RESUMO
The purpose of this article is to report on the development and initial use of a pesticide knowledge test (PKT) specifically designed to evaluate agricultural workers' knowledge of the content mandated by the federal Worker Protection Standard (WPS). The PKT is a 20-item, true-false test, used in a sample of 414 adult and adolescent migrant farmworkers in Oregon. The overall mean score, i.e., number correct, was 15.67(78.4%), with both adults and adolescents demonstrating the most difficulty with questions related to the overall health effects of pesticides. The internal consistency was 0.73, when estimated using a method to correct for small sample sizes. Only six items had less than 70% correct answers. Content validity was achieved by basing the items directly on the Worker Protection Standard; face validity was obtained by having the final version of the test reviewed by a bilingual (English-Spanish) educator familiar with the requirements of the WPS. Overall, adult participants scored better than adolescents, and those with previous pesticide training scored better than those without. There were no differences in scores based on gender or whether the test was taken in English or Spanish; however, participants who spoke indigenous languages scored significantly lower than those who did not. These results indicate that the PKT is a valid, reliable measure of worker knowledge of the content of the WPS, although it does not measure the extent to which that knowledge is actually used in the work setting.
Assuntos
Doenças dos Trabalhadores Agrícolas/prevenção & controle , Exposição Ambiental/efeitos adversos , Conhecimentos, Atitudes e Prática em Saúde , Hispânico ou Latino/psicologia , Saúde Ocupacional , Praguicidas/efeitos adversos , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , México/etnologia , Oregon , Medição de Risco , Inquéritos e Questionários , Migrantes , Estados Unidos , United States Environmental Protection AgencyRESUMO
In recent years there has been heightened concern over the potential of occupational or environmental exposures to affect neurological function in children and adolescents. The current study was designed to develop computerized tests to effectively assess neurobehavioral function in Hispanic adolescents working in agriculture and to evaluate those tests in Hispanic youths working in agriculture and in a non-agricultural group. After exclusions, 96 adolescents currently working in agriculture (AG) and 51 adolescents currently non-migratory and not working in agriculture (Non-AG) were tested. Neurobehavioral tests were selected from the computerized Behavioral Assessment and Research System. AG test performance was significantly below Non-AG performance on the cognitive tests. However, educational and cultural differences between the AG and Non-AG groups may explain this difference. Repeat testing of the AG group revealed substantially improved performance, further supporting educational or cultural differences as an explanation for the group differences. Together, these results expose the limitations in case-control or cross-sectional designs for testing migrant worker populations in the United States. Longitudinal or cross-sectional designs with repeat testing offer more promise and may be essential for drawing accurate conclusions in migrant worker groups where there are no truly equivalent comparison or control groups.
Assuntos
Comportamento do Adolescente/fisiologia , Agricultura , Sintomas Comportamentais/diagnóstico , Hispânico ou Latino/psicologia , Desempenho Psicomotor/fisiologia , Adolescente , Comportamento do Adolescente/efeitos dos fármacos , Sintomas Comportamentais/induzido quimicamente , Computadores , Escolaridade , Feminino , Guatemala/etnologia , Humanos , Masculino , México/etnologia , Exposição Ocupacional/efeitos adversos , Oregon , Praguicidas/efeitos adversos , Testes Psicológicos , Fatores Sexuais , Migrantes/psicologiaRESUMO
Research to identify adverse effects in humans chronically exposed to neurotoxic substances in the workplace or environment typically assesses people at one point in time in a cross-sectional study. The most widely used strategy employs performance measures taken from a single point in time and compares these with either performance of a control group or established normative data. However, multiple comparison points of the same people on the same test allow the dissection of acute--from chronic--exposure effects, among other important questions. When performance measures are used from multiple points in time, within-subject deviations are examined. For either research design, the goal is to minimize the effects of practice and to obtain stable performance on a test. Demographic variables such as age, education, and cultural background or ethnicity influence performance on neurobehavioral tests. These variables may also influence the development of stable performance. Different populations may have different learning curves so that stable performance on a test is achieved with different amounts of practice. This is especially important when making comparisons across groups that may not have equivalent backgrounds. The performance of three groups, English-speaking adults, Spanish-speaking adolescents, and Spanish-speaking migrant adolescents, was examined. Each group completed a battery of neurobehavioral tests from the Behavioral Assessment and Research System (BARS) during four sessions. Repeated measures ANOVAs were used to investigate performance across time. Tests measuring motor performance produced stable performance from the first session. More complex tasks that involved attention and memory showed a practice effect across sessions.
Assuntos
Testes Neuropsicológicos/normas , Síndromes Neurotóxicas/diagnóstico , Neurotoxinas , Doenças Profissionais/diagnóstico , Exposição Ocupacional , Adolescente , Adulto , Atenção , Escolaridade , Feminino , Lateralidade Funcional , Humanos , Idioma , Aprendizagem , Masculino , México , Síndromes Neurotóxicas/fisiopatologia , Síndromes Neurotóxicas/psicologia , Doenças Profissionais/fisiopatologia , Doenças Profissionais/psicologia , Desempenho Psicomotor , Tempo de Reação , Reprodutibilidade dos Testes , Estados UnidosRESUMO
Growth of children during maintenance hemodialysis has been reported to be uniformly poor, with a mean annual loss of 0.4 to 0.8 SD in height. We adopted an intensive program of closely monitored energy and protein intake with dialysis urea clearances exceeding conventional recommendations. Twelve prepubertal or early pubertal children (aged 7 months to 14 years) were monitored for an average of 2.2 years (range 4 to 81 months) while receiving maintenance hemodialysis. These children received an average of 90.6% and 155.9% of their recommended energy and protein nutritional intake, respectively. With a prescribed urea clearance of 5 mL/kg/min, we achieved a mean single treatment urea clearance normalized for total body water of 2.00, a urea reduction ratio of 84.7%, and an average time of hemodialysis of 14.8 h/wk, all well beyond current guidelines. Over the course of dialysis treatment, the improvement in height SD score was+0.31 SD/y (+0.32 excluding the 2 children treated with recombinant human growth hormone). Normal growth was achieved without overt obesity and was associated with normal pubertal growth spurt. These findings suggest that the combination of increased dialysis and adequate nutrition can promote normal growth in children treated with long-term hemodialysis.