Academic journal article Human Organization

Perceptions of Pesticide Associated Cancer Risks among Farmers: A Qualitative Assessment

Academic journal article Human Organization

Perceptions of Pesticide Associated Cancer Risks among Farmers: A Qualitative Assessment

Article excerpt

American farmers experience disenfranchisement in occupational and health status that places them at excess risk for injury and disease. Cancer morbidity and mortality investigations have documented excess rates of specific cancers among agricultural workers, and occupational pesticide exposure is thought to be a contributing etiologic agent. We report on a qualitative investigation of dairy farmers' awareness of cancer and their perceptions of pesticide associated cancer risks. A focus group of twelve participants and eleven elicitation interviews were conducted with dairy farmers residing in six Wisconsin counties. Leading themes that emerged from the narratives were farm sustainability concerns, time and stress contributing to pesticide exposure risks, and personal explanations of cancer causes. Prevention program recommendations stemming from these findings call for farm community approaches that target the multiple influences affecting pesticide safety. Such approaches should both originate from and foster collective community wisdom rather than expert models to achieve diffusion of health innovations and to ultimately reduce farm health risks.

Key words: cancer, dairy farmers, health status, pesticides; US, Wisconsin

American farmers experience disenfranchisement in occupational and health status that places them at excess risk for injury and disease. Farming is considered one of the most dangerous occupations due to inherent risk for injury and exposures to hazardous substances. Occupational assessments have demonstrated a variety of hazardous chemical exposures present in the farm environment. Epidemiologic investigations conducted over the last decade have demonstrated increased mortality rates among farming occupations from specific cancers. This report describes a qualitative investigation of the life and work circumstances of a sample of Wisconsin dairy farmers as they described their perceptions of the importance of general health, their concerns about cancer, and their perceived risk of pesticide exposure and importance of pesticide safety.

The Status of Health Services in Rural Areas

Rural areas are in need of increased health care services and health information due to their limited access to health facilities and professionals. The shortage of health care professionals practicing in rural areas in the United States has been well documented (HRSA 1992; US Congress 1990). The majority of academic medical centers are located in urban settings and physicians often originate from and train in urban areas. Traditional medical training does not adequately prepare physicians to meet the health care demands of rural areas. Such health needs are exemplified in agricultural settings, where the risk of injuries resulting from animals, chemicals and machinery are many (Nordstrom et al. 1995; Layde et al.1995; Layde et al. 1996). Poisonings resulting from pesticides as well as other farm chemicals are also a common hazard in farm settings, particularly for children. Newly trained primary care physicians frequently leave their rural service practice and return to metropolitan areas after having difficulty adapting to a rural setting or after overworking themselves with too heavy a client load (Murray and Keller 1991). In addition to a general shortage of health professionals, rural people have limited access to health care due to geographic distance to hospitals and clinics.

Health Risks of Farmers and Other Rural Americans

Rural residents are characterized by lower mortality but higher rates of chronic disease (US Congress 1990). After adjusting for age, race and gender differences among rural and urban residents, mortality rates in rural areas are 4 percent lower than in urban areas. Two exceptions that are higher in rural as compared to urban areas are infant mortality (10.8 v. 10.4 per 1000 infants) and injury-related mortality (0.6 v. 0.4 per 1000 residents). Chronic illness and disability however affect a higher proportion of rural than urban population (14 v. …

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