Flora silvestre (tejido vegetal)

The targeted search strategy described above returned a diverse range of studies - many of which were not relevant in this context. Hence, it was not possible to use the same approach as described for

Sections 2.1 and 2.2 above. The majority of the literature did not specifically address ERHIs associated with living in rural/agricultural areas; rather, specific issues were illuminated (e.g., pesticide exposure, mental health). Therefore, the studies best suited to providing context for the rural/agricultural setting in Queensland will be discussed.

Queensland has a long history of agriculture being a predominant part of the economy and has the largest area of agricultural land of any Australian state (Queensland Government, 2013g). Within the agricultural industry, grazing has been one of the major domains (Queensland Government, 2013h). The rural/agricultural setting centres around the South-West region of Queensland, where cattle and sheep grazing dominate the agricultural industry (Queensland Government, 2013h).

The South-West region of Queensland relies on a number of commodities, with cattle being the most significant industry, followed by wool and sheep (Queensland Government, 2013h). The primary land use in this region is grazing, with 96.3% of the land used for this purpose. Intensive livestock operations, which are often discussed in the context of concentrated animal feeding operations, are not typically found in the area due to land condition, water access, distances, and costs.

A number of other commodities are suited for the region, the growing of which can depend on the current market for them; these include cotton, grapes, hay, and wheat; however, the total land use for these purposes is insignificant (Queensland Government, 2013h). For these reasons, the focus of this section will be on animal husbandry and livestock production, as well as on ‘rurality’. Although all three environments present a rural setting, the rural/agricultural setting is classified as ‘very remote Australia’, while the CSG and coal mining settings are classified as ‘remote Australia’, ‘outer regional Australia’, or a mix thereof (Australian Institute of Health and Welfare, 2004b).

2.3.1 Livestock production and potential ERHIs

Due to the climate in South-West Queensland, there are relatively few pests; therefore, there is typically low chemical usage in the cattle and sheep industries (Queensland Government, 2013h). In terms of antibiotic use in food-producing animals, Australia has generally taken a conservative approach (Barton, Pratt, & Hart, 2003). Intensive livestock operations account for most antibiotic use (Barton et al., 2003) and, as previously mentioned, these operations are not widespread in the selected setting.

In general, a number of health hazards and impacts can be associated with livestock production.

These include zoonotic diseases and antibiotic resistance (Bonfoh et al., 2010), as well as risks from human pathogens such as Escherichia coli O157 (Thorn et al., 2011). Livestock production can be associated with human health hazards related to air quality, as well as with the pathogen load in the environment; however, this is often as production intensifies (Bonfoh et al., 2010).

Zoonotic diseases can be found in extensive agricultural systems, and brucellosis and anthrax are two of the more serious zoonotic diseases (Bonfoh et al., 2010). The brucellosis bacteria, Brucella, is no longer found in cattle in Australia and has never been found in sheep; however, feral pigs can be a source of infection, as can consumption of dairy products from infected animals (Queensland Health, 2010).

Anthrax is very rare in Australia (Queensland Government, 2015a).

As available land diminishes, there is a growing interaction between wildlife, livestock, and humans, which can present opportunities for disease transmission (e.g., Nipah, Hendra, SARS, Ebola) (Bonfoh et al., 2010). A study that examined pathogens in freshwater found that the greatest risk for pathogens entering freshwater is likely to be associated with intensive livestock areas; however, their survival is typically greatest in waters in low intensity (extensive) livestock areas (Thorn et al., 2011).

As previously mentioned, the rural/agricultural environmental setting is classified as ‘very remote Australia’. In areas such as this, and where extensive production systems are predominant, support services (e.g., feed supply, water sources, waste management) are often lacking due to the poor infrastructure and long distances required for travel (Bonfoh et al., 2010).

2.3.2 The rural setting

The rural setting often refers to a certain environment and social setting, along with a strong agricultural presence (Rickards, 2011). In general, residents of the region need to travel long distances for essential services, have limited access to markets and transport networks, and must deal with the

remoteness of the region in which they live (Queensland Government, 2013h). This is typical of many rural and remote regions.

A report discussing determinants of health in rural, regional, and remote areas of Australia noted that residents in regional and remote areas were more likely than residents in urban areas to: report acute or chronic injuries, drink more alcohol, be overweight or obese, and report poorer health status

(Australian Institute of Health and Welfare, 2008a). Conversely, the rates of self-reported diabetes, coronary heart disease, depression, and anxiety were similar for residents in rural and remote areas and residents in urban areas (Australian Institute of Health and Welfare, 2008a). Generally, rurality is not the cause of the rural-urban health differential that has been identified; rather, rural populations have a number of negative determinants of health such as lower income, lower health literacy, higher rates of smoking and alcohol consumption, and an increasing average age (Rickards, 2011).

Some of the areas of concern for rural and remote areas are higher mortality rates, chronic diseases (e.g., coronary heart disease, chronic obstructive pulmonary disease), cancer, injury, mental health, dental health, and infectious diseases (Phillips, 2009). Residents in rural areas have been found to have different attitudes to health and illness, as well as different health-seeking behaviours, compared to residents in urban areas (Elliot-Schmidt & Strong, 1997; Rickards, 2011). For example, rural residents often respond to illness in terms of its effect on productivity, while urban residents respond to illness in terms of discomfort caused by pain. Specific to Australia, it was noted that health outcomes do tend to be poorer outside of major metropolitan areas, with coronary heart disease, circulatory diseases, motor vehicle accidents, and chronic obstructive pulmonary disease acting as the main contributors to higher death rates (Australian Institute of Health and Welfare, 2015). Higher rates may be reflective of other differences, such as access to services and the remote environment (Australian Institute of Health and Welfare, 2015), as well as greater risk factors (Australian Institute of Health and Welfare, 2015; National Rural Health Alliance Inc, 2011).

A number of factors affect a person’s health status, including access to health services. Issues in rural areas include uneven distribution of resources (Allan, 2010), difficulties in recruiting medical professionals, retaining these professionals, and attracting government funding for healthcare delivery (Gregory, Armstrong, & Van Der Weyden, 2006). Potentially higher rates of hospitalisation can be reflective of a lack of access to primary care, in particular, of access to general practitioners in rural areas (New South Wales Health, 2010).

As noted in other sections, mental health is an important issue for community residents and, in rural areas, there are certain factors that influence a person’s response to mental health issues. It was found that residents in rural areas are often reluctant to acknowledge mental health issues; that there is a stigma around mental health problems; and rural conditions, such as economic and social circumstances and a culture of self-reliance, affect help-seeking behaviours (Fuller, Edwards, Procter, & Moss, 2000). In addition, it has been recognised that one of the problems in rural areas in relation to mental health care is providing quality, well-coordinated mental health services to this under-serviced group (Townsend, Pirkis, Pham, Harris, & Whiteford, 2006). There are also certain exposures that can contribute to higher rates of depression and other mental health-related outcomes, including exposure to certain types of pesticides and living on a farm (Beard et al., 2013; Carruth & Logan, 2002; Mackenzie Ross et al., 2010).

While this section has highlighted some issues associated with rurality, these issues may be common across all three of the environmental settings due to their geographic location. As previously noted, Australians who live in areas classified as regional or remote have poorer health than those living in major cities (Australian Institute of Health and Welfare, 2008b; National Rural Health Alliance Inc, 2011). On the other hand, the rural/agricultural setting does not generally have intensive livestock operations, which would present more ERHIs compared to the extensive livestock grazing systems that are in place in the given setting.

2.3.3 Rural/agricultural setting conclusion

The literature reviewed in Section 2.3 above showed that there is likely to be less environmentally-related health impact potential in the rural/agricultural setting compared to the primary environmental setting of CSG or the alternative setting of coal mining. The rural/agricultural setting of interest does not contain intensive livestock farming; rather, it is dominated by cattle and sheep grazing. Pesticide and antibiotic use is low and, while there are various health outcomes associated with living in rural areas, this could be applicable to the other two settings. Therefore, the rural/agricultural setting was selected as a suitable alternative environmental setting for this assessment.