Background & Goal
Farm operators experience frequent exposure to high noise and have among the highest prevalence rates of hearing loss across all categories of workers. The USDA estimates there are approximately 3,281,000 farm operators in the United States, with an additional 2 million children who either work on or visit farms also having an increased prevalence of noise-induced hearing loss due to farm noise. Most farms in the US are small, family run businesses which are neither served by labor organizations nor protected by the OSHA Hearing Conservation Standard.
Noise-induced hearing loss is permanent and irreversible, with treatment limited to hearing aids for sound amplification. In addition to hearing loss, noise exposure results in other serious and widespread health problems including elevated blood pressure and heart rate, increased risk of cardiovascular disease, increased risk of acute myocardial infarction, increased stress hormone levels, increased depression, and increased fatigue and tension. Noise exposure is particularly harmful to children and is linked to problems including decreased reading skills and memory, poorer school performance, increased distractibility, annoyance, and aggression. Noise-induced hearing loss is estimated to be the most common occupational disease in the US, costing the average person $12,000/year and the US $242 million annually on compensations for workers’ hearing disability. The collective monetary cost of untreated hearing loss is believed to exceed $100 billion annually.
The goal of Dr. Marjorie McCullagh’s intervention, Quiet4Healthy Farm, is to promote health and improve the quality of life among farm operators and farm youth by eliminating work-related hazardous noise exposures.
Quiet4Healthy Farm is a collection of interventions from two programs, HEAR on the Farm and Hearing Heroes, designed and developed by Marjorie McCullagh, PhD, RN, APHN-BC, COHN-S, FAAOHN, FAAN, of the University of Michigan School of Nursing, and her team in consultation with farm operators and farm youth over several decades. These hearing conservation interventions include a number of features and techniques designed to promote behavior change. In contrast to the limited diagnosis and treatment practices of the past, Dr. McCullagh’s interventions present broad based preventive strategies (turn it down, walk away, and wear hearing protection) and are readily available to the farming population through face-to-face, mail, or Web-based formats. The highly interactive and predictor-based programs use multiple tools such as farmer-to-farmer communication, role modeling, cognitive strategies, videos, persuasive techniques, and animations of hearing physiology to increase farmers’ self-determination in changing their behaviors to prevent noise-induced hearing loss and noise associated health problems. Outcomes are measured using scientifically-based instruments.
Evidence of Success
Strong Quiet4Healthy Farms has succeeded in reaching and changing the behaviors of a highly dispersed and often remote at-risk population. Dr. McCullagh’s partnerships with well-established farm organizations and institutions of higher education such as the American Farm Bureau, the Progressive Agriculture Foundation, and the University of Iowa have resulted in her interventions being used to inform national and state farm organization policies and programs, being adopted in standard curriculum reaching over 100,000 people in 338 US communities annually, and being included in a smartphone app for noise monitoring and education of farmers. Additional opportunities to provide farm operators, farm youth, and their family members access to Dr. McCullagh’s interventions at no cost are in development, including access through the sharing of a URL. Dr. McCullagh’s interventions have demonstrated sustained effectiveness over a 12 month period in increasing the use of hearing conservation strategies. U.S. analysis of economic burden of noise on cardiovascular disease suggests that even a modest 5-dB reduction in noise would reduce the prevalence of hypertension by 1.4% and coronary heart disease by 1.8%, resulting in an annual economic benefit of approximately $3.9 billion.