Interventions Addressing Injury Among Agricultural Workers: A Systematic Review

Agriculture is consistently rated as one of the most dangerous industries by the United States Bureau of Labor Statistics. Injury in the agricultural industry can be attributed to a myriad of factors. The physical nature of this this type of work increases risk for injury secondary to acute and cumulative trauma from day to day work tasks. Agricultural workers often must conduct tasks that involve awkward positions, twisting, reaching overhead, stooping, carrying heavy loads, prolonged sitting, and repetitive motion. Additional ergonomic risk factors come from the operation of heavy machinery, which may include use of vibrating tools and equipment. The risks are further compounded by an aging workforce. As such, there is a demonstrable need for the prevention and management of injuries among agricultural workers. It is critical that injuries are managed in order to allow individuals the means to continue participating in meaningful and necessary tasks on the farm or ranch.

The purpose of this systematic review was to determine whether interventions within the scope of occupational therapy were effective in addressing injury prevention and management among agricultural workers in order to determine what role occupational therapists currently serve among this population. No published studies to date have evaluated the efficacy of occupational therapy intervention for prevention and management of injury within the agricultural community. The purpose of this systematic review was to analyze the effectiveness of interventions within the scope of occupational therapy practice for management and prevention of injuries among individuals working in the agricultural industry. Through review of the literature authors also aimed to demonstrate the role of occupational therapy practitioners in this area of practice. The review was guided by the following focused question: What is the effectiveness of interventions within the occupational therapy scope of practice for preventing and managing injuries among agricultural workers?

A systematic review was completed of scientific, peer-reviewed literature published between January 2012 and January 2018. A list of search terms was generated with the guidance of former literature, collaboration, and interviews with members of the agricultural community and rural health practitioners. Databases included MEDLINE, PsychINFO, OTSeeker, OTSearch, CINAHL, PubMed, and the Cochrane Database of Systematic Reviews. A total of 479 articles were initially identified. Of these, 22 were selected for screening, and five were ultimately included in this review.

Themes identified included education, musculoskeletal interventions, and environmental adaptations. Moderate evidence exists for the efficacy of interventions within the scope of occupational therapy practice for prevention and management of injury for agricultural workers. There is evidence that interventions that affect the physical environment and improve body structure and function are effective for preventing injury. The use of environmental modifications and physical agent modalities were found to be effective for the management of pain symptoms. While education was discussed informally throughout all reviewed articles, there is limited evidence for the effectiveness of this intervention for injury prevention. Educational approaches are, however, very commonly utilized for promoting safety on the farm or ranch and preventing injuries. Work among individuals in agriculture often represents a means of livelihood and personal identify. Occupational therapists are equipped to address agricultural injuries allowing not only for return to work but also for engagement in a meaningful and productive occupation.

References

Hildebrand, M.W. (2015). The role of occupational therapy in the health and well-being of older farmers. Gerontology SIS, 38(3), 1-4

Milani, D., & Monteiro, M.S. (2012). Musculoskeletal symptoms and work ability among agricultural machinery operators. Work, 41, 5721-5724. DOI: 10.3233/WOR-2012-0930-5721

Fisher, E., & Donham, K.J. (2011). Agricultural medicine core course: Building capacity for health and safety professionals. Journal of Agromedicine, 16, 106-116. DOI: 10.1080/1059924X.2011.560065