Farmers risk death by not knowing what to do when experiencing chest pain

Farmers are at high risk of dying from heart attacks because they are not sure what to do when they experience chest pain, a Deakin University study has found.

In a pilot study of 186 agricultural workers in rural Victoria, Deakin medical researchers assessed the farmer's knowledge of chest pain treatment, local emergency services and their likely response to chest pain. Each participant also underwent a health assessment.

The researchers found that the majority of participants were at high risk of acute coronary events, such as angina and heart attacks, with 61 per cent of the men and 74 per cent of the women either overweight or obese. When asked to name their nearest emergency department (ED), 10 per cent nominated health services or towns where no ED existed. And 67 per cent of participants believed it was safe to travel to hospital by car while potentially having a heart attack.

"The study results provide an interesting and disturbing insight into the emergency medical care seeking behaviours of farm men and women in rural Victoria. Of concern is the pervading uncertainty of what to do if experiencing chest pain," said Dr Tim Baker, Director of Deakin's Centre for Rural Emergency Medicine.

"This group of farmers is at considerable risk of experiencing acute coronary events, yet many would make decisions about when and how to seek medical help for chest pain that are at odds with what they should be doing.

"For example, one-third would not seek help unless they thought the pain was caused by a heart attack. Furthermore, if chest pain was experienced during the night, around one in ten would wait until morning before seeking treatment.

"Many were also skeptical of calling an ambulance in an emergency, believing it is quicker and therefore safer to travel to hospital by car."

Dr Baker said that improving health literacy among farm men and women is of the utmost importance as they have higher rates of clinical risk factors and appear to be lagging in emergency knowledge and services when compared with their urban and regional counterparts.

"Farmers are generally the most remotely located and would achieve greater benefit from acting quickly in response to chest pain and other medical emergencies," Dr Baker said.

"Programs addressing behavioural barriers to accessing care and improving emergency decision making could well result in saving lives."

The results of the study, 'Farmers with acute chest pain are uncertain how and when to seek help: A pilot study', are published as an early view article in Emergency Medicine Australasia, the journal of the Australasian College for Emergency Medicine.

The study was conducted by Dr Tim Baker, from Deakin's Centre for Rural Emergency Medicine, and Scott McCombe, Cate Mercer-Grant, and Susan Brumby, from the National Centre for Farmer Health at Deakin University School of Medicine and Western District Health Service.

Deakin University's Centre for Rural Emergency Medicine (CREM) is a joint initiative between the Department of Human Services, Alcoa of Australia, Portland District Health, South West Healthcare (Warrnambool) and the Deakin Medical School.