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The purpose of the Fifth International Symposium was to build on the approach of the four previous symposia. The first symposium (1977) focused on the impact of grain dust and health, the second symposium (1985) highlighted the broad range of health and safety issues in agriculture, the third symposium (1992) challenged us to think of health and safety issues in agriculture in the context of sustainability, and the fourth symposium, “Rural Health and Safety in a Changing World” (1998) (see 2000 Journal of Agricultural Safety and Health, vol. 5, issues 1-4), moved toward a broader approach to agricultural and rural health issues. We named the Fifth International Symposium “The Future of Rural Peoples” because of the increasing realization that the health of rural people needs to be considered in the context of the economy, the environment, and the community. We hereby summarize some of the thoughts and recommendations of 450 researchers, practitioners, policymakers, and rural people. The symposium was enriched by the participation and support of the Canadian Agriculture Safety Association, the Canadian Rural Health Research Society, the Agromedicine Consortium, all ten National Institutes of Occupational Safety and Health (NIOSH) agricultural health and safety research centers (High Plains Intermountain Center for Agricultural Health and Safety; Pacific Northwest Agricultural Safety and Health Center; Southwest Center for Agricultural Health, Injury Prevention, and Education; Northeast Center for Agricultural Safety and Health; Southeast Center for Agricultural Health and Injury Prevention; Great Plains Center for Agricultural Health; Midwest Center for Agricultural Research, Education, and Disease and Injury Prevention; Western Center for Agricultural Health and Safety; Great Lakes Center for Agricultural Safety and Health; and Southern Coastal Agromedicine Center), the National Children’s Agricultural Health and Safety Centre, and the agricultural production industry through Agrivision Corporation. Some 428 scientific presentations took place in Saskatoon, Canada, on October 18-23, 2003. The extent of the symposium is difficult to capture, with the articles in this edition of the Journal of Agricultural Safety and Health and this summary representing only a taste of the richness of the event.

We report on our strategies to minimize bias in the FIRM study, a prospective case-control study of risk factors for serious farmwork-related injury. The study base is adult males working on farms in the catchment regions of 14 larger regional hospitals in one Australian state. Cases are identified on presentation to the emergency departments, while age-matched controls are recruited via random telephone survey. Eligibility criteria for cases include a maximum abbreviated injury severity score of at least 2, to minimize the potential for selection bias against those with less severe injuries treated outside the hospital system. An audit at one hospital showed that 93% of eligible patients identified in the electronic surveillance system had been approached regarding participation. Results to date show that 38% of those approached decline to have their contact details made available to researchers. Those who decline are asked to complete two key questions to enable comparison with those who participate. Control recruitment relies on telephoning regional households until an individual from the study base, satisfying the matching criteria, is identified. This process minimizes the potential for selecting against farm workers who may live off-farm. Ninety-four percent of age-matched eligible controls have participated to date. We are testing a dynamic pool of individuals identified as study base members but not matched on the first call to determine its effect on the probabilities of selection. Our strategies appear to be minimizing detection, selection, and response bias, thereby enhancing the validity of the study results.

The negative health effects of exposure to grain dust have previously been examined, but few studies have observed the effects on newly hired employees. Young grain workers are of interest because changes in pulmonary function may occur after a short duration of employment, and because older grain workers may represent a survivor population. The New Grain Workers Study (NGWS), a longitudinal study of 299 newly hired male grain industry workers, was conducted between 1980 and 1985. The objectives were to determine the effects of employment in the grain industry on pulmonary function. Pre-employment physical examinations and pulmonary function tests were conducted on subjects at the Division of Respiratory Medicine, Department of Medicine, Royal University Hospital, University of Saskatchewan. The Grain Dust Medical Surveillance Program (GDMSP) was a Labour Canada program that began in 1978. All subjects were grain workers employed in the grain industry in Saskatchewan. All subjects completed a respiratory symptoms questionnaire and underwent pulmonary function testing. Baseline observations were recorded every three years between 1978 and 1993. Data were available on 2184 grain workers. Generalized estimating equations were used to fit marginal and transitional multivariable regression models to determine the effects of grain dust exposure on pulmonary function. Marginal and transitional models were then compared. Height, exposure weeks, and previous FVC were predictive of FVC in the NGWS, while exposure weeks and previous FEV1 were predictive of FEV1 . These models, as well as a transitional regression model built using the GDMSP data, were used to compute predicted mean annual decline in pulmonary function. Non-smoking grain workers in the NGWS had the highest pulmonary function test values, but also had the greatest predicted annual decline in pulmonary function. Ever-smoking grain workers in the GDMSP had the lowest pulmonary function test values. Non-smoking grain workers in the GDMSP had the least predicted annual decline in pulmonary function.

Previous reports have indicated that injuries involving augers (screw conveyors) are a serious problem in agriculture, but to date on-site engineering inspections linking injuries to mechanical and procedural aspects have not been available. This article details four events involving injuries as the result of being entangled in auger flighting. In each report, the circumstances surrounding the injury event are outlined, and the machinery involved is evaluated in terms of its compliance with current safety standards. In three of the four instances, the machinery did not conform to current guarding standards or to safety sign standards. In these three cases, injuries were preventable with improved guarding according to ASAE Standards. In the other case, the machine complied with ASAE Standards, but the injury could have been prevented with improved guarding of the auger flighting.

This cross-sectional survey was conducted as Phase I of the Prairie Ecosystem Study (PECOS): Environmental Pesticide Exposure and Human Health. In November of 1995, community volunteers delivered a self-administered household questionnaire to 1185 rural households in southern Saskatchewan, Canada. The survey provided a broad description of the general health and the physical environment of 511 men, 499 women, and 393 children (

Farmers experience higher rates of noise-induced hearing loss (NIHL) beginning at an earlier age than non-farming control subjects. NIHL is a preventable disability. In 1995, the Agricultural Health and Safety Network, a cooperative farm safety program sponsored by the rural municipalities of Saskatchewan and the Centre for Agricultural Medicine, initiated an education and screening program to promote hearing conservation among farm operators. Educational materials designed to raise awareness about hearing conservation were mailed directly to 18,650 farming families. A booklet, Hearing Conservation for Farm Families, was developed for the project. A postage-paid reply card enabled the farm operator and adult family members to request a hearing screening test provided by a qualified health professional close to their home community. Approximately 3,000 requests for hearing screening were received. Due to the wide geographic dispersion of the population, the cooperation of several agencies was critical in the provision of hearing screening to individuals. The protocol was developed cooperatively by the Saskatchewan Hearing Aid Plan (SHAP) and the Centre for Agricultural Medicine. Qualified health professionals from SHAP, local health districts, and the Centre for Agricultural Medicine conducted the hearing screening throughout the province. Results of screening indicated that many of the participants had already incurred significant levels of NIHL. Provision of screening tests gave the health professionals an opportunity to discuss noise exposure, prevention strategies, and the use of personal protective equipment with participants.

The Agricultural Health and Safety Network (the Network) is unique in North America. This extension program, aimed at preventing occupational illness and disability in Saskatchewan farmers, is funded and directed by rural municipal councils on behalf of their farming ratepayers. The Network was established in 1988 as a joint initiative between the Centre for Agricultural Medicine and the Saskatchewan Association of Rural Municipalities. Membership in the Network is voluntary and subject to an annual fee. Growth in membership has been sustained during the last 10 years in spite of the challenges of a strained economic environment in the agricultural sector and increasing pressure on the tax dollars available to rural municipalities. The original membership has grown from 1,000 farm families to over 21,500 farm families, approximately 38% of the farms in Saskatchewan. The evolution of the Network has been a study in co-operation, imagination and determination. The challenge of developing and delivering targeted and effective prevention programs to groups of farmers in a widely dispersed geographical area remains. Models for successful program delivery at or near the farm gate have been developed, evaluated and standardized by Centre health processionals. The current rapid alteration of the rural landscape provides new challenges and opportunities as the Network moves into its second decade. The vision of an industry driven and self-supporting workplace health and safety program for farmers remains.

As reported from previous cross-sectional studies, grain farmers have increased prevalence of respiratory symptoms and lower lung function values than do rural-dwelling, non-farming men (Dosman et al., 1987). A pilot study was conducted to determine acute changes in lung function in farmers exposed to high level of dust during shoveling cereal grain (composed of wheat, barley, oats, and canola seed) in a grain storage facility (granary). Twenty-two male grain farmers (mean age ± S.D., 39.8 ± 10.5 years) and 22 age-matched, non-exposed control subjects (39.7 ± 10.5 years) participated in the study. Grain farmers and control subjects were similar in height, weight, and smoking habits. Prior to shoveling grain in the granary, farmers completed a respiratory questionnaire and had spirometry measurements taken by a technician. Following shoveling grain, farmers had repeat spirometry and completed a questionnaire ascertaining acute symptoms. Two spirometry measurements were also made on control subjects. The mean time period between two spirometry measurements in control subjects (107.2 ± 38.5 min) was greater than was the mean time between measurements for men shoveling for grain (76.0 ± 29.8 min). The exposed grain farmers had a greater period change in lung function measurements in comparison to the control subjects. Similar results were observed after allowing for the differences in the time period between two sequential spirometry measurements in the grain farmers and control subjects. Mean acute respiratory symptom scores were significantly greater in the exposed grain farmers than in the control subjects. Further studies are required to examine the physiological mechanisms of changes in lung function in farmers acutely exposed to grain dust.