Pesticide toxicity assessment and geographic information system (GIS) application in small-scale rice farming operations, Thailand.

The objectives of the study were to evaluate the impact of pesticide exposure on farmer health during non-active rice farming and active rice farming periods and present the change in the individual cholinesterase activities (%reduction) on the geographic information system (GIS) mapping in Nakhon Ratchasima Province, Thailand. Acetyl- and butyryl-cholinesterase (AChE and BuChE) activities were monitored during both study periods using Test-mate ChE (Model 400). The location of paddy fields was specified using Garmin geographic positioning system MAP 62s. Fifty-eight farmers who participated in this study had an average age of 49.2 ± 6.9 years. Higher prevalence of all health symptoms was observed among farmer participants during the active rice farming period comparing to the non-active rice farming period (p < 0.01). Furthermore, farmers had significantly lower activities of AChE and BuChE during the active rice farming period comparing to the non-active rice farming period (p < 0.01). Our findings indicate that the GIS mapping indicate that the cases with a significant enzyme inhibition have dispersed across the agricultural and the nearby residential areas. This, investigation can be used to promote safer use of pesticides among farmers and mitigate pesticide exposure among residents living in close proximity to a rice field.

Longitudinal assessment of kidney function in migrant farm workers.

Chronic kidney disease of unknown etiology (CKDu) is an epidemic that affects young agricultural workers in several warm regions of the world. However, there is a lack of monitoring of kidney issues in regions with extremely warm environments such as the Northwest of Mexico, a semi-arid region with a growing agricultural industry, where migrant and seasonal farm workers (MSFWs) travel to work in the fields. The objective of this study was to longitudinally assess kidney functioning of MSFWs in relation to pesticide exposure, heat stress and dehydration in a large-scale farm in Mexico. We enrolled 101 MSFWs, of whom 50 were randomly selected to work in an organic certified area and 51 were randomly selected to work in a conventional area. We also enrolled 50 office workers within the same region as a reference group. We collected urine and blood samples from all workers in addition to demographic, behavioral, and occupational characteristics. The physiological strain index (PSI) was used to estimate workers' heat strain. Sampling was conducted at pre-harvest (March) and late in the harvest (July). Linear mixed models were built with the estimated glomerular filtration rate (eGFR) as the dependent variable. We found a significant decrease in kidney function in MSFWs compared to office workers. By the late harvest, one MSFW developed kidney disease, two MSFWs suffered a kidney injury, and 14 MSFWs were at risk of a kidney injury. We found that the eGFR in MSFWs decreased significantly from pre-harvest (125 ± 13.0 mL/min/1.73 m2) to late harvest (109 ± 13.6 mL/min/1.73 m2) (p < 0.001), while no significant change was observed in office workers. The eGFR was significantly lower in MSFWs who worked in the conventional field (101.2 ± 19.4 mL/min/1.73 m2) vs the organic field (110.9 ± 13.6 mL/min/1.73 m2) (p = 0.002). In our final model, we found that dehydration was associated with the decrease of eGFR. We also found an interaction between heat strain and job category, as a significant decline in eGFR by job category (conventional/organic MSFWs and office workers) was related to an increase in heat strain. This suggests that pesticide exposure needs to be considered in combination with heat stress and dehydration. This study provides valuable information on kidney function in MSFWs, and it shows the importance of early long-term monitoring in farm workers in other regions where CKDu has not been evaluated yet.

Farmer and farm worker illnesses and deaths from COVID-19 and impacts on agricultural output.

Farmers and farm workers are critical to the secure supply of food, yet this population is potentially at high risk to acquire COVID-19. This study estimates the prevalence of COVID-19 among farmers and farmworkers in the United States by coupling county-level data on the number of farm workers relative to the general population with data on confirmed COVID-19 cases and deaths. In the 13 month period since the start of the pandemic (from March 1, 2020 to March 31, 2021), the estimated cumulative number of COVID-19 cases (deaths) was 329,031 (6,166) among agricultural producers, 170,137 (2,969) among hired agricultural workers, 202,902 (3,812) among unpaid agricultural workers, and 27,223 (459) among migrant agricultural workers. The cases amount to 9.55%, 9.31%, 9.39%, and 9.01% of all U.S. agricultural producers, hired workers, unpaid workers, and migrant workers, respectively. The COVID-19 incidence rate is significantly higher in counties with more agricultural workers; a 1% increase in the number of hired agricultural workers in a county is associated with a 0.04% increase in the number of COVID-19 cases per person and 0.07% increase in deaths per person. Although estimated new cases among farm workers exhibit similar trends to that of the general population, the correlation between the two is sometimes negative, highlighting the need to monitor this particular population that tends to live in more rural areas. Reduction in labor availability from COVID-19 is estimated to reduce U.S. agricultural output by about $309 million.

Pesticide application, educational treatment and infectious respiratory diseases: A mechanistic model with two impulsive controls.

In this paper, we develop and analyze an SIS-type epidemiological-mathematical model of the interaction between pesticide use and infectious respiratory disease transmission for investigating the impact of pesticide intoxication on the spread of these types of diseases. We further investigate the role of educational treatment for appropriate pesticide use on the transmission dynamics. Two impulsive control events are proposed: pesticide use and educational treatment. From the proposed model, it was obtained that the rate of forgetfulness towards educational treatment is a determining factor for the reduction of intoxicated people, as well as for the reduction of costs associated with educational interventions. To get reduced intoxications, the population's fraction to which is necessary to apply the educational treatment depends on its individual effectiveness level and the educational treatments' forgetfulness rate. In addition, the turnover of agricultural workers plays a fundamental role in the dynamics of agrotoxic use, particularly in the application of educational treatment. For illustration, a flu-like disease with a basic reproductive number below the epidemic threshold of 1.0 is shown can acquire epidemic potential in a population at risk of pesticide exposure. Hence, our findings suggest that educational treatment targeting pesticide exposure is an effective tool to reduce the transmission rate of an infectious respiratory disease in a population exposed to the toxic substance.

Percepción social del riesgo y dinâmicas de género en la producción agrícola basada en plaguicidas en la pampa húmeda Argentina / Social risk perception and gender dynamics in pesticide-based agricultural production in the Argentine pampas / Percepção social do risco e dinâmicas de gênero na produção agrícola baseada em pesticidas na pampa úmida Argentina

Resumen El objetivo de este trabajo es analizar las vinculaciones entre las identidades de género y las lógicas de la organización social del cuidado, relacionadas con los riesgos ambientales-sanitarios a partir de los significados y prácticas relativas a la producción agrícola basada en plaguicidas en la pampa húmeda argentina. Realizamos dos trabajos de campo etnográficos de largo alcance y analizamos, por una parte, el proceso de identificación y denuncia de los riesgos relativos a los plaguicidas por mujeres y su relación con la construcción social de femineidades y con la organización generizada del cuidado. En segundo lugar, indagamos un posible vínculo entre la exposición a los plaguicidas y una estrategia de reafirmación de la virilidad.

Abstract This paper analyzes the connections between gender identities and the logics surrounding the social organization of care related to the environmental and health risks that stem from meanings and practices of pesticide-based agricultural production in the Argentine Pampas. After conducting two long-reach ethnographic field-work, we explore the process of women's identifying and denouncing of pesticides related risks and its relationship both with the social construction of femininities and with the gendered organization of care. Furthermore, we study a possible link between the exposure to pesticides and a strategy of reaffirmation of virility.

Resumo O objetivo deste trabalho é analisar as vinculações entre as identidades de gênero e as lógicas da organização social do cuidado, em relação com os riscos ambientais-sanitáriosa partir dos significados e práticas relativas à produção agrícola baseada em pesticidas nos pampas da Argentina. Realizamos dois trabalhos de campo etnográficos de amplo alcance e analisamos, por um lado, o processo de identificação e denúncia dos riscos relacionados coma construção social de feminilidades e com a organização generificada do cuidado. Por outro lado, indagamos sobre um vínculo possível entre a exposição aos pesticidas e uma estratégia de reafirmação da virilidade.

Assessment of Primary Health Care for rural workers exposed to pesticides.

OBJECTIVE: To evaluate the attributes of Primary Health Care (PHC) for rural workers; to analyze sociodemographic conditions, history of poisoning and hospitalizations for pesticides and use of personal protective equipment; and to verify exposure to pesticides by determining bioindicators. METHODS: Cross-sectional, descriptive-analytical study with a sample of 1,027 rural workers living in municipalities belonging to a regional health department in Southern Minas Gerais, whose PHC is governed by the Family Health Strategy model. We used the adult version of the Primary Care Assessment Tool (PCATool Brazil) and a structured questionnaire to collect socioeconomic data, history of poisoning and hospitalization for pesticides and use of personal protective equipment. Blood samples were collected to measure biomarkers of pesticide exposure and signs of renal and hepatic sequelae. RESULTS: Low education was prevalent, as well as the intense contact of workers with pesticides. Frequent use of personal protective equipment was higher among men, as was the history of poisoning and hospitalizations for pesticides. Rates of 20% poisoning, 15% liver disease and 2% nephropathy were detected. Signs of hepatotoxicity were more frequent in men. Gender differences were all statistically significant. Regarding PHC, only the attribute "degree of affiliation" had a high score. None of the poisoning cases detected in the study were previously diagnosed. CONCLUSIONS: Despite the high coverage of the Family Health Strategy, occupational risk and its consequences have not been detected by health services, which do not seem oriented to primary care, even lacking their essential attributes. There is a need for immediate and effective adaptation of public policies regarding the health of rural workers, with adequate training of teams and review of the portfolio of PHC services offered.

Assessment of Primary Health Care for rural workers exposed to pesticides / Avaliação da atenção primária à saúde de trabalhadores rurais expostos a praguicidas

ABSTRACT OBJECTIVE To evaluate the attributes of Primary Health Care (PHC) for rural workers; to analyze sociodemographic conditions, history of poisoning and hospitalizations for pesticides and use of personal protective equipment; and to verify exposure to pesticides by determining bioindicators. METHODS Cross-sectional, descriptive-analytical study with a sample of 1,027 rural workers living in municipalities belonging to a regional health department in Southern Minas Gerais, whose PHC is governed by the Family Health Strategy model. We used the adult version of the Primary Care Assessment Tool (PCATool Brazil) and a structured questionnaire to collect socioeconomic data, history of poisoning and hospitalization for pesticides and use of personal protective equipment. Blood samples were collected to measure biomarkers of pesticide exposure and signs of renal and hepatic sequelae. RESULTS Low education was prevalent, as well as the intense contact of workers with pesticides. Frequent use of personal protective equipment was higher among men, as was the history of poisoning and hospitalizations for pesticides. Rates of 20% poisoning, 15% liver disease and 2% nephropathy were detected. Signs of hepatotoxicity were more frequent in men. Gender differences were all statistically significant. Regarding PHC, only the attribute "degree of affiliation" had a high score. None of the poisoning cases detected in the study were previously diagnosed. CONCLUSIONS Despite the high coverage of the Family Health Strategy, occupational risk and its consequences have not been detected by health services, which do not seem oriented to primary care, even lacking their essential attributes. There is a need for immediate and effective adaptation of public policies regarding the health of rural workers, with adequate training of teams and review of the portfolio of PHC services offered.

ABSTRACT OBJETIVO Avaliar os atributos da atenção primária à saúde (APS) na assistência à saúde de trabalhadores rurais; analisar condições sociodemográficas, histórico de intoxicação e internações por agrotóxicos e uso de equipamentos de proteção individual; e verificar a exposição aos praguicidas pela determinação de bioindicadores. MÉTODOS Estudo transversal, descritivo-analítico, com amostra de 1.027 trabalhadores rurais residentes em municípios pertencentes a uma superintendência regional de saúde do sul de Minas Gerais, cuja APS é regida pelo modelo da Estratégia Saúde da Família. Utilizou-se o Instrumento de Avaliação da Atenção Primária (PCATool Brasil) versão adulto e um questionário estruturado para coleta de dados socioeconômicos, histórico de intoxicação e internação por agrotóxicos e uso de equipamentos de proteção individual. Foram coletadas amostras sanguíneas para dosagem de biomarcadores de exposição a praguicidas e de sinais de sequelas renais e hepáticas. RESULTADOS A baixa escolaridade foi prevalente, bem como o contato intenso dos trabalhadores com praguicidas. O uso frequente de equipamentos de proteção individual foi maior entre os homens, assim como o histórico de intoxicação e de internações por agrotóxicos. Detectaram-se índices de 20% de intoxicação, 15% de hepatopatia e 2% de nefropatia. Os sinais de hepatotoxicidade foram mais frequentes em homens. As diferenças entre sexos foram todas estatisticamente significantes. Com relação à APS, apenas o atributo "grau de afiliação" apresentou escore elevado. Nenhum dos casos de intoxicação detectados no estudo tinha diagnóstico prévio. CONCLUSÕES A despeito de uma alta cobertura da Estratégia Saúde da Família, o risco ocupacional e suas consequências não têm sido detectados pelos serviços de saúde, que se apresentam como não orientados à atenção primária, carecendo mesmo de seus atributos essenciais. Percebe-se a necessidade de adequação imediata e efetiva das políticas públicas no que concerne à saúde do trabalhador rural, com adequada capacitação das equipes e revisão da carteira de serviços da APS ofertados.

[Accident at work and occupational diseases for the foresters]. / Accidents du travail et maladies professionnelles chez les forestiers : un risque fort dans un secteur en mutation.

Professional accidents and occupational diseases are a major subject for the workers and the social welfare policy. The workers in forest are particularly exposed to accidents. This is a sector that will be essential for dressing the ecological challenges of the xxith century, and could generate many new jobs. The present article proposes a statistical analysis of the accidents and the diseases witch affect the forest workers from the data of the CCMSA, in order to explore potential ways for improving their working conditions and safety.

Intersectoral action: social agriculture, environment and health: sector brief on agriculture

The Health 2020 policy framework has been adopted by all Member States of the WHO European Region to address Europe’s great social and health challenges, calling upon the health sector to reach out to, and work with, all the various sectors and parties in the continuing work of improving people’s health and well-being. Agriculture, environment and health are closely interlinked. Agricultural practices alter physical environments and create environmental risks, directly affecting the health and well-being of the populations living in these environments. By working together, the health and agriculture sectors can improve the environment and living conditions of people, reduce inequalities and support human development.

Assessment of the type of farmers' low back pain.

BACKGROUND: Spinal overload among blue-collar workers occurs most frequently in the lumbar spine. Long-lasting spinal overload results in pain syndromes leading to limitations in everyday and professional life. MATERIAL AND METHODS: The research included 106 adult males working as farmers for at least 10 years. The control group included 50 male white-collar workers. Four research tools were used: an interview questionnaire, a questionnaire assessing pain intensity and limitations in everyday functioning of study participants, a Numeric Rating Scale (NRS) measuring pain intensity and Oswestry Disability Index. RESULTS: The research revealed that as many as 86% of the farmers (91 individuals) experienced low back pain. In the control group only 64% of all the white-collar workers complained of pain in this part of the spine. The farmers defined their low back pain as constant pain or stiffness significantly more often. In addition, they reported hip pain radiating to one or 2 legs and experienced chronic and acute back pain more frequently. The total time in which they experienced this pain was usually 11-20 years. The correlation between pain intensity measured on a numeric scale and the level of disability of farmers was revealed. CONCLUSIONS: The research revealed that individual farmers complained of low back pain significantly more often. The pain was usually defined as constant pain, chronic pain, acute pain or hip pain radiating to legs. Med Pr 2018;69(4):355-364.

EVALUATION OF AGRICULTURAL TRACTOR SEAT COMFORT WITH A NEW PROTOCOL BASED ON PRESSURE DISTRIBUTION ASSESSMENT.

Professional drivers have been found to be at a high risk of developing low back pain due to prolonged sitting and vehicle vibration. In a previous survey carried out on 1,155 tractor drivers, tractor vibration and/or incorrect posture while driving were found to cause low back disorders in more than 80% of the interviewed drivers. In this context, the present research introduces a new evaluation protocol to assess the ergonomic characteristics of agricultural tractor seats through the use of pressure sensors, taking into account both static and dynamic conditions. The degree of comfort was defined by analyzing the pressure distribution exerted by a sample of 12 drivers sitting on two seats in five different operating conditions. The pressure distribution values thus obtained were compared with the corresponding pressures recorded with the 12 drivers sitting on a reference seat (rigid seat, backrest, and suspension) designed for the purpose. From the comparison, it was possible to define a comfort index (CI) that allowed an objective assessment of the two seats. Statistical analysis showed that the CIs of the two seats were significantly different in all five operating conditions. Moreover, the two seats showed different CIs as a function of the operating condition. Although less comfortable, one seat showed almost constant CI values in all five operating conditions. Conversely, the other seat showed a progressively decreasing CI from the static condition to the uneven ground condition.

Acute Pesticide-Related Illness Among Farmworkers: Barriers to Reporting to Public Health Authorities.

Farmworkers are at high risk of acute occupational pesticide-related illness (AOPI) and AOPI surveillance is vital to preventing these illnesses. Data on such illnesses are collected and analyzed to identify high-risk groups, high-risk pesticides, and root causes. Interventions to address these risks and root causes include farmworker outreach, education, and regulation. Unfortunately, it is well known that AOPI is underreported, meaning that the true burden of this condition remains unknown. This article reviews the barriers to reporting of farmworker AOPI to public health authorities and provides some practical solutions. Information is presented using the social-ecological model spheres of influence. Factors that contribute to farmworker AOPI underreporting include fear of job loss or deportation, limited English proficiency (LEP), limited access to health care, lack of clinician recognition of AOPI, farmworker ineligibility for workers' compensation (WC) benefits in many states, insufficient resources to conduct AOPI surveillance, and constraints in coordinating AOPI investigations across state agencies. Solutions to address these barriers include: emphasizing that employers encourage farmworkers to report safety concerns; raising farmworker awareness of federally qualified health centers (FQHCs) and increasing the availability of these clinics; improving environmental toxicology training to health-care students and professionals; encouraging government agencies to investigate pesticide complaints and provide easy-to-read reports of investigation findings; fostering public health reporting from electronic medical records, poison control centers (PCCs), and WC; expanding and strengthening AOPI state-based surveillance programs; and developing interagency agreements to outline the roles and responsibilities of each state agency involved with pesticide safety.

A Case History Introducing the Oregon Ag Seminar Series-Keys to Program and Research-to-Practice Success.

This case history of Oregon state's Ag Seminar Series is consistent with the Socio-Ecological Model, demonstrating how policy at a state level can influence an organizational approach with impacts that ultimately influence safety practices on the farm. From modest beginnings, the Ag Seminar Series, offered through a workers compensation insurance company, now serves over 2,300 Oregon farmers annually in English and Spanish. This case offers unique but also replicable methods for educators, insurers, and researchers in safety education, safety motivators, and research-to-practice (r2p).

Integrating Agricultural Injury Prevention with Rural Pediatrics: A Pilot Assessment.

BACKGROUND: Childhood agricultural injuries are an important public health problem. Pediatricians are a trusted source of expertise in children's health and safety and could serve as a sphere of influence to augment child agricultural injury prevention efforts. The purpose of this pilot study was to begin to explore the perspectives of pediatricians in a large rural health clinic about addressing child agricultural injury prevention within their practice. METHODS: Structured interviews were conducted with nine pediatricians who maintain a clinical practice of at least 2 days a week and care for newborns through adolescents. Detailed interviewer notes were reviewed and summarized. RESULTS: Rural pediatricians readily acknowledge substantial numbers of farm children in their practice. In general, these providers: (1) recognize farming environments as a safety risk and see agricultural injury prevention as an important topic to be addressed with their patients, (2) are comfortable discussing the topic, but seldom actually initiate such conversations, and (3) doubt farm parents would be receptive to integrating agricultural injury prevention into a rural pediatric practice. CONCLUSION: While rural pediatricians recognize child safety risks in farm environments, they are reluctant to actually initiate this conversation with parents. Future research should explore both pediatricians' hesitancy to discuss agricultural injury prevention and farm parents' readiness for integrating the topic into pediatric primary care visits. Such would help to assess the viability of pediatricians as a sphere of influence for augmenting child agricultural injury prevention efforts.

Precariedad en las condiciones de trabajo y salud de los trabajadores del sector bananero del Ecuador / Precarious working conditions and health of workers in the banana sector of Ecuador

El objetivo de la presente investigación fue determinar la influencia de las condiciones y organización del trabajo en el proceso salud enfermedad de los trabajadores bananeros en el Ecuador. El recorte empírico del trabajo se sitúo en la provincia de Los Ríos la cual es considerada la nueva capital bananera, ya que allí se ubican la mayoría de compañías bananeras del país. La orientación metodológica fue un enfoque cualitativo que incluyó observaciones, encuestas y entrevistas en profundidad a trabajadores, delegados y dirigentes gremiales de los cantones de Babahoyo (La Unión); Buena Fe (San Pedro de la Y) y Quevedo. Entre los hallazgos del trabajo se han identificado las principales políticas y estrategias patronales para gestionar el trabajo, y cuáles son las diversas expresiones que adoptan la flexibilización y precarización laboral. En tal sentido, se destaca la ausencia de normas contractuales sobre el modo de contratación, despido, salarios, imposición de tareas, condiciones de trabajo, entre otras, las cuales expresan la situación de gran vulnerabilidad de los trabajadores. Por otro lado, se registran problemáticas de salud vinculadas con diferentes factores de riesgo, entre los que se ubica la presencia de agrotóxicos, combinado con un trabajo intensivo, de ritmo alto, rutinario, de producción masiva que permiten un control mínimo del trabajador sobre el proceso productivo. También la presencia de jornada (especialmente en las fases de cosecha y postcosecha)(AU)

The objective of this study was to determine the influence of working conditions and work organization on the health-disease process of banana workers in Ecuador. The empirical component of our research was located in the province of Los Ríos, considered the new banana capital of Ecuador, where most of the banana companies of that country are located. The qualitative methodology included in-depth interviews with workers, representatives and union leaders from the cantons of Babahoyo (La Unión); Good Faith (San Pedro de la Y) and Quevedo. Among the main results, we identified the main employer policies and strategies to manage the work, and the different manifestations reflected by job flexibilization and precariousness. In this sense, the absence of contractual rules on hiring, dismissal, wages, job tasks, working conditions, among others, underscore a great degree of vulnerability of the workers. On the other hand, there are health problems associated with different risk factors, including the presence of agrochemicals, combined with intensive, highpaced, routine, mass-production work that allowslittle control of the production process by the workers. Also observed was the presence of strenuous and stressful work shifts, with high demands, with minimum rest breaks and days off (especially in the harvest and post-harvest seasons)(AU)

Identifying the gaps in Nepalese migrant workers' health and well-being: a review of the literature.

BACKGROUND: The health and well-being of migrant workers from low-income countries is often neglected in travel medicine. This article uses Nepal as a case study to highlight key issues affecting this particular group of international travellers. METHODS: This narrative review used a comprehensive systematic literature search to identify relevant studies on Nepal. The included articles were thematically analysed leading to four key themes or risk factors. RESULTS: The search found 18 articles from which we identified 3 key themes related directly to migrant workers: (1) sexual risk taking; (2) occupational health and (3) lifestyles, and a fourth theme related to partners and family of migrant workers who are left behind in Nepal. Of the 18 included articles, 11 articles discussed sexual risk taking and HIV, whilst considerably fewer focused on work-related risk factors and lifestyle factors in migrant workers. CONCLUSIONS: Migrant workers who are generally healthy appear to be similar to tourist travellers in regarding sexual health as a key issue related to being abroad. Risky sexual behaviour increases in individuals separated from their usual sexual partners, away from their own communities and families, leading to the so-called 'situational disinhibition'. Considering the recent media coverage of deaths and injuries among migrant workers in the Middle East, it is interesting to see that their sexual health is more prevalent in the research literature. This article argues that travel medicine should provide more emphasis to the health and well-being of migrant workers as a highly vulnerable group of travellers with additional impact on the health of those left behind.

Impact of Multidrug Resistance on Tuberculosis Recurrence and Long-Term Outcome in China.

Little is known about the impact of drug resistance on recurrence in TB. We conducted a cohort study to measure the impact of multi-drug resistance (MDR) on TB recurrence over nine years in Henan Province China. We reviewed medical records and conducted field interviews of 100 MDR and 150 non-MDR TB patients who were treated between 2001 and 2002. We compared long-term recurrence rates, risk factors, and outcomes in 2010 for 234 individuals who could be followed up. About one third (29.5%, 69/234) suffered recurrence after completion of treatment. The overall recurrence rate was 35/1,000 patient-years (PY), with a much higher rate (65/1,000 PY) among MDR-TB patients. MDR (HR: 2.75; CI: 1.58-4.79) and patient annual household income less than 10,000 Yuan (HR: 2.05; CI 1.11-3.80) were associated with recurrence. The mean time for recurrence among MDR-TB patients was 5.7 years, compared to 7.2 years among non-MDR-TB patients. Among the recurrence group members, 61.3% died, and 18.8% had failed treatments. We believe that the high TB recurrence rate after 9 years suggests that a high cure rate cannot accurately predict long-term outcome. We recommend that TB surveillance and control should be strengthened with a focus on MDR-TB and directly observed treatment, to reduce TB recurrence and transmission of MDR-TB.

Trends in Nonfatal Agricultural Injury in Maine and New Hampshire: Results From a Low-Cost Passive Surveillance System.

OBJECTIVES: Agriculture is a dangerous industry, and although data on fatal injuries exist, less is known about nonfatal injuries. The purpose of this study is to describe trends in agricultural morbidity in Maine and New Hampshire from 2008 to 2010 using a newly established passive surveillance system. This passive system is supplied by injury cases gathered from prehospital care reports and hospital data. METHODS: Demographics and specifics of the event were recorded for each incident case. RESULTS: The average age of injured people in Maine and New Hampshire was 41.7. Women constituted 43.8% of all agricultural injuries. Machinery- (n = 303) and animal- (n = 523) related injuries accounted for most agricultural incidents. Of all injured women, over 60% sustained injuries due to animal-related causes. Agricultural injuries were spread across the two states, with clustering in southern New Hampshire and south central Maine, with additional injuries in the Aroostook County area, which is located in the northeast part of the state. Seasonal variation in agricultural injuries was evident with peaks in the summer months. There was some overlap between the agricultural and logging industry for tree-related work. CONCLUSIONS: Our methods are able to capture traumatic injury in agriculture in sufficient detail to prioritize interventions and to evaluate outcomes. The system is low-cost and has the potential to be sustained over a long period. Differences in rates of animal- and machinery-related injuries suggest the need for state-specific safety prioritization.

Assessment of hematological parameters in workers exposed to organophosphorus pesticides, carbamates and pyrethroids in Cundinamarca 2016-2017.

OBJECTIVE: To establish hematotoxic alterations through clinical and paraclinical exploration in workers who are exposed to organophosphorus pesticides, carbamates and pyrethroids (OPCP) due to their work in production, packaging, distribution and fumigation processes in Cundinamarca-Colombia between 2016 and 2017. MATERIALS AND METHODS: A cross-sectional descriptive epidemiological study was carried out on a sample of 92 workers from six companies, mostly aged between 18 and 30 years, of which 61 % were males and 39 % females, and 71 % were workers in the operational area and 29 % in the administrative area. Univariate, bivariate and multivariate analyses were performed. RESULTS: Clinical exploration reported findings in 17 % of the sample group, of which only 2 % presented with erythrocyte cholinesterase outside the reference range. The values of hematological parameters such as peripheral blood smear (PBS) and complete blood count (CBC) were outside the range in 15 % and 47 % of the sample, respectively. DISCUSSION: The results suggest that there are hematological alterations in this group that could possibly be associated with chronic exposure to OPCP.