of observational epidemiological studies reporting prevalence (informed by the Joanna Briggs Institute method), this paper reviews peer-reviewed literature that explicitly compares farmer and non-farmer mental health (n = 48). In doing so, it provides a central and accessible evidence base for researchers and practitioners, and simultaneously reveals a stark lack of consensus; specifically, 54.0% of measures deployed to assess farmer mental health determined it to be the same as or even better than non-farming populations. This ambiguity sits in sharp contrast to the unequivocally worrisome farmer suicide statistics. Informed by the literature, the paper discusses potential reasons for this mismatch, including (i) farmers' progression through a different "pathway" to suicide that is not always preceded by mental illness, and (ii) a failure of current methods to accurately gauge the mental health status of farmers. The paper concludes by recommending more research into farmers' "pathway" to suicide, and highlights the need for a dedicated and multi-disciplinary programme of methods research that will afford a more culturally appropriate and effective means of understanding mental health in the farming community.

The Destructive Effects of Recreational Off-Highway Vehicles on Farmer Well-Being: Mental Health Consequences Outweigh Economic Losses

In many countries, the use of recreational off-highway vehicles (ROVs) occasionally spills over into agricultural lands. The conflict between ROV users and farmers is escalating due to the growing popularity of ROVs. Determined action of authorities for mitigating the phenomenon may necessitate an understanding of the nature and extent of the actual damage caused by ROVs. However, it is currently unknown how ROVs harm agriculture and what is their main deleterious effect on farmers. We tested our hypothesis that economic costs are the leading reason for farmer distress using in-depth interviews with 46 Israeli farmers that are affected by ROVs. We found that contrary to our hypothesis, economic costs were low and negligible, despite high levels of anger, distress, or hopelessness expressed by almost all farmers. The main reason for outrage and frustration was the emotional impact of ROV activity on the farmers. Therefore, measuring the effects of ROVs on agriculture in terms of economic losses will probably be ineffective in convincing policymakers to act against the reckless use of ROVs in agricultural lands. On the other hand, conveying the emotional implications for the farmers can potentially promote change if accompanied by explanations on the importance of caring for the mental health and well-being of a sector that already suffers from levels of stress and mental health problems that are among the highest of any other industry in the world.

Barriers to and Facilitators of Engaging With and Adhering to Guided Internet-Based Interventions for Depression Prevention and Reduction of Pain-Related Disability in Green Professions: Mixed Methods Study

BACKGROUND

Internet-based interventions (IBIs) are effective for the prevention and treatment of mental disorders and are valuable additions for improving routine care. However, the uptake of and adherence to IBIs are often limited. To increase the actual use of IBIs, it is important to identify factors for engaging with and adhering to IBIs.

OBJECTIVE

We qualitatively evaluated barriers and facilitators regarding a portfolio of guided IBIs in green professions (farmers, gardeners, and foresters).

METHODS

Interview participants were selected from 2 randomized controlled trials for either the prevention of depression (Prevention of Depression in Agriculturists [PROD-A]) or the reduction of pain interference (Preventive Acceptance and Commitment Therapy for Chronic Pain in Agriculturists [PACT-A]) in green professions. The intervention group in PROD-A (N=180) participated in an IBI program, receiving access to 1 of 6 symptom-tailored IBIs. The intervention group in PACT-A (N=44) received access to an IBI for chronic pain. Overall, 41 semistructured qualitative interviews were conducted and transcribed verbatim. Barriers and facilitators were identified via inductive qualitative content analysis, with 2 independent coders reaching almost perfect intercoder reliability (Cohen κ=0.92). A quantitative follow-up survey (30/41, 73%) was conducted to validate the results. Subgroup analyses were performed based on intervention characteristics.

RESULTS

We identified 42 barriers and 26 facilitators, which we assigned to 4 superordinate categories related to the intervention (20 barriers; 17 facilitators), work (4 barriers; 1 facilitator), individual (13 barriers; 8 facilitators), and technical (5 barriers; 0 facilitators) aspects. Key barriers (identified by at least 50% of the interviewees) were time-consuming work life (29/40, 73%) and time-consuming private life (23/40, 58%). Similarly, the most frequently identified facilitators included presence of motivation, curiosity, interest and perseverance (30/40, 75%), flexible time management at work (25/40, 63%), and support from family and friends (20/40, 50%). Although agreement with barriers in the quantitative follow-up survey was rather low (mean 24%, SD 11%), agreement with facilitators was substantially higher (mean 80%, SD 13%). Differences in agreement rates were found particularly between intervention completers and noncompleters. Completers agreed significantly more often that perceived IBI success; being motivated, curious, interested, and perseverant; and having a persisting level of psychological strain have been facilitating. Noncompleters agreed more often with experiencing the e-coach contact as insufficient and technical problems as hindering for intervention completion.

CONCLUSIONS

Based on these results, strategies such as customization of modules for more flexible and adaptive use; video chat options with the e-coach; options to facilitate social support by family, friends, or other participants; or using prompts to facilitate training completion can be derived. These approaches could be evaluated in further quantitative research designs in terms of their potential to enhance intervention use in this occupational group.

TRIAL REGISTRATION

German Clinical Trials Register DRKS00014000, https://tinyurl.com/3bukfr48; German Clinical Trials Register DRKS0001461, https://tinyurl.com/ebsn4sns.

Risk Factors for Brain Health in Agricultural Work: A Systematic Review

Certain exposures related to agricultural work have been associated with neurological disorders. To date, few studies have included brain health measurements to link specific risk factors with possible neural mechanisms. Moreover, a synthesis of agricultural risk factors associated with poorer brain health outcomes is missing. In this systematic review, we identified 106 articles using keywords related to agriculture, occupational exposure, and the brain. We identified seven major risk factors: non-specific factors that are associated with agricultural work itself, toluene, pesticides, heavy metal or dust exposure, work with farm animals, and nicotine exposure from plants. Of these, pesticides are the most highly studied. The majority of qualifying studies were epidemiological studies. Nigral striatal regions were the most well studied brain area impacted. Of the three human neuroimaging studies we found, two focused on functional networks and the third focused on gray matter. We identified two major directions for future studies that will help inform preventative strategies for brain health in vulnerable agricultural workers: (1) the effects of moderators such as type of work, sex, migrant status, race, and age; and (2) more comprehensive brain imaging studies, both observational and experimental, involving several imaging techniques.

Are guided internet-based interventions for the indicated prevention of depression in green professions effective in the long run? Longitudinal analysis of the 6- and 12-month follow-up of a pragmatic randomized controlled trial (PROD-A)

OBJECTIVE

Evidence of long-term stability for positive mental health effects of internet-based interventions (IBIs) for depression prevention is still scarce. We evaluate long-term effectiveness of a depression prevention program in green professions (i.e. agriculture, horticulture, forestry).

METHODS

This pragmatic RCT (n = 360) compares a tailored IBI program to enhanced treatment as usual (TAU+) in green professions with at least subthreshold depression (PHQ ≥ 5). Intervention group (IG) received one of six IBIs shown previously to efficaciously reduce depressive symptoms. We report 6- and 12-month follow-up measures for depression, mental health and intervention-related outcomes. Intention-to-treat and per-protocol regression analyses were conducted for each measurement point and complemented by latent growth modeling.

RESULTS

After 6 months, depression severity (β = -0.30, 95%-CI: -0.52; -0.07), insomnia (β = -0.22, 95%-CI: -0.41; -0.02), pain-associated disability (β = -0.26, 95%-CI: -0.48; -0.04) and quality of life (β = 0.29, 95%-CI: 0.13; 0.45) in IG were superior to TAU+. Onset of possible depression was not reduced. After 12 months, no intervention effects were found. Longitudinal modeling confirmed group effects attenuating over 12 months for most outcomes. After 12 months, 55.56% of IG had completed at least 80% of their IBI.

CONCLUSIONS

Stability of intervention effects along with intervention adherence was restricted. Measures enhancing long-term effectiveness of IBIs for depression health promotion are indicated in green professions.

TRIAL REGISTRATION

German Clinical Trial Registration: DRKS00014000. Registered: 09 April 2018.

Weather, Workload and Money: Determining and Evaluating Sources of Stress for Farmers in Ireland

The demands of modern farming can place substantial stress upon the farmer, adversely impacting their wellbeing. This study identifies both the prevalence of stress and assesses the demographic, farm, and social characteristics that impact the incidence of stress. We report the results of a survey of a nationally representative sample of farm enterprises in Ireland undertaken in association with the Teagasc National Farm Survey (NFS) in 2018, which saw 736 questionnaires completed by farm operators. Frequency analysis is used to report the primary sources and prevalence of stress. A probit model is developed identifying and quantifying the factors that impact the incidence of stress. There were 57% of farmers who reported experiencing stress resulting from their farm work. Key sources of stress included "poor weather", (47%), "workload" (32%) and "financial" concerns (28%). The results of the probit model establish that the effect of age on the incidence of stress is significant, positive, and non-linear, indicating as farmers get older they are more likely to experience stress but at a declining rate. Operating a sheep farm system, as opposed to any other type of farm system, reduces the probability of stress. Working off-farm also reduces the probability of stress by 0.097, other things being equal. The findings highlight variance in the levels of stress reported by farmers by age and farm system, and consequently, the need to develop targeted supports that take consideration of differences within the population of farmers and farm enterprises.

Locus of control moderates the association of COVID-19 stress and general mental distress: results of a Norwegian and a German-speaking cross-sectional survey

BACKGROUND

An internal locus of control (LoC I) refers to the belief that the outcome of events in one's life is contingent upon one's actions, whereas an external locus of control (LoC E) describes the belief that chance and powerful others control one's life. This study investigated whether LoC I and LoC E moderated the relationship between COVID-19 stress and general mental distress in the general population during the early months of the COVID-19 pandemic.

METHODS

This cross-sectional survey study analysed data from a Norwegian (n = 1225) and a German-speaking sample (n = 1527). We measured LoC with the Locus of Control-4 Scale (IE-4), COVID-19 stress with a scale developed for this purpose, and mental distress with the Patient Health Questionnaire 4 (PHQ-4). Moderation analyses were conducted using the PROCESS macro for SPSS.

RESULTS

The association between COVID-19 stress and general mental distress was strong (r = .61 and r = .55 for the Norwegian and the German-speaking sample, respectively). In both samples, LoC showed substantial moderation effects. LoC I served as a buffer (p < .001), and LoC E exacerbated (p < .001) the relation between COVID-19 stress and general mental distress.

CONCLUSIONS

The data suggest that the COVID-19 pandemic is easier to bear for people who, despite pandemic-related strains, feel that they generally have influence over their own lives. An external locus of control, conversely, is associated with symptoms of depression and anxiety. The prevention of mental distress may be supported by enabling a sense of control through citizen participation in policy decisions and transparent explanation in their implementation.

The impact of a 6-week community-based physical activity and health education intervention-a pilot study among Irish farmers

BACKGROUND

There is a higher prevalence of lifestyle-related diseases among Irish farmers than the general adult population. Lifestyle interventions that increase physical activity and improve dietary patterns have been associated with reduced chronic disease risk and improved quality of life among high-risk populations. The impact of lifestyle interventions among Irish farmers is unknown.

AIM

To assess the effectiveness of a community-based intervention on farmer health, cardiovascular fitness, lower limb strength endurance, and dietary intake.

METHODS

A 6-week physical activity and lifestyle education intervention involving two 60-min circuit-based exercise training sessions and one 60-min health education workshop per week was implemented. Pre- and post-measurements included total body weight, body fat percentage, lean muscle mass, resting blood pressure, fasting blood glucose, cholesterol, triglycerides, cardiovascular fitness, lower limb strength, perceived physical and mental health, and dietary intake.

RESULTS

Thirty farmers completed the intervention giving an adherence rate of 75%. At baseline, mean BMI (32.7 ± 4.1 kg/m²), body fat percent (31.7 ± 6.7), waist circumference (110.2 ± 10.4 cm), systolic (128.7 ± 7.8 mmHg) and diastolic (86.2 ± 6.8 mmHg) blood pressure were higher than recommended levels. Significant improvements (p < 0.05) were found for total body weight, BMI, waist and hip circumferences, cardiovascular fitness, lower limb strength endurance, systolic blood pressure, total energy, total fat, total unsaturated fat, monounsaturated fat, saturated fat, trans fat, total carbohydrate, sodium, cholesterol and percentage energy intakes of total fat, saturated fat, protein, and physical and mental health scores.

CONCLUSIONS

Irish farmers remain at high risk of developing chronic diseases but respond positively to lifestyle intervention.

Neighborhood farm density, types of agriculture, and depressive symptoms among older farmers: a cross-sectional study

BACKGROUND

Farmers may have an increased risk for poor mental health. In connection with this, factors specific to the neighborhood environment such as farm density and the type of agriculture, might be important for mental wellbeing. In this study we aimed to clarify the cross-level interaction on depressive symptoms between farm density at the neighborhood level by type of agriculture and the longest occupation of individuals (farmer or non-farmer).

METHODS

Data came from the 2016 wave of the Japan Gerontological Evaluation Study (JAGES) that were linked to governmental agricultural data. Information was analyzed from 147,549 respondents aged 65 years or older, residing in 1024 neighborhoods in 39 municipalities. We calculated farm (crop or animal husbandry) density at the neighborhood level, dividing the number of agricultural management entities by the population. Three-level (individual, neighborhood, and municipality) Poisson regression analysis was used to calculate the prevalence rate ratios of depressive symptoms.

RESULTS

The prevalence of depressive symptoms was higher among individuals whose longest occupation was farmer compared to non-farmer. The estimated probability of depressive symptoms by a cross-level interaction analysis showed that among farmers of both genders, those who were residing in neighborhoods where the farm density was low had a higher prevalence of depressive symptoms, regardless of the type of agriculture. The slope of the relationship between depressive symptoms and animal husbandry farm density varied by occupation, with a higher prevalence of depressive symptoms observed in male farmers compared to male non-farmers.

CONCLUSIONS

The high prevalence of depressive symptoms among farmers in neighborhoods with a low farm density may reflect a scarcity of formal and informal social support in such communities. The health effects of the neighborhood environment on farmers, such as farm density, which may vary by the type of agriculture, should be further researched.

Effectiveness of guided internet-based interventions in the indicated prevention of depression in green professions (PROD-A): Results of a pragmatic randomized controlled trial

BACKGROUND

Major Depressive Disorder (MDD) has a major impact on public health. Reduction of depression burden in general population is of greatest importance and might be achieved by implementation of depression prevention measures into routine care. We evaluate an online prevention measure as part of a national project aiming to reduce depression in the occupational group of green professions.

METHODS

This two-armed pragmatic RCT (n = 360) evaluates the effectiveness of a tailored internet-based intervention (IMI) program compared to enhanced treatment as usual. The IMI program entailed access to one of six guided IMIs each focusing on different symptom areas (depressive mood with optional comorbid diabetes, perceived stress, insomnia, panic and agoraphobia and harmful alcohol consumption). Eligible were entrepreneurs, spouses, family members and pensioners in green professions with adequate insurance status and at least subthreshold depression (PHQ≥5). Primary outcome was depressive symptom severity (QIDS-SR16) at 9-weeks post-treatment (T1). Various secondary outcomes were assessed at T1.

RESULTS

A small effect of depression reduction (d=-0.28, 95%-CI: -0.50 to -0.07) was found at T1 favouring the IMI program (β=-0.22, 95%-CI: -0.41 to -0.02, p=.033). Categorical analysis indicated a reduced risk of potential MDD with NNTB=28.11. Adherence to the IMI program at T1 was exceptionally low.

LIMITATIONS

Results are limited to green professions and representativeness might be restricted by self-selection of participants.

CONCLUSION

Depression burden in green professions can be reduced by this online prevention measure. Yet, short-term effectiveness is restricted by low adherence rates.

TRIAL REGISTRATION

German Clinical Trial Registration: DRKS00014000. Registered: 09 April 2018.

Identification of a novel function of a component in the jasmonate signaling pathway for intensive pesticide degradation in rice and environment through an epigenetic mechanism

Developing a biotechnical system with rapid degradation of pesticide is critical for reducing environmental, food security and health risks. Here, we investigated a novel epigenetic mechanism responsible for the degradation of the pesticide atrazine (ATZ) in rice crops mediated by the key component CORONATINE INSENSITIVE 1a (OsCOI1a) in the jasmonate-signaling pathway. OsCOI1a protein was localized to the nucleus and strongly induced by ATZ exposure. Overexpression of OsCOI1a (OE) significantly conferred resistance to ATZ toxicity, leading to the improved growth and reduced ATZ accumulation (particularly in grains) in rice crops. HPLC/Q-TOF-MS/MS analysis revealed increased ATZ-degraded products in the OE plants, suggesting the occurrence of vigorous ATZ catabolism. Bisulfite-sequencing and chromatin immunoprecipitation assays showed that ATZ exposure drastically reduced DNA methylation at CpG context and histone H3K9me2 marks in the upstream of OsCOI1a. The causal relationships between the DNA demethylation (hypomethylatioin), OsCOI1a expression and subsequent detoxification and degradation of ATZ in rice and environment were well established by several lines of biological, genetic and chemical evidence. Our work uncovered a novel regulatory mechanism implicated in the defense linked to the epigenetic modification and jasmonate signaling pathway. It also provided a modus operandi that can be used for metabolic engineering of rice to minimize amounts of ATZ in the crop and environment.

Suicide in Spanish Farmers in Two Geographical Areas with Differing Rates of Pesticide Use

This study assesses whether farmers' suicides were associated with the pesticide use in Spain. The cohort study followed 9.5 million men aged 20-64 years who were employed in 2001. The mortality among farmers and non-farmers during the period 2001-2011 was estimated in a geographical area with high pesticide use and in an area with low pesticide use. For three major causes of death (suicide, unintentional accidents, and rest of causes of death), we estimated the age-standardized mortality rates with 95% confidence intervals (CI) between farmers and non-farmers in both areas. Farmers in the high pesticide use area showed a lower mortality rate of suicide and unintentional accidents than farmers in the rest of Spain, with mortality rate ratios of 0.74 (95% CI 0.65-0.85) and 0.57 (95% CI 0.52-0.62), respectively. Our findings on pesticide use and farmers' suicide are different from those observed in several previous investigations.

General and reproductive health outcomes among female greenhouse workers: a comparative study

Background

Agricultural activities as well as exposure to pesticides could have many adverse effects on health status and reproductive outcomes especially in reproductive aged greenhouse workers. The present study aimed to compare the general and reproductive health outcomes between female greenhouse workers and housewives.

Methods

This cross-sectional study was conducted on 645 females of reproductive age. They were categorized into two groups according to occupation in greenhouse (308 female greenhouse workers as exposed group and 337 housewives as control group). Participants were interviewed using a questionnaire about reproductive outcomes and occupational status. Clinical measures include blood pressure (BP), pulse and respiratory rate (PR and RR), body mass index (BMI) and hematological parameters. Mann-Whitney U test was used to assess differences between two groups in quantitative variables. Chi-square or Fisher’s exact tests was used to determine the differences in the distribution of categorical variables. Data was analyzed using SPSS software version 16.

Results

The average daily working hours of the greenhouse workers were 6.94 ± 1.99 h. Only 44.3% of them used personal protective equipment. Data revealed that the rate of spontaneous abortion, infertility, low birth weight (LBW), abnormal births and preterm birth were significantly higher among the greenhouse workers compared to the control group (p ≤ 0.05). The average number of female infants in greenhouse workers was significantly higher than the control group (p ≤ 0.05). Clinical measurements indicated an increase in RR of greenhouse workers and mean of BMI was decreased in them. Hematological parameters demonstrated that there was a significant increase in white blood cells (WBC) and significant decrease in hemoglobin (Hb), hematocrit (HCT), mean corpuscular volume (MCV) and mean corpuscular hemoglobin concentration (MCHC) among the female greenhouse workers compared to the control (p ≤ 0.05).

Conclusion

Local government efforts is needed to address associated issues including acute effects on health and long-term health risks, resulting from pesticide exposure to greenhouse workers, and gender differences should be considered. Also, occupational health and safety training is necessary and can be helpful in reducing adverse reproductive outcomes.

Stress, anxiety, depression, and resilience in Canadian farmers

PURPOSE

To estimate the prevalence of stress, anxiety, depression, and resilience amongst Canadian farmers.

METHODS

An online cross-sectional survey using validated psychometric scales [Perceived Stress Scale (PSS), Hospital Anxiety and Depression Scale, Connor-Davidson Resilience Scale] conducted with farmers in Canada between September 2015 and February 2016.

RESULTS

1132 farmers participated in the study. The average PSS score was 18.9. Approximately 57% and 33% of participants were classified as possible and probable cases for anxiety, respectively; the respective proportions for depression were 34% and 15%. The average resilience score was 71.1. Scores for stress, anxiety, and depression were higher, and resilience lower, than reported normative data. Females scored less favorably on all mental health outcomes studied, highlighting important gender disparities.

CONCLUSIONS

These results highlight a significant public health concern amongst farmers, and illustrate a critical need for research and interventions related to farmer mental health. These findings are important for policymakers, physicians, and public and mental health service providers, and can help to inform decision-making, policy recommendations, resource allocation, and development and delivery of training programs for farmers.

Suicide and Types of Agriculture: A Time-Series Analysis in Japan

OBJECTIVE

In recent years, rural areas have reported higher suicide rates than urban areas worldwide. Although agricultural activity is a key characteristic of many rural areas, rurality may also have heterogeneous qualities based on the type of agriculture pursued. However, to date, no study has examined potential linkages between suicide rate and types of agriculture.

METHOD

In this study, we used 1983-2007 annual time-series data of the standardized mortality ratio (SMR) of suicide and product-specific agricultural outputs in Japanese municipalities to shed light on this phenomenon. We conducted a multilevel linear regression analysis, taking into account a hierarchical structure of the time-series data, limiting our analysis to municipalities where agricultural land use was high.

RESULTS

Our multilevel analysis showed that the animal husbandry output was positively associated with suicide SMR in both women and men, with a stronger relationship among women, whereas no association was observed in agricultural crop output. Temporal analysis showed that the association could be observed consistently throughout the period between 1983 and 2007.

CONCLUSIONS

This study raises the possibility that the industrial and cultural characteristics of communities that rely on animal husbandry may be associated with an increased risk of suicide.

Farmer Burnout in Canada

While farmers in several countries worldwide are reported to be at higher risk for poor mental health outcomes like chronic stress, depression, and anxiety, there is a paucity of research on burnout in farmers. This cross-sectional study used an online survey administered between September 2015 and February 2016 to investigate burnout (as measured by the Maslach Burnout Inventory-General Survey (MBI-GS)) amongst farmers in Canada. The specific objectives were to measure the three components of burnout (exhaustion, cynicism, and professional efficacy), and to explore potential associated risk factors, as well as to determine the prevalence of the different burnout profiles (engaged, ineffective, overextended, disengaged, and burnout). MBI-GS results were obtained from 1075 farmers. Approximately 70% of the study sample identified as male and 30% as female, and participants were from a variety of farming commodities. Scores for exhaustion, cynicism, and professional efficacy were all higher than international norms. While 43% of participants were classified as engaged, 44% were classified in the ineffective, overextended, or disengaged profiles (i.e., intermediate profiles on the engagement - burnout continuum), and 12% were classified in the burnout profile. Risk factor results highlighted the positive effects of farmer support from spouse/romantic partner, friends, and industry. Overall, the results from this study demonstrate cause for concern with respect to farmer burnout, suggest potential avenues for intervention, and serve as a call to action to better support farmers in Canada.

Key Risk Factors Affecting Farmers' Mental Health: A Systematic Review

Recently, concern has increased globally over farmers' mental health issues. We present a systematic review of the outcomes, locations, study designs, and methods of current studies on farmers' mental health. In particular, this review aims to fill an important gap in understanding of the potential key risk factors affecting farmers' mental health around the world. 167 articles on farmer mental health were included in a final systematic review using a standardized electronic literature search strategy and PRISMA guidelines. The four most-cited influences on farmers' mental health in the reviewed literature respectively were pesticide exposure, financial difficulties, climate variabilities/drought, and poor physical health/past injuries. The majority of studies were from developed countries, most specifically from the United States, Australia, and the United Kingdom. Comparative studies on the mental health of farmers and other occupational workers showed mixed results, with a larger portion identifying that psychological health disturbances were more common in farmers and farm-workers. Knowledge of farmer psychological disorder risk factors and its impacts are essential for reducing the burden of mental illness. Further research will be required on climate change impacts, developing country farmers' mental health, and information on how to reduce help-seeking barriers amongst farmers.

Meeting Farmers Where They Are - Rural Clinicians' Views on Farmers' Mental Health

Objective: To explore rural clinicians' understanding of farmers' mental health and well-being, current health services, and potential responses.Methods: Qualitative design, with semi-structured, taped interviews of five family physicians and four mental health nurses-counselors practicing in rural Grey-Bruce counties, Ontario. Transcripts analyzed with N-Vivo through iterative coding of emergent themes and mapping of relationships among themes.Results: Participating rural clinicians all expressed admiration for farmers. They shared insights around three main themes: 1) farming as a unique subculture; 2) farming involved both benefits and challenges for health; and 3) farmers rarely seek care. Clinicians need to take advantage of contact opportunities to ask about mental health. Several suggested ways to meet farmers where they are, e.g., through better funding for house-farm calls and community events.Conclusion: Clinician responses to farmers' mental health challenges include recognizing farmers' distinct context. Complementary health promotion in conjunction with farm organizations is needed to reach farmers.

An Analysis of Farmers' Human Characteristics as Drivers of Their Anxiety

Background: Past research has shown farmer anxiety and stress have significantly affected many farmers and their families due not only to the impact on feelings of happiness and success, but also on output efficiency, accident rates, and health. The past approach to ameliorating anxiety has been through utilizing coping mechanisms such as sharing with significant others, venting, planning, self-blame, and positive thinking. A problem has also been farmers' reluctance to voice difficulties and seek help.Method: An alternative, more basic approach to anxiety amelioration is possible. This involves isolating the human characteristics that lead to anxiety, and subsequently modifying these to reduce anxiety and its associated impacts. Accordingly, the extensive literature on anxiety and stress was reviewed to facilitate developing an hypothesis outlining the important components explaining farmer anxiety. To assess the parameters of farmer anxiety, a random survey of New Zealand farmers was used to obtain their ratings on their anxiety. Regression models were used to quantify the relationships.Results: Specific farmer personal characteristics were shown to be highly related to anxiety. These included a farmer's personality, objective set, belief in their ability to control outcomes, as well as education and age.Conclusion: This analysis provides the information required to direct counseling efforts to modify the anxiety creating personal variables and, consequently, reduce anxiety and its impact on a longer term basis.

Depression, Suicidal Ideation, and Resilience among Rural Farmers in a Drought-Affected Area of Trichy District, Tamil Nadu

Background:

Changes in climatic conditions and other factors including trade and commerce have influenced agriculture worldwide. These factors have created a crisis among farmers.

Objectives:

The objective of this study was to find out the prevalence of depression and suicidal ideation, to measure the resilience, and to find out the factors that influence depression and resilience among farmers.

Materials and Methods:

A community-based cross-sectional analytical study was performed among farmers residing in a drought-affected area of Tiruchirappalli district of Tamil Nadu. The sample size was 191 and cluster sampling was used to select the participants. Structured, pretested questionnaires were used to find the prevalence of depression, suicidal ideation, and resilience among farmers. Pearson Correlation, Student's t-test, analysis of variance, and Pearson Chi-square test were used to identify the factors influencing depression and resilience.

Results:

A total of 194 farmers participated in the study. The mean age of the farmers was 46.68 ± 12.6 years, majority 64% were males and 89% were literates. Among the participants, 97.4% had some form of depression, and 67% had severe depression. About 60% of the farmers had suicidal ideation. Male farmers, farmers with few years of farming experience, and severe reduction in yield had a higher level of depression. Suicidal ideation was influenced by gender, small-scale farming, fewer years of experience in farming, and the impact of drought on yield. The mean resilience score was 49.4 ± 10. Gender and years of experience in farming had a significant association with resilience.

Conclusion:

High prevalence of depression and suicidal ideation and low level of resilience has been observed among the farmers. Interventions need to be provided for marginal and small-scale farmers, male farmers in the affected area to reduce the impact of drought in these farmers.

Farming habit, light exposure, physical activity, and depressive symptoms. A cross-sectional study of the HEIJO-KYO cohort

BACKGROUND

Bright light therapy and exercise interventions are effective methods for treating seasonal and non-seasonal affective disorders. Synchronization of internal circadian rhythms with the external environment by light therapy and physical activity may partly explain its efficacy. In the present study, we objectively measured daytime light exposure and physical activity in real life situations with elderly participants, and investigated the association between farming habits and the prevalence of depressive symptoms.

METHODS

This cross-sectional was conducted among 1005 participants (mean age: 71.5) of a community-based cohort study. Depressive symptoms were assessed by the Geriatric Depression Scale (GDS score ≥ 6) and administration of antidepressant.

RESULTS

Farming habit with long duration (> 7.0 h/week) showed significantly lower odds ratios (OR) for depressive symptoms (adjusted OR 0.63, 95% confidential interval,0.41 to 0.96) compared with participants without farming habit independent of confounders such as age, gender, body mass index smoking, drinking, daytime ambulatory systolic blood pressure, diabetes, living alone, education, income, and daylength. Even in farming with short duration (≤ 7.0 h/week), we found significant association with lower OR for depressive symptoms (adjusted OR 0.64, 95%CI, 0.42 to 0.97). Light exposure and daytime physical activity measured by wrist actigraphy were significantly higher among participants with longer farming habits (p for trend < 0.01). Physical activity mediated 12.0% of association between farming habit and depressive symptoms.

LIMITATIONS

A cross-sectional association may be found because the participants with depressive symptoms tended to avoid farming. A longitudinal study is warranted to determine the direction of causality.

CONCLUSIONS

Participants with farming habit showed significantly lower OR for depressive symptoms than those without farming habit, and it was partly mediated by physical activity.

The Mental Health of the Organic Farmer: Psychosocial and Contextual Actors

Despite the large body of research and literature on the health and mental health of farmers, we should not assume that research findings necessarily apply to the organic farmer. The limited literature on the mental health of the organic farmer points to potential differences. Research has found that workers on organic farms may be happier than their counterparts; others have identified added sources of stress related to the perceived need of organic farmers to embrace concepts linked to the organic movement. However, further research is needed to identify both risk and protective factors for mental health among organic farmers. The purpose of this qualitative descriptive study was to explore the psychosocial and contextual factors that may relate to the mental health of the organic farmer. Key informant interviews were conducted with 10 farm producers and 20 farm workers. The findings indicated that respondents recognized mental health as influential in the workplace and the future of organic practices (e.g., the mental, financial, physical stress). Some of the risk factors mentioned by participants reflected those experienced by conventional, nonorganic farmers. Participants also reported contentment with farming as an occupation, the benefits of being connected to the land, feelings of social and environmental responsibility, and engagement in social activities that may promote human and social capital. These feelings and activities ultimately benefit the farmer, contribute to social cohesion, and may have positive implications for mental health. Results suggest that there may be protective mental health factors unique to the organic farmer.

Anxiety and depression among dairy farmers: the impact of COPD

Background

Chronic obstructive pulmonary disease (COPD) and farming are two conditions that have been associated with an increased risk of anxiety and depression. Dairy farming is an independent risk factor for COPD.

Objective

To test the hypotheses that the prevalence of anxiety and/or depression is higher in dairy farmers with COPD than in farmers without COPD, and higher in dairy farmers with COPD than in non-farmers with COPD.

Methods

Anxiety and depression were evaluated using the Hospital Anxiety and Depression Scale in 100 dairy farmers with COPD (DF-COPD), 98 dairy farmers without COPD (DF-controls), 85 non-farming patients with COPD (NF-COPD) and 89 non-farming subjects without COPD (NF-controls), all identified by screening in the Franche-Comté region of France. Anxiety and depression were considered present when the Hospital Anxiety and Depression Scale score was ≥8. COPD was defined by a post-bronchodilator forced expiratory volume in 1 second/forced vital capacity ratio <0.7.

Results

The crude prevalence of anxiety did not differ between the four groups, ranging from 36% in NF-controls to 47% in NF-COPD (p=0.15 between groups). Similarly, the prevalence of depression did not differ significantly between the four groups (p=0.16 between groups). In dairy farmers (n=198), the only factors associated with anxiety were quality of life and current smoking. Depression in dairy farmers was associated with airflow limitation (lower forced expiratory volume in 1 second and COPD grade 2 or more) as well as with some COPD-related features (dyspnea severity, current smoking, and poorer quality of life). In non-farmers, both anxiety and depression were associated with airflow limitation and COPD-related features.

Conclusion

In our population, the prevalence of anxiety and/or depression was similar in dairy farmers with and without COPD and in non-farmers with COPD. Nevertheless, the degree of airway obstruction and some COPD-related features were associated with depression among dairy farmers, whereas these factors were not associated with anxiety.

Organic solvent exposure and depressive symptoms among licensed pesticide applicators in the Agricultural Health Study

PURPOSE

Although organic solvents are often used in agricultural operations, neurotoxic effects of solvent exposure have not been extensively studied among farmers. The current analysis examined associations between questionnaire-based metrics of organic solvent exposure and depressive symptoms among farmers.

METHODS

Results from 692 male Agricultural Health Study participants were analyzed. Solvent type and exposure duration were assessed by questionnaire. An "ever-use" variable and years of use categories were constructed for exposure to gasoline, paint/lacquer thinner, petroleum distillates, and any solvent. Depressive symptoms were ascertained with the Center for Epidemiologic Studies Depression Scale (CES-D); scores were analyzed separately as continuous (0-60) and dichotomous (<16 versus ≥16) variables. Multivariate linear and logistic regression models were used to estimate crude and adjusted associations between measures of solvent exposure and CES-D score.

RESULTS

Forty-one percent of the sample reported some solvent exposure. The mean CES-D score was 6.5 (SD 6.4; median 5; range 0-44); 92% of the sample had a score below 16. After adjusting for covariates, statistically significant associations were observed between ever-use of any solvent, long duration of any solvent exposure, ever-use of gasoline, ever-use of petroleum distillates, and short duration of petroleum distillate exposure and continuous CES-D score (p < 0.05). Although nearly all associations were positive, fewer statistically significant associations were observed between metrics of solvent exposure and the dichotomized CES-D variable.

CONCLUSIONS

Solvent exposures were associated with depressive symptoms among farmers. Efforts to limit exposure to organic solvents may reduce the risk of depressive symptoms among farmers.

Farm-Related Concerns and Mental Health Status Among Norwegian Farmers

The agricultural sector in Norway has undergone structural changes over the past 50 years. The objective of this study was to analyze the distribution of concerns about farm economy, work time, and mental complaints among Norwegian farmers. In a sample of single principal owner-operators (n = 2,676), we calculated the unadjusted and adjusted odd ratios (ORs) for concerns about the farm economy, concerns for insufficient time to complete work, and high symptom load of mental complaints. Structural equation modeling (SEM) was used to explore the associations between farm characteristics, concerns, and mental health. Farmers had a high probability for an increased symptom load of mental complaints. The level of farm income was more strongly associated with economic concerns and mental health concerns when a major part of total household income resulted from farming. The high workload required in farming combined with off-farm supplemental employment was additionally associated with higher levels of time concerns and mental complaints. Norwegian farmers have a relatively high workload both in farming and in off-farm work but are able to make sustainable plans for their individual workload needs. The high individual workload in both these arenas poses a challenge, but was not associated with a greater probability for a high symptom load of mental complaints.

Symptoms of depression and all-cause mortality in farmers, a cohort study: the HUNT study, Norway

OBJECTIVES

To explore all-cause mortality and the association between symptoms of depression and all-cause mortality in farmers compared with other occupational groups, using a prospective cohort design.

METHODS

We included adult participants with a known occupation from the second wave of the Nord-Trøndelag Health Study (Helseundersøkelsen i Nord-Trøndelag 2 (HUNT2) 1995-1997), Norway. Complete information on emigration and death from all causes was obtained from the National Registries. We used the depression subscale of the Hospital Anxiety and Depression Scale (HADS) to measure symptoms of depression. We compared farmers to 4 other occupational groups. Our baseline study population comprised 32 618 participants. Statistical analyses were performed using the Cox proportional hazards models.

RESULTS

The estimated mortality risk in farmers was lower than in all other occupations combined, with a sex and age-adjusted HR (0.91, 95% CI 0.82 to 1.00). However, farmers had an 11% increased age-adjusted and sex-adjusted mortality risk compared with the highest ranked socioeconomic group (HR 1.11, 95% CI 0.98 to 1.25). In farmers, symptoms of depression were associated with a 13% increase in sex-adjusted and age-adjusted mortality risk (HR 1.13, 95% CI 0.88 to 1.45). Compared with other occupations this was the lowest HR, also after adjusting for education, marital status, long-lasting limiting somatic illness and lifestyle factors (HR 1.08, 95% CI 0.84 to 1.39).

CONCLUSIONS

Farmers had lower all-cause mortality compared with the other occupational groups combined. Symptoms of depression were associated with an increased mortality risk in farmers, but the risk increase was smaller compared with the other occupational groups.

Disability pension and symptoms of anxiety and depression: a prospective comparison of farmers and other occupational groups. The HUNT Study, Norway

OBJECTIVES

Agriculture has undergone major changes, and farmers have been found to have a high prevalence of depression symptoms. We investigated the risk of work disability in Norwegian farmers compared with other occupational groups, as well as the associations between symptoms of anxiety and depression and future disability pension.

METHODS

We linked working participants of the HUNT2 Survey (1995-97) aged 20-61.9 years, of whom 3495 were farmers and 25,521 had other occupations, to national registry data on disability pension, with follow-up until 31 December 2010. We used Cox proportional hazards regression to estimate hazard ratios (HRs) of disability pension, and to investigate the associations between symptoms of anxiety and depression caseness at baseline (score on the anxiety or depression subscales of the Hospital Anxiety and Depression Scale (HADS) ≥8) and disability pension.

RESULTS

Farmers had a twofold increased risk of disability pension (age-adjusted and sex-adjusted HR 2.07, 95% CI 1.80 to 2.38) compared with higher grade professionals. Farmers with symptoms of depression caseness had a 53% increased risk of disability pension (HR 1.53, 95% CI 1.25 to 1.87) compared with farmers below the cut-off point of depression caseness symptoms, whereas farmers with symptoms of anxiety caseness had a 51% increased risk (HR 1.51, 95% CI 1.23 to 1.86).

CONCLUSIONS

Farmers have an increased risk of disability pension compared with higher grade professionals, but the risk is lower than in most other manual occupational groups. Farmers who report high levels of depression or anxiety symptoms are at substantially increased risk of future work disability, and the risk increase appears to be fairly similar across most occupational groups.