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      Identifying and mitigating risks for agricultural injury associated with obesity

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          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.


          • 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.

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          Most cited references 22

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          Establishing a standard definition for child overweight and obesity worldwide: international survey.

          To develop an internationally acceptable definition of child overweight and obesity, specifying the measurement, the reference population, and the age and sex specific cut off points. International survey of six large nationally representative cross sectional growth studies. Brazil, Great Britain, Hong Kong, the Netherlands, Singapore, and the United States. 97 876 males and 94 851 females from birth to 25 years of age. Body mass index (weight/height(2)). For each of the surveys, centile curves were drawn that at age 18 years passed through the widely used cut off points of 25 and 30 kg/m(2) for adult overweight and obesity. The resulting curves were averaged to provide age and sex specific cut off points from 2-18 years. The proposed cut off points, which are less arbitrary and more internationally based than current alternatives, should help to provide internationally comparable prevalence rates of overweight and obesity in children.
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            Beyond body mass index.

             A Prentice,  S. Jebb (2001)
            Body mass index (BMI) is the cornerstone of the current classification system for obesity and its advantages are widely exploited across disciplines ranging from international surveillance to individual patient assessment. However, like all anthropometric measurements, it is only a surrogate measure of body fatness. Obesity is defined as an excess accumulation of body fat, and it is the amount of this excess fat that correlates with ill-health. We propose therefore that much greater attention should be paid to the development of databases and standards based on the direct measurement of body fat in populations, rather than on surrogate measures. In support of this argument we illustrate a wide range of conditions in which surrogate anthropometric measures (especially BMI) provide misleading information about body fat content. These include: infancy and childhood; ageing; racial differences; athletes; military and civil forces personnel; weight loss with and without exercise; physical training; and special clinical circumstances. We argue that BMI continues to serve well for many purposes, but that the time is now right to initiate a gradual evolution beyond BMI towards standards based on actual measurements of body fat mass.
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              The effectiveness of worksite nutrition and physical activity interventions for controlling employee overweight and obesity: a systematic review.

              This report presents the results of a systematic review of the effectiveness of worksite nutrition and physical activity programs to promote healthy weight among employees. These results form the basis for the recommendation by the Task Force on Community Preventive Services on the use of these interventions. Weight-related outcomes, including weight in pounds or kilograms, BMI, and percentage body fat were used to assess effectiveness of these programs. This review found that worksite nutrition and physical activity programs achieve modest improvements in employee weight status at the 6-12-month follow-up. A pooled effect estimate of -2.8 pounds (95% CI=-4.6, -1.0) was found based on nine RCTs, and a decrease in BMI of -0.5 (95% CI=-0.8, -0.2) was found based on six RCTs. The findings appear to be applicable to both male and female employees, across a range of worksite settings. Most of the studies combined informational and behavioral strategies to influence diet and physical activity; fewer studies modified the work environment (e.g., cafeteria, exercise facilities) to promote healthy choices. Information about other effects, barriers to implementation, cost and cost effectiveness of interventions, and research gaps are also presented in this article. The findings of this systematic review can help inform decisions of employers, planners, researchers, and other public health decision makers.

                Author and article information

                [a ]Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
                [b ]School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
                [c ]Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
                [d ]Department of Emergency Medicine, Queen's University, Kingston, Ontario, Canada
                Author notes
                [* ]Corresponding author at: Department of Public Health Sciences, Queen's University, Kingston, ON K7L 3N6, Canada.Department of Public Health SciencesQueen's UniversityKingstonONK7L 3N6Canada Nathan.king@

                The Saskatchewan Farm Injury Cohort Study Team (Phase 2) consists of William Pickett PhD and James Dosman MD (co-principal investigators), Louise Hagel MSc, Robert Brison MD, Andrew Day MSc, Nathan King MSc, Joshua Lawson PhD, Catherine Trask PhD, Barbara Marlenga PhD, Lesley Day PhD, Niels Koehncke MD, and Donald C Voaklander, PhD.

                Prev Med Rep
                Prev Med Rep
                Preventive Medicine Reports
                07 June 2016
                December 2016
                07 June 2016
                : 4
                : 220-224
                27413685 4929122 S2211-3355(16)30053-5 10.1016/j.pmedr.2016.06.003
                © 2016 Published by Elsevier Inc.

                This is an open access article under the CC BY-NC-ND license (

                Regular Article

                agriculture, workplace injury, obesity, sex, prevention


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