Occupational health and safety among farmers: a comprehensive study in Central Anatolia, Turkey

Abstract

Background

The agricultural sector is vital for food production, economic stability, and environmental sustainability. However, it also poses significant occupational health and safety challenges due to factors such as heavy machinery usage, exposure to chemicals, and challenging environmental conditions.

Method

This cross-sectional study involved 366 farmers affiliated with the Yozgat Chamber of Agriculture in Turkey. Data on demographic characteristics, occupational factors, and work accidents were collected with interview technique between May and August 2023. While descriptive data were expressed as categories with numbers and percentages, chi-square analysis was used to compare the obtained answers with the status of having or not having a work accident. Binary logistic regression analysis was used to estimate the effect of independent variables on the probability of having a work accident.

Results

The study revealed that 33.0% of farmers experienced work accidents in the last year. Most accidents occurred during work shifts (28.8%) and in the fall season (34.8%). Factors contributing to accidents included lack of personal protective equipment (51.5%) and transportation-related issues (36.4%). Logistic regression analysis indicated that working more than 8 h daily, working 5 days or more per week, and using bus/minibus transportation significantly increased the likelihood of experiencing work accidents.

Conclusion

Findings underscore the importance of implementing effective occupational health and safety measures, including proper training, provision of personal protective equipment, and improving transportation safety. Addressing these issues can enhance the well-being of agricultural workers and contribute to a safer working environment in the sector.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-024-20249-7.

Introduction

The agriculture sector is closely intertwined with food production and nutrition. Moreover, it impacts all countries in terms of maintaining a healthy environment, ecological balance, and ensuring sustainability, in addition to its contribution to the ratio of active population and workforce, national income, and provision of raw materials and capital for industry. Therefore, it is a sector of significant importance both economically and socially. Occupational health and safety in the agricultural sector constitute a critical issue that should not be overlooked.

Farming is a highly risky and challenging profession, exposing individuals to a substantial number of work-related accidents and health issues each year. Given the inclusion of women, children, and elderly individuals in many regions, this profession is particularly precarious. In Europe, the vast majority of farms rely entirely on the collective labor of all family members (Eurostat [13]), potentially predisposing to unsafe practices due to the prevalence of traditional methods learned from older family members (Nilsson [35]). Additionally, agricultural activities entail working with heavy machinery and the widespread use of plant health products and chemicals (Öz and Çakmak [39]). These activities are often carried out under challenging environmental conditions by individuals with low levels of education, which, when evaluated comprehensively, can lead to work accidents (Holte and Follo [18]). In developed countries, health and safety authorities have been observed to conduct educational and innovative campaigns addressing farm hazards (HSE [19]; HSENI [20]). However, some regulatory bodies responsible for agricultural regulations may exhibit indifference toward unsafe agricultural practices (Shortall [49]). For instance, in one of its responses to a rural planning review, the National Farmers’ Union (NFU) of the United Kingdom stated that farmers can independently act on their private properties (NFU [34]).

Moreover, in addition to playing an important role in sustainable development, the agricultural sector has more than 1 billion working individuals today, according to ILO estimates. It is believed that at least 170,000 agricultural workers lose their lives in workplace accidents annually, with 12.8% of fatal occupational accidents in the European Union being associated with agriculture (ILO [21]). Additionally, agricultural workers commonly face non-fatal serious injuries such as those caused by animals, machinery, and falls. However, the actual statistics might be higher. Research on farm injuries and illnesses also highlights data quality issues such as underreporting, non-response, and timing of data collection (Patel et al. [40]). Data deficiencies regarding agricultural production exist in Turkey. According to data from the Social Security Institution, the number of work accidents in agriculture was reported as 2 individuals in 2022 (SGK [47]), as the existing records only cover insured employees.

Upon examination of official Turkish websites, it has been determined that the informal employment rate for the year 2023 is documented in the TÜİK report titled ‘Labor Force Statistics, 1st Quarter: January-March, 2023.’ According to the table titled ‘Registration status of the employed in social security institutions’ in the report, the informal employment rate for 2023 is stated as 31% (TUIK [52]). The sector with the highest informal employment rate in Turkey is the agricultural sector, with a rate of 84.56%. A significant majority of workers engaged in agricultural activities continue to work without social security coverage. The optional nature of social security coverage for workers in the agricultural sector has contributed to their informal employment (SGK [48]).

National-level data are significantly inadequate compared to actively collected field data. The rates of agricultural work accidents exhibit considerable variability in published articles.

Different reports on work accident rates among farmers attract researchers’ attention. However, studies conducting comprehensive analyses of factors that could affect adverse working conditions and health status in the agricultural sector are limited.

For example, Yıldırım and Altuntaş discussed the contribution of safety and health policies for farmers to the regulation and prevention of agricultural injury statistics. Some studies emphasize interventions that could be undertaken to improve health in agriculture (Nag, P. K., Gite, L. P., Nag, P. K., & Gite, 2020) [33], while others focus on the adoption of occupational health and safety (OHS) practices in agriculture and the identification of agricultural risk factors based on existing records (McNamara et al. [30], [31]). These studies underscore the importance of occupational health and safety among farmers in the academic sphere and suggest a critical role in enhancing the quality of life for farmers and society as a whole. Through increased availability of comprehensive data, awareness in the agricultural sector will rise, professional risks will be better understood, and consequently, higher-quality working lives can be provided for this relatively overlooked segment of society. With the belief that further research may be necessary in this field, we conducted a survey on farmers working in a city in the Central Anatolia region of Turkey. In this study, which encompasses individual reports from participants, our aim was not only to contribute to current work accident statistics but also to assess the impact of occupational and demographic factors on work accidents.

Materials and methods

Study design

This research adopts a cross-sectional design.

Population and sample

The population of this study consists of farmers affiliated with the Yozgat Chamber of Agriculture. The sample size was determined using the known population formula. The population comprises 6,975 individuals, and the calculated sample size according to this formula is 366 (n = 366). The calculation was made assuming the parameters p: 0.50, α: 0.05 and d: 0.05. In case of missing data in records, the relevant record was excluded from the scope. Other exclusion criteria included inconsistent records and communication difficulties.

Dependent and independent variables

Age, marital status, occupational title, educational status, years of working in the profession, vocational training, daily working hours, weekly working hours, number of breaks, pesticide usage, means of transportation to the workplace, visitation by healthcare personnel in the last year, subjective health status were determined as independent variables, while experiencing a work accident in the last year was used as the dependent variable.

Data collection method

The data was collected by face-to-face interview technique conducted by the researchers between May and August 2023. The average time for completing a survey was approximately 15 minutes. Written and verbal consent for participation in the study was obtained from individuals in coffeehouses, homes, and gardens after obtaining approval for participation in the rural areas. The questions prepared by researchers included questions related to age, marital status, occupational title, educational status, years of working in the agricultural sector, daily working hours (in hours), weekly working hours (in days), pesticide usage, means of transportation to the workplace, experience of work accidents in the last year, time period of the accident, season of the accident, pesticide shortage during the accident, injured body part during the accident, perception of health status, visitation by healthcare personnel in the last year, alternative medicine usage, perception of adequate utilization of healthcare services, and time taken to reach healthcare facilities. The questions were developed based on a review of the literature by the researchers. To enhance comprehensibility, feedback was obtained from three experts, and a pre-survey was conducted with a group of 20 farmers to revise the questions (Supp 1. Survey).

Data analysis

Data were analyzed using the SPSS 26.0 package program. Descriptive statistics, including numbers and percentages, were used to summarize the characteristics of the study participants. To compare the characteristics of participants with the occurrence of work accidents in the last year, the Pearson chi-square test was initially applied as a univariate analysis. Binary logistic regression analysis was used to predict the relationship between variables and the occurrence of work accidents in the last year. In the logistic regression analysis, those who did not experience a work accident in the last year were coded as the reference category (Code=0). Variables included in the model were coded with "0" to form reference categories, such as being an employer, having less than 5 years of occupational experience, being in the 18-25 age group, being unmarried, not receiving vocational training, working less than 5 days per week, working 0-8 hours per day, completing work with one break per day, not taking any measures regarding occupational health and safety, using private transportation to the workplace, not using personal protective equipment while working, and assessing individual health status as poor. Variables that exhibited significant differences (p<0.05) in the chi-square analyses were selected as potential risk factors for the occurrence of work accidents in the last year. The effect sizes of risk factors were measured using odds ratios (OR) with a 95% confidence interval (CI). The results of the Hoshmer-Lemeshow test were found to be X2=5856, sigma=0.663.

Evaluation techniques

Statistical analyses resulting in p<0.05 were considered significant, using both univariate and multivariate statistical methods.

Process and facilities

The data of this study were collected after obtaining official permissions for data collection from the Yozgat Chamber of Agriculture, the governorship and the university ethics committee. The findings obtained from the data are based on the statements declared by the farmers participating in the study. Because there are no records of agricultural workers without insurance in Turkey. In addition, for employees with insurance records, non-fatal work accident records are not available in official institutions. For this reason, the results we obtained were limited to the information that individuals remembered and declared within the scope of the research.

Results

36.3% of the farmers participating in the study were in the 26–35 age group, 73.3% were married, 77.5% were workers and 39.0% were secondary school graduates (Table 1.). In this study, it was found that the rates of farmers working in the agricultural sector for less than 5 years and those working for 5 years or more were equal. 62.3% of the participants indicated that they received agricultural vocational training. The percentage of those working more than 8 h per day was 42.3%, while the percentage of those working more than 5 days per week was 46.0%, and the daily number of breaks was determined to be 2 with the highest percentage of 54.0%. While 66.5% of the farmers reported using Personal Protective Equipment (PPE), those who reached the working area by truck/van/tractor were predominant at 55.8%. The rate of experiencing occupational accidents in the last year was reported as 33.0% (Table 2).

Table 1.

Sociodemographic Findings of Farmers

Sociodemographic characteristics		Number (n)	Percentage (%)
Age	18–25	42	10,5
	26–35	145	36,3
	36–45	127	31,8
	45+	86	21,5
Marital status	Single	107	26,7
	Married	293	73,3
Professional title	Employer	90	22,5
	Worker	310	77,5
Education status	Not educated	7	1,8
	Primary school graduate	90	22,5
	Secondary school graduate	156	39,0
	High school graduate	94	23,5
	High school graduate	53	13,3
TOTAL		400	100,0

Table 2.

Findings on Working conditions and Safety habits of farmers

Findings on working conditions and safety perceptions		Number (n)	Percentage (%)
Years of experience in the profession	Less than 5 years	200	50,0
	5 years and above	200	50,0
Vocational training	No	249	62,3
	Yes	151	37,8
Daily working time (hours)	0–8	231	57,8
	More than 8 h	169	42,3
Weekly working time (days)	Less than 5 days	216	54,0
	5 days and more	184	46,0
Number of breaks per day	1,00	114	28,5
	2,00	208	52,0
	3,00	78	19,5
PPE use case	No	134	33,5
	Yes	266	66,5
Mode of transportation to the work area	Special vehicle	118	29,5
	Truck/van/tractor	223	55,8
	Bus/ minibus	59	14,8
Accident at work	No	268	67,0
	Yes	132	33,0
TOTAL		400	100,0

Farmers who experienced occupational accidents had these accidents occur during the shift at a rate of 28.8%, and at the beginning of the shift at a rate of 22.7%. Accidents occurred in the fall at a rate of 34.8%, and factors considered by farmers as the cause of the accident were related to transportation/traffic at a rate of 36.4%. Participants associated their workplace accidents with lack of Personal Protective Equipment (PPE) usage at a rate of 51.5%. The injured areas as a result of the accidents were determined to be foot/leg (45.5%), head (22.7%), and hand/arm (31.8%) (Table 3).

Table 3.

Findings on the Accident experienced by Farmers with work accidents (n = 132)

Findings of the experienced work accident		Number (n)	Percentage (%)
The time period in which the accident occurred	Shift head	30	22,7
	Morning	13	9,8
	Mid-shift	38	28,8
	Midday	26	19,7
	End of shift	16	12,1
	Evening	9	6,8
The season in which the accident occurred	Spring	38	28,8
	Summer	42	31,8
	Autumn	46	34,8
	Winter	6	4,5
Factors that caused the accident	Machine-power tool	31	23,5
	Small hand tools	23	17,4
	Chemicals	30	22,7
	Transport-transport vehicles/traffic	48	36,4
Lack of PPE in the accident	No	64	48,5
	Yes	68	51,5
Accidental injured area	Foot and Leg	60	45,5
	Head	30	22,7
	Hand/arm	42	31,8
TOTAL		132	100,0

Of the farmers participating in the research, 27.5% subjectively interpreted their health condition as poor. According to the participants, the rate of being visited by any healthcare personnel in the last year was 48.0%, and the rate of resorting to alternative medicine in case of illness or accident that could affect health was 60.0%. Those who believed they had sufficient access to healthcare services were 58.0%, while those who believed they did not have sufficient access were reported as 42.0%. 44.5% of the farmers stated that the time to reach healthcare facilities was approximately less than 30 min, 37.3% between 30 and 59 min, and 18.2% more than 60 min (Table 4).

Table 4.

Farmers’ attitudes and needs towards Health services

Attitudes and Needs Towards Health Services		Number (n)	Percent (%)
Health status	Bad	110	27,5
	Good	290	72,5
Visit by healthcare personnel in the last year	No	208	52,0
	Yes	192	48,0
Use of alternative medicine	No	164	40,0
	Yes	236	60,0
Perception of sufficient benefit from healthcare services	No	168	42,0
	Yes	232	58,0
Time to reach healthcare facility	Less than 30 min	178	44,5
	30–59 min	149	37,3
	60 min and above	73	18,2
TOTAL		400	100,0

According to the descriptive characteristics of the farmers, whether they had a work accident in the last year; 54.7% of those aged 45 and over, 35.8% of those who are married, 52.2% of those working as employers, 71.4% of those without education, 42% of those working in this sector for more than five years, 44.0% of those with vocational training, 46.7% of those working more than eight hours a day, 46.7% of those working more than five days a week. 45.7%, 46.2% among those who take three breaks a day, 36.5% among those using PPE, 55.9% among those who go to work by bus/minibus, 36.5% among those who have been visited on-site by any healthcare personnel in the last year, 40.9% among those who evaluate their general health status as poor, and the groups The difference between them was statistically significant (p < 0.05) (Table 5).

Table 5.

Distribution of occupational accidents in the last year according to the descriptive characteristics of farmers

Descriptive Variables		Incident of work-related accident within the last year			X2	P
		No	Yes	Total
		N (%)	N (%)	N (%)
Age	18–25	33 (78,6)	9(21,4)	42 (100)	25,957	0,00
	26–35	110(75,9)	35(24,1)	145(100)
	36–45	86(67,7)	41(32,3)	127(100)
	45+	39(45,3)	47(54,7)	86 (100)
Marital status	Single	80 (74,8)	27(25,2)	107(100)	3,985	0,04
	Married	188(64,2)	105(35,8)	293(100)
Position	Employer	43 (47,8)	47(52,2)	90(100)	19,407	0,00
	Worker	225(72,6)	85(27,4)	310(100)
Educational status	Did not receive education	2(28,6)	5(71,4)	7(100)	14,636	0,00
	Primary school	54(60,0)	36(40,0)	90(100)
	Middle school	114(73,1)	42(26,9)	156(100)
	High school	69 (73,4)	25(26,6)	94(100)
	Vocational school	29 (54,7)	24(45,3)	53(100)
Years of experience in the profession	Less than 5 years	152(76,0)	48(24,0)	200(100)	14,654	0,00
	5 years and more	116(58,0)	84(42,0)	200(100)
Vocational training	No	184(73,9)	65(26,1)	249(100)	14,185	0,00
	Yes	84 (55,6)	67(44,4)	151(100)
Daily working hours	0–8 h	178(77,1)	53(22,9)	231(100)	25,008	0,00
	8+	90 (53,3)	79(46,7)	169(100)
Weekly working hours	Less than 5 days	168(77,8)	48(22,2)	216(100)	24,670	0,00
	5 days and above	100 (54,3)	84(45,7)	184(100)
Number of breaks	1	83(72,8)	31(27,2)	114(100)	8,131	0,01
	2	143(68,8)	65(31,2)	208(100)
	3	42(53,8)	36(46,2)	78(100)
Use of personal protective equipment (PPE)	No	99(73,9)	35(26,1)	134(100)	4,315	0,03
	Yes	169(63,5)	97(36,5)	266(100)
Transportation to workplace	Personal vehicle	89(75,4)	29(24,6)	118(100)	18,082	0,00
	Truck/ Tractor	153(68,6)	70(31,4)	223(100)
	Bus/ Minibus	26(44,1)	33(55,9)	59 (100)
Visit by healthcare personnel	No	146(70,2)	62 (29,8)	208(100)	1,997	0,15
	Yes	122(63,5)	70 (36,5)	192(100)
Health status	Bad	65(59,1)	45(40,9)	110(100)	4,293	0,03
	Good	203(70,0)	87(30,0)	290(100)

In the binary logistic regression analysis conducted, working more than 8 h daily increases the likelihood of experiencing a work accident by 1.8 times compared to those working fewer hours, working 5 days or more per week increases the likelihood by 1.7 times compared to those working fewer days per week, and using a bus/minibus for transportation increases the likelihood by 2.6 times compared to other means of transportation, while perceiving one’s health condition as good reduces the likelihood by 0.3 times compared to those interpreting it as poor (Table 6.).

Table 6.

Investigation of the factors affecting the Occupational Accident in Farmers by Binary Logistic Regression Analysis

Variables in the Equation
aVariables in the Equation	B	S.E.	Wald	df	Sig.	Exp (B)	95% C.I.for EXP(B)
							Lower	Upper
Position Employer (Reference)
Position (Worker)	-,558	,300	3,459	1	,063	,572	,318	1,031
Age (18–25)
Age (26–35)	,037	,464	,006	1	,937	1,037	,418	2,575
Age (36–45)	,028	,480	,003	1	,954	1,028	,401	2,635
Age (45 and above)	,857	,498	2,954	1	,086	2,356	,887	6,257
Vocational Education (No) (Reference)
Vocational Education (Received)	,532	,279	3,638	1	,056	1,703	,985	2,941
Daily Working Hours (0–8 h) (Reference)
Daily Working Hours (Over 8 h)	,635	,274	5,365	1	,021	1,888	1,103	3,232
Weekly Working Hours (Less than 5 days) (Reference)
Weekly Working Hours (5 days and above)	,586	,281	4,350	1	,037	1,797	1,036	3,118
Transportation (Personal vehicle) (Reference)
Transportation (Truck/Van/Tractor)	,176	,286	,378	1	,539	1,192	,681	2,087
Transportation (Bus/Minibus)	,976	,404	5,821	1	,016	2,654	1,201	5,863
Health Status (Bad) (Reference)
Health Status (Good)	-1,080	,276	15,337	1	,000	,340	,198	,583
Constant	-,824	,603	1,863	1	,172	,439

^aVariable(s): Position, Years in Agriculture, Age, Marital Status, Vocational Education, Daily Working Hours, Weekly Working Hours, Daily Break Count, Transportation Method to Workplace, PPE Usage, Health Status

The sensitivity of the model was 42.4%, specificity was 87.3%, and the percentage of explained total variance was 24.8% (Cox & Snell R square = 0.178, Nagelkerke R square = 0.248).

Discussion

This study examined the occupational health and safety measures, working conditions, health issues, and experience of work accidents among farmers settled in villages affiliated with the Yozgat province center.

Descriptive characteristics of farmers

The agricultural sector typically employs individuals with lower levels of education, averaging around 8 years (Doğan et al. [11]; Everest et al. [14]; Gelaye et al. [15]; Kızılaslan et al., [27]; Kucaba et al. [28]). There is a strong correlation between education level and both productivity and occupational safety in the agricultural sector (Cecchini et al. [8]; Güğerçin and Baytorun [17]). A skilled workforce can better implement modern farming techniques and transition towards sustainable agricultural practices.

Vocational training for farmers encompasses various policies and practices at the international level, with significant differences observed among countries (Holte and Follo [18]; Jakob et al. [23]; Karttunen and Rautiainen [24]; Ryan et al. [44]). In Turkey, the education levels and rates of training among farmers show considerable variations across regions and provinces (Akpınar and Özyıldırım [2]; Yeşiltepe et al. [58]). International studies demonstrate significant disparities in the rates of vocational training among farmers across countries and regions (Molineri et al. [32]; Tougeron et al. [51]). Consequently, further research and policy development efforts are needed to enhance the effectiveness of vocational training for farmers.

Agricultural workers constitute a disadvantaged occupational group due to their need to contend with education, health, and social issues alongside long working hours. Numerous studies have shown that extended working hours in the agricultural sector lead to problems, with significant adverse health effects, particularly noted among Western countries (Burger [6]; Virtanen et al. [56]). According to the Organisation for Economic Co-operation and Development (OECD) report of 2017, Turkey ranks among the countries with the longest working hours (OECD [36]). Findings from this study are consistent with research conducted in provinces such as Niğde and Adana, indicating excessively long daily working hours (Doğan et al. [11]; Okyay et al. [37]).

The use of PPE in the agricultural sector varies significantly according to geographical regions and countries. Studies have revealed PPE usage rates ranging from 20 to 25% in countries such as Greece, Poland, and Nigeria, whereas research conducted in Ankara reported rates of 98.8% and in Adana, 83.2% (Keskin [25]; Kucaba et al. [28]; Okyay et al. [37]; Olowogbon et al. [38]). The disparities in the usage rates, which stood at 66.5% in this study, may be attributed to economic factors, educational levels, agricultural policies, and environmental factors. In this study, as found in some cross-sectional studies conducted in Turkey, the rate of PPE usage among agricultural workers was high. From one perspective, this may be due to the workers providing false statements out of fear that the research results could lead to penal sanctions. From another perspective, it can be associated with the increasing awareness and demand of consumers regarding how the food they consume is produced. During the marketing process, the use of PPE by producers can create the perception of responsible and sustainable farming practices, thereby increasing consumer trust. Although there are significant gaps in knowledge about the correct use of PPE in Turkey, procuring these materials is not difficult. Considering that our study mainly consisted of farmers working in established positions and affiliated with the agricultural chamber, it is conceivable that farmer organizations and the media may have had positive contributions.

Occupational accidents and injuries in the agricultural sector hold significant importance in terms of health and safety, with notable differences observed among countries (Bahşi and Kendi [4]; Keskin [25]; Molineri et al. [32]; Rostamabadi et al. [43]). For instance, while the accident rate in Ankara was determined to be 14.7%, it was reported as 43.2% in Osmaniye and Konya (Bahşi and Kendi [4]; Keskin [25]). Additionally, farm-related injury rates vary across different countries, with figures such as 43.6% in Argentina and 42.7% in Iran (Molineri et al. [32]; Rostamabadi et al. [43]). Therefore, international collaboration and knowledge sharing in occupational health and safety are crucial for preventing accidents and injuries in the agricultural sector (Sexsmith et al. [45]).

Descriptive findings of farmers who experienced work accidents

The distribution of occupational accidents in the agricultural sector according to time periods is an important measure for evaluating working conditions and safety policies. A study in Turkey revealed that 30% of agricultural work accidents occur during lunchtime (Baydaş and Altuntaş [5]). According to 2021 data, the majority of accidents in the Agriculture, Forestry, and Fishing sector happen between 11:00–11:59 (SGK [46]). Our finding suggests that lunchtime poses a significant risk, indicating the need for additional precautions during these hours.

Occupational accidents in the agricultural sector are influenced by seasons, as it involves outdoor and hazardous activities susceptible to climate and weather conditions. The high incidence of agricultural accidents during the autumn season observed in this study is likely due to the regional harvesting of crops during this period. A similar study conducted in Minnesota also demonstrated a peak in farm accidents during the autumn season (Landsteiner et al. [29]).

The causes of accidents are emphasized in determining occupational health and safety policies in the agricultural sector. According to data from 2021, especially in the agricultural sector, accidents such as falls, machinery-related incidents, and collisions stand out (SGK [46]). In Turkey, accidents caused by motorized systems in inland areas are significant (Alçayır and Hacıseferoğulları [3]; Baydaş and Altuntaş [5]). Countries like Iran, Poland, and Argentina have more accidents related to the use of agricultural hand tools (Kica and Rosenman [26]; Kucaba et al. [28]; Molineri et al. [32]; Rostamabadi et al. [43]). Traffic accidents and agricultural transportation are also significant issues frequently encountered in Ankara and Poland (Keskin [25]; Rorat et al. [42]). Regional and climatic factors, farmers’ agricultural knowledge, technology usage, and legal regulations are among the reasons for these differences.

Workers in the agricultural sector are often exposed to heavy and physically demanding tasks, increasing the risk of injuries to their lower extremities as farmers typically engage in activities such as standing, walking, and carrying heavy loads. Studies conducted in Michigan, Switzerland, Iran, and a southern province of our country have highlighted the high risk of lower extremity injuries (Kica and Rosenman [26]; Okyay et al. [37]; Rostamabadi et al. [43]). The frequent occurrence of foot and leg injuries in this research can be attributed to encountering different ground conditions in agricultural fields, including uneven terrain, slippery surfaces, and sharp objects.

Health issues pose a significant concern for workers in the agricultural sector, significantly impacting their quality of life and work productivity. For instance, musculoskeletal disorders are reported more frequently in Finland, while skin disorders are more common in European countries (Karttunen and Rautiainen [24]; Ulrich et al. [54]). Moreover, recent studies indicate a high prevalence of respiratory disorders in the agricultural sector, with digestive and respiratory ailments being among the most common diagnoses in our country (Işıktekin Atalay et al. [22]; Jakob et al. [23]). Similarly, our findings underscore the importance of addressing health risks among agricultural workers and establishing appropriate health policies.

When examining the utilization of health services in the event of health problems or accidents among agricultural workers, the rate of benefitting from healthcare services obtained from this research is similar to that of agricultural farmers nationwide, ranging between 60 and 70%. Consistent with the literature, the most common reasons for inadequate utilization of health services among agricultural workers are often cited as neglecting health problems, lack of time, and difficulty accessing healthcare facilities (Erbörü [12]; Işıktekin Atalay et al. [22]; Keskin [25]; Şimşek [50]). Additionally, our research found that the rate of alternative medicine usage among farmers is 60%, suggesting that besides medical treatment, farmers prefer alternative medicine practices for addressing health issues.                 

Changes in the occurrence of work accidents based on certain variables

According to the Social Security Institution data in Turkey, the most common age range for occupational accidents in the agricultural, fishing, and forestry sectors is reported to be 21–30 years old (SGK [46]). The research findings indicate an increase in the rate of occupational accidents with age, particularly a significant rise observed in those aged over 45; this suggests that older workers may be more prone to accidents in tasks requiring rapid manual dexterity compared to younger individuals (Camkurt [7]).

Studies in the agricultural sector demonstrate that occupational accidents are influenced by various factors, and marital status is one of them. Consistent with our results, the impact of marital status on occupational accidents in the agricultural sector has been examined, indicating that marriage may increase accidents due to workers dealing with family issues or health problems (Camkurt [7]).

Although employers are responsible for managing business operations, they may face higher risks of experiencing occupational accidents compared to other employees. Studies conducted in Argentina and the USA show that employers have higher rates of experiencing occupational accidents (Kica and Rosenman [26]; Molineri et al. [32]). Similarly, this study found that employers’ rates of experiencing occupational accidents were approximately twice as high as those of workers. Employers’ focus on production profitability may lead to insufficient attention to safety measures.

Research on the impact of education levels on occupational accidents in the agricultural sector is crucial, with education levels being proposed to play a decisive role in occupational accidents (Baydaş and Altuntaş [5]). In a study conducted on seasonal agricultural workers, it was found that accidents related to agricultural tools decreased as the education level increased (Alçayır and Hacıseferoğulları [3]; Keskin [25]). This study found that illiterate farmers were most involved in occupational accidents, followed by graduates, highlighting the high rates of occupational accidents among those with higher education levels.

Research on the causes of occupational accidents has evaluated the relationship between work experience and occupational accidents. Several studies have found higher rates of occupational accidents in the initial years of work (Akpınar and Özyıldırım [2]; Camkurt [7]; Celik et al. [9]; Chaou et al. [10]; Doğan et al. [11]Gonültaş et al., [16]). In this study, it was found that longer work experience increased the likelihood of experiencing occupational accidents; this may be attributed to sectoral dynamics or changes in occupational safety measures and legal regulations over time.

Education is a significant factor in modernizing agricultural practices. A study conducted in Turkey, found that knowledge and attitudes regarding occupational health and safety were not associated with occupational accidents in agriculture (Akkuş [1]). However, studies have shown that more than half of the workers receiving agricultural education in Turkey inner and southern regions have experienced occupational accidents (Bahşi and Kendi [4]). This study found that the rate of occupational accidents among those receiving vocational agricultural education was approximately twice as high as those who did not. Therefore, improving the effectiveness of agricultural training for workers and increasing awareness of occupational health and safety is essential.

Excessive working hours may increase the risk of occupational accidents in the agricultural sector and adversely affect workers’ health (Wong et al. [57]). A study conducted in Alberta found that agricultural work lasted at least 12 h per day and was extremely exhausting (Reid-Musson et al., [41]). A study in Polatlı, Ankara, indicated that seasonal agricultural workers did not have sufficient rest time, with a total daily rest period of approximately 2 h (Keskin [25]). These findings underscore the importance of working hours and rest periods for health and safety in the agricultural sector.

Occupational accidents in agriculture arise from hazards such as the use of cutting and piercing tools, exposure to chemicals, and working with agricultural machinery. The use of protective equipment is essential for reducing these hazards; however, this study found high rates of occupational accidents among workers using protective equipment, emphasizing the need for a comprehensive approach to occupational health and safety (Güğerçin and Baytorun [17]).

Research indicates that the risk of traffic accidents during the transportation of agricultural workers increases, especially on intercity roads and secondary roads between fields (Akpınar and Özyıldırım [2]). Although the tradition of transporting workers by trucks has decreased, it is stated that tractors and pickups are preferred in villages, while Ford Transit minibusses are preferred on intercity roads (Yıldırım [59]). This study found that those commuting to work by bus/minibus experienced the highest rate of occupational accidents, followed by those using pickups/tractors, while the lowest rate was observed among those using private vehicles. Therefore, increasing workers’ awareness of traffic safety is important.

Health problems associated with working conditions in agriculture may be related to work accidents. It is suggested that farmers’ health conditions can affect their job performance and expose them to accidents (Uehli et al. [53]; Üner and Yılmaz [55]; Yeşiltepe et al. [58]). In this study, it was observed that the rate of work accidents is higher among farmers who perceive their general health as poor and have been visited by a healthcare professional within the last year. This could be explained by factors such as the effects of health problems and medications, leading to lack of attention, shortened reaction times, and increased drowsiness.

Authors’ contributions

SY and ME. The research’s planning, implementation, conducting ethical permits, conducting surveys, statistical analysis, writing, and reviewing. All have read and approved the final version of the manuscript.

Funding

No financial support was received from any person or institution for the research.

Availability of data and materials

The datasets generated and/or analyzed during the current study are not publicly available due to limitations of ethical approval involving the participants’ data and anonymity but are available from the corresponding author on reasonable request.

Declarations

Ethics approval and consent to participate

The approval of the ethics committee of the study was obtained with the decision of the Yozgat Bozok University Ethics Committee numbered 36/15, dated 21/09/2022. Institutional permission for the study was obtained from the Yozgat Governor’s Office. Only participants who gave proper oral and written informed consent are included in our study. During the investigation, if the respondents feel any discomfort, they can withdraw from the investigation at any time without any penalty. The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2013. It was observed by the ethics committee of Yozgat Bozok University that informed consent was obtained from the participants and that the study was conducted in accordance with ethical guidelines.

Consent for publication

Not Applicable.

Competing interests

The authors declare no competing interests.