FEATURE ARTICLE
Research
Health Hazards and Preventive Measures
of Farm Women
Emerging Issues
by Bonnie Juve' Meeker, DNS, RN, Ann Carruth, DNS, RN,
ABSTRACT
Currently, an increasing number of farms are
family owned and women are directly involved in
the farming operations as an independent man-
ager or partner. Women play an important role
in farm management by marketing farm prod-
ucts , purchasing materials, and financial plan-
ning. Because of this involvement, women can be
exposed to potential health hazards that can
result in chronic illness, debilitation, or death.
This study explored and described health haz-
ards affecting farm women in southeast
Louisiana, preventive measures used by farm
women, and their consistency in using protective
equipment with varying levels of time commit-
ment toward farm operations. This cross section-
al study included women older than 18 whose
famil y participated in farming operations. A
stratified, random sample design with parishes
comprising the strata and simple random selec-
tion without replacement within each stratum
was used to select family addresses. A total of 519
women who met the criteria completed a struc-
tured 30 minute telephone interview conducted
using The Louisiana Farm Health and Injury
ABOUT THE AUTHORS
Dr. Meeker is Associate Professor, Dr. Carruth is Associate Professor,
and Dr. Holland is Associate Professor, Southeastern Louisiana
University, College of Nursing & Health Sciences, Baton Rouge,
Louisiana.
JULY 2002, VOL. 50, NO.7
and Catherine B. Holland, PhD, RN , ANP
Survey instrument. Information elicited included
farm work characteristics, prevention practices,
and demographics. Results showed that women
working 1 to 20 hours per week were less likely
to wear personal protective equipment (PPE)
than women working more than 20 hours per
week. This included wearing seat belts on trac-
tors; using hearing, eye, or breathing protection;
and wearing gloves or boots. No differences were
found between groups for use of skin protection,
hair holders, or helmets on all terrain vehicles
(ATVs). The researchers concluded that if nurs-
ing interventions such as teaching and counsel-
ing related to prevention methods could be pro-
vided, the incidence of acute and chronic illness-
es and traumatic injury would decline.
ithin the farmin g indu stry and community,
W women have been considered "invisible support-
ers" of the male role as farm worker and manag-
er. For many years, the female role has been accepted as
"farmer's wife" or "homemaker" (Engberg, 1993). Cur-
rently, this is not the situation becau se many farms are
family owned. An increasing number of women are direct-
ly involved in the farming operation as managers by mar-
keting farm products, making purchases of necessary farm
materials, managing computer records, and assisting with
long term planning (Taylor, 1997). Women play an impor-
tant part in managing the farm and performing many of the
farm duties either alone or with a family member.
The trend has shifted to larger farms and smaller
familie s. Thu s, even more daughters have entered the
307

Farm women notonly take care of the household
functions, but assist in farm management activities,
such as marketing farm products, purchasing materials,
and financial planning. Thus, occupational health nurses
need to develop strategies for targeting groups of
women who may be at risk for health hazards related to
participation in various farming operations. Interven-
tions such as counseling and teaching related to
prevention methods that could lead to a reduction in
illnesses and injury are needed. Occupational health
nurses need to collaborate with various community
leaders to provide education about the operation of
farm equipment and appropriate Personal Protective
Equipment (PPE). This can be achieved by working with
the local Cooperative Extension Agency.
farming business as either a partner or the independent
franchise manager (Henderson, 2000; United States
Department of Agriculture [USDA], 1999). Therefore,
women can be exposed to many potential health hazards
that can result in chronic illnesses, debilitation, or death.
Specifically, women living and working on dairy
farms or cattle ranches are at high risk for exposure to var-
ious environmental hazards. Not only are women working
with livestock, but also they are involved with hay and
grain production. Many factors should be considered
when addressing health hazard exposure and women
farmers, including inhaled grain dust, pesticides and other
chemicals, and animal waste (Engberg, 1993). One
important factor that easily can be controlled to prevent
acute and chronic health problems is the length of time an
individual is exposed to a specific hazard. If women who
farm are exposed to various health hazards on a daily
basis, many health problems can be prevented by consis-
tently using proper protective equipment (PPE).
The concern about women farmers' exposure to
health hazards raises the following research question: Is
protective equipment being used [by women] when per-
forming farm work based on various length of exposure
time? This study explored and described health hazards
affecting southeast Louisiana women working on farms,
preventive measures used by them, and the consistency
with which women with varying levels of time commit-
ment toward farm operations use protective equipment.
REVIEW OF LITERATURE
Although exposure to various health hazards, length of
time exposed, and prevention methods related to farm work
have been reported in the literature, minimal investigation
into the effect of behavior on health has been conducted.
Reed (1999) examined the role of farm women in Kentucky
and Texas. It was reported that although 46% of women in
both states described themselves as farm homemakers, they
engaged in farm tasks on a regular basis. The tasks includ-
308
ed work with various animals, field irrigation, farm equip-
ment operation, and general farm management.
The investigators concluded that farm women view
themselves as homemakers and may not perceive them-
selves as at risk of exposure to health hazards, such as poi-
soning, accidents, and sun exposure. Therefore, when farm
women seek health care attention for cold and flu symp-
toms, cuts and bruises, and sunburn, they do not see these
as hazardous or life threatening problems resulting from
performing farm chores. Direct contact in farm work
exposes women to potential injury and illness. Some stud-
ies have reported a variety of chores in which farm women
engage. Chores most frequently mentioned include
(Boyle, 1997; Reed, 1999):
• Vegetable gardening.
• Caring for the animals (including milking dairy cows).
• Recordkeeping.
• Farm errands.
• Direct involvement in harvesting crops.
Differences in health hazard exposure to farm work
are directly related to farm chores and exposure to chemi-
cals and biological sources. For example, the literature
reports information related to a high incidence of sponta-
neous abortions in female farm workers exposed to pesti-
cides (Werner, 1993). Other literature reports various haz-
ards involving accidents; bodily injury from constant phys-
ical strain; and exposure to chemicals, grain dust, and bio-
logical sources, especially for women living and working
on dairy farms (Ahonen, 1990; Boyle, 1997; Sachs, 1996).
In one study of injuries to dairy farmers, 52% of those
injured were women involved in milking and feeding the
livestock (Boyle, 1997).
Exposure to pesticides, animal waste, and grain dust
often can have a long term effect on the body. Symptoms
sometimes remain dormant and may not appear for
months or years later. By then the individual may have
developed infections, respiratory disease, cancer, pesti-
cide toxicity, dermatitis, or blindness. As a result, short or
long term exposure can lead to disability or death, and,
therefore, greatly decrease quality of life (Mullan, 1996;
Pel!, 1997; Van Essen, 1999).
Farm workers, especially women, are exposed to a
variety of chemicals and inhalation substances on a daily
basis. Fertilizers and pesticides often come in dry form and
must be mixed prior to application. If proper equipment is
not used, acute and chronic poisonings, respiratory dis-
ease, and cancer can occur because of exposure to mucous
membranes (Shapiro, 1980; Wright, 1993).
Exposure to livestock waste can result in respiratory
tract irritation and diseases of the bone, central nervous
system, cardiovascular system, and liver. In addition,
mycotic zoonoses can cause systemic fungal infections
of the epidermis, hair, and nails (Haas, 1995).
Another major hazard category for farm workers is
accidents, especially from equipment such as tractors and
three or four wheeled all terrain vehicles (ATVs). These
machines often are used for farm work, such as trans-
porting small farm equipment, animals, and feed when a
trailer is attached. Also, the power take off device used by
tractors, hay balers, and bush hog machines can cause
AAOHN JOURNAL
scalping if long hair gets caught in the device (CDC,
1992; Roerig, 1993). Actual incidents described in the lit-
erature raise important questions for this population:
• To what extent are safety devices such as seat belts,
helmets, and hair holders available?
• If safety equipment and PPE are available, under what
circumstances do farm women use them?
• Are there reasons explaining why women do not wear
safety equipment?
• Do women find PPEs more cumbersome than men?
With a better understanding of these issues, nurses
can more effectively educate farm women about prevent-
ing illness, accidents, and disability.
Respiratory Problems
Some believe that because farmers work in the coun-
try, they breath more fresh air than the workers in the
smog filled, crowded city. This is a misconception. Vari-
ous tasks increase the farmer's likelihood of harmful
exposure to the respiratory tract, especially when proper
preventive measures (e.g., wearing a mask) are not used
(Langley, 1998).
Respiratory responses to various irritants depend on
factors such as the intensity and duration of exposure,
characteristics of the product, and the individual's sus-
ceptibility (Ehlers, 1993). The farm family experiences
firsthand frequent exposure to these dusts, chemicals, and
gases that lead to potential respiratory hazards.
Diseases resulting from exposure to respiratory haz-
ards have been described. For example, Farmer's Lung
(i.e., a form of hypersensitivity pneumonitis from minute
inhaled antigens created by fungal spores in moldy hay
and grain) and Silo Filler's Disease (i.e., a chemical
pneumonitis from nitrogen oxides found in grain silos)
are two diseases specific to this population. Confinement
house gases from dairy cattle are a buildup of waste prod-
ucts resulting in the formation of toxic carbon dioxide
gases. They cause severe debilitating respiratory function
(Donham, 1982; Werner, 1993; Wright, 1993).
Biological Sources
Frequent exposure to animal waste products, espe-
cially in the humidity of southeast Louisiana where dairy
farming is common, can contribute to infectious zoonot-
ic diseases. These diseases can be contracted through
direct or indirect contact with infected livestock on dairy
or cattle farms (Donham, 1982).
Cattle can transmit approximately 40 infectious
organisms to humans (e.g., salmonella) affecting the gas-
trointestinal, cardiovascular, and central nervous sys-
tems. In farm families, diseases can occur when infected
farm animals, especially cattle, contaminate the barnyard
with uterine discharges and placentae. Organisms remain
dormant on the ground for months, but, when inhaled,
cause infection (Haas, 1995). Many of these infections
are difficult to diagnose because symptoms mimic
influenza (Haas, 1995; Werner, 1993). Using protective
equipment (e.g., gloves, rubber boots) along with proper
hygiene, reduces the transmission of infectious diseases
that lead to illness.
JULY 2002, VOL. 50, NO.7
Pesticides
Pesticide exposure is a great contributor to farm fam-
ily health problems and occurs mostly because of inaccu-
rate mixing and careless use. Studies suggest that proper
mixing and careful use with protective equipment such as
masks, eye wear, and gloves can prevent potential health
hazards (Henry, 1997; Lusk, 1996; Winstead, 1993).
Most of this information has been reported in a gen-
eral manner. It projects "the farmer" as a family, encom-
passing man, woman, and child. Therefore, any of these
health hazard concerns related to accidents and exposure
to various chemicals, toxic dust, and biological waste
products can affect any member of the farm worker team,
especially women.
METHODS
Factors contributing to occupational illness and
injury prevention behavior among farm women were
investigated as part of the Louisiana Farm Family Injury
Prevention and Health Initiative (LAFFIP+HI). This
cross sectional study included women older than 18
whose family participated in farming operations, spoke
English, and had a telephone in the home. Participants
were chosen from a sampling pool of 4,808 farms in
Louisiana. The names of farm owners were obtained
from mailing lists maintained by the Louisiana State Uni-
versity Agricultural Center and the Farm Service Agency
for 10 parishes in southeast Louisiana.
A stratified, random sample design with parishes
comprising the strata and simple random selection with-
out replacement within each stratum was used to select
addresses. Sampling was proportional within parish to
provide representative participation in keeping with pop-
ulation density. Trained callers conducted 30 to 45
minute telephone interviews. In the event two women at
an address were engaged in farming operations, the
woman most involved was asked to participate.
Telephone interviews proceeded in two phases. The
first phase determined household eligibility and solicited
study participation. During the second stage, eligible
women who agreed to participate were interviewed to col-
lect project data. Closer examination identified occupa-
tional illness and injury prevention behaviors among par-
ticipants completing the eligibility screen.
Of those who completed the eligibility screen, 657
participants (57.6% participation rate among known eli-
gible farms) completed full interviews. Of these 657 par-
ticipants, 519 (78.9%) were actively involved with dairy
or cattle ranching. Closer examination of this subset was
undertaken to identify occupational illness and injury
prevention practices.
Study Variables
The Louisiana Farm Health and Injury Survey
instrument (Southwest Center for Agricultural Health,
Injury Prevention, and Education, 1998) was used to elic-
it information related to characteristics of farm work,
prevention practices, and demographics. Postcards were
sent to households selected in the sample prior to the ini-
tiation of the survey to introduce the sponsoring universi-
309
 Table 1
Demographic Characteristics of Southeast Louisiana Farm Women Involved in
Work on a Dairy Farm or Cattle Ranch (N =519)
1 to 20 Hours More than 20 Hours
Characteristic n Percent n Percent
Age (years)
20 to 34 34 9.3 18 11.8
35 to 49 105 28.7 47 30.7
50to 65 136 37.2 69 45.1
Older than 65 91 24.8 19 12.4
Race
White 342 93.4 145 94.8
Other 24 6.6 8 5.2
Education
Less than high school 31 8.5 18 11.8
High school 133 36.3 71 46.4
Greater than high school 202 55.2 64 41.8
Marital Status
Married 329 89.9 138 90.2
Other 37 10.1 15 9.8
Off the farm work status
Full time 127 34.7 27 17.6
Part time or seasonal 43 11.7 18 11.8
Do notwork off the farm 196 53.6 108 70.6
Net Farm Income
oto 9,999 292 79.8 105 68.6
10,000 to 19,999 51 13.9 32 20.8
20,000 to 30,000 or more 12 3.3 13 8.5
Unknown or refused 11 3.0 3 1.8
Type of Farm Frequency - Frequency
Beef Cattle 272 - 84 -
Dairy 85 - 67 -

Range of acreage 3 to 2,800 acres 1 to 2,700 acres

ty research center, promote credibility of the project, and
encourage participation.
Questions for the instrument were taken from a survey
developed by the Southeast Center for Agricultural Health
and Injury Prevention and a West Texas A & M survey. To
calculate farm labor commitment time, the average number
of hours worked each day was multiplied by the average
number of days worked each week. Weekly time commit-
ment was categorized as I to 20 hours per week, and more
than 20 hours per week. Off the farm work status was
grouped as none, part time, and full time. Number of days
driving a tractor per year was recorded 0 to 365 days.
Engagement in various farm tasks was coded as yes or no.
To determine prevention practices, women were
asked whether they engage in 10 prevention practices.
Each behavior was coded yes, no, or not applicable.
These practices included:
• Wearing seat belt on farm machinery.
• Wearing hearing protection.
• Using eye protection.
• Wearing breathing protection.
• Protecting skin.
• Wearing gloves.
• Wearing a helmet to ride three or four wheeled ATVs.
• Wearing a helmet when riding horses.
• Using a hair holder.
• Wearing rubber boots.
Education was grouped as less than high school,
high school or GED, and beyond high school. Age was
determined by asking birth date and grouped by 10 year
intervals from 40 years to 80 years and older. Ethnic
background was grouped as White and nonWhite. Mari-
tal status was grouped as married or not married. Gross
income per year was grouped in categories of $10,000

310 AAOHN JOURNAL

intervals up to $50,000. Incomes greater than $50,000
were rated as $50,000 to $75,000 and more than $75,000. Table 2

Data Analysis
Farm Tasks by Time Commitment Toward
The population of interest for analysis was restricted Farm Operations
to women whose family owned dairy or cattle ranches or
farms. Ten parishes in Louisiana were targeted for sam- Task 11020hours More Ihan 20
pling. Data management and analyses were performed per week hours per week
using Statistical Package for the Social Sciences (SPSS n =366 n = 153
Inc., Chicago, IL) version 9.0 for Windows (Microsoft, Run errands
Redmond, WA) software. Descriptive and categorical Yes 296 (80.9) 148(96.7)
data analysis methods were used to examine the associa- No 70 (19.1) 5 (3.3)
tions among occupational related disease and injury pre-
Pay farm bills
vention behaviors and the time commitment to the farm
Yes 260 (71.1) 133 (86.9)
operation. Responses coded as not applicable were
excluded from chi-square analysis. No 106 (28.9) 20 (13.1)
Prepare farm income tax
RESULTS Yes 143 (39.1) 83 (54.2)
Table I (page 310) shows the demographics for the No 223 (60.9) 70 (45.8)
519 farm women included in the analysis. The majority of
Order farm supplies
farm women were married, White, and more than half of
Yes 194 (53.0) 117 (76.5)
the sample had an education of Grade 12 or higher. The age
No 172 (46.9) 36 (23.5)
range was 20 to 86 years, with an average age of 53.5 (SD
= 13.7). In the year before the interview, Louisiana women Haul goods to market
spent an average of 27.47 (SD = 63.25) days driving a trac- Yes 78 (21.3) 60 (39.3)
tor. The mean acreage of the farms on which the Louisiana No 288 (78.7) 93 (60.7)
women worked was 32 acres (range, 1 to 2,800 acres). The Haul animals to market
major commodities were beef cattle, dairy cattle, and hay. Yes 106 (28.9) 78 (50.9)
No 260 (71.1) 75(49.1)
Occupational Related Risk Factors
More than half (70.5%) of the sample worked 1 to 20 Drive a farm tractor
hours toward the farming operation, and 153 women Yes 161 (43.9) 96 (62.7)
(29.5%) worked more than 20 hours. In addition to work- No 205 (56.1) 57 (37.3)
ing on the farm, many women worked part time or season- Apply pesticides
ally (n = 61, 11.8%) or full time (n = 154,29.4%). Yes 89 (24.3) 47 (30.7)
Table 2 shows the type and frequency of farm tasks. No 274 (74.9) 106 (69.3)
Table 3 indicates preventive behaviors engaged in by
farm women contributing to the farm operation by time Work with farm animals
commitment. Yes 200 (54.6) 135 (88.2)
Proportionally, women working more than 20 hours No 166(45.4) 18 (11.8)
per week consistently engaged in farm tasks more often AUend farm meetings
than women who contributed fewer than 20 hours per Yes 127(34.6) 77 (50.3)
week. With the exception of wearing helmets when rid- No 239 (65.4) 76 (49.7)
ing ATVs, wearing helmets when riding horses, and use
of sunscreen, women who engaged in the farm operations Help move vehicles
more than 20 hours per week engaged in preventive Yes 203 (55.4) 123 (80.3)
behaviors proportionally more often. No 162 (44.2) 29 (18.9)
Significance testing for differences was undertaken
using chi-square tests. A series of two way contingency
table analyses were conducted to determine whether more likely to engage in the following preventive behav-
women engaged in preventive behaviors more or less iors than women working fewer than 20 hours per week:
often, given the level of time commitment to the farm • Wearing seat belts on tractors, X2 0, n = 394) = 7.47,
operation. In each analysis, the two variables were p = .006.
engagement of behavior (yes or no) and time commitment • Wearing breathing protection, X2 0, n = 444) = 5.01,
(fewer than or more than 20 hours per week). No signifi- p= .02.
cant differences were found between groups for use of skin • Wearinghearing protection, X2 0, n =435) =3.9,p =.04.
protection, X2 0, n = 483) = .60, p = .44; use of hair hold- • Wearing eye protection, X2 0, n =442) = 3.76,p = .05.
er, X2 (1, n =450) = .57, p = .45; or wearing a helmet when • Wearing gloves, X2 (1, n = 474) = 3.8, p = .04.
riding an ATV, X2 (1, n = 325) = .05, p = .82. Women with • Wearing rubber boots, X2 (1, n = 475) = 13.23, p =
time commitment greater than 20 hours per week were .0001.

JULY 2002, VOL. 50, NO.7 311

 • Driving a tractor.
Table 3 • Working with farm animals.
• Working with pesticides.
Engagement in Preventive Behaviors by • Running errands.
Time Commitment toward Farm Operations • Paying bills.
• Ordering farm equipment.
Preventive 1 to 20 hours More than 20 • Helping move vehicles.
Behavior per week hours per week However, the women did not usually attend farm
n (%) n (%) meetings. The complexity of activities performed by
Rubber boots 240 (74.1) 134 (88.7) these women was consistent with other research examin-
ing women's performance of tasks in agricultural opera-
Gloves 229 (70.9) 120 (79.5)
tions (Reed, 1999). Women engage in physically
Sunscreen 238 (71.7) 103 (68.2) demanding farm tasks in addition to their administrative
roles (Reed, 1999). This could explain why women do
Eye protection 162 (53.5) 88(63.1)
not attend farm meetings, thus missing opportunities to
Hair holder 119 (39.0) 62 (42.8) learn important safety information.
Seat belt on When comparing the women who worked on the
farm equipment 53 (20.0) 42 (32.6) farm fewer than 20 hours per week with those who
worked more than 20 hours per week, the researchers
Breathing protection 85 (28.1) 55 (38.7) found unanticipated patterns of preventive behavior.
Hearing protection 73 (24.6) 47 (33.8) Women who worked fewer than 20 hours per week were
less likely to wear seat belts on tractors, hearing or eye
Helmet when riding all protection, and gloves or boots. In addition, these women
terrain vehicles (ATVs) 27 (11.6) 10(10.7) were less likely to use a mask for breathing protection.
Helmet when riding horses 15 (7.0) 4 (4.5) Although these women spend less time working on the
farm, their behaviors put them at greater risk for injury,
chronic illness, debilitation, and death than women who
spend more time working on the farm and use protective
equipment. This was the first known study addressing
DISCUSSION preventive behaviors in relationship to exposure risks.
The purpose of this study was to explore and No significant differences were found between the
describe potential health exposures affecting women groups of women participating in the preventive behav-
working on family owned farms, preventive measures iors of wearing helmets on ATVs, wearing hair holders,
used by them, and the use of PPEs among women with or using skin protection. The researchers contribute this
variable levels of time commitment toward farm opera- to the small number of women in each group reporting
tions. This sample consisted of 519 women who live or adequate use, and to the fact that an equal number in each
work on family owned cattle and dairy farms. group have learned throughout time to protect themselves
The mean age of farm women was 53.5 years. This from some dangerous behaviors. This is consistent with
finding was consistent with findings by Reed (1999) findings reported by the Centers for Disease Control
and the 1997 Census of Agriculture (USDA, 1999) for (CDC, 1992) and Roerig (1993).
mean age in male farm owners. The occupation of farm- A majority of the women (n = 274, 74.9%) working
ing is unique because the exposure risks are consistent fewer than 20 hours per week indicated they did not
throughout time. Farming is often multigenerational, apply pesticides. However, these same women were less
with extended retirement age. Farmers engage in repeti- likely to engage in preventive behaviors, such as:
tious activities throughout time, and, therefore, are • Wearing breathing protection, X2 (I, n = 444) = 5.01,
exposed to the hazards and risks other occupations may p = .02.
not experience. As women continue to participate in • Wearing eye protection, X2 (I, n = 442) = 3.76, p = .05.
farming, they too may be exposed to the hazards on a • Wearing gloves, X2 (I, n = 474) = 3.8, p = .04.
farm during the course of their life. • Wearing rubber boots, X2 (I, n = 475) = 13.23, p =
Women in this study tended to work on and off the .0001.
farm, with the majority of women (58%) reporting work- In many instances, individuals believe PPEs are used
ing off the farm. In addition, more than half the women to prevent immediate injury. However, PPEs may help pro-
reported working fewer than 20 hours per week on the tect against the known long term occupational health risks
farm. This is consistent with Reed (1999), who found associated with farm work, including spontaneous abor-
women in Kentucky and Texas often work on and off the tions, respiratory diseases, cancer, dermatitis, blindness,
farm. Women in this study also were found to engage in pesticide toxicity, or death (CDC, 1992; Haas, 1995; Lang-
multiple tasks and roles in addition to home and family ley, 1998; Roerig, 1993; Shapiro, 1980; Wright, 1993).
responsibilities. Future research to determine the dose effect of exposure to
Women in this study, regardless of time commitment, hazards and incidence of illnesses among women is need-
were engaged in a multitude of farm tasks, including: ed. The results could help validate the need for PPE use.

312 AAOHN JOURNAL

 In this study, the researchers examined tasks and pre-
ventive behavior activities based on time commitment to
the farm operation. Women contributing to the farm oper-
ation more than 20 hours per week proportionally
engaged in farm tasks more often than those women
working fewer than 20 hours per week. This finding sug-
gests that greater time commitment contributes to an
increased number and complexity of tasks.
Consistent with other research findings (Reed, 1999),
many women in this study drove tractors. Driving a tractor
(n = 205, 56.1 %) was reported less often by women work-
ing I to 20 hours per week than women working more than
20 hours per week. Women working I to 20 hours per
week were significantly less likely to wear seat belts on
tractors, X2 (I, n = 394) = 7.47,p = .006. Regardless of time
commitment, women who do not wear seat belts are at
greater risk of serious and possibly fatal injury because of
trauma from tractor rollovers.
Use of PPEs is needed to prevent a variety of occu-
pational illness and injury. For example, wearing gloves
prevents transmission of diseases and hand trauma. Noise
associated with dairy pumps, ATVs, tractors, and heavy
equipment all exceed 110 decibels, posing an occupation-
al risk for hearing loss. Slips, falls, transmission of dis-
eases, and risk of electrocution are associated with envi-
ronmental exposure to the elements. In this study, women
working I to 20 hours per week for the farm operation
were significantly less likely to use PPEs that would
reduce risk of injury associated with these hazards.
Although women working I to 20 hours per week
reported wearing sunscreen and helmets on ATVs more
often, the proportion of use was not significantly differ-
ent between the two groups. The researchers conclude
that a high percentage of both groups wore sunscreen
because of many years of public health messages target-
ing individuals exposed to sun. On the other hand, both
groups did not engage in use of helmets when riding
ATVs. It is speculated that this behavior is prevalent
because helmets are inconvenient, costly, and cumber-
some. Although many of the currently reported ATV
injuries occur during recreational use, ATVs are used
extensively on farms for rounding dairy herds, hauling,
and spraying fence rows. Therefore, occupational health
nurses need to educate farm women about the need for
helmets and other PPE while riding ATVs.
Little information is available about women work-
ing in farm operations. Thus, findings from this
research add to the body of knowledge related to the
need for primary prevention for women who work on
farms. However, this study had a few limitations. Data
were collected through interviewer administered, 30
minute telephone surveys, which may have led some
women to give erroneous information. With this in
mind, the response rate was higher than many studies
using paper and pencil methods. Additionally, missing
data were minimized because a computer program
assisted prompting during interviews.
Participants were predominately White, high school
graduates who were married, and lived on a family
owned farm in Louisiana. Therefore, the findings cannot
JULY 2002, VOL. 50, NO.7
be generalized to women from different backgrounds and
ethnicities, different work roles, different types of farms,
or in different locations. It is possible that women self
selected to participate in the study because they were
more educated and worked fewer hours, thus increasing
their interest and availability and biasing the results.
Women in this study were at risk because of the tasks
they perform and their pattern of PPE use. Nevertheless,
a major finding of this study was the actual amount of
time women perform various duties on the farm. Women
who work I to 20 hours per week tend to use fewer pre-
ventive measures. The combination of not using PPEs
and exposure to many potential health hazards can result
in chronic illnesses, debilitation, or death.
WORKPLACE IMPLICATIONS
Occupational health nurses need to develop strategies
for identifying at risk individuals. If interventions such as
counseling and teaching prevention methods could be
provided, this could lead to a reduction in acute and
chronic illnesses and traumatic injury. Nurses in the work-
place are in a unique position to identify farm women at
risk for exposure to potential health hazards and chronic
health problems. For example, education and counseling
are needed to help agricultural communities become more
aware of the need to use PPEs. Nurses should collabora-
tively explore with farm families the importance of reduc-
ing health hazards and promoting the use of safety fea-
tures and PPEs, such as seat belts and helmets.
The results of this study indicate women who work
on a part time basis in a farm operation may be at greater
risk for preventable injuries and illnesses. Therefore, even
though all women need to be targeted, the occupational
health nurse should be aware of women less involved in
farm work on a regular basis because they may lack the
proficiency necessary to perform complex tasks. To pro-
mote safe and consistent use of farm equipment within
agricultural communities, relationships should be devel-
oped with county extension agents and public health
departments to develop written materials and oral presen-
tations related to wearing:
• Skin protection.
• Helmets on ATVs.
• Seat belts on tractors.
• Gloves.
• Rubber boots.
• Hair holders.
• Hearing and eye protection.
Because many women do not attend farm meetings,
creative methods of dissemination must be developed.
Nurses and other community leaders could conduct pre-
sentations at various community farm meetings targeted
at discussion of health risks for women. Also, because the
average age of farm women in this study was 53, educa-
tion related to proper use of farm equipment could be
provided by representatives at farm equipment stores and
through focus groups at county fairs, churches, and other
community venues. Many other ideas for primary pre-
vention can be formulated because it has been demon-
strated the problem exists.
313
 Because farm related injuries and illnesses among
women is an emerging issue, this study needs to be repli-
cated to investigate other important variables. These
include barriers to PPE use, appropriate educational
strategies specifically targeting women, use of PPE by
size of farm in addition to hours of work, and minority
status of farm families in Louisiana, along with family
income levels.
This project is supported through a cooperative
agreement with the Centers for Disease Control and Pre-
vention and the National Institute for Occupational Safe-
ty and Health (U07ICCU6I20I7-03) and sponsored by
the Southwest Center for Agricultural Health, Injury Pre-
vention. and Education.
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