Search

Sleep is crucial for maintaining the recovery and restoration of the body and brain. Less sleep is associated with poor mental and physical performance. Seasonal changes in sleep patterns can be observed. This paper examines seasonal effects on sleep timing, duration, and problems in two Cree First Nation communities in Saskatchewan, Canada. Data were available from a community survey of 588 adults aged 18 years and older (range: 18–78 years) with 44.2% males and 55.8% females. Results are presented using descriptive statistics and a binary logistic-regression model to identify the association between seasonal changes in sleep patterns, and demographic, social, and environmental factors. The participants reported sleeping the least during the spring and summer months and sleeping the most during the fall and winter months. This was further confirmed by sleep hours and the lower proportion of recommended hours of sleep during the spring and summer, and a higher proportion of longer sleep duration during the fall and winter months. There was no significant variation in sleeping onset and wake-up times by season. Overall, there were no significant differences in the prevalence of sleep deprivation, insomnia, and excessive daytime sleepiness by season. When stratified by age group and sex, some differences existed in the prevalence of sleep problems by season. More than two-thirds (68.6%) of the participants reported that there was a change in sleep patterns across seasons, and about 26.0% reported a very or extremely marked change in sleep patterns across seasons. Changes in sleep patterns by season were related to money left at the end of the month and damage caused by dampness in the house.

BACKGROUND Cultures of safety in farm work settings are under the authority of a responsible owner-operator, who establishes rules, attitudes, and behaviors for farm work practices. This novel analysis provides new evidence to show that risks that can lead to injury and are commonly practiced on Canadian farms are indeed transferred between generations. METHODS Baseline data were provided by representatives from eligible and consenting farms (n = 589) in the province of Saskatchewan, Canada, during the first quarter of 2013. Mailed questionnaires were sent to participating farms and completed by a single respondent. Questionnaires included scaled assessments of hazards and safety practices by farm operators, and young workers on each farm. Descriptive and multiple regression analyses were used to examine relationships between farm owner-operator risks and safety practices and those reported for the young workers. FINDINGS Graphical descriptive analyses showed that as farm owner-operator risks increased, so did those reported for children and young workers. Similarly, as farm owner-operator safe work practices increased, young worker hazards decreased, albeit more modestly. The young worker hazard scale increased by 0.20 (95% CI: 0.10-0.30) points, and decreased by 0.08 (95% CI: -0.016 to -0.000) points for each one-point increase in the owner-operator hazard and safe work practices scales, respectively. CONCLUSIONS Occupational health and safety risks and protections experienced on farms appear to be transferred between generations. This suggests the need to target farm owner-operators, the responsible authority on the farm, as a focus of primary prevention strategies aimed at injury risks to children and young workers.

Workers in swine operations may be at increased risk of developing respiratory problems. These respiratory conditions are more prevalent among workers who are smokers. Tumor necrosis factor (TNF) genes play an important role in human immune responses to various respiratory hazards. This study aimed to investigate whether polymorphisms in TNF genes might alter the effects of smoking on lung function among workers in swine operations. Three hundred and seventy-four full-time workers from large swine operations and 411 non-farming rural dwellers in Saskatchewan were included in this study. Information on demographic and lifestyle characteristics, pulmonary function, and blood samples were obtained. Multiple linear regression analyses were used in the statistical analysis. Three promoter polymorphisms (rs1799724, rs361525, and rs1800629) in the TNF gene were investigated. Only the interaction term between smoking status and rs1799724 was significant in the multiple regression models. Among workers with the rs1799724 polymorphism (TT+TC), current smokers exhibited significantly lower lung function than nonsmokers. These associations were not observed among workers with the wild-type (CC). These findings were not observed among non-farming rural dwellers. Data demonstrated the possible involvement of TNF gene in (1) development of adverse respiratory conditions among workers who are smokers, (2) importance of smoking cessation among workers, especially those with polymorphisms in the TNF gene, and (3) potential implications in treatment, screening, and prevention.

Insecticide use has been linked to increased risk of non‐Hodgkin lymphoma (NHL), however, findings of epidemiologic studies have been inconsistent, particularly for NHL subtypes. We analyzed 1690 NHL cases and 5131 controls in the North American Pooled Project (NAPP) to investigate self‐reported insecticide use and risk of NHL overall and by subtypes: follicular lymphoma (FL), diffuse large B‐cell lymphoma (DLBCL) and small lymphocytic lymphoma (SLL). Odds ratios (OR) and 95% confidence intervals for each insecticide were estimated using logistic regression. Subtype‐specific associations were evaluated using ASSET (Association analysis for SubSETs). Increased risks of multiple NHL subtypes were observed for lindane (OR = 1.60, 1.20‐2.10: FL, DLCBL, SLL), chlordane (OR = 1.59, 1.17‐2.16: FL, SLL) and DDT (OR = 1.36, 1.06‐1.73: DLBCL, SLL). Positive trends were observed, within the subsets with identified associations, for increasing categories of exposure duration for lindane (P trend = 1.7 × 10−4), chlordane (P trend = 1.0 × 10−3) and DDT (P trend = 4.2 × 10−3), however, the exposure‐response relationship was nonlinear. Ever use of pyrethrum was associated with an increased risk of FL (OR = 3.65, 1.45‐9.15), and the relationship with duration of use appeared monotonic (OR for >10 years: OR = 5.38, 1.75‐16.53; P trend = 3.6 × 10−3). Our analysis identified several novel associations between insecticide use and specific NHL subtypes, suggesting possible etiologic heterogeneity in the context of pesticide exposure., What's new? Insecticides are persistent environmental pollutants that have been linked to increased risk of non‐Hodgkin lymphoma (NHL). Although NHL encompasses a heterogeneous group of malignancies, few studies have examined subtype‐specific associations for insecticide exposure. Analyzing data from population‐based case‐control studies of lymphatic cancers, the authors of this study show that lindane, chlordane, and DDT are associated with increased risk of multiple NHL subtypes. Analyses further uncovered a novel link between increased follicular lymphoma risk and pyrethrum use. None of the insecticides investigated, however, were associated with all NHL subtypes, suggesting a role for etiologic heterogeneity in pesticide exposure and NHL risk.

OBJECTIVE This study aims to assess the annual changes in lung function among farm and nonfarm adult residences in rural Saskatchewan, Canada. METHODS Data from the Saskatchewan Rural Health Study survey (2010 to 2014) among 724 adults were used. RESULTS For forced expiratory volume in 1 second (FEV1) measurements, estimates of annual decline (in milliliters) were highest in older age male (65+ years) (Mean, SD) (-42.63, 21.16); and among old heavy smokers (-57.79, 24.30). Estimates of annual decline in forced vital capacity (FVC) were highest in current smokers without the use of natural gas (-25.78, 14.78) and among old heavy smokers (-33.88, 20.28). Living on a farm is associated with decreased FEV1 and FVC, but not statistically significant by sex and age. CONCLUSIONS A complex mix of personal and contextual factors may affect these estimates.

Objectives Sleep deprivation is a common problem in Canada and is associated with many health problems. More than a quarter of Canadians get fewer than the recommended sleep hours (, Highlights • The prevalence sleep deprivation was about 25% in these two First Nation communities. • Association between sleep deprivation and males with nighttime insomnia observed. • Another important finding was association between visible mold and sleep deprivation.

OBJECTIVES: Some epidemiological studies have suggested positive associations between glyphosate use and non-Hodgkin lymphoma (NHL), but evidence is inconsistent and few studies could evaluate histological sub-types. Here, associations between glyphosate use and NHL incidence overall and by histological sub-type were evaluated in a pooled analysis of case–control studies. METHODS: The analysis included 1690 NHL cases [647 diffuse large B-cell lymphoma (DLBCL), 468 follicular lymphoma (FL), 171 small lymphocytic lymphoma (SLL), and 404 other sub-types] and 5131 controls. Logistic regression was used to estimate adjusted odds ratios (OR) and 95% confidence intervals (CI) for NHL overall and sub-types with self-reported ever/never, duration, frequency, and lifetime-days of glyphosate use. RESULTS: Subjects who ever used glyphosate had an excess of NHL overall (OR 1.43, 95% CI 1.11–1.83). After adjustment for other pesticides, the OR for NHL overall with "ever use" was 1.13 (95% CI 0.84–1.51), with a statistically significant association for handling glyphosate >2 days/year (OR 1.73, 95% CI 1.02–2.94, P-trend=0.2). In pesticide-adjusted sub-type analyses, the ordinal measure of lifetime-days was statistically significant (P=0.03) for SLL, and associations were elevated, but not statistically significant, for ever years or days/year of use. Handling glyphosate >2 days/year had an excess of DLBCL (OR 2.14, 95% CI 1.07–4.28; P-trend=0.2). However, as with the other sub-types, consistent patterns of association across different metrics were not observed. CONCLUSIONS: There was some limited evidence of an association between glyphosate use and NHL in this pooled analysis. Suggestive associations, especially for SLL, deserve additional attention.

Objective To assess the predictors associated with incidence and longitudinal changes in the prevalence of chronic bronchitis (CB) among farm and non-farm residents of rural Saskatchewan, Canada. Methods The Saskatchewan Rural Health Study was a prospective study of the lung health of rural dwellers. We obtained information on 4624 households, 8261 individuals (2797 households, 4867 individuals) at baseline (follow-up). Results Incidence of CB was 4.3% over 4 years. The prevalence was 6.4% and 5.3% (baseline) and 12.1% and 9.2% (follow-up) in non-farm and farm residents, respectively. The prevalence of CB was associated with current smokers; father ever had lung trouble; obesity; mother smoked during pregnancy; allergic reaction to cats and to pollen; household income inadequacy and age. Conclusion Prevalence and incidence of CB in rural people appear to be a complex mix of personal and contextual factors.

Inadequate housing is commonplace in First Nations in Canada, often leading to environmental impacts on housing such as dampness and mold. First Nations communities suffer from a higher prevalence of respiratory-related health conditions than the general Canadian population. There is limited Canadian literature evaluating the relationship between housing factors and the respiratory health of adults within First Nations communities. This study was undertaken with two Saskatchewan First Nations communities. The study population consisted of 293 individuals within 131 households. The individuals completed questionnaires on their general and respiratory health, and one member of each household completed a household questionnaire. The collection of environmental samples from within the house was undertaken. The respiratory outcomes of interest focused on the individuals with ever wheeze, reported by 77.8% of the individuals, and shortness of breath, reported by 52.6% of the individuals. Body mass index, the nontraditional use of tobacco (i.e., current and ex-smoking), the nontraditional use of tobacco in the house (i.e., smoking in the house), dampness in the house in the last 12 months, and always having a smell of mold in the house were significantly associated with respiratory symptoms. The results reveal that respiratory symptom rates were high in the population and housing factors were significantly associated with respiratory symptoms. Addressing and redressing housing inadequacies in First Nations communities are important in preventing additional burdens to health.

Objective This study aimed to determine the prevalence of hormone-related cancers (HRCs) among Saskatchewan rural dwellers and explore associated risk factors. Methods Data were analyzed from the Saskatchewan Rural Health Study (SRHS), which was a prospective cohort (2010 to 2014). Completed questionnaires were obtained from 4624 (2797) households, with information about 8261 (4867) individuals more than or equal to 18 years at baseline (follow-up). The crude prevalence of HRCs was calculated using appropriate formulae. Adjusted prevalence was calculated using logistic regression based on the generalized estimating equation (GEE). Results Crude prevalence of HRCs was 3.0% at the baseline. Variables significantly associated with HRCs were: exposure to radiation comprising ultraviolet radiation from sunlight as well as ionizing radiation (odds ratio [OR] 3.39; 95% confidence interval [CI]: 2.23, 4.84), previous history of cancer in sibling (OR = 1.51, 95% CI: 1.11, 2.07) and in father (OR = 1.37; 95% CI = 1.01, 1.86). Conclusions The study informs the Saskatchewan Health Region for health care resource allocation.

Insomnia is a common problem in Canada and has been associated with increased use of health care services and economic burden. This paper examines the prevalence and risk factors for insomnia in two Cree First Nation communities in Saskatchewan, Canada. Five hundred and eighty-eight adults participated in a baseline survey conducted as part of the First Nations Sleep Health Collaborative Project. The prevalence of insomnia was 19.2% among participants with an Insomnia Severity Index score of ≥15. Following the definition of nighttime insomnia symptoms, however, the prevalence of insomnia was much higher, at 32.6%. Multivariate logistic regression modeling revealed that age, physical health, depression diagnosis, chronic pain, prescription medication use for any health condition, and waking up during the night due to terrifying dreams, nightmares, or flashbacks related to traumatic events were risk factors for insomnia among participants from two Saskatchewan Cree First Nation communities.

Study objectives Estimates of sleep duration and quality are lacking for Canadian First Nations peoples. This study examines the prevalence of and risk factors for short/normal/long sleep duration and sleep quality. Methods Five hundred eighty-eight adults participated in the baseline survey of the First Nations Sleep Health Project conducted in 2018-2019 in Saskatchewan, Canada. Sleep duration and quality were self-reported. Results Mean sleep duration was 8.18 hours per night. About 45.5% slept the recommended 7 hours per night. However, short sleep duration and poor sleep quality were relatively common: about one-quarter of the participants slept fewer hours than recommended. Sleep duration was significantly less for men than women. Women were significantly more likely to report poor sleep quality than males. Multiple regression models revealed that age was significantly related with shorter sleep duration; sex and employment status were significantly related with sleep duration; and sex and income indicators were significantly associated with sleep quality. Nearly half of participants reported having had the recommended hours of sleep, but nearly two-thirds reported poor sleep quality. Conclusions Information about the proportion of First Nations adults who sleep the recommended duration and the quality of sleep is important in informing health care and health policy.

To determine predictors associated with longitudinal changes in colorectal cancer (CRC) prevalence in farm and non-farm rural residents in Saskatchewan, Canada.Data from the Saskatchewan Rural Health Study were collected from 8261 individuals nested within 4624 households at baseline survey in 2010 and 4867 individuals (2797 households) at follow-up survey in 2014. The study sample consists of 5599 individuals (baseline) and 3933 at (follow-up) (more than or equal to 50 years).The prevalence of CRC increased over time among rural farm (baseline: 0.8%; follow-up: 1.3%, P 0.05) and non-farm (baseline: 1.4%; follow-up: 2.0%, P 0.05) residents. Longitudinal predictors of CRC prevalence were: quadrant, location of home, mother ever had cancer, age, body mass index (BMI), sex, radiation, natural gas.Longitudinal changes in prevalence of CRC among farm and non-farm residents appear to depend on a complex combination of individual and contextual factors.

PURPOSE: Saskatchewan has a high prevalence of diabetes. It is the largest, rurally populated, predominantly agricultural province in Canada. This research aims to determine the risk factors associated with the incidence and longitudinal changes in the prevalence of diabetes among Saskatchewan’s adult rural farm and non-farm residents. METHODS: The Saskatchewan Rural Health Study (SRHS) is a prospective cohort study conducted in two phases: a baseline survey (2010, 8261 participants) and a follow-up survey (2014, 4867 participants). Generalized estimation equations and survival analysis techniques were used to determine diabetes prevalence and incidence risk factors, respectively. RESULTS: Incidence of diabetes among rural residents was 2.75%. Positive family history, high BMI, sleep apnea and an abnormal Epworth Sleepiness Score (ESS) were significant predictors for diabetes incidence. A substantial increase (1.98%) of diabetes prevalence was observed after four years of follow-up. Risk factors of diabetes prevalence were increasing age, male, low income, positive family history, high BMI, hypertension and heart attack. CONCLUSION: A mix of individual and contextual factors interacting in complex pathways were responsible for the high incidence and prevalence of diabetes among rural residents. The most original finding of that study was a positive association of sleep apnea, and ESS with incident diabetes warrants further research to identify a causal linkage. Increased diabetes risk among rural male insecticide users indicates an adverse consequence of unprotected chemical exposures in the agricultural field. Urgent population-based preventive measures should initiate to slow the increasing trend of diabetes prevalence among rural residents.

Objective: The objective of the study was to determine the prevalence and associated risk factors of asthma in Aboriginal adolescents in Canada based on the Canadian Aboriginal Peoples Surv...

Background Children are commonly injured on farms, yet no studies provide evidence about exposures that leave rural children visiting farms at risk. Objectives The objectives of this study were to study (a) how frequently rural nonfarm children are exposed to farms, farm work and associated activities; and (b) the safety conditions and practices on farms being visited. Methods A cross-sectional survey was administered in Saskatchewan, Canada to rural parents during 2014. Participation included reports on 458 farms visited by rural children, and then 549 children from 312 families who had been exposed to a farm in the past year. Child-level indicators included age, sex, farm safety education and training, engagement in farm work and play activities and exposure to specific farm safety hazards. Farm-level indicators included self-perceived safety conditions, and child supervision practices. Results One-third of the children sampled (n=549) had been exposed to a farm in the past year. Safety conditions, practices and supervision varied by demographic subgroup. Farm safety education and agriculture training were most common in the oldest age group (13 to 17 years; 24.7% and 9.2%, respectively) of which 40.8% had worked on a farm previously, averaging 10 hours/week (interquartile range 3 to 20) during summer months. Mechanized and nonmechanized work was observed for children of both sexes and rose with age. Physical hazards were reported both proximally (≤100 yards) and distally (>300 yards) to farm homes. Conclusions Children who visit farms are potentially exposed to risk, and these risks increase with age as children take on formal work roles, leaving them vulnerable to farm injury.

Objectives Less is known about the respiratory health of general farming and non-framing populations. A longitudinal Saskatchewan Rural Health Study (SRHS) was conducted to explore the association between individual and contextual factors with respiratory health outcomes in these populations. Hence, the objectives are to: (i) describe the updated methodology of longitudinal SRHS—an extension of baseline survey methodology published earlier; (ii) compare baseline characteristics and the prevalences of respiratory health outcomes between drops-outs and completers; and (iii) summarize key findings based on baseline survey data. Results The SRHS was a prospective cohort study conducted in two phases: baseline survey in 2010 and a follow-up in 2014. Each survey consisted of two components, self-administered questionnaire and clinical assessments. At baseline, 8261 participants (≥ 18 years) (4624 households) and at follow-up, 4867 participants (2797 households) completed the questionnaires. Clinical assessments on lung functions and/or allergies were conducted among a sub-group of participants from both the surveys. To date, we published 15 peer-reviewed manuscripts and 40 abstracts in conference proceedings. Findings from the study will improve the knowledge of respiratory disease etiology and assist in the development and targeting of prevention programs for rural populations in Saskatchewan, Canada.

All-terrain vehicles (ATV's) are a hazardous source of injury in many contexts and geographical regions, but to date have not been investigated in Saskatchewan.Baseline surveys from the Saskatchewan Farm Injury Project were examined at two time points in terms of: (1) rates and correlated characteristics of reported ATV use; and (2) qualitative content analysis of injury events involving ATVs. The sample of eligible farmers was 2,972 in 2007 and 1,702 in 2013.Self-reported ATV use increased on Saskatchewan farms over the five-year period, both in terms of the number of individuals using ATV's on the farm and the days per year of operation. ATV use is significantly more common on farms with livestock, among male farmers, and among younger farmers. Farmers with low back pain were also more likely to report ATV use. Qualitative content analysis of farmers' reported "most serious injury" on the farm revealed themes related to: (1) tasks undertaken with ATV's at the time of the incident (e.g., stock work and personal transport); (2) contributing factors (vehicle, environmental and driver); and (3) safety reflections.The apparent trends of increasing ATV use on Saskatchewan farms and serious nature of the injury incidents reported indicate that this is an issue worthy of further investigation.

OBJECTIVES: To determine among rural-dwelling on-reserve Saskatchewan First Nations people whether racial discrimination is associated with depression, and in turn, if this relationship is moderated by gender. METHODS: As a component of a community-based participatory research project, a cross-sectional, interviewer-administered survey of 874 adults living on 2 Cree First Nation reserves in rural north-central Saskatchewan was conducted during May–August in 2012 and 2013. Self-reported, health-provider diagnosis of depression was the dependent variable and experiences of interpersonal racial discrimination was the primary exposure. Chi-square and multiple logistic regression were the main analytic techniques. Generalized estimating equations were applied to account for clustering within households. RESULTS: Overall, 64% of participants reported being treated unfairly in 1 or more situations because of their ethnicity; 38% indicated discrimination occurring in 3 or more situations. Nineteen percent reported a diagnosis of depression. Adjusted analyses indicated that compared to those with no experience of racial discrimination, those reporting 1–2 and 3 or more situations were 1.77 times (95% CI: 1.06–2.95) and 1.91 times (95% CI: 1.19–3.04) more likely to have diagnosed depression respectively. The relationship between racial discrimination and depression was not modified by gender, although women were 1.85 times (95% CI: 1.24–2.76) more likely to report depression than men. CONCLUSION: Interpersonal racial discrimination was associated with depression among First Nations women and men in rural Saskatchewan. Research directed at identifying the most efficacious interventions, programs and policies to combat racism is required to advance the goal of health equity.

Background and objective The relationship between farming exposures and pulmonary function in a rural paediatric population was evaluated. Methods Baseline data collection records of the Saskatchewan Rural Health Study (SRHS), a population-based study, were used. A subset of children (6–14 years old) participated in clinical testing, including anthropometric measures and pulmonary function testing (PFT), using spirometry (n = 584). PFTs followed ATS criteria and all statistical analyses were controlled for age, sex and height. Results Among clinical testing participants, 47.5% were females and 54.5% were farm dwelling. Of those living on farms, 77.5% were livestock farms. Mean percent predicted value (PPV) for forced expiratory volume in 1 s (FEV1 ) and forced vital capacity (FVC) among children living on a farm were 104.8% and 105.4%, respectively. Mean PPV for FEV1 and FVC among children not living on a farm were 102.7% and 101.4%, respectively. After adjustment, higher FEV1 (=0.079, SE = 0.033, P = 0.03) and FVC (=0.110, SE = 0.039, P = 0.006) were seen among children living on a farm. A trend towards lower FEV1 /FVC ratio (−0.013, SE = 0.008, P = 0.09) among children living on a farm was seen compared with children not living on a farm. Higher FVC and lower FEV1 /FVC ratio were seen in children who regularly emptied grain bins (P

Objectives To examine sleep patterns in a large cohort of rural children and explore the association between sleep patterns and injury occurrence. Methods Cross-sectional analyses of the baseline survey from a prospective cohort study (2012 to 2017) was conducted with 46 rural schools in Saskatchewan, Canada who distributed surveys to parents of 2275 rural dwelling farm and nonfarm children aged 0 to 17 years. Parents reported child sleep characteristics and farm or nonfarm injury in the previous calendar year. Multivariable log-binomial regression examined associations between sleep characteristics and injury risk. Results There was a significant trend of decreasing sleep duration with increasing age (P-trend < 0.001). Short sleep duration on weekdays (RR: 2.14; 95% CI: 1.25 to 3.66) and sleep debt (RR: 1.89; 95% CI: 1.21 to 2.95) increased injury risk in school-age children (7 to 12 years) but not in teens. A nearly fivefold increase in injury risk was identified among school-age children reporting all sleep problems (RR: 4.99; 95% CI: 1.99 to 12.50). Snoring in teens (13 to 17 years), often a symptom of obstructive sleep apnea, was associated with increased injury risk (RR: 1.98; 95% CI: 1.17 to 3.33). There were no statistically significant associations identified between sleep characteristics and injury risk in preschool children. Conclusion Injuries to rural children are an important public health concern. This study highlights the impact of sleep problems on risk for injury among rural children. These findings are discussed in light of the recent American Academy of Pediatrics Technical Report on Insufficient Sleep in Adolescents and Young Adults.

Background A complex, poorly understood bifurcated health policy regime exists for Canada's First Nations people for extended health benefits coverage. This research adds to a small body of literature on the regime's impact on access and quality of care and its role in perpetuating health inequities in First Nations populations. Methods Using a case study of sleep apnea care in Saskatchewan, we identified issues of health service access and coverage through a literature review of extended benefits programs, legislation and policies and through 10 key informant interviews with federal and provincial extended benefit program administrators and sleep medicine physicians. Results Important access and coverage differences were found for First Nations populations, many of which were recognized by federal and provincial policy makers. Despite these, government respondents recommended few policy ameliorations, perhaps due to system complexities, constitutional constraints or political sensitivities. Conclusions We suggest three policy options to ameliorate current hardships wrought by this policy bifurcation.

Because of time and cost constraints, objective classification of atopic and nonatopic asthma has been limited in large epidemiologic studies. However, as we try to better understand exposure-outcome associations and ensure appropriate treatment of asthma, it is important to focus on phenotype-defined asthma classification.To compare atopic and nonatopic asthma in rural children with regard to risk factors and clinical outcomes.We conducted a cross-sectional study in rural Saskatchewan, Canada, in 2011. Parents of 6- to 14-year-old children completed a health and exposure survey. Skin prick tests were completed in a subsample of 529 children. Asthma was based physician diagnosis. Asthma status was defined as no asthma, nonatopic asthma, and atopic asthma.Asthma prevalence was 14.7% of which 32.1% of cases were atopic. After adjustment, early respiratory illness and a family history of asthma were predictors of childhood asthma, regardless of atopic status (P.05). Being overweight and having a dog in the home were associated with an increased risk of nonatopic asthma (P.05). A mother with a history of smoking increased the risk of atopic asthma (P = .01). Compared with those with nonatopic asthma, in the past 12 months, children with atopic asthma were more likely to report a sneezy, runny, or blocked nose or have shortness of breath (odds ratio2), whereas those with nonatopic asthma were more likely to have parents who missed work (odd ratio3). Those with nonatopic asthma had significantly lower forced expiratory volume in 1 second compared w2ith those with atopic asthma.Exposures may contribute differentially to atopic and nonatopic asthma and result in differential clinical presentation or burden. The study of these characteristics is important for etiologic understanding and management decisions.

Introduction: Despite some attention paid to farm stress in the popular press, recent Canadian research examining the mental wellbeing of farming populations relative to other rural dwellers is sparse. International research on the topic has shown inconsistent findings and has mainly focused on men. The objective of the present study was to examine the correlates of mental health among rural Saskatchewan women and men, positioning farm/non-farm residence as a main explanatory variable, and depression and binge drinking as measures of mental health. Methods: The cross-sectional sample consisted of 1701 women (47.8% farm) and 1700 men (53.3% farm) who participated in the 2014 phase of the Saskatchewan Rural Health Study, a prospective cohort study primarily examining the respiratory health of rural people in the southern part of the province of Saskatchewan, Canada. Data were collected using mailed self-report questionnaires and included measures of mental health assessing health professional diagnosed depression and binge drinking, in addition to a broad array of demographic characteristics, stressors and resources. Multiple logistic regression was the primary method of analysis; generalized estimating equations were utilized to account for household clustering. All analyses were conducted separately for women and men and by mental health indicator. Results: Farm/non-farm residence was related to depression but only under particular circumstances, which in turn differed by gender. In women, non-farm residents with two or more chronic conditions reported more depression than their farm counterparts (odds ratio (OR)=2.62; 95% confidence interval (CI) 1.28-5.36); non-farm men with secondary school education reported greater depression than farm-dwelling men (OR=2.93; 95%CI 1.31-6.59). The remaining correlates of depression were generally consistent with previous research in rural populations, including younger age, being non-partnered (men only), higher stress, greater financial strain (women only) and lower social support (women only). Binge drinking was significantly elevated in non-farm women (OR=1.68; 95%CI 1.21-2.33) and non-farm men (OR=1.70; 95%CI 1.33-2.17) compared to the farming population. Among women only, not having access to a regular family doctor/nurse practitioner was associated with an increased likelihood of binge drinking (OR=2.05; 95%CI 1.13-3.71) compared to women perceiving better access. Conclusion: The present study is one of very few recently published quantitative studies of the correlates of mental health among farm and non-farm adults in rural Canada. The findings suggest that non-farm dwellers in rural Saskatchewan may be more vulnerable to compromised mental health than their farming counterparts. Additional research employing a longitudinal design and enhanced measurement is required to confirm or refute these findings.

While damp housing is a recognized risk factor for asthma and atopy in children, its importance for adult health is inconclusive. We investigated the relationship between damp housing and adult atopic and non-atopic asthma in two Canadian First Nations communities. Methods: As part of the First Nations Longitudinal Respiratory Health Study, initiated in 2012, participating adults completed a health and environmental questionnaire followed by clinical assessment of atopy. Asthma was defined as any doctor diagnosed asthma. Atopic asthma included asthma and a positive skin prick test (SPT) ≥ 3mm to any of 6 allergens including house dust mite, three mold species, cat, and local grasses. Major household factors assessed included recent household damage caused by dampness; presence of mold and mildew; pets; and smoking. Multinomial logistic regression models with 3 outcomes [non-atopic asthma, atopic asthma and no asthma (referent)] were used to assess associations between asthma phenotypes and damp housing factors adjusting for covariates. Results: Of the 874 participants, 669 had allergy testing. The prevalence of asthma and atopy was 14.9 % and 21.1%, respectively. The most prevalent SPT responses were to cat (11.1%) and Cladosporium (7.9%). Of those with asthma, 28.0% were atopic. While mold or mildew in the home was not associated with asthma phenotypes, adults with atopic asthma were more likely to live in houses with home dampness (adjusted odds ratio: 3.4, 95% confidence interval: 1.41–8.17). No such associations were found for non-atopic asthma. Conclusion: This study supports the evidence that home dampness is an important domestic risk factor for adults with an atopic asthma history.

Purpose The purpose of this study was to investigate associations between pesticide exposures and risk of Hodgkin lymphoma (HL) using data from the North American Pooled Project (NAPP). Methods Three population-based studies conducted in Kansas, Nebraska, and six Canadian provinces (HL = 507, Controls = 3886) were pooled to estimate odds ratios and 95% confidence intervals for single (never/ever) and multiple (0, 1, 2–4, ≥ 5) pesticides used, duration (years) and, for select pesticides, frequency (days/year) using adjusted logistic regression models. An age-stratified analysis (≤ 40/ > 40 years) was conducted when numbers were sufficient. Results In an analysis of 26 individual pesticides, ever use of terbufos was significantly associated with HL (OR: 2.53, 95% CI 1.04–6.17). In age-stratified analyses, associations were stronger among those ≤ 40 years of age. No significant associations were noted among those > 40 years old; however, HL cases ≤ 40 were three times more likely to report ever using dimethoate (OR: 3.76 95% CI 1.02–33.84) and almost twice as likely to have ever used malathion (OR: 1.86 95% CI 1.00–3.47). Those ≤ 40 years of age reporting use of 5 + organophosphate insecticides had triple the odds of HL (OR: 3.00 95% CI 1.28–7.03). Longer duration of use of 2,4-D, ≥ 6 vs. 0 years, was associated with elevated odds of HL (OR: 2.59 95% CI 1.34–4.97). Conclusion In the NAPP, insecticide use may increase the risk of HL, but results are based on small numbers.

Significance The agricultural industry differs from other businesses in the composition of its workforce. Often farm owner-operators work beyond what society would expect to be a normal retirement age. Older farmers may be less receptive to behavioral changes designed to improve worksite safety and are at increased risk for experiencing a work-related injury. We had a unique opportunity to evaluate the relative influence of specific occupational conditions and practices reported by older farm operators (age ≥55 years) on the occurrence of injury using a longitudinal approach. Materials and methods Baseline data were provided by eligible and consenting farm members in the first quarter of 2013. These farms were then followed longitudinally by mail surveys over 24 months to document injury experiences. For each survey, mailed questionnaires were sent to participating farms and completed by a single respondent. Cox proportional hazard models were used to determine which characteristics of the farm work environment were protective. Results A total of 96 farm injuries were reported by 73 of 566 farm operators. Medium (hazard ratio [HR] = 0.58; confidence interval [CI], 0.35-0.96) or high (HR = 0.53; CI, 0.30-0.94) worksite physical safety and high economic security (HR = 0.41; CI, 0.24-0.71) were protective in reducing injury among older farmers. Conclusion Safety features in the physical environment and economic security are important protective factors for injury among older farmers. This supports injury prevention theory that suggests that engineering controls are superior to changes in work practices or the use of personal protective equipment in reducing injuries among older farmers.

Multiple myeloma (MM) has been consistently linked with agricultural activities, including farming and pesticide exposures. Three case-control studies in the United States and Canada were pooled to create the North American Pooled Project (NAPP) to investigate associations between pesticide use and haematological cancer risk. This analysis used data from 547 MM cases and 2700 controls. Pesticide use was evaluated as follows: ever/never use; duration of use (years); and cumulative lifetime-days (LD) (days/year handled × years of use). Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression adjusted for age, province/state of residence, use of proxy respondents and selected medical conditions. Increased MM risk was observed for ever use of carbaryl (OR = 2.02, 95% CI = 1.28-3.21), captan (OR = 1.98, 95% CI = 1.04-3.77) and DDT (OR = 1.44, 95% CI = 1.05-1.97). Using the Canadian subset of NAPP data, we observed a more than threefold increase in MM risk (OR = 3.18, 95% CI = 1.40-7.23) for ≤10 cumulative LD of carbaryl use. The association was attenuated but remained significant for >10 LD of carbaryl use (OR = 2.44; 95% CI = 1.05-5.64; ptrend = 0.01). For captan, ≤17.5 LD of exposure was also associated with a more than threefold increase in risk (OR = 3.52, 95% CI = 1.32-9.34), but this association was attenuated in the highest exposure category of >17.5 LD (OR = 2.29, 95% CI = 0.81-6.43; ptrend = 0.01). An increasing trend (ptrend = 0.04) was observed for LD of DDT use (LD > 22; OR = 1.92, 95% CI = 0.95-3.88). In this large North American study of MM and pesticide use, we observed significant increases in MM risk for use of carbaryl, captan and DDT.

In some occupational contexts overweight and obesity have been identified as risk factors for injury. The purpose of this study was to examine this hypothesis within farm work environments and then to identify specific opportunities for environmental modification as a preventive strategy. Data on farm-related injuries, height and weight used to calculate body mass index (BMI), and demographic characteristics were from the Phase 2 baseline survey of the Saskatchewan Farm Injury Cohort; a large cross-sectional mail-based survey conducted in Saskatchewan, Canada from January through May 2013. Multivariable logistic regression was used to examine associations between BMI and injury. Injury narratives were explored qualitatively. Findings were inconsistent and differed according to gender. Among women (n = 927), having overweight (adjusted OR: 2.94; 95% CI: 1.29 to 6.70) but not obesity (1.10; 95% CI: 0.35 to 3.43) was associated with an increased odds of incurring a farm-related injury. No strong or statistically significant effects were observed for men (n = 1406) with overweight or obesity. While injury-related challenges associated with obesity have been addressed in other occupational settings via modification of the worksite, such strategies are challenging to implement in farm settings because of the diversity of work tasks and associated hazards. We conclude that the acute effects of overweight in terms of injury do require consideration in agricultural populations, but these should also be viewed with a differentiation based on gender., Highlights • Obesity can increase risk for injury through biological and physical mechanisms. • Associations between BMI status and agricultural injury were examined. • Findings were inconsistent and differed according to gender. • Overweight is a potential risk factor for injury, specifically in farm women. • We suggest ergonomic modifications that are potentially effective for farm settings.

Obstructive sleep apnea (OSA) is the most common sleep-disordered breathing condition. Patients with OSA symptoms are often not diagnosed clinically, which is a concern, given the health and safety risks associated with unmanaged OSA. The availability of fewer practicing medical specialists combined with longer travel distances to access health care services results in barriers to diagnosis and treatment in rural communities. This study aimed to (1) determine whether the proportion of adults reporting OSA symptoms in the absence of a sleep apnea diagnosis in rural populations varied by travel distance to specialist medical care and (2) assess whether any distance-related patterns were attributable to differences in the frequency of diagnosis among adults who likely required this specialist medical care. We used a cross-sectional epidemiologic study design, augmented by analysis of follow-up survey data. Our study base included adults who completed a 2010 baseline questionnaire for the Saskatchewan Rural Health Study. Follow-up occurred until 2015. 6525 adults from 3731 households constituted our sample. Statistical models used log-binomial regression. Rural adults who reported the largest travel distances (≥250 km) to specialist medical care were 1.17 (95% CI: 1.07, 1.29) times more likely to report OSA symptoms in the absence of a sleep apnea diagnosis than those who reported the smallest (

Workers in swine operations are exposed to dust, bacteria, and virus, and are at increased risk of respiratory problems. Toll-like receptors (TLR) play an important role in human immune responses to respiratory hazards. Worker gender and age may significantly modify the involvement of TLR in the etiology of these respiratory outcomes. The aim of this study was to investigate whether modification effects of worker gender and age altered associations between polymorphisms in the TLR genes and lung function. This study included 374 full-time workers from large swine operations from Saskatchewan. Information on demography, lifestyle, pulmonary function, and blood samples were obtained. Multiple linear regression and decision tree model were used in the analysis. Among females aged

ObjectivesTo investigate the association between occupational exposure to aromatic hydrocarbon solvents and risk of multiple myeloma (MM) in a large, consortium-based study.MethodsWe pooled data on 2854 cases and 10 743 controls from nine studies participating in the InterLymph consortium. Occupational exposures to benzene, toluene and xylene were assigned by a job–exposure matrix, coupled with ‘correction’ of exposure probability by self-reported or expert-assessed exposure from the individual studies. Cumulative intensity was calculated as the job-specific exposure intensity multiplied by job duration, summed across jobs. Associations were estimated using logistic regression, with inclusion of covariates for study matching factors and other potential confounders. We repeated our main analysis using random-effects meta-analysis to evaluate heterogeneity of effect.ResultsBenzene, toluene and xylene were each associated with MM. For the three solvents, the highest quartile of high-probability cumulative intensity exposure (vs unexposed) was associated with 42% to 63% increased risks of MM. Associations with toluene and xylene exposures were fairly consistent and robust to sensitivity analyses. The estimated effect for benzene was moderately heterogeneous between the studies. Each solvent’s association with MM was stronger for exposure occurring within 20 years of diagnosis than with exposure lagged by more than 20 years.ConclusionsOur study adds important evidence for a role of aromatic hydrocarbon solvents in causation of MM. The difficulty in disentangling individual compounds in this group and a lack of data on potential carcinogenicity of toluene and xylene, in widespread current use, underscore a need for further epidemiological evaluation.