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      Identifying and mitigating risks for agricultural injury associated with obesity

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          Abstract

          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.

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          Most cited references18

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          Beyond body mass index.

          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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            Daytime sleepiness and sleep habits of Australian workers.

            Excessive daytime sleepiness in the general community is a newly recognized problem about which there is little standardized information. Our aim was to measure the levels of daytime sleepiness and the prevalence of excessive daytime sleepiness in a sample of Australian workers and to relate that to their self-reported sleep habits at night and to their age, sex, and obesity. Sixty-five percent of all 507 employees working during the day for a branch of an Australian corporation answered a sleep questionnaire and the Epworth sleepiness scale (ESS) anonymously. Normal sleepers, without any evidence of a sleep disorder, had ESS scores between 0 and 10, with a mean of 4.6 +/- 2.8 (standard deviation). They were clearly separated from the "sleepy" patients suffering from narcolepsy or idiopathic hypersomnia whose ESS scores were in the range 12-24, as described previously. ESS scores > 10 were taken to represent excessive daytime sleepiness, the prevalence of which was 10.9%. This was not related significantly to age (22-59 years), sex, obesity, or the use of hypnotic drugs but was related significantly but weakly to sleep-disordered breathing (frequency of snoring and apneas), the presence of insomnia, and reduced time spent in bed (insufficient sleep).
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              Work, obesity, and occupational safety and health.

              There is increasing evidence that obesity and overweight may be related, in part, to adverse work conditions. In particular, the risk of obesity may increase in high-demand, low-control work environments, and for those who work long hours. In addition, obesity may modify the risk for vibration-induced injury and certain occupational musculoskeletal disorders. We hypothesized that obesity may also be a co-risk factor for the development of occupational asthma and cardiovascular disease that and it may modify the worker's response to occupational stress, immune response to chemical exposures, and risk of disease from occupational neurotoxins. We developed 5 conceptual models of the interrelationship of work, obesity, and occupational safety and health and highlighted the ethical, legal, and social issues related to fuller consideration of obesity's role in occupational health and safety.
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                Author and article information

                Contributors
                Journal
                Prev Med Rep
                Prev Med Rep
                Preventive Medicine Reports
                Elsevier
                2211-3355
                07 June 2016
                December 2016
                07 June 2016
                : 4
                : 220-224
                Affiliations
                [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@ 123456queensu.ca
                [1]

                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.

                Article
                S2211-3355(16)30053-5
                10.1016/j.pmedr.2016.06.003
                4929122
                27413685
                0062c8ed-c96b-40ee-bb41-f886ba8926bc
                © 2016 Published by Elsevier Inc.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 16 October 2015
                : 30 May 2016
                : 5 June 2016
                Categories
                Regular Article

                workplace injury,agriculture,obesity,sex,prevention
                workplace injury, agriculture, obesity, sex, prevention

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