Farmer Health

Overview

In this chapter we provide an overview of the importance of maintaining good health and explore the interconnectedness between physical, mental, and emotional health and how these factors impact the overall health, wellbeing and safety of individuals within the agricultural sector.

Australians living in small towns fewer than 1000 people and in non-urban areas generally experience a higher level of life satisfaction.  They also report an increase in community connectedness and social cohesion, as well as higher levels of participation in the community and volunteering. As farmers, farm workers and farming families you can often experience unique challenges related to health and wellbeing compared to your metropolitan counterparts, however community engagement plays a crucial role in enhancing health outcomes and supporting a vibrant rural lifestyle. While access to some health services can be less convenient in rural and regional areas, there are many strengths and community resources that help to support you in rural living.

Learn More

Watch the following video to further explore the positive impact of thriving farmers on communities

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Flow on Effects of Farmer Health

When you experience physical or mental health challenges – either minor problems or a more serious injury, it can affect more than just you as the injured party.  The farming family, the farming business and the farming community will all feel the impact, as illustrated in Figure 1 below.

Figure 1:  The flow on effect of poor health on farmers.

Learn More

Watch the following video illustrating the flow on effects of farmer health: https://youtu.be/UQEl6wKpM9I The original publication The Sustainable Farm Families Project: changing attitudes to health further detailing this concept can be accessed at https://farmerhealth.org.au/2009/08/18/the-sustainable-farm-families-project-changing-attitudes-to-health

Farmer impact

The impact of poor health on you as the farmer includes:

• Loss of income from not being able to work or having to pay additional labour costs to fill the gap.
• Pain and suffering caused by the injury or illness.
• Associated costs of medical treatment, medical specialists and travel and accommodation to access medical treatment – often specialist treatment is only available in major cities which can be some distance away.

Family impact

Poor farmer health can often require your family members to provide extra levels of support. This can include:

• Time away from the farm to provide transport to medical appointments, collecting medical supplies, visiting you in hospital or caring for you at home.
• Requirements to backfill labour on the farm to ensure tasks are completed. This work can often fall on your children as well as partners and other relatives.
• Requirements for your partners or children to take time away from off-farm work which can result in loss of off-farm income, and result in an increased risk of harm when operating equipment or travelling over terrain they are unfamiliar with.

Farm impact

The farm business is always impacted as a result of poor farmer health. This includes:

• Loss of you as key labour, as well as your intellectual knowledge and experience which may not be clearly documented for others to efficiently and safely take over tasks.
• Significant animal welfare risk, especially over the summer months and during challenging seasons where feed is scarce and water supplies need to be carefully managed.
• Serious impact on the timely application of sprays and management of crops when you are out of action or not able to work at full capacity.

Community impact

The loss to the broader farming community due to poor farmer health may include:

• Loss of your expertise and input into community groups and boards including school councils and agricultural shows.
• Loss of volunteers – you may hold important roles in groups such as the Country Fire Authority or first responders, or at local sporting and other clubs.
• Reduction in your contribution as a key farming group influencer or mentor.
• A negative impact on other businesses connected via supply chain and other agriculture-dependent services.

A small community can suffer immeasurable loss of capacity when even one local farmer such as yourself experiences poor health.

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Taking Action to improve your health

1. Diet & Nutrition

Good health is essential for your life, your family’s wellbeing and your farming business. Eating well and having a nutritious diet plays a critical role in maintaining good health.

While farming often involves busy days, working long hours and limited time to go home to cook or prepare a meal, some planning in advance can make a big difference. At certain times of the year lunch and dinner is often eaten ‘on the go’ and packing a nutritious lunchbox with food items that are easy to eat, look appealing and store well will:

• Provide you with the right fuel to work effectively and efficiently.
• Help to maintain a healthy weight.
• Reduce the risk of diet-related conditions, such as high cholesterol, high blood pressure and obesity.
• Reduce the risk of chronic diseases such as type 2 diabetes, cardiovascular disease and some types of cancers.

The Australian Guide to Healthy Eating can assist with incorporating the five core food groups into lunch boxes. The bulk of foods in a lunchbox should come from vegetables, legumes, fruit and grain foods. Moderate amounts of lean meat and poultry, fish, eggs, tofu, nuts, seeds, milk, yoghurt, cheese and/or their alternatives (mostly reduced fat) are recommended. Small amounts of healthy fats can also be included. Food choices which are high in saturated fats, salt and sugar tend to be low in fibre, high in energy and lack important nutrients like vitamins.

Fibre is very important and is found in fruit and vegetables. Fibre plays the important role of maintaining gut health and assisting in the elimination of food waste from the body. Fats are considered an essential part of our diet and important for good health. Some fats are considered healthier options than others. Healthy fats include oily fish like salmon or sardines, nuts and seeds. Less healthy fats include fatty meat and fried foods Salt – a little salt is needed for good health and it occurs naturally in almost every food we eat, but the amount varies. Meat, vegetables and fruit have naturally occurring salt present in very small quantities. Try to avoid processed foods where possible and be mindful of the amount of salt you are adding to your cooking and food. Sugar – naturally occurring sugars are found in milk, fruit, vegetable and legumes and usually accompany other nutrients which are beneficial to health. Refined sugars are added to processed food and drink in large amounts and found in cakes, biscuits and soft drinks. Refined sugars are energy dense and nutrient poor and contribute to weight gain.

Learn more

1. You can find further information about diet and nutrition on the Diet and Nutrition – Fuelling Farmers’ Lunch Boxes page of the National Centre For Farmer Health website https://farmerhealth.org.au/2017/12/19/diet-nutrition-fuelling-farmers-lunch-boxes which includes the Australian Guide to Healthy Eating (https://www.eatforhealth.gov.au/guidelines/australian-guide-healthy-eating).
2. You can view the current Australian Alcohol guidelines at https://www.nhmrc.gov.au/health-advice/alcohol to learn more.

2. Physical fitness

Regular physical activity is an important part of keeping physically fit, a demonstrated way to reduce stress and often a great opportunity to connect socially.

You service and maintain your farm machinery, get rid of weeds and keep your livestock in healthy condition to maximise production. Have you also thought about what you are doing to keep yourself highly productive and in good working order?

The Australian Bureau of Statistics report that a staggering 67% of Australian adults are either overweight or obese and 76% of Australian adults are not meeting the recommended guidelines for physical activity.

The nature of farming is changing. Mechanisation and automation have reduced the daily physical activities of walking, running, riding and climbing. The once physical job of milking cows has become semi- (and in some cases fully-) automated – requiring only a fraction of the physical effort it used to. While farmers often are physically strong, they may lack stamina, speed or suppleness.

3. Sleep

Sleep is a really critical, yet often underestimated factor for maintaining good personal health. It is important for several reasons:

• Physical Health: Quality sleep supports the immune function, helps repair muscles and tissues, and regulates hormones, including those related to stress and appetite. Chronic sleep deprivation is linked to various health issues, such as obesity, diabetes, and cardiovascular disease.
• Mental Health: Getting enough sleep is essential for both emotional regulation and cognitive function. Lack of sleep is often associated with increased stress, anxiety, and depression. On the flip side, sufficient rest improves mood and resilience.
• Cognitive Performance: Sleep plays a key role in consolidating memory, learning, and problem-solving skills. It enhances focus, creativity, and decision-making abilities, all of which are vital for daily functioning.
• Metabolic Health: Sleep affects how the body processes and stores carbohydrates, regulates insulin sensitivity, and manages appetite.
• Longevity: Consistent, restorative sleep is associated with a longer lifespan. Sleep quality is a predictor of overall health and can influence chronic disease risk.

What is the right amount of sleep to have nightly? This depends on factors such as age and lifestyle. In Australia, the recommended amount of sleep aligns closely with international guidelines, such as those from the National Sleep Foundation. The Australian Sleep Association and the Sleep Health Foundation suggest similar ranges based on age. For adults (18-64), the recommended amount of sleep daily is 7-9 hours, whilst for older adults (65+), it is slightly less at 7-8 hours.  What is important is to listen to your body and adjust accordingly. Feeling rested and alert during the day is a good indicator that you’re getting the right amount of sleep for you.

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Muscles, Bones and Injury Prevention

1.     Protection and injury prevention of muscle and bones

Healthy muscles let you move freely and keep your body strong.

Did you know you have more than 600 muscles in your body? These muscles help you move, lift things, pump blood through your body and even help you breathe. They help you to play sport, dance, walk the dog, swim and other fun activities. They also help you do jobs on the farm too like setting up temporary fencing, hosing down the dairy, or chasing cheeky calves.

Strong muscles help protect you from injury. For example, if the muscles around your knee are weak, you may be more likely to injure that knee. Strong muscles also help you keep your balance so you are less likely to slip or fall. However, muscles lose size and strength as we get older, which can contribute to fatigue, weakness, a reduced tolerance to exercise and musculoskeletal conditions such as osteoarthritis

Farmers and farm workers are commonly affected by muscle and ligament strains – just ask any physio. Lifting objects that are too heavy (particularly when muscles are cold), twisting and bending while carrying a load, sudden jolts or even bad posture can injure soft tissue and joints. Injuries to joints, in particular the back, can have a major impact on your health and the day-to-day running of your farm, including losing the ability to get jobs done.

Lifting and carrying calves during peak times can lead additional strain to the back, shoulders, and neck. Some tips to help protect your body when handling calves can be found in the Manual Handling chapter.

It is also helpful to carry out muscle maintenance by regular stretching, booking in a massage or visiting your chiropractor or physiotherapist to keep you functioning well during these peak times. The structure of bone also changes as we age, resulting in loss of bone tissue. Low bone mass means bones are weaker and this places you at risk of breaks from a sudden bump or fall. Bones become less dense as we age for a number of reasons, including:

• An inactive lifestyle.
• Hormonal changes – in women, menopause triggers the loss of minerals in bone tissue. In men, the gradual decline in sex hormones leads to the later development of osteoporosis.
• Loss of calcium and other minerals.

Regular exercise can prevent many age-related changes to muscles, bones and joints – and help reverse these changes as well. It’s never too late to start living an active lifestyle and enjoying the benefits.

Vitamin D (most commonly sourced from exposure to sunlight) helps the body to absorb calcium and maintain healthy bones. While sunshine may be important, it’s also important to balance this against the risk of sun damage.

Remembering to use the 3 points of contact rule when climbing on or off equipment (tractors, ladders, etc.) can help prevent serious injury of muscles and bones. For example, when climbing into a tractor always ensure you have three points of contact. Have 1 hand on the handrail of the tractor cab, one hand on the mud guard and one foot on the step. The same rules apply when dismounting. This is often when accidents occur, especially in winter when surfaces are wet and muddy. Sturdy work boots with good grip on the soles also helps to prevent slips and falls.

As dairy farmers we spend a considerable proportion of the working day standing on concrete. Just like with cows, standing for long periods on concrete can leave you vulnerable to ‘lameness’ and hip and groin pain.

Standing on concrete twice a day for up to 3-4 hours is not what our feet are designed to do. It can lead to the arch of the foot to collapse and roll inwards (known as pronation).  As the foot pronates, additional stress is placed is on the joints and soft tissues in the foot. This can result in a number of painful foot conditions including plantar fasciitis, bunions and corns.

The good news is that, just as in dairy cows, ‘lameness’ is preventable, and it does not need to involve a GP or podiatrist. A good pair of thermally insulated gum boots with a shock absorbing footbed can do the trick, while also keeping your feet warm.

Pain, tightness, catching, clicking and locking of the hip joint and groin area can also be caused by extended periods of sitting on quad bikes.  Tight hip flexors from sitting too long can lead to lower back and hip pain.  There as specific stretches and exercises that relax and strengthen the hip flexors which can be suggested by your health professional.  With improved strength and flexibility, you are likely to experience less pain, injury and gain better movement of the hip joint.

Learn more

1. To learn more about the heart check out this fantastic Directors Blog – Hearten up! Heart health matters written by Dr Susan Brumby https://farmerhealth.org.au/2020/09/22/directors-blog-hearten-up-heart-health-matters. You may also like to download the infographic summary here: https://farmerhealth.org.au/wp-content/uploads/2020/09/Hearten-Up6-1.pdf
2. To understand the safest way to expose yourself to sunshine, check out the Sunshine Map on the Healthy Bones Australia website https://healthybonesaustralia.org.au/your-bone-health/vitamin-d-bone-health/
3. Watch this video about how to safely enter and exit a tractor: https://www.youtube.com/watch?v=SQta6icfH48
4. Access more information about tractor safety including safe entering and exiting at Safe Work Australia https://www.safeworkaustralia.gov.au/sites/default/files/2023-07/tractor-safety-infographic_july2023.pdf

Visit this article How do you strengthen hip flexors? for detailed hip flexor stretching tips and tricks:  https://www.medicalnewstoday.com/articles/320489

2. Eyes

Farmers and agricultural workers perform many tasks which are likely to expose them to flying particles, fragments, sparks, dust, hazardous substances or UV radiation. Tasks with the highest risk for eye injury include grinding, welding and hammering. Other at-risk activities include cutting, drilling, spraying chemicals, smelting, sanding, chipping and chiselling. Flash burn or welders flash occurs when the cornea (the tissue which covers the eye) has been exposed to UV light from a welding torch. Other sources of UV light include direct sunlight, sun reflection and sunlamps – including halogen lamps. Flash burn symptoms develop 5-10 hours after exposure and can be incredibly painful. Individuals will develop watery-red eyes, blurred vision and sensitivity to light.

Treatment of flash burn (depending on severity) may include local anaesthetic drops, pain killers and eye padding to rest the eye. If flash burns become infected they require antibiotic treatment. If left untreated, there is an increased risk of vision impairment and loss. Chemical burns occur when a liquid chemical contacts the eye. The injury is most likely to happen when chemical splashes over the face. Chemical burn may also result from rubbing the eyes after handling chemicals. Eyes are incredibly vascular and will absorb chemicals into the bloodstream more rapidly than when splashed on the skin. Depending on the chemical and degree of exposure, the resulting eye injury may range from temporary redness and irritation to blindness.

If you think you have injured your eye(s), seek professional advice immediately.

3. Ears

Agriculture is loud and hearing loss is higher among farmers compared to the general population. On average, hearing loss in farmers occurs 10-15 years earlier than for the non-agricultural population. 

Exposure to very loud noise for a short time or moderately loud noise for a prolonged period will damage the tiny hair cells in the inner ear. Once damaged, these hair cells are unrepairable.

Continual use of loud machinery and equipment on farms—such as tractors, augers, firearms, chainsaws, radios and tools in the workshop—increases the risk of permanent hearing loss for farmers.

Chemicals (known as ototoxic chemicals) can also damage hearing. Examples of ototoxic chemicals are organophosphates (used as an insecticide) and trichloroethylene (a liquid chemical commonly used to remove grease from metal parts). If an ototoxic chemical enters the bloodstream—via inhalation (lungs), oral (mouth) or dermal (skin) absorption—this can increase the risk of hearing loss.

According to a Hearing Australia report, hearing loss among farmers and agricultural workers is widespread, with 65% of farmers aged between 15 and 75+ years experiencing some degree of hearing loss. Young farmers are around seven times more likely to have hearing loss than the general population of the same age.

Noise exposure for dairy farmers can include tractors, post-hole diggers, post drivers, balers, the dairy and plant room.  Pumps, compressors, crushers and augers also pose a risk and hearing protection is recommended when working around these machinery items. Further information can be found in chapter 4 – Tractors and Mobile Plant.

For further information relating to hearing safety, please refer to the Working Environment section of this manual.

Learn more

1. Read more on this topic: https://www.hearing.com.au/news-and-articles/hearing-australia-urges-greater-action-on-occupational-noise-induced-hearing-loss/
2. Visit the Deafness Forum website to learn how to insert ear plug correctly: https://www.deafnessforum.org.au/resources/student-hearing-fact-sheets/
3. Visit Victorian Hearing for a list of the best smartphone decibel meter apps to measure noise levels https://victorianhearing.com.au/the-best-smartphone-decibel-meter-apps-to-measure-noise-levels/
4. Great Plains Center for Agricultural Health https://gpcah.public-health.uiowa.edu/visual-data/ have some great flyers you can print off in the Hearing Conservation section

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Preventable Illnesses and conditions

1. Respiratory conditions

When we breathe in, air containing oxygen enters through the mouth or nose, travels down the windpipe into each lung where oxygen is transferred to passing blood and carbon dioxide is removed. The blood then carries oxygen throughout the body to our cells.

Respiratory damage can happen after inhaling hazardous or infectious materials into the lungs. This can damage the delicate structure of the lungs, making them less efficient at oxygen uptake. Farmers have a higher risk of developing respiratory illness than people working in other professions due to inhaling organic and inorganic dust, smoke (e.g. tobacco, crop stubble burn), toxic gases and agricultural chemicals.

The most common respiratory illnesses for farmers include asthma, organic dust toxic syndrome and farmer’s lung. It is predicted that the prevalence of respiratory disease will increase with the changing climate so it is important to take preventative action now.

The most common signs of asthma are Night and early morning coughing or when laughing. Difficulty breathing. Chest tightness. Wheezing.

Thunderstorm asthma is thought to be triggered by a unique combination of high grass pollen counts.  During these storms, pollen is swept up in wind and carried long distances. This can lead to asthma and seasonal hay fever. This can also affect farmers who may not have experienced asthma before. Do not ignore symptoms like wheezing or shortness of breath – see your GP or emergency department.

Farmer’s Lung is a non-infectious disease caused by inhaling dust from mouldy hay, straw or grain. The disease causes flu-like symptoms including cough, fever and chills, difficulty in breathing, muscle pain and general discomfort.

Lung damage caused by Farmer’s Lung is not reversible. In some cases, scar tissue (pulmonary fibrosis) develops, further interfering with the normal function of the lungs. If farmers delay treatment, there can be serious and irreversible damage.

For those farmers who are sensitive, repeated exposure to the allergic trigger can lead to more severe symptoms such as chronic cough with phlegm containing pus, shortness of breath, loss of appetite and weight loss.

Learn more

1. Further information can be found in chapter 14 – Working Environment.
2. Take a look at What Is Diaphragmatic Breathing? https://www.healthline.com/health/diaphragmatic-breathing#steps to learn techniques to improve your breathing.

2. Diabetes

Type 2 diabetes is the fastest growing disease in Australia with 1.2 million or 1 in 20 Australians having diabetes. Many people go undiagnosed. Farm men and women have a high risk of developing diabetes and other lifestyle diseases such as obesity and hypertension.

Abdominal fat (measured easily by your waist measurement) is the greatest risk factor in the development of type 2 diabetes. Think of it as toxic waste (waist).

Studies from the National Centre for Farmer Health Sustainable Farm Families™ program found that the prevalence of abdominal obesity (waist circumference >88 cm for females and >102 cm for males) in Australian farming men and women was 8.7% higher than the Australian average, increasing their risk of developing diabetes by four times.

Diabetes develops progressively, like weeds in your paddock. When maintained well, your crop or pasture looks great. When neglected for too long, you have a problem.

The good news is that type 2 diabetes can be delayed and even prevented with sustained healthy lifestyle change. Paying attention to some of your food choices—most notably the carbohydrates you eat—is important. The Glycaemic Index (GI) is a ranking of carbohydrate in foods according to how it affects your blood glucose levels. Carbohydrates with a low GI value (55 or less) are more slowly digested, absorbed and metabolised and cause a lower and slower rise in blood glucose and, therefore usually, insulin levels. This is a good thing.

Learn more

1. Visit Carbohydrates and the glycaemic index https://www.betterhealth.vic.gov.au/health/healthyliving/carbohydrates-and-the-glycaemic-index to learn more about the Glycaemic index.

2. To find out your risk of developing type 2 diabetes within the next five years, complete the diabetes risk assessment on Diabetes Australia website: https://www.diabetesaustralia.com.au/risk-calculator/

3. Cancer

Cancer is a disease which affects the body’s cells.  In Australia, some cancers occur at higher rates in rural areas.

Factors contributing to higher risks include:

• Limited access to services for diagnosing and treating cancer.
• Later diagnosis of cancer.
• Lower socioeconomic status.
• Reduced rates of physical activity.
• Increased rates of high-risk alcohol consumption.
• Higher rates of smoking.
• Higher proportion of Aboriginal and Torres Strait Islanders.
• Higher rate of sun exposure

In 2022, bowel cancer was the second most common cancer in both men and women in Australia and was more common in people over the age of 50. Factors that increase your risk of bowel cancer include inherited genetic risk and family history; inflammatory bowel disease; polyps; high red meat consumption, especially processed meat; being overweight or obese; high alcohol consumption; and smoking.

All Australians between the ages of 50-74 years are recommended to perform a non-invasive test which is sent out free once you turn 50. People with a family history of bowel cancer are also recommended to have additional screening via colonoscopy.

Breast cancer was estimated to be the most common cancer in Australian women (it can develop in men, although is less common) in 2022. There is no proven method of preventing breast cancer, however, the risk of breast cancer can be reduced by lowering alcohol consumption and maintaining a healthy weight.

Early detection can improve the outcome of the disease depending on type of breast cancer, test results, the rate of tumour growth, age, fitness and medical history.

In some individuals, breast pain can be rare so it is important to perform regular breast self- examinations and discuss your options with a GP if you have a mother, sister or daughter who has been diagnosed with breast cancer under the age of 50 years. A mammogram will find changes that are too small to be felt during physical examination.

Prostate cancer is estimated to be the most commonly diagnosed cancer in Australian men. The cause of prostate cancer is not known. Prostate cancer is more common in older men and those with a family history of the disease. Early detection and treatment can significantly improve prostate cancer survival.

Changes in the prostate may be detected through an examination with a GP, and (ii) a blood test to see if your prostate specific antigen (PSA) is above normal levels for your age.

Discussing your prostate health with your GP and making a plan is important. Men 50 to 69 years with average risk of the disease, should have a PSA test every two years. Men with a family history of prostate cancer should have testing from 40 to 45 years of age.

Lung cancer is described as the most common fatal cancer in both males and females. The most common cause of lung cancer is tobacco smoking. Other risk factors include exposure to occupational substances such as diesel fumes, agrichemicals, soot and asbestos.

There is currently no routine screening test for lung cancer in Australia. Individuals currently identified as ‘high risk’ are adults aged 55 to 80 years who have a smoking history, currently smoking or have quit within the past 15 years.

Learn more

• For more information about bowl cancer screening, call the National Bowel Cancer Screening Program on 1800 020 103.
• For further information on breast screening call on BreastScreen Australia on 13 20 50.

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