Schenker M B
Department of Epidemiology and Preventive Medicine, University of California at Davis 95616-8638, USA.
J Public Health Policy. 1996;17(3):275-305.
Agriculture was one of the earliest industries in which occupational hazards were recognized, but it has been largely excluded from the mainstream of modern preventive medicine and occupational health efforts. This resulted from the heavy industry focus of occupational medicine, from the agrarian myth which stated that work in agriculture was a healthy employment, from the widely dispersed, often family-centered, nature of farming, and from neglect of migrant and seasonal farmworker populations. Since the middle of this century it has been recognized that agriculture is one of the most hazardous major industries, but whereas the injury and fatality rates in other hazardous industries (e.g. mining, construction) have fallen substantially, there has been no comparable decline in agriculture. In addition to occupational injuries and fatalities, there is a wide range of chronic diseases that result from agricultural exposures. These include musculoskeletal, respiratory, dermatologic and reproductive disorders. Hearing loss is increased among farmers, several cancers have been associated with farming or agricultural exposures, and increased suicides have been observed in some farming populations. Recommendations for disease prevention and health promotion must be sensitive to the unique nature of farming, including the demographically different farmer, farm family, and hired farmworker populations. Approaches discussed in the paper include engineering changes, education with evaluation of its effectiveness, and enforcement of appropriate laws.
农业是最早认识到职业危害的行业之一，但在很大程度上被排除在现代预防医学和职业健康工作的主流之外。这是由于职业医学侧重于重工业、农业神话（即认为农业工作是健康的职业）、农业广泛分散且通常以家庭为中心的性质以及对流动和季节性农场工人人口的忽视。自本世纪中叶以来，人们已经认识到农业是最危险的主要行业之一，但其他危险行业（如采矿、建筑）的工伤和死亡率大幅下降，而农业却没有类似的下降。除了职业伤害和死亡外，农业接触还会导致多种慢性疾病。这些疾病包括肌肉骨骼、呼吸、皮肤和生殖系统疾病。农民的听力损失增加，几种癌症与农业或农业接触有关，并且在一些务农人群中观察到自杀率上升。疾病预防和健康促进的建议必须考虑到农业的独特性质，包括人口统计学上不同的农民、农场家庭和雇佣的农场工人人口。本文讨论的方法包括工程改造、对教育效果进行评估以及执行适当的法律。
