By MEGGIE. I. FOSTER
Associate Editor

WEST LAFAYETTE, Ind. — Day-in and day-out, American farmers work with their hands reaching and grabbing, bending and stooping with their legs, twisting and turning their torso, not to mention the overall level of physical endurance required to carry on ordinary farm tasks.

After years of continued repetition – reaching, grabbing, bending, stooping and twisting, the muscles around the weight-bearing joints of the body begin to break down. The result – a musculoskeletal disorder most commonly referred to as arthritis. The most common type of arthritis is osteoarthritis affecting the bony muscle tissues in the hands, thumbs, knees, hips and spine.

Many farmers would contend that arthritis is simply an unwelcome work hazard and one that can simply not be avoided. According to the organizers of Arthritis, Agriculture and Rural Life Conference – May 11-13 – on the campus of Purdue University in West Lafayette, Ind., this is not the case. In fact, arthritis is one of the most preventable diseases in the United States, yet, still, a major cause of work disability in rural communities.

“Fifty million people have arthritis today,” said Tom Fite of the Arthritis Foundation. “It is so common that has become acceptable. One mission of our organization is to make people realize that arthritis is completely unacceptable.” Fite said that arthritis disables more people in the United States than any other disease including cancer, diabetes and heart disease.
“This is unacceptable,” he stated. “It costs our nation $190 billion a year in lost work, medical costs and disability payments. This is an epidemic. And as the baby boomers begin to age it’s only going to get worse.”

“I’m convinced we’re losing more money from arthritis and its impact on farmers than we are poultry diseases,” commented Bill Field, director of the National AgrAbility Project and professor of agricultural and biological engineering at Purdue University, referring to the fact that more people were in (West Lafayette) for a poultry event than the arthritis and ag event. “There is a high level of complacency and acceptance of this issue, and unfortunately people just aren’t taking it seriously.”

That is, except, the keynote speaker on May 11 – Dr. Steven Kirkhorn, medical director of the National Farm Medicine Center in Marshfield, Wis., who focuses on occupational medicine, as well as worker compensation and disability.
According to Kirkhorn, nearly 27 million Americans suffer with pain, stiffness, swelling and thickened joints from osteoarthritis, and this number is expected to increase with the obesity epidemic. “It is estimated that between 1.04 and 2.23 million farmers and ranchers are disabled in the United States and by far farmers are among the highest risk for hand-wrist arthritis,” Kirkhorn said.
The risk factors for osteoarthritis include genetics, heavy physical work beginning at a young age, lack of exercise, diseases affecting joints and obesity. In Indiana, nearly 27 percent of the population is considered obese and 68 percent are considered overweight, he explained.

“Once you start to gain weight it’s harder to lose it, and it’s especially difficult to lose it as you age because you generally become less active,” Kirkhorn added.

Additionally, Kirkhorn said that the nature of agricultural work such as weather extremes, wet slippery surfaces, natural positioning of produce in the fields often leads to awkward positions, physical characteristics of living or perishable product many times negatively affects work conditions and the age and type of farm equipment often causes extra strain and stress on farmworkers.
For instance, older dairy barn designs such as stanchions or tie stalls require more bending and stooping, while newer design considerations such as parallel and rotary milking parlors require more reaching and less stooping. “Stoop work is defined as work below knees 40 percent of the time – results in lower back and neck pain and knee disorders,” he said.

Also in the poultry profession, processing baby chicks requires more heavy lifting, high repetition, hand force, awkward positions and bending of the wrists. “The farm culture has always been work until you drop, don’t stop – overlook pain – wait until it gets really bad and then it becomes a dangerous situation,” Kirkhorn said.

While not surprising, dairy farmers tend to suffer from arthritis more than any other sector in agriculture. “Traditionally arthritis is greater in dairy work than grain farming because it mainly affects hips and knees, also back,” he said. “The hand-wrist symptoms associated with cleaning, pre-milking and attaching milkers two times a day, six days a week for six hours,” he said. Additionally, orchard workers, grapevine pruning and fruit harvesting tend to take an aggressive toll on the body’s muscles and joints. In fact, in a recent report, back, neck and shoulder strain accounted for 39 percent of occupational health problems at a migrant health center in New England.

Besides continual repetition of movement, equipment can also be to blame for the early onset of arthritis. For instance, poor fitting equipment, vibration and ill work space where a farmer may continually be hitting his elbow are potential causes of muscle and joint disorders. Another common issue in agriculture profession is also lower back pain, most often the result of repetitive heavy work such as lifting, pushing, pulling, loading, picking, weeding, pruning or carrying. “Lower back pain ranges in 20 to 75 percent in farmers with extensive tractor driving – 40 percent is the average,” he said.

Devices such as added handholds and steps on equipment, power lifts to get in cab, improved seating, automatic feeding system, automated hitching system, hand clutch, spinner knob on steering wheel and finger brake controls that can help prevent and reduce the pain and suffering associated with arthritis.
Additional treatment may include appropriate exercise, weight control, aspirin, heat and cold packs, joint injections of steroids, non-surgical treatments and joint replacements. However, for farmers recovering from hip surgery – the recovery time is six to eight weeks before they may return to the tractor and a stunning one year before they can carry feed, seed or hay bales.

According to Kirkhorn, the best preventative strategy against arthritis is avoiding repetitive joint injuries, maintaining an exercise routine, stretching before activities, maintaining a good weight and avoiding obesity.

Additionally, he recommends engineering out ergonomic hazards on the farm that require overlifting, overextending the arms or bending and stooping the body repeatedly. Also, reducing activities with high repetition, providing padding to decrease vibration, installing extra steps, grab bars and lifts, modifying controls, installing good shock absorbers, taking shorter more frequent breaks rather than longer more infrequent breaks are key preventative tools in the fight against arthritis.

But Kirkhorn’s overall best advice is to begin arthritis prevention at a young age, rather than waiting until it becomes so debilitating that work tasks are too difficult or nearly impossible to complete.