Occupational health and safety in agriculture : current situation and objectives for the future

About half of the human population lives and works in rural areas, mainly engaged in agriculture. Since agriculture produces foods and uses land, it is at the basis of the healthiness of millions people, but it might also cause environmental resource depletion and pollution. Therefore, agriculture is linked with the wellbeing of entire communities and agricultural workers are a precious resource in any country but, despite their social relevance, they are neglected by research, prevention and welfare, and are suffering a gap in life quality, sanitation, income, and distribution of welfare benefits if compared to urban dwellers. Several reasons can explain this gap: remoteness, isolation and distance from the welfare structures, prevalence of small size and family based enterprises, and of selfemployed, seasonal and informal workers, usually not addressed by occupational health and safety legislation. Moreover, variability and instability of working conditions and practices, levels of exposure to risk factors, and use of complex and variable mixtures of chemicals, affect the possibility of doing sound risk assessment and management. In this context, significant inequalities are evident: same levels of risk are not addressed in the same way; workers highly exposed to risk factors are not addressed with the necessary interventions; access to health care is limited or lacking. One of the main objectives for the next future is the creation of basic occupational health services (BOHSs) in rural areas, to be achieved only through the collaboration of workers and employers’ associations and the involvement of rural general practitioners, who are very often the only providers of occupational health care to rural workers. From BOHSs, search of under-reported cases of occupational diseases, and of new and emerging risk factors and diseases can be performed, allowing the identification of evidence based needs and priorities. At our Centre we are running a project aimed at creating BOSHs in the territory. Currently we assist about 1,000 workers of 300 small agricultural enterprises. We are pointing out several occupational and work related diseases in these workers, such as respiratory affections, noise induced hearing loss and immunological changes indicative of a contact with organic dusts. Moreover, we have pointed out cases of non-adequate coverage of anti-tetanus in unity, in particular in migrant and seasonal workers. Our experience shows that it is possible to provide disadvantaged groups of workers with occupational health care, and that the workers provided with it are healthier than the others.