Farming characteristics and self-reported health outcomes of Irish farmers

Farming characteristics and self-reported health outcomes of Irish farmers Abstract Background Irish farmers represent a ‘high-risk’ group for non-communicable diseases, which, arguably, pose a greater occupational health challenge for farmers. To date, there has been little exploration of the farming characteristics associated with farmers’ poor health outcomes. Aims To examine the relationship between farming and male farmers’ self-reported health outcomes and to compare the study findings to national health studies to explore which factors specifically are associated with Irish farmers’ poorer health outcomes relative to the general population. Methods This cross-sectional survey research used self-reported quantitative data on the health outcomes and health behaviours of male farmers from the South-East of Ireland. Data were entered into SPSS and descriptive and binary regression techniques were used for data analysis. Results There were 314 participants (99% response rate). Age, full-time farming and dairy farming significantly impacted self-reported health outcomes and health behaviours. There was a high prevalence of self-reported arthritis compared with the national average of Irish males. ‘Younger’ farmers (<45 years) were more likely to engage in harmful health behaviours such as smoking and ‘binge-drinking’ one or more times per week. Conclusions This study identified self-reported patterns of risky lifestyle behaviours among particular subgroups of Irish farmers for whom targeted health interventions are warranted. Interventions are particularly important for younger farmers who may see themselves as invincible and impregnable to ill-health. Arthritis, farm work-related illness, men’s health Introduction It is established that farmers are at risk of occupational injury and diseases [1]. Irish farmers, however, also represent a ‘high-risk’ group for occupational and lifestyle diseases. Recent studies have found that Irish farmers had significantly higher mortality rates from cardiovascular disease, cancers and any cause of death compared to other occupational groups [2]. This is in stark contrast to findings in most other countries [3]. The factors underpinning Irish farmers’ poorer health are not fully understood. In particular, little is known about which Irish farmer subgroups may be at increased risk of ill-health and for whom targeted health interventions may be warranted. This study sought to address this gap by examining the relationship between male farmers’ self-reported health outcomes and health behaviours on the one hand and their age and farming characteristics on the other. Methods Ethical approval was granted by the Ethics Committee of Waterford Institute of Technology (Ref. 12HSES07) in Ireland. This cross-sectional study used self-reported quantitative data obtained from farmers who attended either a training course from Teagasc (Irish Agriculture and Food Development Authority) or an Irish Farmers’ Association meeting, between March and August 2013 in the south-east of Ireland. Farmers aged ≥18 years were eligible for inclusion. The questionnaire was a modified version of a previously validated survey instrument [4]. Descriptive statistics were used to describe the prevalence of responses while chi-square analysis explored associations between age and farming characteristics and self-reported health outcomes (Table 1). The significant outcomes were then subjected to binary regression analysis (Table 2). Table 1. Socio-demographic and farm characteristics, self-reported health and health behaviours n (%) Age in years (n = 302)  <45 179 (59)  45–64 105 (35)  ≥65 18 (6) Farming hours (n = 300)  Full-time 205 (68)  Part-time 95 (32) Farm enterprise (n = 314)a  Cattle (suckler) 98 (31)  Dairy and drystock 86 (27)  Sheep 81 (25)  Cattle (drystock) 59 (19)  Intensive dairying 54 (17)  Tillage 54 (17)  Other (forestry, horses) 6 (2) Farm size acres (n = 310)  ≤50–100 112 (36)  101–200 132 (43)  >200 66 (21) General self-reported health and weight  Self-rating of health (n = 311)   Very good–excellent 202 (65)   Good 93 (30)   Poor–fair 16 (5) Experience of illness in the past 12 months (n = 121)a  LBP 79 (65)  Arthritis 30 (25)  Anxiety 29 (24)  Asthma 19 (16)  Depression 15 (12)  Other 24 (20) Utilization of doctor services (n = 310)  In the past 12 months 176 (57)  Longer than a year 73 (23)  Never 61 (20) Preventive health screening in the last 12 months (n = 294)  Yes 156 (53)  No 138 (47) Do you currently smoke? (n = 288)  Yes 57 (20)  No 231 (80) How often do you drink alcohol (n = 292)  One or more times per week 65 (22)  One or more times per month 119 (41)  On occasion 72 (25)  Never 36 (12) How often do you have six or more standard drinks on one occasion (n = 255)  One or more times per week 55 (22)  One or more times per month 72 (28)  Less often 90 (35)  Never 38 (15) n (%) Age in years (n = 302)  <45 179 (59)  45–64 105 (35)  ≥65 18 (6) Farming hours (n = 300)  Full-time 205 (68)  Part-time 95 (32) Farm enterprise (n = 314)a  Cattle (suckler) 98 (31)  Dairy and drystock 86 (27)  Sheep 81 (25)  Cattle (drystock) 59 (19)  Intensive dairying 54 (17)  Tillage 54 (17)  Other (forestry, horses) 6 (2) Farm size acres (n = 310)  ≤50–100 112 (36)  101–200 132 (43)  >200 66 (21) General self-reported health and weight  Self-rating of health (n = 311)   Very good–excellent 202 (65)   Good 93 (30)   Poor–fair 16 (5) Experience of illness in the past 12 months (n = 121)a  LBP 79 (65)  Arthritis 30 (25)  Anxiety 29 (24)  Asthma 19 (16)  Depression 15 (12)  Other 24 (20) Utilization of doctor services (n = 310)  In the past 12 months 176 (57)  Longer than a year 73 (23)  Never 61 (20) Preventive health screening in the last 12 months (n = 294)  Yes 156 (53)  No 138 (47) Do you currently smoke? (n = 288)  Yes 57 (20)  No 231 (80) How often do you drink alcohol (n = 292)  One or more times per week 65 (22)  One or more times per month 119 (41)  On occasion 72 (25)  Never 36 (12) How often do you have six or more standard drinks on one occasion (n = 255)  One or more times per week 55 (22)  One or more times per month 72 (28)  Less often 90 (35)  Never 38 (15) aMultiple answers possible. View Large Table 1. Socio-demographic and farm characteristics, self-reported health and health behaviours n (%) Age in years (n = 302)  <45 179 (59)  45–64 105 (35)  ≥65 18 (6) Farming hours (n = 300)  Full-time 205 (68)  Part-time 95 (32) Farm enterprise (n = 314)a  Cattle (suckler) 98 (31)  Dairy and drystock 86 (27)  Sheep 81 (25)  Cattle (drystock) 59 (19)  Intensive dairying 54 (17)  Tillage 54 (17)  Other (forestry, horses) 6 (2) Farm size acres (n = 310)  ≤50–100 112 (36)  101–200 132 (43)  >200 66 (21) General self-reported health and weight  Self-rating of health (n = 311)   Very good–excellent 202 (65)   Good 93 (30)   Poor–fair 16 (5) Experience of illness in the past 12 months (n = 121)a  LBP 79 (65)  Arthritis 30 (25)  Anxiety 29 (24)  Asthma 19 (16)  Depression 15 (12)  Other 24 (20) Utilization of doctor services (n = 310)  In the past 12 months 176 (57)  Longer than a year 73 (23)  Never 61 (20) Preventive health screening in the last 12 months (n = 294)  Yes 156 (53)  No 138 (47) Do you currently smoke? (n = 288)  Yes 57 (20)  No 231 (80) How often do you drink alcohol (n = 292)  One or more times per week 65 (22)  One or more times per month 119 (41)  On occasion 72 (25)  Never 36 (12) How often do you have six or more standard drinks on one occasion (n = 255)  One or more times per week 55 (22)  One or more times per month 72 (28)  Less often 90 (35)  Never 38 (15) n (%) Age in years (n = 302)  <45 179 (59)  45–64 105 (35)  ≥65 18 (6) Farming hours (n = 300)  Full-time 205 (68)  Part-time 95 (32) Farm enterprise (n = 314)a  Cattle (suckler) 98 (31)  Dairy and drystock 86 (27)  Sheep 81 (25)  Cattle (drystock) 59 (19)  Intensive dairying 54 (17)  Tillage 54 (17)  Other (forestry, horses) 6 (2) Farm size acres (n = 310)  ≤50–100 112 (36)  101–200 132 (43)  >200 66 (21) General self-reported health and weight  Self-rating of health (n = 311)   Very good–excellent 202 (65)   Good 93 (30)   Poor–fair 16 (5) Experience of illness in the past 12 months (n = 121)a  LBP 79 (65)  Arthritis 30 (25)  Anxiety 29 (24)  Asthma 19 (16)  Depression 15 (12)  Other 24 (20) Utilization of doctor services (n = 310)  In the past 12 months 176 (57)  Longer than a year 73 (23)  Never 61 (20) Preventive health screening in the last 12 months (n = 294)  Yes 156 (53)  No 138 (47) Do you currently smoke? (n = 288)  Yes 57 (20)  No 231 (80) How often do you drink alcohol (n = 292)  One or more times per week 65 (22)  One or more times per month 119 (41)  On occasion 72 (25)  Never 36 (12) How often do you have six or more standard drinks on one occasion (n = 255)  One or more times per week 55 (22)  One or more times per month 72 (28)  Less often 90 (35)  Never 38 (15) aMultiple answers possible. View Large Table 2. Socio-demographic and farming characteristics impacting farmers’ self-reported health—binary analysis Independent variable Dependent variable P value OR 95% CI for OR Lower Upper Health rating very good–excellent Age in years <0.05 1.74 1.01 0.99  <45  ≥45 (indicator) Farm enterprise Mixed (indicator)  Dairy <0.05 2.13 1.18 3.85  Cattle NS 1.06 0.53 2.11 Utilization of doctor services in past 12 months Age in years <0.001 2.55 1.48 4.40  <45 (indicator)  ≥45 Engagement in health screening in past 12 months Age in years <0.001 3.08 1.75 5.43  <45 (indicator)  ≥45 Smoking Age in years <0.001 4.25 1.93 9.36  <45  ≥45 (indicator) Alcohol Age in years <0.05 2.73 1.17 6.35  <45  ≥45 (indicator) LBP Full-time farming <0.05 2.45 1.09 5.48 Part-time (indicator) Arthritis Age in years <0.001 6.31 2.14 18.63  <45 (indicator)  ≥45 Independent variable Dependent variable P value OR 95% CI for OR Lower Upper Health rating very good–excellent Age in years <0.05 1.74 1.01 0.99  <45  ≥45 (indicator) Farm enterprise Mixed (indicator)  Dairy <0.05 2.13 1.18 3.85  Cattle NS 1.06 0.53 2.11 Utilization of doctor services in past 12 months Age in years <0.001 2.55 1.48 4.40  <45 (indicator)  ≥45 Engagement in health screening in past 12 months Age in years <0.001 3.08 1.75 5.43  <45 (indicator)  ≥45 Smoking Age in years <0.001 4.25 1.93 9.36  <45  ≥45 (indicator) Alcohol Age in years <0.05 2.73 1.17 6.35  <45  ≥45 (indicator) LBP Full-time farming <0.05 2.45 1.09 5.48 Part-time (indicator) Arthritis Age in years <0.001 6.31 2.14 18.63  <45 (indicator)  ≥45 CI, confidence interval; NS, not significant; OR, odds ratio. View Large Table 2. Socio-demographic and farming characteristics impacting farmers’ self-reported health—binary analysis Independent variable Dependent variable P value OR 95% CI for OR Lower Upper Health rating very good–excellent Age in years <0.05 1.74 1.01 0.99  <45  ≥45 (indicator) Farm enterprise Mixed (indicator)  Dairy <0.05 2.13 1.18 3.85  Cattle NS 1.06 0.53 2.11 Utilization of doctor services in past 12 months Age in years <0.001 2.55 1.48 4.40  <45 (indicator)  ≥45 Engagement in health screening in past 12 months Age in years <0.001 3.08 1.75 5.43  <45 (indicator)  ≥45 Smoking Age in years <0.001 4.25 1.93 9.36  <45  ≥45 (indicator) Alcohol Age in years <0.05 2.73 1.17 6.35  <45  ≥45 (indicator) LBP Full-time farming <0.05 2.45 1.09 5.48 Part-time (indicator) Arthritis Age in years <0.001 6.31 2.14 18.63  <45 (indicator)  ≥45 Independent variable Dependent variable P value OR 95% CI for OR Lower Upper Health rating very good–excellent Age in years <0.05 1.74 1.01 0.99  <45  ≥45 (indicator) Farm enterprise Mixed (indicator)  Dairy <0.05 2.13 1.18 3.85  Cattle NS 1.06 0.53 2.11 Utilization of doctor services in past 12 months Age in years <0.001 2.55 1.48 4.40  <45 (indicator)  ≥45 Engagement in health screening in past 12 months Age in years <0.001 3.08 1.75 5.43  <45 (indicator)  ≥45 Smoking Age in years <0.001 4.25 1.93 9.36  <45  ≥45 (indicator) Alcohol Age in years <0.05 2.73 1.17 6.35  <45  ≥45 (indicator) LBP Full-time farming <0.05 2.45 1.09 5.48 Part-time (indicator) Arthritis Age in years <0.001 6.31 2.14 18.63  <45 (indicator)  ≥45 CI, confidence interval; NS, not significant; OR, odds ratio. View Large Results From a captive target group (n = 316), 314 farmers (99%) filled in the questionnaire (Table 1). The majority of farmers (Table 1) were under 45 years, in full-time farming and engaged in a variety of farm enterprises (cattle/suckler, dairy, drystock and sheep). Over a third of farmers reported having experienced a health condition in the past 12 months, mainly lower back pain (LBP), arthritis (rheumatoid and/or osteoarthritis) and anxiety. Over half of farmers reported having visited a doctor in the past 12 months. Almost one in five farmers reported being a current smoker. The vast majority of farmers reported regular consumption of alcohol, with one in five reporting weekly ‘drinking’. One in five farmers also reported weekly ‘binge-drinking’ (six or more alcoholic drinks per drinking session). Nevertheless, the prevalence of ‘at-risk’ self-reported health behaviours was lower than the general population of Irish males [5]. Significant binary regression (Table 2) findings showed that ‘younger’ farmers (<45 years) were more likely to report a positive health rating (‘very good’/’excellent’), smoking and weekly alcohol consumption. Farmers >45 years were more likely to report having experienced arthritis, and having engaged with preventive health screening and general practitioner services in the past 12 months. Full-time farmers were more likely to report having experienced LBP in the past 12 months. Dairy farmers were more likely to report a positive health rating. Discussion This study found that that farmer age, full-time farming and dairy farming significantly impacted self-reported health outcomes. Farmers aged >45 years were significantly more likely to report having experienced arthritis in the past 12 months with 13% having experienced self-reported rheumatoid arthritis (RA). Full-time farming was found to be significantly associated with LBP. Dairy farmers were significantly more likely to report a positive health rating (very good–excellent). Dairy farming in Ireland is, on average, the most profitable farm enterprise and a higher household income has been associated with higher self-reported health status [6]. This suggests that the more positive health rating of Irish dairy farmers might not only be influenced by age but also by income level. ‘Younger’ farmers (<45 years) were more likely to report a positive health rating but also to engaging in harmful health behaviours such as smoking and ‘binge-drinking’ one or more times per week. In addition to the known negative health effects of smoking, binge-drinking has also been found to be an independent risk factor for ischaemic stroke [7] and is associated with higher risk of occupational injury [8] which is a particular concern due to the hazards associated with farming. In the context of masculinity theory, young men tend to connect health with ‘being able to function’ and see themselves as invincible and impregnable to ill-health [9]. This study has certain limitations. The convenience sample means that the results may not be generalizable to the farming population as a whole. The socio-demographics of this study population are not representative of the national average of Irish famers. Farmers with greater health problems are unlikely to be captured in the study due to the ‘healthy worker’ effect. Self-report measures rely on participants providing honest and reliable responses and should therefore be treated with caution. Despite these limitations, this study identifies self-reported patterns of risky lifestyle behaviours among particular subgroups of Irish farmers for whom targeted health interventions are warranted. More research is needed to examine why the prevalence of self-reported RA was three times higher among farmers compared with the general population. Findings also indicate that ‘younger’ farmers were engaged in more detrimental health behaviours, specifically in relation to smoking and harmful drinking, indicating the need for different and more targeted programs directed at younger farmers. Key points Farmer age, full-time farming and dairy farming significantly impacted self-reported health outcomes. The high prevalence of self-reported arthritis raises concerns among this occupation group. Younger (<45 years) male farmers were more likely to engage in harmful health behaviours such as smoking and ‘binge-drinking’ one or more times per week which could be a threat for occupational health and safety. Competing interests None declared. References 1. Whelan S , Ruane DJ , McNamara J , Kinsella A , McNamara A . Disability on Irish farms—a real concern . J Agromedicine 2009 ; 14 : 157 – 163 . Google Scholar CrossRef Search ADS PubMed 2. Smyth B , Evans DS , Kelly A , Cullen L , O’Donovan D . The farming population in Ireland: mortality trends during the ‘Celtic Tiger’ years . Eur J Public Health 2013 ; 23 : 50 – 55 . Google Scholar CrossRef Search ADS PubMed 3. Toch-Marquardt M , Menvielle G , Eikemo TA , et al. Occupational class inequalities in all-cause and cause-specific mortality among middle-aged men in 14 European populations during the early 2000s . PLoS One 2014 ; 9 : e108072 . Google Scholar CrossRef Search ADS PubMed 4. Morgan K , McGee H , Watson D , Perry I , Barry M , Lente van E. SLAN 2007: Survey of Lifestyle, Attitudes & Nutrition in Ireland: Main Report . 2008 . http://epubs.rcsi.ie/cgi/viewcontent.cgi?article=1002&context=psycholrep 5. Department of Health . Healthy Ireland Survey 2015 . Stationery Office Dublin : Dublin, Ireland , 2015 . 6. Mackenbach JP , Martikainen P , Looman CWN , Dalstra JAA , Kunst AE , Lahelma E . The shape of the relationship between income and self-assessed health: an international study . Int J Epidemiol 2005 ; 34 : 286 – 293 . Google Scholar CrossRef Search ADS PubMed 7. Sundell L , Salomaa V , Vartiainen E , Poikolainen K , Laatikainen T . Increased stroke risk is related to a binge-drinking habit . Stroke 2008 ; 39 : 3179 – 3184 . Google Scholar CrossRef Search ADS PubMed 8. Dawson DA . Heavy drinking and the risk of occupational injury . Accid Anal Prev 1994 ; 26 : 655 – 665 . Google Scholar CrossRef Search ADS PubMed 9. Richardson N . ‘The “buck” stops with me’—reconciling men’s lay conceptualisations of responsibility for health with men’s health policy . Heal Sociol Rev 2010 ; 19 : 419 – 436 . Google Scholar CrossRef Search ADS © The Author(s) 2018. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/about_us/legal/notices) http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Occupational Medicine Oxford University Press

Farming characteristics and self-reported health outcomes of Irish farmers

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© The Author(s) 2018. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com
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1471-8405
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Abstract

Abstract Background Irish farmers represent a ‘high-risk’ group for non-communicable diseases, which, arguably, pose a greater occupational health challenge for farmers. To date, there has been little exploration of the farming characteristics associated with farmers’ poor health outcomes. Aims To examine the relationship between farming and male farmers’ self-reported health outcomes and to compare the study findings to national health studies to explore which factors specifically are associated with Irish farmers’ poorer health outcomes relative to the general population. Methods This cross-sectional survey research used self-reported quantitative data on the health outcomes and health behaviours of male farmers from the South-East of Ireland. Data were entered into SPSS and descriptive and binary regression techniques were used for data analysis. Results There were 314 participants (99% response rate). Age, full-time farming and dairy farming significantly impacted self-reported health outcomes and health behaviours. There was a high prevalence of self-reported arthritis compared with the national average of Irish males. ‘Younger’ farmers (<45 years) were more likely to engage in harmful health behaviours such as smoking and ‘binge-drinking’ one or more times per week. Conclusions This study identified self-reported patterns of risky lifestyle behaviours among particular subgroups of Irish farmers for whom targeted health interventions are warranted. Interventions are particularly important for younger farmers who may see themselves as invincible and impregnable to ill-health. Arthritis, farm work-related illness, men’s health Introduction It is established that farmers are at risk of occupational injury and diseases [1]. Irish farmers, however, also represent a ‘high-risk’ group for occupational and lifestyle diseases. Recent studies have found that Irish farmers had significantly higher mortality rates from cardiovascular disease, cancers and any cause of death compared to other occupational groups [2]. This is in stark contrast to findings in most other countries [3]. The factors underpinning Irish farmers’ poorer health are not fully understood. In particular, little is known about which Irish farmer subgroups may be at increased risk of ill-health and for whom targeted health interventions may be warranted. This study sought to address this gap by examining the relationship between male farmers’ self-reported health outcomes and health behaviours on the one hand and their age and farming characteristics on the other. Methods Ethical approval was granted by the Ethics Committee of Waterford Institute of Technology (Ref. 12HSES07) in Ireland. This cross-sectional study used self-reported quantitative data obtained from farmers who attended either a training course from Teagasc (Irish Agriculture and Food Development Authority) or an Irish Farmers’ Association meeting, between March and August 2013 in the south-east of Ireland. Farmers aged ≥18 years were eligible for inclusion. The questionnaire was a modified version of a previously validated survey instrument [4]. Descriptive statistics were used to describe the prevalence of responses while chi-square analysis explored associations between age and farming characteristics and self-reported health outcomes (Table 1). The significant outcomes were then subjected to binary regression analysis (Table 2). Table 1. Socio-demographic and farm characteristics, self-reported health and health behaviours n (%) Age in years (n = 302)  <45 179 (59)  45–64 105 (35)  ≥65 18 (6) Farming hours (n = 300)  Full-time 205 (68)  Part-time 95 (32) Farm enterprise (n = 314)a  Cattle (suckler) 98 (31)  Dairy and drystock 86 (27)  Sheep 81 (25)  Cattle (drystock) 59 (19)  Intensive dairying 54 (17)  Tillage 54 (17)  Other (forestry, horses) 6 (2) Farm size acres (n = 310)  ≤50–100 112 (36)  101–200 132 (43)  >200 66 (21) General self-reported health and weight  Self-rating of health (n = 311)   Very good–excellent 202 (65)   Good 93 (30)   Poor–fair 16 (5) Experience of illness in the past 12 months (n = 121)a  LBP 79 (65)  Arthritis 30 (25)  Anxiety 29 (24)  Asthma 19 (16)  Depression 15 (12)  Other 24 (20) Utilization of doctor services (n = 310)  In the past 12 months 176 (57)  Longer than a year 73 (23)  Never 61 (20) Preventive health screening in the last 12 months (n = 294)  Yes 156 (53)  No 138 (47) Do you currently smoke? (n = 288)  Yes 57 (20)  No 231 (80) How often do you drink alcohol (n = 292)  One or more times per week 65 (22)  One or more times per month 119 (41)  On occasion 72 (25)  Never 36 (12) How often do you have six or more standard drinks on one occasion (n = 255)  One or more times per week 55 (22)  One or more times per month 72 (28)  Less often 90 (35)  Never 38 (15) n (%) Age in years (n = 302)  <45 179 (59)  45–64 105 (35)  ≥65 18 (6) Farming hours (n = 300)  Full-time 205 (68)  Part-time 95 (32) Farm enterprise (n = 314)a  Cattle (suckler) 98 (31)  Dairy and drystock 86 (27)  Sheep 81 (25)  Cattle (drystock) 59 (19)  Intensive dairying 54 (17)  Tillage 54 (17)  Other (forestry, horses) 6 (2) Farm size acres (n = 310)  ≤50–100 112 (36)  101–200 132 (43)  >200 66 (21) General self-reported health and weight  Self-rating of health (n = 311)   Very good–excellent 202 (65)   Good 93 (30)   Poor–fair 16 (5) Experience of illness in the past 12 months (n = 121)a  LBP 79 (65)  Arthritis 30 (25)  Anxiety 29 (24)  Asthma 19 (16)  Depression 15 (12)  Other 24 (20) Utilization of doctor services (n = 310)  In the past 12 months 176 (57)  Longer than a year 73 (23)  Never 61 (20) Preventive health screening in the last 12 months (n = 294)  Yes 156 (53)  No 138 (47) Do you currently smoke? (n = 288)  Yes 57 (20)  No 231 (80) How often do you drink alcohol (n = 292)  One or more times per week 65 (22)  One or more times per month 119 (41)  On occasion 72 (25)  Never 36 (12) How often do you have six or more standard drinks on one occasion (n = 255)  One or more times per week 55 (22)  One or more times per month 72 (28)  Less often 90 (35)  Never 38 (15) aMultiple answers possible. View Large Table 1. Socio-demographic and farm characteristics, self-reported health and health behaviours n (%) Age in years (n = 302)  <45 179 (59)  45–64 105 (35)  ≥65 18 (6) Farming hours (n = 300)  Full-time 205 (68)  Part-time 95 (32) Farm enterprise (n = 314)a  Cattle (suckler) 98 (31)  Dairy and drystock 86 (27)  Sheep 81 (25)  Cattle (drystock) 59 (19)  Intensive dairying 54 (17)  Tillage 54 (17)  Other (forestry, horses) 6 (2) Farm size acres (n = 310)  ≤50–100 112 (36)  101–200 132 (43)  >200 66 (21) General self-reported health and weight  Self-rating of health (n = 311)   Very good–excellent 202 (65)   Good 93 (30)   Poor–fair 16 (5) Experience of illness in the past 12 months (n = 121)a  LBP 79 (65)  Arthritis 30 (25)  Anxiety 29 (24)  Asthma 19 (16)  Depression 15 (12)  Other 24 (20) Utilization of doctor services (n = 310)  In the past 12 months 176 (57)  Longer than a year 73 (23)  Never 61 (20) Preventive health screening in the last 12 months (n = 294)  Yes 156 (53)  No 138 (47) Do you currently smoke? (n = 288)  Yes 57 (20)  No 231 (80) How often do you drink alcohol (n = 292)  One or more times per week 65 (22)  One or more times per month 119 (41)  On occasion 72 (25)  Never 36 (12) How often do you have six or more standard drinks on one occasion (n = 255)  One or more times per week 55 (22)  One or more times per month 72 (28)  Less often 90 (35)  Never 38 (15) n (%) Age in years (n = 302)  <45 179 (59)  45–64 105 (35)  ≥65 18 (6) Farming hours (n = 300)  Full-time 205 (68)  Part-time 95 (32) Farm enterprise (n = 314)a  Cattle (suckler) 98 (31)  Dairy and drystock 86 (27)  Sheep 81 (25)  Cattle (drystock) 59 (19)  Intensive dairying 54 (17)  Tillage 54 (17)  Other (forestry, horses) 6 (2) Farm size acres (n = 310)  ≤50–100 112 (36)  101–200 132 (43)  >200 66 (21) General self-reported health and weight  Self-rating of health (n = 311)   Very good–excellent 202 (65)   Good 93 (30)   Poor–fair 16 (5) Experience of illness in the past 12 months (n = 121)a  LBP 79 (65)  Arthritis 30 (25)  Anxiety 29 (24)  Asthma 19 (16)  Depression 15 (12)  Other 24 (20) Utilization of doctor services (n = 310)  In the past 12 months 176 (57)  Longer than a year 73 (23)  Never 61 (20) Preventive health screening in the last 12 months (n = 294)  Yes 156 (53)  No 138 (47) Do you currently smoke? (n = 288)  Yes 57 (20)  No 231 (80) How often do you drink alcohol (n = 292)  One or more times per week 65 (22)  One or more times per month 119 (41)  On occasion 72 (25)  Never 36 (12) How often do you have six or more standard drinks on one occasion (n = 255)  One or more times per week 55 (22)  One or more times per month 72 (28)  Less often 90 (35)  Never 38 (15) aMultiple answers possible. View Large Table 2. Socio-demographic and farming characteristics impacting farmers’ self-reported health—binary analysis Independent variable Dependent variable P value OR 95% CI for OR Lower Upper Health rating very good–excellent Age in years <0.05 1.74 1.01 0.99  <45  ≥45 (indicator) Farm enterprise Mixed (indicator)  Dairy <0.05 2.13 1.18 3.85  Cattle NS 1.06 0.53 2.11 Utilization of doctor services in past 12 months Age in years <0.001 2.55 1.48 4.40  <45 (indicator)  ≥45 Engagement in health screening in past 12 months Age in years <0.001 3.08 1.75 5.43  <45 (indicator)  ≥45 Smoking Age in years <0.001 4.25 1.93 9.36  <45  ≥45 (indicator) Alcohol Age in years <0.05 2.73 1.17 6.35  <45  ≥45 (indicator) LBP Full-time farming <0.05 2.45 1.09 5.48 Part-time (indicator) Arthritis Age in years <0.001 6.31 2.14 18.63  <45 (indicator)  ≥45 Independent variable Dependent variable P value OR 95% CI for OR Lower Upper Health rating very good–excellent Age in years <0.05 1.74 1.01 0.99  <45  ≥45 (indicator) Farm enterprise Mixed (indicator)  Dairy <0.05 2.13 1.18 3.85  Cattle NS 1.06 0.53 2.11 Utilization of doctor services in past 12 months Age in years <0.001 2.55 1.48 4.40  <45 (indicator)  ≥45 Engagement in health screening in past 12 months Age in years <0.001 3.08 1.75 5.43  <45 (indicator)  ≥45 Smoking Age in years <0.001 4.25 1.93 9.36  <45  ≥45 (indicator) Alcohol Age in years <0.05 2.73 1.17 6.35  <45  ≥45 (indicator) LBP Full-time farming <0.05 2.45 1.09 5.48 Part-time (indicator) Arthritis Age in years <0.001 6.31 2.14 18.63  <45 (indicator)  ≥45 CI, confidence interval; NS, not significant; OR, odds ratio. View Large Table 2. Socio-demographic and farming characteristics impacting farmers’ self-reported health—binary analysis Independent variable Dependent variable P value OR 95% CI for OR Lower Upper Health rating very good–excellent Age in years <0.05 1.74 1.01 0.99  <45  ≥45 (indicator) Farm enterprise Mixed (indicator)  Dairy <0.05 2.13 1.18 3.85  Cattle NS 1.06 0.53 2.11 Utilization of doctor services in past 12 months Age in years <0.001 2.55 1.48 4.40  <45 (indicator)  ≥45 Engagement in health screening in past 12 months Age in years <0.001 3.08 1.75 5.43  <45 (indicator)  ≥45 Smoking Age in years <0.001 4.25 1.93 9.36  <45  ≥45 (indicator) Alcohol Age in years <0.05 2.73 1.17 6.35  <45  ≥45 (indicator) LBP Full-time farming <0.05 2.45 1.09 5.48 Part-time (indicator) Arthritis Age in years <0.001 6.31 2.14 18.63  <45 (indicator)  ≥45 Independent variable Dependent variable P value OR 95% CI for OR Lower Upper Health rating very good–excellent Age in years <0.05 1.74 1.01 0.99  <45  ≥45 (indicator) Farm enterprise Mixed (indicator)  Dairy <0.05 2.13 1.18 3.85  Cattle NS 1.06 0.53 2.11 Utilization of doctor services in past 12 months Age in years <0.001 2.55 1.48 4.40  <45 (indicator)  ≥45 Engagement in health screening in past 12 months Age in years <0.001 3.08 1.75 5.43  <45 (indicator)  ≥45 Smoking Age in years <0.001 4.25 1.93 9.36  <45  ≥45 (indicator) Alcohol Age in years <0.05 2.73 1.17 6.35  <45  ≥45 (indicator) LBP Full-time farming <0.05 2.45 1.09 5.48 Part-time (indicator) Arthritis Age in years <0.001 6.31 2.14 18.63  <45 (indicator)  ≥45 CI, confidence interval; NS, not significant; OR, odds ratio. View Large Results From a captive target group (n = 316), 314 farmers (99%) filled in the questionnaire (Table 1). The majority of farmers (Table 1) were under 45 years, in full-time farming and engaged in a variety of farm enterprises (cattle/suckler, dairy, drystock and sheep). Over a third of farmers reported having experienced a health condition in the past 12 months, mainly lower back pain (LBP), arthritis (rheumatoid and/or osteoarthritis) and anxiety. Over half of farmers reported having visited a doctor in the past 12 months. Almost one in five farmers reported being a current smoker. The vast majority of farmers reported regular consumption of alcohol, with one in five reporting weekly ‘drinking’. One in five farmers also reported weekly ‘binge-drinking’ (six or more alcoholic drinks per drinking session). Nevertheless, the prevalence of ‘at-risk’ self-reported health behaviours was lower than the general population of Irish males [5]. Significant binary regression (Table 2) findings showed that ‘younger’ farmers (<45 years) were more likely to report a positive health rating (‘very good’/’excellent’), smoking and weekly alcohol consumption. Farmers >45 years were more likely to report having experienced arthritis, and having engaged with preventive health screening and general practitioner services in the past 12 months. Full-time farmers were more likely to report having experienced LBP in the past 12 months. Dairy farmers were more likely to report a positive health rating. Discussion This study found that that farmer age, full-time farming and dairy farming significantly impacted self-reported health outcomes. Farmers aged >45 years were significantly more likely to report having experienced arthritis in the past 12 months with 13% having experienced self-reported rheumatoid arthritis (RA). Full-time farming was found to be significantly associated with LBP. Dairy farmers were significantly more likely to report a positive health rating (very good–excellent). Dairy farming in Ireland is, on average, the most profitable farm enterprise and a higher household income has been associated with higher self-reported health status [6]. This suggests that the more positive health rating of Irish dairy farmers might not only be influenced by age but also by income level. ‘Younger’ farmers (<45 years) were more likely to report a positive health rating but also to engaging in harmful health behaviours such as smoking and ‘binge-drinking’ one or more times per week. In addition to the known negative health effects of smoking, binge-drinking has also been found to be an independent risk factor for ischaemic stroke [7] and is associated with higher risk of occupational injury [8] which is a particular concern due to the hazards associated with farming. In the context of masculinity theory, young men tend to connect health with ‘being able to function’ and see themselves as invincible and impregnable to ill-health [9]. This study has certain limitations. The convenience sample means that the results may not be generalizable to the farming population as a whole. The socio-demographics of this study population are not representative of the national average of Irish famers. Farmers with greater health problems are unlikely to be captured in the study due to the ‘healthy worker’ effect. Self-report measures rely on participants providing honest and reliable responses and should therefore be treated with caution. Despite these limitations, this study identifies self-reported patterns of risky lifestyle behaviours among particular subgroups of Irish farmers for whom targeted health interventions are warranted. More research is needed to examine why the prevalence of self-reported RA was three times higher among farmers compared with the general population. Findings also indicate that ‘younger’ farmers were engaged in more detrimental health behaviours, specifically in relation to smoking and harmful drinking, indicating the need for different and more targeted programs directed at younger farmers. Key points Farmer age, full-time farming and dairy farming significantly impacted self-reported health outcomes. The high prevalence of self-reported arthritis raises concerns among this occupation group. Younger (<45 years) male farmers were more likely to engage in harmful health behaviours such as smoking and ‘binge-drinking’ one or more times per week which could be a threat for occupational health and safety. Competing interests None declared. References 1. Whelan S , Ruane DJ , McNamara J , Kinsella A , McNamara A . Disability on Irish farms—a real concern . J Agromedicine 2009 ; 14 : 157 – 163 . Google Scholar CrossRef Search ADS PubMed 2. Smyth B , Evans DS , Kelly A , Cullen L , O’Donovan D . The farming population in Ireland: mortality trends during the ‘Celtic Tiger’ years . Eur J Public Health 2013 ; 23 : 50 – 55 . Google Scholar CrossRef Search ADS PubMed 3. Toch-Marquardt M , Menvielle G , Eikemo TA , et al. Occupational class inequalities in all-cause and cause-specific mortality among middle-aged men in 14 European populations during the early 2000s . PLoS One 2014 ; 9 : e108072 . Google Scholar CrossRef Search ADS PubMed 4. Morgan K , McGee H , Watson D , Perry I , Barry M , Lente van E. SLAN 2007: Survey of Lifestyle, Attitudes & Nutrition in Ireland: Main Report . 2008 . http://epubs.rcsi.ie/cgi/viewcontent.cgi?article=1002&context=psycholrep 5. Department of Health . Healthy Ireland Survey 2015 . Stationery Office Dublin : Dublin, Ireland , 2015 . 6. Mackenbach JP , Martikainen P , Looman CWN , Dalstra JAA , Kunst AE , Lahelma E . The shape of the relationship between income and self-assessed health: an international study . Int J Epidemiol 2005 ; 34 : 286 – 293 . Google Scholar CrossRef Search ADS PubMed 7. Sundell L , Salomaa V , Vartiainen E , Poikolainen K , Laatikainen T . Increased stroke risk is related to a binge-drinking habit . Stroke 2008 ; 39 : 3179 – 3184 . Google Scholar CrossRef Search ADS PubMed 8. Dawson DA . Heavy drinking and the risk of occupational injury . Accid Anal Prev 1994 ; 26 : 655 – 665 . Google Scholar CrossRef Search ADS PubMed 9. Richardson N . ‘The “buck” stops with me’—reconciling men’s lay conceptualisations of responsibility for health with men’s health policy . Heal Sociol Rev 2010 ; 19 : 419 – 436 . Google Scholar CrossRef Search ADS © The Author(s) 2018. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/about_us/legal/notices)

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Occupational MedicineOxford University Press

Published: Feb 17, 2018

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