Hazards for women and children in rural settings/Peligros para las mujeres y ninos en el ambito rural.
The farm environment is unique for children, not only because it is their parents workplace but also because it is their home and playground. Although children's exposure to risks is high, parents' attention is often reduced because they are working. Risk exposure for children is further increased by their participation in chores involving animals and machinery. Children on farms can be required to perform tasks for which they are not yet prepared (4).
The potential risks of a farm include agricultural machinery, livestock, chemicals and zoonosis. Farms also have a higher potential risk of injuries (5). Injuries are not distributed randomly among populations at risk. Positive associations between one's prior injuries and risk of subsequent injury have been observed. It seems that some families suffer more accidents than others (3).
Individual people are mainly responsible for handling their own health risks, since many risks are characterized as behavioral in origin and, therefore, largely under individual control (6). Nevertheless, these risks are perceived differently by society. Risk does not mean the same for all groups of people and must be addressed in a social, cultural and economic context (7, 8).
Argentinian farmers have a low perception of the risks involving professional illnesses, being totally focussed on labor accidents. Awareness of zoonoses among rural housewives is scarce and differs from the knowledge shown by urban housewives (9).
The objectives of this study were: a) to identify possible risk factors associated to rural accidents in women, b) to describe women's knowledge about zoonoses (species and means of transmission), c) to describe women's risk perception about farming, d) to describe mother's risk perception about children's rural activities, e) to estimate the initial age of exposure to rural environmental risks for children in farming, and f) to identify possible risk factors associated with rural accidents in children.
MATERIALS AND METHODS
An observational study was conducted between March and April 2012 in the rural area of Egusquiza, Santa Fe Province, Argentina (31[degrees] 5' 42" S, 61[degrees] 37' 37" W). The study design was cross-sectional, the unit of interest were the women who lived on a farm and their children. The target population: women that raised their children in the rural environment of Central Santa Fe Province and children who grow up there.
Population data was obtained from Egusquiza County. From a total of 125 households, 41 lived in the rural environment. In two of the households women refused to answer the questionnaire and in another three there no one was present on three visits. Women lived in thirty-two of the remaining households and could complete a structured questionnaire during a personal interview. The questionnaire was divided into two sections: one to gather women's data (demographic characteristics, farming accidents, personal protective equipment use, risk perception of farm chores and zoonoses knowledge) and the other section was to gather children's data (farming chores, mother's risk perception about their children's labor in the farm and accidents until the age of sixteen). Accidents data was recorded for the last 12 months and all years under exposure in both cases (women and children).
For the purpose of this study "housewives" were defined as those women who work only at home, and "farm worker" were those who also work on the farm. There were 32 respondents, 23 of them had children.
Risk perception was defined as "the notion of the probability of a subsequent adverse health event" (6). This probability was measured according to an ordinal scale (high/medium/low) (10).
Personal protective equipment (PPE) use was quantified with an ordinal scale (never/ sometimes/ always) in accordance with Tarabla (10).
The purpose and importance of the study was explained prior to the interview, emphasizing that responses would be anonymous, since the interest was not the experience of any particular respondent but the frequency of events at the population level. All interviews were performed by the senior author.
Statistical analyses included [chi square] (Chi), Student's t-test and Pearson's correlation coefficient. All statistical analysis was performed using InfoStat[R] program (Universidad Nacional de Cordoba, Argentina).
This study was approved by the safety and ethics committee of the Facultad de Ciencias Veterinarias, Universidad Nacional del Litoral. Protocol n[degrees]: 160/2013. Exp.: 15817.
Women demographic characteristics
On average, the respondents were 37.4 years old (between 18 and 79). Most of the respondents were legally married (65.6 %) or were living with their partner (15.6 %). Most women had at least one child (71.9 %, N= 23) (12.5 % had 5 children; 20.8 % had 4; 37.5 % had 3 and 12.5 % had 1 or 2). In total, data from 70 children was gathered from 23 mothers.
Twenty-one percent were housewives (21.9 %, n= 7) and 78.1 % (n= 25) were also farm workers.
Many women had suffered an accident on the farm (65.6 %). The most frequent accident was being kicked by an animal (last 12 months= 25 %, all years of exposure= 18.8 %), followed by burns and being bumped or cut by an object (Table 1). The most common lesions were contusion (last 12 months= 46.9 %, all years of exposure=37.5 %), cut wounds and muscle contractures (Table 2). Hands were the body part most commonly affected (last 12 months= 18.8 %, all years of exposure= 21.9 %), followed by legs and knees.
No significant association was found between having an accident and age (p=0.45). Farm workers had suffered more accidents in the last 12 months than housewives (60 % and 28.6 %, respectively, p= 0.084). Similar results were obtained when all years of exposure were taken into account (56 % and 14.3 % respectively, p= 0.040).
Women PPE use
Farm workers usually did not use personal protective equipment (PPE). Hearing protection, gloves and safety goggles were rarely used (Table 3). Seatbelts were used more frequently in the city and main roads. The same thing was observed with headlights, they were used in daylight by 84.6 % of the women driving on main roads.
Women's risk perception
Worker women showed high risk perception for urban driving, agrochemical handling and driving on main roads (85.7 %, 70 % and 66.7 %) (Table 4). There was no significant association between risk perception and PPE use.
Most respondents (66.7 %) said that children helped in farm tasks (handling big animals= 66.7 %, driving tractors= 50 %, hand tools usage= 25 %, tasks that involved pets= 20.8 %, and physical effort= 16.7 %) (Figure 1).
On average children started to drive a tractor when they were 12.2 years old (minimum= 9, maximum= 18). The task that they started to do earliest was working with animals (since 4 years old with an average of 9.7). Work with hand tools started at 10 years old with an average of 13.2. The maximum age to start a chore was 18 years old.
Mother's risk perception about children's rural activities
Most mothers (87.5 %) thought it was good for children to learn how to perform farm chores starting at a young age. Risk perception was different depending on the chore involved. Many women thought that farm chores were not risky at all (60 %). Considering the 40 % of women who assumed some level of risk, 57.1 % believed that making or repairing a wire fence was the lowest risk task that a child could do, followed by work with animals (46.7 %). The tasks with the highest perceived risk were handling chemicals and pesticides (100 %), brucellosis vaccination (100 %), grain or hay grinding (87.5 %), tractors and machinery driving (76.9 % y 73.3 % respectively), noisy work (71.4 %), abortion and carcass handling (66.7 % and 62.5 % respectively). Work with hand and power tools was considered as high risk by 46.7 % of the respondents, somewhat risky by 20 % and low risk by 33.3 %. The same proportion of mothers considered helping with calving a high or low risk activity (42.9 % each) and the remaining 14.2 % considered it a task with medium risk. Risk perception with regard to their children's labor on the farm were highly correlated (r> 0.75).
More than 7 % of the children (7.1 %) have suffered an accident on the farm. The most frequent accident was being trapped by machinery (60 %, n=3). The machinery involved was a grain crusher and a disc plow. Some injuries were mild (lower extremities contusion). Only one of those accidents caused a severe injury (finger amputation). Other kinds of accidents suffered by children were being knocked or cut by an object (20 %, n=1) and being knocked by an animal (20 %, n=1). All the reported accidents occurred in the last 12 months.
No association was found between the independent variables--number of children, mother's formal education level, tasks that mothers did daily, and accidents in mothers or children while helping inn farm tasks--and the dependent variable of children's accident on the farm in the last 12 months or before (p>0.2). Neither was their a significant association between work accidents in fathers and children's accidents, or between a child's accident and age at which the child started helping with farm tasks (p>0.2). For that reason, a logistic regression model could not be performed.
This study was based on a small population of families who lived and worked on livestock farms. Asking women about their children's accidents was sustained in studies made in others countries, where it was proved that they are better interlocutors of their children's accidents than doctors or fathers (11). Results cannot be extrapolated from this small population to the total population who live and work in farms in our country, but at least this is the first study about the subject in Argentina.
Most women had suffered accidents on the farm, but the case of housewives is remarkable. They had suffered accidents on the farm just because of proximity to hazards. They were not involved directly in farm work but they got hurt just because of the exposure to risks (3).
Women's risk perception of farm work was high in many tasks but it did not make them try to protect themselves or their children. PPE use among working women was very low and it seems to be that knowledge of farm hazards was not related to the safety precautions they took to protect themselves (12).
The proportion of children who helped in farm tasks was large. This leads children to be exposed to risks since they are very young, even by standing near the adults who are working (4).
Tevis (13) conducted a study in USA to determinate at what age children start to do some tasks on farms. On average, by five years of age children fed pets and chickens and collected eggs. By the age of seven boys and girls already fed horses. Children were around cows since they were eight. Some of the parents said their children drove all terrain vehicles since they were 9. Tractors were driven by boys and girls between 10 and 11 years old. In our study the ages at which children started to do farm chores were not so different on average. Children start driving tractors and doing chores involving large animals at an older age. Some mothers said their children started to help in farm chores when they were 18. This could be because parents made them finish their studies before starting to work or because of memory bias. In Argentina law n[degrees] 26390 establishes that children can work when they are 16 years old. The problem is that farm work is usually considered a game or like any other task that children do to help their parents. This leads to them starting to do farm chores before they are ready to do it. Many times they are simple observers of the chores, but this exposes them to risks (3).
Mothers' risk perception about their children doing adult tasks was low. Furthermore, there were contradictions between mother's risk perception about certain chores and the age children started to make them. As Zentner et al. (12) said: "perception of risks did not necessarily translate into safety actions". An example of this is tractor driving, which was considered as high risk by most of the mothers, and children started doing it from the age of 12. There is also a misinterpretation of certain zoonosis exposures like brucellosis. Mothers understood that brucellosis vaccination was a high-risk task because it is a live vaccine and their children could get the illness through an erroneous manipulation of it. They considered calving assistance as a less risky task, even though this is a very important source of brucellosis and other zoonosis. This could represent an ignorance of the means of transmission of the illness or it could be because of a "free of Brucellosis" status for the farm leading them to think there is no more problem with it.
In our study mothers' risk perception were highly correlated. This has not occurred in other national studies made among rural veterinarians and workers where correlations were low (14,15).
Children's accidents were not significantly associated with any of the independent variables under study, not even with fathers' farm accidents like others researchers found (3). Maybe this is caused by the low number of accidents found among children in this study. This could be a reflection of reality or could be caused by mothers' memory bias like we said before.
There is no correspondence between mothers' risk perception about their children working on farms and the age they started letting children participate in farm chores. Children must be safe in their homes and we must protect them from accidents that are totally avoidable. Also risk communication is necessary to inform the women involved and to reduce exposure. It is very important to continue this line of investigation, perhaps with a larger number of families or in other locations to know the real situation in Argentina
Conflict of interest: None
Funding: This work was supported by a CAIDO Project financed by Universidad Nacional del Litoral, Santa Fe, Argentina and PICT no 10-0989 Project financed by Agencia Nacional de Promocion Cientifica (Argentina).
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Ana I. Molineri , Marcelo L. Signorini-Porchietto  y Hector D. Tarabla 
 Universidad Nacional del Litoral. Santa Fe, Argentina. firstname.lastname@example.org; amolineri@ hotmail.com
 Consejo Nacional de Investigaciones Cientificas y Tecnicas. Departamento de Instituto Nacional de Tecnologia Agropecuaria EEA. Santa Fe Argentina. email@example.com
 Instituto Nacional de Tecnologia Agropecuaria EEA Rafaela. Facultad de Ciencias Veterinarias Universidad Nacional del Litoral. Santa Fe, Argentina. firstname.lastname@example.org
Received 3 October 2013/Sent for Modification 12 January 2014/Accepted 5 March 2015
Table 1. Women's type of accidents Accident % All years (n) % Last 12 months (n) Animal kick 18.8(6) 25.0(8) Physical effort 12.5(4) 9.4(3) Burn 12.5(4) 18.8(6) Hit 12.5(4) 15.6(5) Falls 9.4(3) 15.6(5) Contact with chemicals 9.4(3) 9.4(3) Twisted ankle 3.1(1) 18.8(6) Pressed by an animal 6.3(2) 6.3(2) Hit by an animal 3.1(1) 6.3(2) Excessive exposure to sun heat 6.3(2) 3.1(1) Contact with electricity 6.3(2) 3.1(1) Animal bite 3.1(1) 3.1(1) Car crash 6.3(2) 0.0 Hit by machinery 0.0 3.1(1) Hit by a tractor 0.0 0.0 Machinery crash 0.0 0.0 Pressed by machinery 0.0 0.0 Tractor crash 0.0 0.0 Table 2. Types of injuries Injury % All years (n) % Last 12 months (n) Contusion 37.5 (12) 46.9 (15) Cut wound 12.5 (4) 15.6 (5) Muscle contracture 15 (5) 3.1 (1) Burn 9.4 (3) 3.1 (1) Sprain 0 12.5 (4) Sunstroke 9.4 (3) 0 Internal trauma 0 6.3 (2) Scrape 0 6.3 (2) Allergy 6.3 (2) 0 Object in eye 0 6.3 (2) Fracture 0 6.3 (2) Muscle tear 0 3.1 (1) Luxation 0 3.1 (1) Intoxication 3.1 (1) 0 Suffocation 0 0 Pointed wound 0 0 Ligament tear 0 0 Amputation 0 0 Table 3. Mother's PPE use PPE USE (%) Never Sometimes Always Hearing protection 100 0.0 0.0 Gloves: calving help 84.6 0.0 15.4 abortion manipulation 50.0 0.0 50.0 carcass handling 33.3 33.3 33.3 agrochemical handling 66.7 22.2 11.1 fencing 100 0.0 0.0 working with hand tools 75.0 25.0 0.0 grinding 100 0.0 0.0 Safety goggles: calving help 92.3 0.0 7.7 abortion manipulation 100 0.0 0.0 carcass handling 100 0.0 0.0 agrochemical handling 75.0 25.0 0.0 grinding 100 0.0 0.0 Chemicals resistant coveralls for 40.0 60.0 0.0 handling agrochemicals Waist protective belt 70.6 11.8 17.6 Headlights on in daylight on main roads 0.0 15.5 84.6 on rural roads 14.3 7.1 78.6 Seatbelt on main roads 0.0 9.1 90.9 on rural roads 26.1 26.1 47.8 on the farm 77.3 13.6 9.1 in the city 0.0 0.0 100 Cover machinery 11.1 22.2 66.7 Stop machinery 16.7 16.7 66.7 Read machinery instructions 66.7 16.7 16.7 Table 4. Women risk perception of their farm task Risk perception (%) High Medium Low Noisy tasks (n=7) 28.6 28.6 42.9 Helping in births (n=14) 7.1 42.9 50.0 Abortion manipulation (n=22) 0.0 50.0 50.0 Carcass handling (n=23) 33.3 0.0 66.7 working with animals (n=23) 13.0 52.2 34.8 Agrochemical handling 70.0 20.0 10.0 Grinding (n=3) 33.3 66.7 0.0 Fencing (n=2) 50.0 50.0 0.0 Hand tools (n=7) 0.0 42.9 57.1 Machinery (n=6) 16.7 50.0 33.3 Tractor (n=9) 0.0 55.6 44.4 Main road driving(n=15) 66.7 20.0 13.3 Rural road driving (n=17) 11.8 41.2 47.1 Farm driving (n=15) 6.7 20.0 73.3 Urban driving (n=14) 85.7 7.1 7.1 Homemade salami eating (n=18) 33.3 22.2 44.4 Figure 1. Children's task in the farm Physical effort 17% Little animals 21% Hand tools 25% Tractors 50% Big animals 67% Note: Table made from bar graph.
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|Title Annotation:||texto en ingles|
|Author:||Molineri, Ana I.; Signorini-Porchietto, Marcelo L.; Tarabla, Hector D.|
|Publication:||Revista de Salud Publica|
|Date:||Feb 1, 2015|
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