What Farmers Can Teach Us About Hearing Protector Use
Marjorie McCullagh, PhD, RN, PHCNS-BC, COHN-S
Farmers are exposed to hazardous noise from equipment and livestock (Table 1), and experience higher rates of noise-induced hearing loss (NIHL) than non-farmers of similar age (Rabinowitz, Sircar, Tarabar, Galusha, & Slade, 2005). Unlike workers in general industry, farmers generally work in a non-regulated environment and are not commonly served by work-based health programs. Other challenges to using hearing protection in the farm work environment include intermittent noise exposure, diversity of noisy work activities, and lack of organization of workers. Although the best way to prevent NIHL is to eliminate noise whenever possible (e.g., “buy quiet” and use automation), noise elimination is often not technically or economically feasible in the farm work environment (Murphy, 1992). Use of hearing protection devices (HPDs) would help prevent NIHL, but use among farmers is low. For example, recent studies have described frequency of farmers’ use of HPDs as 7% of the time exposed to loud noise (Carruth, Robert, Hurley, & Currie, 2007), seldom (Gates & Jones, 2007), and poor (Jenkins, Stack, Earle-Richardson, Scofield, & May, 2007). Factors influencing use of hearing protectors among farmers have been identified as barriers (such as difficulty communicating and fear of not hearing warning sounds), access and availability of HPDs, and interpersonal influences such as family support for HPD use (McCullagh, Lusk & Ronis, 2002).
Although most farmers do not use HPDs consistently when they are exposed to loud noise, a small minority of farmers have successfully adopted this safety practice into their work. Currently we know little about the motivations and mechanisms for this success from the perspective of the user. Understanding of this would be useful in the future development of interventions to increase HPD use. A qualitative study was conducted in effort to describe farmers’ personal experiences in successfully becoming HPD users, influencing others’ use of HPDs, and overcoming barriers to the use of HPDs.
Design & Methods
Institutional review board approval of the study protocol was secured prior to collection of data. Study participants were screened and recruited individually from farm trade shows and commodity meetings in the upper Midwest. Farmers were selected who reported they are exposed to loud noise in their farm work and use hearing protection all of the time, or nearly all of the time (90% or better), they are exposed to loud noise. Sampling continued until saturation was reached.
Face-to-face interviews were conducted using a semi-structured interview guide. Questions focused on actions that the farmer takes to protect himself from farm noise, who encouraged or supported the farmer’s use of hearing protection, how the farmer might have influenced the use of hearing protectors by other farmers, and how the farmer overcomes obstacles to using hearing protection at work. An additional item asked farmers to describe their personal motivations for becoming a user of HPDs.
After the farmer provided informed consent, he was individually interviewed one time for about 10 to 25 minutes. Interviews took place on the exhibit floors of farm shows, or common areas at trade group meetings, and were videorecorded. Participants received a cash incentive of $20 in recognition of their time.
Results
Twenty farmers participated; all but one were men. Although most (90%) participants were middle-aged (35-60 years), the age range of participants was 18 to 65 years. Producers of crops, livestock, and dairy were included. Most were owner-operators.
All the participants reported they were frequently exposed to loud noise as part of their farm work. Many were well-informed about the effects of noise exposure on hearing, as well as the impact of hearing loss on work, social, and family life. Participants told us they were motivated to use HPDs by a desire to prevent losing their good hearing, to prevent extension of their hearing loss, or to avoid the annoyance of loud noise. Most of them knew what it was like to have NIHL through their own experience, or that of a close family member, most commonly a parent. Many of them had tried to influence another person’s use of HPDs, particularly other family members.
All participants were regular users of HPDs, and most used foam plugs or muffs exclusively, or alternated between these two. As owner-operators, farmers were responsible for their own selection and purchase of HPDs. None reported that the cost was a barrier to their use. Most participants purchased HPDs at a local retail outlet, and were unaware of the variety of types of HPDs available for their use (e.g., semi-aurals, pre-molded plugs). All informants described methods they had developed to overcome problems with access and barriers to use of HPDs. For example, most participants reported that they place a supply of hearing protectors in locations around their farm operation where exposure to noise was likely. Although it is common for farmers to fear failure to hear equipment sounds when they wear HPDs, several interviewees reported that their HPDs enhanced their ability to hear (e.g., in-cab radios and critical equipment sounds). Others adapted alternative methods for monitoring equipment operation (e.g, using gauges and inspections, and being more aware of changes in vibrations that signal equipment malfunction). Many of these frequent users make a practice of purchasing HPDs in bulk, and carry HPD s with them as they move about the farm.
Conclusions & Implications
Although most farmers have high noise exposure, high rates of NIHL, and low rates of use of HPDs, some farmers are models for using HPDs in their noisy work world. Important lessons were learned from these frequent users. First, consistent use of HPDs in the farm work environment is possible. There are specific methods for overcoming the most common obstacles to farmers’ use of HPDs. These videotaped recordings of actual farmers who consistently use HPDs will be used in the development of a future Intervention to increase HPD use among farmers.
This study was supported by NIOSH (R03 OH 008358).
References
Carruth, A., Robert, A. E., Hurley, A., & Currie, P. S. (2007). The impact of hearing impairment, perceptions and attitudes about hearing loss, and noise exposure risk patterns on hearing handicap among farm family members. AAOHN Journal, 55(6), 227.
Gates, D. M., & Jones, M. S. (2007). Populations at risk across the lifespan: Case reports: A pilot study to prevent hearing loss in farmers. Public Health Nursing, 24(6), 547.
Jenkins, P. L., Stack, S. G., Earle-Richardson, G. B., Scofield, S. M., & May, J. J. (2007). Screening events to reduce farmers’ hazardous exposures. Journal of Agricultural Safety and Health, 13(1), 57-64.
McCullagh, M., Lusk, S. L., & Ronis, D. L. (2002). Factors influencing use of hearing protection among farmers: A test of the Pender health promotion model. Nursing Research, 51(1), 33-39.
Murphy, D. (1992). Safety and health for production agriculture. St. Joseph, MI: American Society of Agricultural Engineers.
Rabinowitz, P. M., Sircar, K. D., Tarabar, S., Galusha, D., & Slade, M. D. (2005). Hearing loss in migrant agricultural workers. Journal of Agromedicine, 10(4), 9-17.
Table 1. Noise Levels of Selected Common Farming Activities (dBA)
| Tractors | 74-112 |
| Grain dryers | 85-110 |
| Combines | 85-105 |
| Chain saws | 77-115 |
| Pig squeals | 85-112 |
Source: Themann, C. (1993). Agricultural noise exposure and control. In D. Pedersen, Cooperative agricultural surveillance training: Farm family health hazard surveillance program. Cincinnati, OH: NIOSH.
Author Biographical Information
Marjorie McCullagh is Assistant Professor of Nursing and Director of the Occupational Health Nursing Program at the University of Michigan School of Nursing. Her research focuses on promotion of hearing health for farmers and farm families.