RESUMEN
OBJECTIVES: Examine associations between pesticide exposure and signs or symptoms of parkinsonism. METHODS: Prior to the 2014 pesticide spray season, the authors examined 38 active pesticide handlers aged 35 to 65 (median: 43.5) who participated in the State of Washington's cholinesterase monitoring program in the Yakima Valley, where cholinesterase-inhibiting insecticides are applied in fruit orchards. A movement disorder specialist assessed the workers using the Unified Parkinson's Disease Rating Scale (UPDRS) motor subscore 3 (UPDRS3). Participants also self-reported work and medical histories, including the UPDRS activities of daily living subscore 2 (UPDRS2). The authors explored the relation between these scores and lifetime occupational pesticide exposure while accounting for age. RESULTS: All participants were Hispanic men born in Mexico who had worked in agriculture for 4 to 43 years (median: 21 years, including 11 years applying pesticides, mostly in the United States). Ten participants (26%) reported difficulty with one or more UPDRS2 activities of daily living (maximum = 2), and nine (24%) had a UPDRS3 >0 (maximum = 10). The most common symptom and sign, respectively, were excess saliva (n = 6) and action tremor (n = 5). UPDRS2 and UPDRS3 scores were unrelated to the number of years applying pesticides, but UPDRS3, especially action tremor, was positively associated with living on or by a farm. CONCLUSIONS: Symptoms and signs of parkinsonism were absent to mild in this small sample of active workers who apply cholinesterase-inhibiting insecticides in Washington State, USA. Future studies should be larger and examine older, retired workers with greater cumulative exposure to agricultural pesticides at work and home, including other types of agricultural pesticides.
Asunto(s)
Enfermedades de los Trabajadores Agrícolas/diagnóstico , Agricultura , Trastornos Parkinsonianos/diagnóstico , Plaguicidas/economía , Plaguicidas/toxicidad , Adolescente , Adulto , Anciano , Enfermedades de los Trabajadores Agrícolas/etnología , Enfermedades de los Trabajadores Agrícolas/etiología , Niño , Preescolar , Agricultores , Femenino , Humanos , Masculino , México , Persona de Mediana Edad , Exposición Profesional/efectos adversos , Trastornos Parkinsonianos/etnología , Trastornos Parkinsonianos/etiología , Washingtón/etnología , Recursos Humanos , Adulto JovenRESUMEN
OBJECTIVE: Personal protective equipment (PPE) reduces pesticide exposures, but many farmworkers complain that it is difficult to obtain. We examined if PPE provision increased usage. We also delivered motivational messaging aimed to promote PPE use. METHODS: First, we delivered a daily survey through a mobile phone app to assess PPE use. Farmworkers subsequently received a daily, individualized motivational message based on their PPE use and reported difficulties. PPE use was evaluated at baseline and at the close of the study. RESULTS: PPE behaviors improved for gloves (Pâ≤â0.01) and safety glasses (Pâ≤â0.001). Use of long-sleeved shirts, hats, and long pants were already consistently used at baseline and did not exhibit significant change. CONCLUSIONS: Our findings demonstrate that PPE provision and delivery of motivational messaging through mobile phones may increase PPE usage for farmworkers.
Asunto(s)
Enfermedades de los Trabajadores Agrícolas/prevención & control , Emigrantes e Inmigrantes , Promoción de la Salud/métodos , Americanos Mexicanos , Exposición Profesional/prevención & control , Equipo de Protección Personal/estadística & datos numéricos , Telemedicina/métodos , Adolescente , Adulto , Enfermedades de los Trabajadores Agrícolas/inducido químicamente , Enfermedades de los Trabajadores Agrícolas/etnología , Teléfono Celular , Femenino , Humanos , Masculino , Persona de Mediana Edad , Aplicaciones Móviles , Exposición Profesional/efectos adversos , Plaguicidas/toxicidad , Proyectos Piloto , Texas , Adulto JovenRESUMEN
BACKGROUND: Agriculture poses varied dangers to hired farm workers in the U.S., but little information exists on occupational risks for chronic musculoskeletal pain. We examined common work positions, such as kneeling, carrying heavy loads, and repetitive motion that may increase the risk for chronic musculoskeletal pain. METHODS: MICASA is a population-based study of occupational exposures and health in hired farm workers in California. This analysis includes 759 participants, 18-55 years old, engaged in farm work and residing in Mendota, CA. Chronic pain was defined as pain lasting 6 weeks or longer at specific body sites (back, knee, hip, etc.) over the entire farm work career. RESULTS: Mean age was 37.9 years. Sixty-five percent participants were born in Mexico, 27.7% were born in El Salvador, and 4.2% were U.S-born. Chronic pain was associated with older age and female sex. After adjustment for age, years working in agriculture, and smoking, stooping/bending >30 hr/week among both men (OR = 2.49, 95% CI: 1.03-5.99) and women (OR = 2.15, 95% CI: 1.04-4.46) was associated with chronic hip pain. Driving tractors or other heavy farm equipment >60 hr/week was associated with increased odds of chronic hip pain (OR = 2.16, 95% CI: 1.02-4.54) among men. We also observed significant associations with kneeling or crawling >35 hr/week among women for both chronic back pain (OR = 2.96, 95% CI: 1.27-6.93) and knee pain (OR = 3.02, 95% CI: 1.07-8.50), respectively. CONCLUSIONS: Chronic musculoskeletal pain is prevalent among farm workers and is associated with common work positions. Further research should focus on developing preventive interventions for tasks associated with increased pain risk. These interventions should be targeted to specific types of agricultural tasks.
Asunto(s)
Enfermedades de los Trabajadores Agrícolas/etiología , Dolor Crónico/etiología , Hispánicos o Latinos , Dolor Musculoesquelético/etiología , Adolescente , Adulto , Enfermedades de los Trabajadores Agrícolas/etnología , California/epidemiología , Dolor Crónico/etnología , Estudios Transversales , El Salvador/etnología , Femenino , Humanos , Entrevistas como Asunto , Modelos Logísticos , Masculino , México/etnología , Persona de Mediana Edad , Dolor Musculoesquelético/etnología , Postura , Prevalencia , Estudios Prospectivos , Factores de Riesgo , Encuestas y Cuestionarios , Adulto JovenRESUMEN
OBJECTIVE: Musculoskeletal injuries are recognized as an important health issue for farmworkers. This study aimed to assess musculoskeletal health in South Georgia farmworkers through an exploration of pain status, health beliefs, occupational tasks, work conditions, access to care, and demographics. PARTICIPANTS: Interviews were conducted with 83 farmworkers at pro bono medical clinics. METHODS: Mixed methods interview topics, based upon an adapted theoretical model, included: work history, current work practices, musculoskeletal symptoms, health beliefs, acculturation, general health, access to care, and demographics. RESULTS: Pain was reported by 81.9% of participants. The low back (57.4%) and mid back (52.9%) were the most commonly reported sites of pain. Adapted model constructs were identified quantitatively and qualitatively. Open-ended responses described health beliefs, barriers to accessing care, and farmworkers' sense of responsibility to provide for their families. CONCLUSIONS: Data revealed that musculoskeletal pain is common and suggest associations with work tasks and conditions. Numerous barriers to accessing care exist and must be considered. Solutions may include farm-based prevention, enhanced education, improved measurement tools, and ongoing use of ecological models to guide research and interventions.
Asunto(s)
Enfermedades de los Trabajadores Agrícolas/etnología , Actitud Frente a la Salud , Enfermedades Musculoesqueléticas/etnología , Salud Laboral , Dolor/etnología , Migrantes/estadística & datos numéricos , Aculturación , Adolescente , Adulto , Enfermedades de los Trabajadores Agrícolas/prevención & control , Estudios Transversales , Femenino , Georgia/epidemiología , Accesibilidad a los Servicios de Salud , Estado de Salud , Encuestas Epidemiológicas , Humanos , Entrevistas como Asunto , Masculino , México/etnología , Persona de Mediana Edad , Modelos Teóricos , Enfermedades Musculoesqueléticas/prevención & control , Dolor/etiología , Estaciones del Año , Factores Socioeconómicos , Encuestas y Cuestionarios , Adulto JovenRESUMEN
The U.S. migrant and seasonal farmworker (MSFW) workforce is aging. Aging causes functional changes that can affect work performance and increase injury/accident risk. It also has been linked with deferred health-seeking. The exploratory study was conducted to investigate occupational injuries and health-seeking in Hispanic MSFW on the U.S.-Mexico border. Data were collected using an abbreviated Spanish-version of the California Agricultural Worker Health Survey. Nearly 60% of the 141 participants were middle-aged or older. Musculoskeletal injuries and those consistent with agrochemical and environmental exposures were common. Farmworkers aged >40 years were 2.5-5 times more likely than younger MSFW to report persistent single and multiple injuries involving the knees, shoulder, feet, and hands. Except for neck and back injuries, few received any medical treatment. Although many self-treated with traditional home remedies, few used CAM practitioners. The study findings highlight the multiple workplace health and health-seeking challenges faced by aging immigrant MSFW.
Asunto(s)
Enfermedades de los Trabajadores Agrícolas/etnología , Traumatismos Ocupacionales/etnología , Aceptación de la Atención de Salud/etnología , Migrantes/estadística & datos numéricos , Adolescente , Adulto , Distribución por Edad , Anciano , Envejecimiento , Enfermedades de los Trabajadores Agrícolas/etiología , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , México/etnología , Persona de Mediana Edad , Traumatismos Ocupacionales/etiología , Aceptación de la Atención de Salud/estadística & datos numéricos , Dinámica Poblacional , Sudoeste de Estados Unidos/epidemiología , Adulto JovenAsunto(s)
Emigración e Inmigración , Estado de Salud , Migrantes/estadística & datos numéricos , Enfermedades de los Trabajadores Agrícolas/etnología , Canadá , Femenino , Accesibilidad a los Servicios de Salud , Humanos , Masculino , México/etnología , Enfermedades Profesionales/etnología , Filipinas/etnología , Factores de Riesgo , Estados Unidos/etnología , Poblaciones VulnerablesRESUMEN
This article examines nerves among participants in the Canada/Mexico Seasonal Agricultural Workers Program (C/MSAWP). Based on in-depth interviews with 30 Mexican farm workers in southwestern Ontario, we demonstrate that nerves embodies the distress of economic need, relative powerlessness, and the contradictions inherent in the C/MSAWP that result in various life's lesions. We also explore their use of the nerves idiom as an embodied metaphor for their awareness of the breakdown in self/society relations and, in certain cases, of the lack of control over even themselves. This article contributes to that body of literature that locates nerves at the "normal" end of the "normal/abnormal" continuum of popular illness categories because, despite the similarities in symptoms of nerves among Mexican farm workers and those of anxiety and/or mood disorders, medicalization has not occurred. If nerves has not been medicalized among Mexican farm workers, neither has it given rise to resistance to their relative powerlessness as migrant farm workers. Nonetheless, nerves does serve as an effective vehicle for expressing their distress within the context of the C/MSAWP.
Asunto(s)
Enfermedades de los Trabajadores Agrícolas/etnología , Enfermedades de los Trabajadores Agrícolas/psicología , Estrés Psicológico/etnología , Estrés Psicológico/psicología , Migrantes/psicología , Adulto , Agricultura , Canadá/epidemiología , Características Culturales , Emociones , Femenino , Humanos , Control Interno-Externo , Entrevistas como Asunto , Lenguaje , Masculino , México/etnología , Persona de Mediana Edad , Ontario/epidemiología , Poder Psicológico , Estaciones del Año , Medio Social , Lugar de Trabajo/psicología , Adulto JovenAsunto(s)
Enfermedades de los Trabajadores Agrícolas/epidemiología , Enfermedades de los Trabajadores Agrícolas/prevención & control , Necesidades y Demandas de Servicios de Salud , Migrantes , Enfermedades de los Trabajadores Agrícolas/etnología , Guatemala/etnología , Humanos , México/etnología , Estados Unidos/epidemiologíaRESUMEN
Despite federal regulations, farmworkers often lack access to basic information about pesticides applied at their worksites. Focus groups revealed that farmworkers have developed an extensive body of lay knowledge, based on personal perceptions, about pesticides and pesticide exposure including means of pesticide exposure, means of pesticide entry into the body, and the potential health effects of pesticide exposure. We describe how this lay knowledge, when combined with technical information that is required to be provided to workers by law, provides valuable data to consider before developing and implementing health interventions designed to reduce the adverse health effects of pesticide exposure.
Asunto(s)
Enfermedades de los Trabajadores Agrícolas/inducido químicamente , Conocimientos, Actitudes y Práctica en Salud , Hispánicos o Latinos/educación , Exposición Profesional/prevención & control , Plaguicidas/toxicidad , Factores de Edad , Enfermedades de los Trabajadores Agrícolas/etnología , Enfermedades de los Trabajadores Agrícolas/prevención & control , Composición Familiar , Femenino , Florida , Grupos Focales , Haití/etnología , Humanos , Masculino , México/etnología , Exposición Profesional/efectos adversosRESUMEN
Human life history is distinguished by long lifespan, delayed reproduction, intergenerational asymmetric benefit transfers from adults to juveniles and between adults, and a large brain able to engage in unprecedented levels of learning, reasoning, and insight. The evolution of these traits depends on relatively low human mortality. Understanding why humans have low mortality is therefore critical for understanding the evolution of key human traits. One explanation is that the evolution of food provisioning during periods of health crisis reduced mortality. This hypothesis turns on health risk having posed a significant adaptive problem that could be effectively buffered by healthcare provisioning. Unfortunately, the frequency, duration, and fitness effects of temporary disability are difficult to estimate based on osteological evidence alone, and systematic ethno-biological research on these issues among extant small-scale societies with little access to Western medical care is lacking. Here I present data on 678 injuries and illnesses suffered by 40 Shiwiar forager-horticulturalists, based on physical evidence and informant reports. A subsample of 17 individuals provided data on incidence and duration of disability for 215 pathological incidents. Results indicate that injury and illness occur frequently across the lifespan. Most living individuals have suffered temporarily disabling health crises likely to have been lethal without provisioning. The fitness effects of surviving these episodes are high, suggesting that the Shiwiar population structure and lifeway are dependent on infrequent extended provisioning to temporarily disabled individuals, and that provisioning of aid during healthcare crises effectively lowers mortality in this small-scale society.
Asunto(s)
Evolución Biológica , Estado de Salud , Indígenas Sudamericanos/estadística & datos numéricos , Infecciones/etnología , Estilo de Vida/etnología , Enfermedades Profesionales/etnología , Heridas y Lesiones/etnología , Adolescente , Adulto , Distribución por Edad , Enfermedades de los Trabajadores Agrícolas/etnología , Enfermedades de los Trabajadores Agrícolas/mortalidad , Enfermedades de los Trabajadores Agrícolas/rehabilitación , Mordeduras y Picaduras/etnología , Mordeduras y Picaduras/mortalidad , Niño , Preescolar , Atención a la Salud/estadística & datos numéricos , Ecuador , Conducta Alimentaria , Femenino , Humanos , Infecciones/mortalidad , Infecciones/rehabilitación , Masculino , Persona de Mediana Edad , Enfermedades Profesionales/mortalidad , Enfermedades Profesionales/rehabilitación , Prevalencia , Gestión de Riesgos , Distribución por Sexo , Análisis de Supervivencia , Heridas y Lesiones/mortalidad , Heridas y Lesiones/rehabilitaciónRESUMEN
We report on the construction and psychometrics of a survey measure of musculoskeletal symptomatology for use with Spanish-speaking immigrant farmworkers. Survey development included focus groups with workers, forward and backward translations, and pilot testing. The final survey includes a body diagram and items about symptom severity, frequency, and duration and about self-treatment, medical care, and job tasks. We report on the initial test of the survey with 213 commercial nursery workers in Southern California. Fifty-five percent of the workers reported pain, with 30% reporting back pain, 21% reporting upper extremity pain, 19% reporting lower extremity pain, and 10% reporting neck and shoulder pain. A composite symptom score exhibited acceptable test-retest reliability (r = 0.41, p < 0.01) over the annual agricultural cycle. Greater symptomatology was associated with greater frequency of self-treatment (r = 0.42, p < 0.01), seeking professional health care (t = 2.49, p < 0.05), and exposure to high-risk jobs (OR = 2.1, p < 0.05, CI = 1.0 to 4.4), supporting the validity of composite score.
Asunto(s)
Enfermedades de los Trabajadores Agrícolas/etnología , Enfermedades Musculoesqueléticas/etnología , Dimensión del Dolor/normas , Adolescente , Adulto , Anciano , California , Escolaridad , Emigración e Inmigración , Femenino , Humanos , Masculino , México/etnología , Persona de Mediana EdadRESUMEN
OBJECTIVES: In this study, the prevalence of and risk factors for 12 psychiatric disorders were examined by sex and ethnicity (Indian vs non-Indian) among Mexican migrant farm-workers working in Fresno County, California. METHODS: Subjects aged 18 through 59 years were selected under a cluster sampling design (n = 1001). A modified version of the Composite International Diagnostic Interview was used for case ascertainment. The effects of sociodemographic and acculturation factors on lifetime psychiatric disorders were tested. RESULTS: Lifetime rates of any psychiatric disorder were as follows: men, 26.7% (SE = 1.9); women, 16.8% (SE = 1.7); Indians, 26.0% (SE = 4.5); non-Indians, 20.1% (SE = 1.3). Total lifetime rates were as follows: affective disorders, 5.7%; anxiety disorders, 12.5%; any substance abuse or dependence, 8.7%; antisocial personality, 0.2%. Lifetime prevalence of any psychiatric disorder was lower for migrants than for Mexican Americans and for the US population as a whole. High acculturation and primary US residence increased the likelihood of lifetime psychiatric disorders. CONCLUSIONS: The results underscore the risk posed by cultural adjustment problems, the potential for progressive deterioration of this population's mental health, and the need for culturally appropriate mental health services.
Asunto(s)
Enfermedades de los Trabajadores Agrícolas/etnología , Trastornos Mentales/etnología , Migrantes/estadística & datos numéricos , Adolescente , Adulto , Enfermedades de los Trabajadores Agrícolas/diagnóstico , California/epidemiología , Femenino , Humanos , Indígenas Norteamericanos/estadística & datos numéricos , Masculino , Trastornos Mentales/diagnóstico , México/etnología , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Muestreo , Encuestas y CuestionariosRESUMEN
The timely diagnosis and treatment of tuberculosis is an important public health problem in both developed and developing nations. In the United States, migrant farmworkers are estimated to be about six times more likely than other employed adults to develop tuberculosis. The purpose of this study was to investigate explanatory models of tuberculosis among Mexican migrant farmworkers working in western New York state. In-depth interviews were conducted with 26 farmworkers using an open-ended question format. All interviews were conducted in migrant camps and were audio-taped, translated and transcribed by the researcher. Data analysis was performed using Glaser and Strauss' grounded theory method of analysis which involves continuous and simultaneous data collection, coding, and analysis. Study participants included 21 males and 5 females ranging in age from 18 to 65. Respondents had worked as migrant farmworkers an average of 10 years and had an average of five years of schooling. Two-thirds of the participants had previously attended a tuberculosis education program, and four had received treatment for tuberculosis infection in the past. Farmworkers' explanations of tuberculosis etiology, severity, symptoms, prevention, treatment, and social significance are described as well as their beliefs about tuberculosis skin testing and the bacillus Calmette-Guérin (BCG) vaccine. Migrant farmworkers' explanatory models were similar in many aspects to the medical model of tuberculosis, although farmworkers had numerous misconceptions about BCG vaccination. Health care workers should be aware that Mexican migrant farmworkers may have beliefs about tuberculosis that are very compatible with participation in testing and treatment programs if such programs are made accessible to them.