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Farmers are at increased risk for fall-related injury compared with other occupations. Little is known about risk factors for non-fatal falls on the farm. This case-control study, nested within the Agricultural Health Study, aimed to assess risk factors for work-related falls among Iowa farmers. A screener questionnaire sent to 6,999 farmers in 1998 identified 79 farmers who reported a fall-related farm injury that required medical advice or treatment in the previous year. Multivariable logistic regression analysis was used to assess several possible risk factors for injury among these farmers compared with 473 farmers with no injury in the previous year. There were significant associations between fall-related farm injury and age between 40 and 64 years (OR = 2.21; 95% CI = 1.20–4.07), doctor-diagnosed arthritis/rheumatism (OR = 2.05; 95% CI = 1.11–3.79), difficulty hearing normal conversation (even with a hearing aid, in the case of those who used one) (OR = 1.82; 95% CI = 1.07–3.08), and taking medications regularly (OR = 1.80; 95% CI = 1.02–3.18). Aging and health impairments, such as arthritis and hearing difficulties, are risk factors for which accommodations and preventive strategies can be devised to prevent fall-related injuries on the farm. Am. J. Ind. Med. 44:265–272, 2003. © 2003 Wiley-Liss, Inc.

Back pain causes considerable morbidity, disability, and economic loss among workers. Farmers handle heavy objects, often in awkward postures. However, the prevalence of back pain among farmers and the risk factors associated with back pain are not well known. In this study, we assess the frequency of risk factors for back pain among 287 Iowa male farmers. From 1992 to 1994, using a mail questionnaire, we collected data on potential risk factors for back pain. Eighteen months later, we surveyed occurrence of back pain as the outcome measure. Thirty-one percent of farmers reported having daily back pain for a week or more during the past 12 months compared to 18.5% in the general working population. Using a multiple logistic regression model, we found two factors associated with back pain: 45–59 years of age (OR = 2.13, 95% CI 1.02–4.43) and having a non-agricultural job as the major occupation (OR = 2.02, 95% CI 0.98–4.17, P = 0.055). Farmers had a significantly higher prevalence of back pain than the general working population. Middle-aged farmers and those with additional non-agricultural jobs had the highest risk for back pain. Am. J. Ind. Med. 40:646–654, 2001. © 2001 Wiley-Liss, Inc

Farmers are at risk for airways diseases resulting from exposures which include organic agents and chemicals on the farm. Few data on airways disease and farm exposures are available from population-based studies. The Iowa Farm Family Health and Hazard Surveillance Project provided the opportunity to assess associations between symptoms of airway disease and several farm exposures, including pesticides, grain dust, animal confinement, and exposures from silos, in a population-based study. A stratified two-stage cluster sample was used to provide a representative farmer sample from the state. Participants provided questionnaire responses concerning demographic, respiratory symptoms, smoking, and exposure information. Associations between farm exposures and airways disease symptoms were assessed in the 385 farmer participants using χ² analysis and logistic regression analysis adjusting for age and smoking. The most frequently reported respiratory symptoms were flu-like symptoms in connection with dusty work (22%), dyspnea (21%), and phlegm (15%). Current smoking was uncommon (13%). Among farmers, applying pesticides to livestock was associated with significantly increased odds of phlegm (OR = 1.91, 95% CI 1.02–3.57), chest ever wheezy (OR = 3.92, 95% CI 1.76–8.72), and flu-like symptoms (OR = 2.93, 95% CI 1.69–5.12) in models adjusting for age and smoking. Conventional vertical silos were significantly associated with increased odds of chest ever wheezy (OR = 2.75, 95% CI 1.23–6.12) and flu-like symptoms (OR = 2.40, 95% CI 1.31–4.37). There were also significant associations between several respiratory symptoms and the presence of animal confinement facilities on the farm. The association between insecticide application to livestock and symptoms of airways disease is a new finding that could lead to further study of specific airway responses and exposures associated with this practice. Results confirming associations between respiratory symptoms and conventional vertical silos may be important in future studies aimed at prevention and control of exposures in those farm buildings. Am. J. Ind. Med. 38:455–462, 2000. © 2000 Wiley-Liss, Inc.

Despite lowering of the permissible exposure level for lead in construction from 200 to 50 μg/m³ in 1993, excessive lead exposure continues to be a problem. Relatively little data are available from the Midwestern U.S. on the environmental lead concentrations generated during various construction activities and the potential for worker exposure. This study characterized the prevalence of blood lead concentrations in high-risk construction trades in Iowa/Illinois, and identified risk factors for occupational exposure to lead in these construction workers. A sample of 459 workers was selected from the total population of all union members from trade groups of painters, plumbers/pipefitters, ironworkers, laborers, and electricians. Participants completed an interviewer-administered questionnaire obtaining information on demographics, symptoms, occupational history, work practices, personal protective equipment, and training. Venous blood samples were collected from each participant and analyzed for blood lead (using atomic absorption spectroscopy) and free erythrocyte protoporphyrin levels. Blood lead levels (BLLs) of construction workers ranged from 0.1 to 50 μg/dL. Geometric mean blood lead concentrations by trade group were: laborers (7.6 μg/dL, n = 80); painters (5.9 μg/dL, n = 83); ironworkers (5.2 μg/dL, n = 87); plumbers (4.4 μg/dL, n = 82); electricians (2.4 μg/dL, n = 91). Blood lead levels for painters and laborers were significantly higher than other trade groups, and levels for electricians were significantly lower (p < 0.01). Participants reported working primarily on commercial and industrial projects including new construction, renovation, and demolition. There were significant differences between the types of projects performed by different trade groups with laborers performing more highway/bridge renovation (p < 0.01), and plumbers reporting more residential remodeling (p = 0.05), repair of water lines containing lead (p = 0.04), or work on lead joints (p < 0.01). In addition to trade, elevated blood lead levels were associated with the type of construction project (especially bridge renovation and residential remodeling) and activities that include welding, cutting, rivet busting. The age of the home in which the worker lived, and hobbies such as casting/smelting lead for bullets or sinkers, were also important risk factors. Compliance with OSHA's Construction Lead Standard, and implementation of good occupational health and safety practices in general, was poor. Blood lead levels of 459 construction workers differed by the type of trade, type of project and specific job activity owing to differences in the inherent exposure potential of each task. Although the numbers of workers performing lead abatement projects were small, the trend for lower BLL in this group provides evidence that training, implementation of engineering controls, and proper use of personal protective equipment such as respirators is effective in controlling lead poisoning. Am. J. Ind. Med. 36:307–316, 1999. © 1999 Wiley-Liss, Inc.

In 1994, the Iowa Farm Family Health and Hazard Surveillance Project carried out a two‐stage, stratified, cluster survey of Iowa farms using a mail survey. With data from this representative sample of Iowa farmers, we examined the associations between farm‐work–related injuries and possible risk factors for 390 principal farm operators. Forty (10.3%) of these operators reported being injured while doing farm work. We developed a logistic regression to assess associations between potential risk factors and injury. We found three factors significantly associated with injury: younger age (odds ratio [OR] = 3.1, confidence interval [CI] = 1.1–9.3), having an impairment or health problem that limits work (OR = 2.4, CI = 1.5–3.8), and hand or arm exposure to acids or alkalis (OR = 2.6, CI = 1.1–5.9). In the univariate analysis, safety training did not seem to protect farmers from injuries. Am. J. Ind. Med. 33:510–517, 1998. Published 1998 Wiley‐Liss, Inc.

This study evaluated lead poisoning among construction workers renovating a previously deleaded bridge. Twelve of 44 tested workers had blood leads exceeding 20 μg/dL. One was 50 μg/dL and two exceeded 40 μg/dL. Following medical intervention, blood leads dropped significantly, while ZPPs did not. Renovation released lead that had been inaccessible during deleading. Workers did not use engineering controls or respirators, change clothes, wash hands, or shower. Intervention included a lead-compliance program with provisions for exposure evaluation, training, hygiene, and engineering controls. Construction contractors and workers need to be aware that deleading of bridges and other structures may not remove lead from inaccessible locations. In particular, owners of these structures should specify provisions for anticipating and controlling this hazard in contracts. Am. J. Ind. Med. 31:319–323, 1997. © 1997 Wiley-Liss, Inc.