Cultivating a response to injuries on farms

“My God, the old man could handle a spade.” That’s a line from the poem <em>Digging</em> by Seamus Heaney (1939-2013) and it reminds me of my late father. He too could handle a spade. I can still hear its confident rasp as he plunged it into mounds of sand, cement and aggregate; folding them together; instructing me — “Not too much!” — on pouring water; turning powder into sludge into concrete. The concrete supported a new coal bunker, which, true to the old man’s philosophy of not doing things by halves, looked like a Sumerian ziggurat.

My father was an electrician; Heaney’s a farmer, and both are risky occupations. Dad was temporarily blinded while working on a destroyer’s searchlight during the Second World War… and somebody switched it on. Heaney, in an interview with the <em>Daily Telegraph</em> (5 April 2001), recalled his father arriving home and going to bed, having almost drowned after his horse had reared up, overturning his cart on a riverbank.

That was early anecdotal evidence, I suppose, of how life on the farm is freighted with hazard, evidence recently confirmed by Sheehan et al in the <em>Irish Journal of Medical Science</em> (2016, 185 Suppl 5: S246), who stated that farming is “the most dangerous occupation in Ireland”.

They found that between 2009 and 2013, some 54 patients were admitted to Cork University Hospital, having sustained major farm animal-related trauma — fractures, blunt chest trauma and head injuries — including one fatality. The farmers’ average age was 56 years and the authors note that getting older “appears to be the single biggest factor driving increasing injuries on Irish farms”.

 Such studies underline the fact that heavy rain, heavy machinery, heavy animals and chemicals with heavy-sounding names can subtract sharply from the airy notion — popular among many, especially city dwellers — that farm life is one of bucolic bliss.

And the truth is more eye-boggling than fiction. For example, those readers familiar with the (well, perhaps not quite so) popular <em>A Literary History of Iowa</em> (1972) by Clarence A Andrews will find that despite the scope for farming accidents in the early 20th Century, fictional accounts were rather predictable, with farmers butted by bulls, their wives drinking sheep dip and “farm girls all made for the haymow where the hired man was waiting with lust in his eyes and manure on his overalls”.

But let us linger in Iowan farming country: The scene of Grant Wood’s evocative painting of rural life in the United States <em>American Gothic</em> (1930) centred on a couple — husband and wife or father and daughter? — standing in front of their house.

The stern farmer in <em>American Gothic</em> holds a pitchfork and as with Heaney’s father sinking his spade into the ancestral soil, you can’t help thinking: “By God, the old Iowan could handle his triple-tined implement.” But not if he had arthritis. Thus, Taylor-Gjevre et al described in the <em>Journal of Agromedicine</em> (2015, 20: 205-216) the prevalence and occupational impact of arthritis in Saskatchewan farmers. Out of 2,473 farmers, 13 per cent had chronic arthritic diagnoses and arthritic farmers reported reduced participation in a range of activities, including “shovelling/pitchfork work and lifting/carrying”.

 The authors noted that not only does shovelling/pitchfork work involve “heavy use of upper extremities, potentially impaired by arthritic involvement affecting shoulders, elbows or handgrips”, but also the sweeping cross-body movements could exacerbate painful joints in the lower back, hips and knees.

Farming in Ireland employs 6 per cent of the workforce but accounts for 40 per cent of workplace fatalities, a fact cited by Berney et al in <em>Traumatic spinal injuries on farms: Patients treated in the national spinal unit of Ireland 2005-2015</em> and published in the <em>Journal of Orthopaedics</em> (2017, 14: 211-215). Of 31 patients, 26 sustained high-energy injuries, with machinery and livestock implicated in most accidents. The authors identified four significant risk factors on Irish farms that could result in spinal fracture, with or without spinal cord injury: Handling livestock (cows cause more injuries than bulls); heavy farm machinery; moving large hay bales; and falls from heights. They also pointed to the success that prevention strategies have had on the incidence of spinal injuries in rugby and diving, emphasising the need to educate the farming population on the main risks of significant injury.

Faced with an ageing farming population and little indication of decreasing farm-related injuries, the challenge of how best to address the problem is a daunting one, and one hardly helped by the fact that for many of us, farms and farmers are literally out of sight and mind. Which leaves the ultimate responsibility for farmers’ safety with farmers.

Yet farmers are no more immune to taking short-cuts than those medical professionals who choose not to wash their hands. Yes, there’s a difference between incorrectly tethering a spooked heifer and dodging a bar of soap but whatever the difference is, it is not one of attitude. However, if changing one’s attitude were as easy as handling, say, a spade, then the problem would be solved overnight. But, as Seamus Heaney reminds us, not everyone can handle a spade.