This document outlines an approach to occupational safety and health in agriculture according to the Basic Occupational Health Services (BOHS) model. It defines agriculture and its unique features including outdoor work exposing workers to weather conditions. It then describes the BOHS model which involves risk assessment, surveillance of hazards and workers' health, preventative actions, information/education, diagnosis of diseases, and evaluation. The goal is to provide basic occupational health services tailored to local agricultural conditions and needs.

1. Occupational Safety and Health in
Agriculture- The BOHS Approach
Prepared in Public Interest
By
Indian Association of
Occupational Health
April, 2013

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DEFINATION OF AGRICULTURE
Agricultural and forestry activities carried out in agricultural
undertakings including
 Crop production, forestry activities, animal husbandry and insect
raising, the primary processing of agricultural and animal products
by or on behalf of the operator of the undertaking.
 As well as the use and maintenance of machinery, equipment,
appliances, tools, and agricultural installations, including any
process, storage, operation or transportation in an agricultural
undertaking, which are directly related to agricultural production.
REF: ILO convention no. 184

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INTRODUCTION
 An estimated 1.3 billion workers are engaged in agricultural
production worldwide. This represents half of the total world labour
force.
 Almost 60% of them are in developing countries.
 A great majority of agricultural workers are found in Asia, which is
the most densely populated region of the world, with more than
40% of the world's agricultural population concentrated in China
and more than 20% in India.

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SPECIFIC FEATURES OF AGRICULTURE
most tasks are carried out in the open air,
exposing workers to climatic conditions;
the seasonal nature of the work and the urgency
of certain tasks in specific periods;
a wide variety of tasks are performed by the same
person;
the type of working postures and the length of the
tasks performed;

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contact with animals and plants exposing workers
to bites, poisoning, infections, parasitic diseases,
allergies, toxicity and other health problems;
the use of chemicals and biological products ;
the considerable distances between living quarters
and workplaces.
SPECIFIC FEATURES OF AGRICULTURAL
WORK

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LABOUR FORCE IN AGRICULTURE
 Lack of clear-cut distinctions between different categories
of workers.
 Numerous types of labour relations and different forms of
labour force participation.

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PRINCIPLES OF BOHS
The following principles will be applied in the organization of
Basic Occupational Health Services:
 Available to all working people
 Addressing to local needs
 Adapted to local conditions
 Affordable to providers and clients
 Organized by the employer for employees
 Provided by the public sector for the self-employed and the
informal sector
 Supported by intermediate level services

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BOHS MODEL

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ORIENTATION AND PLANNING
1. Analysis of the type of production indicating the risks and
problems typical of the branch or occupation in concern.
 Agriculture involves a wide range of different types of machinery,
animals, plants and products, working in both indoor and outdoor
environments
 In India labour-intensive farming is much more common.
2. Review of problems that have been identified previously in the
company
3. Review of the characteristics of the workforce of the company
 child labour , migrant workers , seasonal, migratory and casual
labour.

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ORIENTATION AND PLANNING
4. Available data on occupational diseases and accidents
5. Data on working methods, chemical substances, etc.
6. The knowledge by employers and employees of occupational
health problems
7. Plans for changes in production systems, e.g. installation of
new facilities, machinery and equipment

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SURVEILLANCE OF THE WORK ENVIRONMENT
1. Identification and evaluation of ergonomic factors which may affect
the workers' health
Ergonomic factors affecting the health outcomes of agricultural workers
include:
 the nature of the physical work environment (noise, heat, lighting,
thermal comfort), the agricultural tasks to be performed;
 the technology applied to the prescribed tasks (including workplace
design, facility design, and agricultural material handling);
 the manner in which tasks are organized (including use of shift
work); and
 Worker characteristics (including demographics, physiology, human
error, and identification and treatment of injured workers).

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SURVEILLANCE OF THE WORK ENVIRONMENT
2. Assessment of conditions of occupational hygiene and factors,
such as physical, chemical, and biological exposures which may
generate risks to the health of workers
2. Assessment, where appropriate, of exposure of workers to adverse
psychological factors and aspects of work organization
3. Assessment of risk of occupational accidents and major hazards
4. Assessment of collective and personal protective equipment
5. Assessment of control systems designed to eliminate, prevent or
reduce exposure
6. Assessment of general hygiene and sanitary facilities

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Occupational Health Problems in Agriculture
Seasons, Unstable
loading
Physical work stress,
Accumulation of fatigue
Risk of traumatism
The overtension
diseases
Open Air work
Weather Conditions,
Dust
Over heating, Over
cooling
Dust diseases
Use of new technology
and machinery
Noise, Vibration
Hearing loss, Vibration
diseases
Pesticides, fertilisers
etc.
Chemical pollution of
environment
Sensitization, Allergic
diseases
Contact with animals
and biopreparations
Biological hazards Zoo-Anthroponoses

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Occupational Health Problems in Agriculture
Seasons,
Unstable
loading
Physical work
stress,
Accumulation of
fatigue
Risk of
traumatism
The overtension
diseases
Open Air work
Weather
Conditions,
Dust
Over heating,
Over cooling
Dust diseases
Use of new
technology and
machinery
Noise, Vibration
Hearing loss,
Vibration
diseases
Pesticides,
fertilisers etc.
Chemical
pollution of
environment
Sensitization,
Allergic
diseases
Contact with
animals and
biopreparations
Biological
hazards
Zoo-
Anthroponoses

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SURVEILLANCE OF WORKERS' HEALTH
The following types of health examinations are carried out either on
the basis of regulations or as a part of good occupational health
practice:
1. Pre-assignment (pre-employment) health examinations
2. Periodic health examinations
3. Return to work health examinations
4. General health examinations
5. Health examinations at termination or after ending of service
 A new type of health examination has recently been introduced for
assessment of work ability of ageing workers.

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SURVEILLANCE OF WORKERS' HEALTH
 In the case of exposure of workers to specific hazards, medical and
health surveillance should include, where appropriate, any
examination and investigations which may be necessary to detect
exposure levels and early effects and responses which also bear in
mind the biological difference between women and men.
 Example, in pesticide handlers.
 Pre-employment screening should ensure that those with inherently
low-level cholinesterase do not undertake work with
organophosphate or carbamate pesticides
 baseline samples, periodic samples,

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ASSESSMENT OF HEALTH AND SAFETY RISKS
A “hazard” is anything with the potential to do harm, whereas a “risk” is
the likelihood of potential harm from that hazard being realised.
 The identification of hazards in the workplace should take into
account:
(a) the situation or events or combination of circumstances that have
the potential to give rise to injury or illness;
(b) the nature of potential injury or illness relevant to the activity,
product or service;
(c) those likely to be harmed (e.g. young workers, older workers,
temporary workers, pregnant workers); and
(d) past injuries, incidents and illness.

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ASSESSMENT OF HEALTH AND SAFETY RISKS
The steps in an occupational health risk assessment include:
1. Identification of occupational health hazards (as a result of
surveillances)
Hazards Description
Mechanical
hazard
Poorly designed and/or guarded agricultural machinery is a
major cause of fatalities and accidents. Injuries from cutting
tools are another major risk.
Psycho social
hazards
low pay, sexual and other harassment, job insecurity, poor
promotion mechanisms, delay in payment of salaries.
Work
organisation
hazards
badly organised shift work and working hours, excessive
overtime, lone working, lack of control over work.
Ergonomic
hazards
These hazards can cause permanent injuries and
disablement. For example: badly designed machinery,
prolonged static working positions, repetitive work, unsuitable
tools used by workers, poor seating
Others - Physical hazards , Biological hazards, chemical hazards, environmental

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ASSESSMENT OF HEALTH AND SAFETY RISKS
2. Identification of workers or groups of workers exposed to specific
hazards for e.g. in tea plantation workers the hazards are
different for pruners, pluckers, sprayers
3. Analysis of how the hazard may affect the worker (ways of entry
and type of exposure, threshold limit values, dosage/ response
relationships, adverse health effects it may cause, etc.in case of
sprayers who are in constant contact with the pesticides)
4. Determination of intensity (level) and magnitude (volume) of risk

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ASSESSMENT OF HEALTH AND SAFETY RISKS
5. Identification of individuals and groups with special vulnerabilities,
e.g. young workers, old workers, pregnant workers, temporary workers
6. Evaluation of available hazard prevention and control measures
7. Making conclusions and recommendations for the management and
control of risks

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ASSESSMENT OF HEALTH AND SAFETY RISKS
Hierarchy of control measures for reducing risks in the work place.
A. Elimination
B. Substitution
C. Others
 technical and engineering control- enclosure, isolation,
ventilation
 Safe systems of work- changing work schedules, extending
rest periods, training and information
 Issuing Personal Protective Equipment (PPE)
8. Documenting the findings of the assessment
9. Periodic review and, if necessary, reassessment of risks

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INFORMATION AND EDUCATION ON RISKS AND
ADVICE ON THE NEED FOR PREVENTIVE AND
CONTROL ACTIONS
The information and education include the following aspects:
1. Workers in agriculture should have the right to be informed and
consulted on OSH matters including risks from new technologies;
and
2. The workers have a right to know and get continuously
information on hazards related to their own work and the
workplace.
3. The employer is responsible for training the workers on safe and
healthy work practices.

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4. The workers have a duty to follow the safety instructions and
safe and healthy work practices.
5. Confidential health information of an individual worker is subject
to special legislation and practices and to informed consent.
6. The advice provided by OHS personnel must be given in a form
which is easily understood by employers and workers.
7. Information given to various partners should be documented.
INFORMATION AND EDUCATION ON RISKS AND
ADVICE ON THE NEED FOR PREVENTIVE AND
CONTROL ACTIONS

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PREVENTIVE ACTIONS FOR THE MANAGEMENT AND
CONTROL OF HEALTH AND SAFETY HAZARDS AND
RISKS
 Control measures should be monitored and reviewed at regular
intervals and if necessary revised, especially when circumstances
change or if new information becomes available about the risks
posed or the suitability of existing control measures.
 Control measures should also be reviewed and if necessary
revised following an accident.

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The risk management actions may comprise:
• Control of hazards at the source
• Ventilation or control technology
• Dust control
• Ergonomic measures
• Use of personal protective equipment
• Regulation of thermal conditions, etc.
PREVENTIVE ACTIONS FOR THE MANAGEMENT AND
CONTROL OF HEALTH AND SAFETY HAZARDS AND
RISKS

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PREVENTION OF ACCIDENTS
1. Safe planning of facilities, machinery, etc.
 The employer should not permit the use of any unsafe or faulty
equipment.
 The employer should ensure the provision of adequate
information, instruction and training for those using equipment,
and that their skill levels are periodically evaluated.
2. Good housekeeping, order and cleanliness
 The employer should ensure that workers are clearly instructed
and supervised in good housekeeping measures that can
prevent slips, trips and falls.

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3. Making walkways and other structures safe (e.g. scaffolds,
fences)
 The employer shall ensure that: walking surfaces and stairs
inside facilities are equipped with adequate lighting; stairs and
ladders are maintained in good condition with handrails in
place; .
4. Guarding dangerous machines- by providing enclosures, safety
symbols surrounding such places.
 Unauthorized persons should not be allowed to operate
machinery. In particular, children should be kept away from all
agricultural equipment.
PREVENTION OF ACCIDENTS

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5. Technical aids for moving and lifting heavy loads
 With regard to the use and maintenance of ladders, the
employer should ensure that appropriate, well-maintained
equipment is available and is appropriate to the task at hand.
the use of mechanical means to lift or lower heavy objects; and
other practices appropriate to the task at hand.
6. Safe tools and safety equipment for workers
 Workers should use handholds when mounting and
dismounting equipment.
7. Analysis of major hazard risks and provision of "redundant
safety"
PREVENTION OF ACCIDENTS

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MAINTAINING PREPAREDNESS TO FIRST AID AND
PARTICIPATION IN EMERGENCY PREPAREDNESS
1. Providing first aid services at the workplace when appropriate
2. Introducing and training first aid practices to workers and
supervisors
3. Maintaining and periodically inspecting the first aid readiness and
facilities
4. Participating from the health point of view in emergency planning
and organizing the health elements in emergency response

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MAINTAINING PREPAREDNESS TO FIRST AID AND
PARTICIPATION IN EMERGENCY PREPAREDNESS
Emergency preparedness
Date______________
Checklist
Self-audit
Step
1
Step2 Step 3
Planning N/A Yes No Priority for
action
What action is
required
1. Does the workplace have an emergency response plan?
2. Does the workplace have established emergency escape routes and procedures?
3. Does the workplace have a trained first-aider(s)?
4. Does the workplace have basic rescue equipment and are workers trained to use
it?

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DIAGNOSIS OF OCCUPATIONAL AND WORK-
RELATED DISEASES
1. Identification of exposure which may cause the disease
2. Examination of clinical findings which are known to be associated
with the specific exposure (lists of occupational diseases)
3. Exclusion of non-occupational factors as a possible cause of
disease
4. Conclusion on existence or non-existence of occupational disease
(diagnosis)
5. Statement on occupational disease for workmen's compensation
6. Proposals for preventive actions to the workplace of the worker in
concern
7. Notification of occupational diseases to authorities

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GENERAL HEALTH CARE, CURATIVE AND
REHABILITATION SERVICES
1. Immunizations and other preventive measures
2. Participation in public health actions and programmes
3. GP-level general health services
4. Inspection and advice on canteens, sanitary facilities
5. Advice and education in general personal and community hygiene
6. Actions for rehabilitation and adjustment of work for workers after
injuries, diseases, reduced work ability and on return to work from long
sick leaves
7. General health promotion and introduction of healthy lifestyles

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RECORD KEEPING
1. General health record, if the workers are treated as patients or
health service clients
2. Data on surveyed, detected and measured occupational exposures
and risk assessments made
3. Statistics on occupational diseases and injuries
4. Data on health examinations
5. Documents on proposals for preventive and control measures

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EVALUATION
1. Evaluation is carried out as an inbuilt part of BOHS activity, at least
annually
2. Evaluation is made when the working methods, production
structures or other aspects at work are substantially changed
3. Evaluation is made if the methods or conditions of operation of
services are substantially changed

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EVALUATION
4. The following questions are answered through evaluation:
a) Do the services respond to the needs of the workplace?
b) Are the activities directed to priority problems?
c) Is good occupational health practice followed?
d) Are the resources, human and technical, sufficient?
e) Are the services effective in elimination of health problems?
f) What can be improved?

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ROVISION OF BOHS
 Primary health services model
 Big company model with in-company services
 Group services organized jointly, e.g. by several SMEs
 Social security institution as a service provider
 Private physician who has special competence in occupational
health
 Private health centre either providing occupational health services
only or occupational health as a part of its services
 Local or regional outpatient clinic of hospitals

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AIMING FOR
THIS
CHANGE

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REFERENCES
 BOHS. a response to the Joint ILO/WHO Committee on Occupational
Health priority area for ILO/WHO/ICOH collaboration, with support of the
Finnish Institute of Occupational Health (FIOH). Author: Professor Jorma
Rantanen. 3rd, revised edition, Helsinki 28 September 2007
 Safety and health in agriculture. Programme on safety, health and the
environment. Labour Protection Department. ILO.
 Code of practice on safety and health in agriculture .2010.
INTERNATIONAL LABOUR OFFICE GENEVA.
 Top on the agenda: Health and safety in agriculture. Labour Education
2000/ 1-2 Nos. 118/119. ILO
 Health, Safety and Environment: A Series of Trade Union Education
Manuals for Agricultural Workers Written by: Peter Hurst & Peter Kirby.
ILO.

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CONTRIBUTORS
 Dr. Shwetha Marali, Senior Resident, Department of Community
Health, St. John’s Medical College
 Dr. Bobby Joseph, Professor and Head, Division of Occupational
Health Services of the same Department..