Impact of heat and a rest-shade-hydration intervention program on productivity of piece-paid industrial agricultural workers at risk of chronic kidney disease of nontraditional origin.

OBJECTIVES: Assess the impact of environmental heat and a rest-shade-hydration (RSH) intervention against heat stress on productivity of piece-paid Mesoamerican sugarcane cutters. These workers are at a high risk of chronic kidney disease of non-traditional origin (CKDnt), from the severe heat stress they experience due to heavy work under hot conditions. RSH interventions in these populations improve kidney health outcomes, but their impact on productivity has yet to be examined. METHODS: We accessed routine productivity data from seed (SC, N = 749) and burned (BCC, N = 535) sugarcane cutters observed over five harvest seasons with increasing RSH intervention at a large Nicaraguan sugarcane mill. Hourly field-site wet-bulb globe temperature (WBGT) was recorded by mill staff and summarized as a daily mean. Mixed linear regression was used to model daily productivity, adjusting for age (18-29, 30-44, and >45 years), sex, WBGT (<28, 28-29, 29-30, 30-31, and >31 °C) on the same and preceding day, harvest season (2017-18 to 2021-22), month, and acclimatization status (<1, 1-2, and >2 weeks). RESULTS: There was an inverse dose-response relationship between SC productivity and WBGT on the same and preceding days, decreasing by approximately 3%/°C WBGT. Productivity increased during the study period, i.e. coinciding with RSH scale-up, by approximately 19% in SC and 9% in BCC. CONCLUSION: Agricultural worker productivity was expected lower on hotter days, strengthening the interest in all stakeholders to mitigate increasing global temperatures and their impact. Despite decreasing the total time allocated for work each day, an RSH intervention appears to result in increased productivity and no apparent loss in productivity.

Village-integrated eye workers for prevention of corneal ulcers in Nepal (VIEW study): a cluster-randomised controlled trial.

BACKGROUND: Corneal ulcers are a common cause of blindness in low-income and middle-income countries, usually resulting from traumatic corneal abrasions during agricultural work. Antimicrobial prophylaxis of corneal abrasions can help prevent corneal ulcers, but delays in the initiation of therapy are frequent. We aimed to assess whether a community-based programme for corneal ulcer prevention would reduce the incidence of corneal ulceration. METHODS: A cluster-randomised trial was performed in village development committees (VDCs) in Nepal. VDCs in the catchment area of Bharatpur Eye Hospital, Nepal with less than 15 000 people were eligible for inclusion. We randomly assigned (1:1) VDCs to either an intervention group or a control group. In the intervention VDCs, existing female community health volunteers (FCHVs) were trained to diagnose corneal abrasions and provide a 3-day course of ophthalmic antimicrobials to their patients. In the control VDCs, FCHVs did not provide this intervention. Participants were not masked given the nature of the intervention. Both groups were followed up for 3 years for photographic evidence of corneal ulceration. The primary outcome was the incidence of corneal ulceration, determined by masked assessment of corneal photographs. The analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, NCT01969786. FINDINGS: We assessed 112 VDCs, of which 24 were enrolled. The study was performed between Feb 4, 2014, and Oct 20, 2017. 12 VDCs were randomly assigned to the intervention group and 12 to the control group. 252 539 individuals were included in the study (130 579 in the intervention group and 121 960 in the control group). FCHVs diagnosed and provided antimicrobials for 4777 corneal abrasions. The census identified 289 corneal ulcers among 246 893 person-years in the intervention group (incidence 1·21 cases [95% CI 0·85-1·74] per 1000 person-years) and 262 corneal ulcers among 239 170 person-years in the control group (incidence 1·18 cases [0·82-1·70] per 1000 person-years; incidence rate ratio 1·03 [95% CI 0·63-1·67]; p=0·93). Medication allergy was self-reported in 0·2% of participants. INTERPRETATION: We did not detect a reduction in the incidence of corneal ulceration during the first 3 years of a community-based corneal ulcer prevention programme. Further study might be warranted in more rural areas where basic eye care facilities are not available. FUNDING: National Eye Institute.

Effectiveness of interventions to promote pesticide safety and reduce pesticide exposure in agricultural health studies: A systematic review.

OBJECTIVE: There is a relationship between pesticide exposure and farmworkers' health. Well-conducted evaluations can provide an insight into how to develop and implement more effective interventions to prevent farmers and farmworkers' exposure to pesticides. This review aimed to summarize the literature on the effectiveness of interventions to promote pesticide safety and reduce pesticide exposure among farmers and farmworkers. METHODS: A comprehensive search on PubMed, Embase, ISI Web of Science, Scopus, Science Direct, Agricola, NIOSHTIC, and Agris databases was performed to identify relevant studies published from 2000 to 2019. Randomized controlled trials (RCTs) and quasi-experimental studies assessing the effectiveness of interventions on a variety of outcomes related to pesticide exposure were considered. The searches were restricted to articles written in English. The methodological quality of included reviews was appraised using the Effective Public Health Practice Project quality assessment tool (EPHPP). RESULTS: The initial search led to 47912 records, 31 studies of which including nine RCTs and twenty-two quasi-experimental studies met the criteria. The majority of the included studies focused on the educational/ behavioral approach. The studies that applied this approach were effective in improving the participants' knowledge and attitude; however, these interventions were less effective in terms of making changes in participants' behaviors and their risk of exposure to toxic pesticides. Multifaceted interventions were moderately effective in terms of improving farmers' and farmworkers' behaviors and reduction in exposure to toxic pesticides. We did not find any studies that had evaluated the effectiveness of engineering/technological, and legislation/enforcement interventions. CONCLUSIONS: Although the majority of studies were based on an educational/behavioral approach and did not assess the effect of interventions on objective measures, the results of this review highlight the significant effectiveness of educational programs and some potential key elements of these interventions. These findings may inform policymakers to develop interventions to reduce pesticide exposure among farmers and farmworkers.

A saúde das mulheres no SUS em tempos de pandemia: mulheres do campo, florestas e das águas

Série de rodas de conversas com lideranças dos coletivos negros, do campo, indígenas, LGBTs e feministas que representam o segmento das e para as políticas de equidade do Ministério da Saúde. As rodas de conversas, no contexto da pandemia da COVID-19, são promovidas pelo Observatório de Determinantes Sociais em Saúde (DSS) e pela Escola Tocantinense do Sistema Único de Saúde (ETSUS). Participantes: 1. Emília Alves da Silva Rodrigues - Coordenadora executiva do Movimento Interestadual de Quebradeiras de Coco Babaçu (MIQCB Tocantins); 2. Francisca Marta Barbosa dos Santos - Engenheira Agrônoma, mestre em Administração Rural e Desenvolvimento; representante da Seagro; 3. Josiane Lima - Integrante da Associação da Reserva Extrativista Extremo Norte do Tocantins (ARENT); 4. Judite Rocha - Mestre em Saúde Pública (FIOCRUZ/UFG), membro do Movimento dos Atingidos por Barragem (MAB TO). Mediadoras: 1. Magna Dias Leite - Assistente Social, mestre em Saúde Pública do Trabalhador, gerente do CEREST-TO; 2. Sayonara Cristina Pereira de Carvalho - Assistente Social do CEREST-TO, especialista em Promoção e Vigilância em Saúde, Ambiente e Trabalho.

Potential exoskeleton uses for reducing low back muscular activity during farm tasks.

BACKGROUND: As the sustainability of the agricultural workforce has been threatened by the high prevalence of back pain, developing effective interventions to reduce its burden within farming will contribute to the long-term health and productivity of workers. Passive back-support exoskeletons are being explored as an intervention to reduce the physical demands on the back muscles, and consequently mitigate the risk of back pain, in many industrial sectors. METHODS: This study investigated whether exoskeleton use could reduce farmers' low back muscle load. Electromyography was used to evaluate exoskeleton use in field and laboratory settings. A total of 14 farmers (13 males and 1 female) with a mean age of 49 (SD = 12) years and 6 female nonfarmers (mean age 28, SD = 5 years) performed a standardized set of tasks that included symmetric and asymmetric lifting and sustained trunk flexion. Following the standardized tasks, 14 farmers also performed regular, real-world, farm tasks with and without use of the exoskeleton at their farms. RESULTS: Exoskeleton use decreased back muscular load during farming activities up to 65%, 56%, and 48% in static, median, and peak muscle activity, respectively. This indicates potential benefits of exoskeleton use to help farmers work under less muscular load. Paradoxically, exoskeleton use during standardized tasks increased muscle activity for some participants. CONCLUSIONS: This study demonstrates the potential effects of using passive exoskeletons in agriculture through observational and experimental research, and is among the first that explores the potential for using exoskeletons during actual work tasks in farm settings.

Comparisons of physical exposure between workers harvesting apples on mobile orchard platforms and ladders, part 1: Back and upper arm postures.

This study compared farmworkers' exposure to non-neutral postures using a new mobile platform apple harvesting method and the traditional method using ladders. Twenty-four workers were recruited and assigned into three groups: ladder workers (n = 8) picking apples from full trees using a ladder, mobile platform workers (n = 8) picking apples from upper part of the trees while standing on a moving platform, and ground-based mobile platform workers (n = 8) picking apples from lower part of the trees which the mobile platform workers left out. Upper arm and back inclinations were continuously monitored during harvesting using tri-axial accelerometers over full work shifts (~8 h). Upper arm posture was characterized as the percentage of time that upper arm flexion and abduction exceeded 30°, 60°, and 90°. Back posture was characterized as the percentage of time that torso angles (sagittal flexion or lateral bending) exceeded 10°, 20°, and 30°. The 10th, 50th, and 90th postural percentiles were also calculated. The platform workers had lower exposures to upper arm flexion and abduction than the ground and ladder workers. There were no differences in torso angles between the ladder and mobile platform workers; however, the ground workers were exposed to more and greater percentages of time in torso flexions.

Comparisons of physical exposure between workers harvesting apples on mobile orchard platforms and ladders, part 2: Repetitive upper arm motions.

Farmworkers are exposed to physical risk factors including repetitive motions. Existing ergonomic assessment methods are primarily laboratory-based and, thus, inappropriate for use in the field. This study presents an approach to characterize the repetitive motions of the upper arms based on direct measurement using accelerometers. Repetition rates were derived from upper arm inclination data and with video recordings in the field. This method was used to investigate whether harvesting with mobile platforms (teams harvesting apples from the platform and the ground) increased the farmworkers' exposure to upper arm repetitive motions compared to traditional harvesting using ladders. The ladder workers had higher repetitive motions (13.7 cycles per minute) compared to the platform and ground workers (11.7 and 12.2 cycles per minutes). The higher repetitions in the ladder workers were likely due to their ability to work independently and the additional arm movements associated with ladder climbing and walking.

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.

A multicomponent ergonomic intervention involving individual and organisational changes for improving musculoskeletal outcomes and exposure risks among dairy workers.

A field intervention study was implemented to evaluate the effects of individual (physical exercise programme and worker ergonomics training) and organisational changes (optimising work-rest schedule and revised task procedure) on musculoskeletal outcomes and their exposure risks among milking workers in a dairy plant. A questionnaire survey (including the Cornell Musculoskeletal Discomfort Questionnaire [CMDQ]) and direct observations of working postures by using the Quick Exposure Check (QEC) method were used at baseline and 12-month follow-up. Shoulder, lower back and neck discomfort were found to be the most common problems. The results showed significant improvements in the frequency (neck, shoulder, lower back, forearm and knee symptoms), severity (shoulder, lower back and knee symptoms) and interference with work (particularly due to lower back symptoms) as well as in the exposure risks to musculoskeletal problems (using the QEC method) after the intervention. The findings support the effectiveness of implemented multiple component intervention for improving musculoskeletal health and exposure risks in the studied occupational group.

Pesticide Poisoning and the Use of Personal Protective Equipment (PPE) in Indonesian Farmers.

This study aimed to investigate the poisoning symptoms occurring in pesticide-exposed farmers. This study was conducted in a red onion farming center area in Wanasari Subdistrict, Brebes, Indonesia, from May to June 2018. This study was designed as the descriptive study. The significance value of p < 0.005 showed that the variable was correlated with the health problems, including excessive fatigue (p value = 0.041), excessive saliva (p value = 0.006), hard breathing (p value = 0.021), frequent urination (p value = 0.047), blurred vision (p value = 0.059), dizziness (p value = 0.032), and finger pain (p value = 0.007). The significance value (p < 0.005) of 0.000 showed that the use of personal protective equipment was correlated with the health problems. Based on the odds ratio value of 1.137, 95% confidence interval = 0.042-0.444 meant that the personal protective equipment was a risk factor of health problems. The results showed that 89.2% of the farmers who used the personal protective equipment were categorized in the healthy group.

Comparison between OSHA-NIOSH Heat Safety Tool app and WBGT monitor to assess heat stress risk in agriculture.

Agricultural workers are exposed to heat stress due to spending significant amount of time outdoors. Risk information from mobile apps is more readily available for timely advice on risk management that is crucial in preventing severe acute illnesses and deaths, but its reliability is unknown. The purpose of this study was to determine the reliability of the OSHA-NIOSH Heat Safety Tool mobile app in providing accurate risk information to prevent heat-related illnesses among agricultural workers in eastern North Carolina. Wet bulb globe temperature (WBGT) indices were datalogged at two agricultural sites using heat stress monitors from April-August 2019 and were assigned to risk levels (minimal, low, moderate, high, extreme) by workload (light, moderate, heavy, very heavy) based on the ACGIH® Threshold Limit Values (TLVs®). Hourly heat index (HI) and its corresponding risk level were obtained using the app. Hourly HI-based risk level assignments were time-matched to their corresponding WBGT-based risk level assignments (682 pairs) and analyzed using cross-tabulation by determining the percentage of hourly WBGT-based risk level assignments ("gold standard") with the same hourly HI-based risk level assignments under different workloads, with a higher percentage indicating higher app reliability. Results showed that the app correctly identified 60-100% of minimal risk conditions, depending on workload type, but its reliability decreased as the heat stress risk condition and workload became more severe. The app identified the majority of low risk conditions for a moderate workload (74%) and moderate risk conditions for a light workload (94%) only, indicating limited use in these specific conditions, while the app identified 0% of either the high risk or extreme risk conditions at any workload type. It is concluded that the performance of the OSHA-NIOSH app in assessing occupational risk to heat stress is not protective of workers particularly for heavy and very heavy workloads, and that the use of the app for the assessment of occupational heat stress risk in agricultural settings is not recommended.

Educational Interventions to Improve Safety and Health Literacy Among Agricultural Workers: A Systematic Review.

Health and safety education for farmers has the potential to increase the level of health, safety literacy, and thereby improve farmers' health and quality of life. The aim of this paper is to provide a systematic review of the published literature documenting different educational interventions for agricultural workers that have the improvement of health and/or safety literacy as an outcome. A systematic search was conducted in PubMed, Embase, Scopus and PsycINFO databases for articles focusing on educational interventions for farmers' health and safety. From the 3357 initial hits, 36 unduplicated records met the inclusion criteria. The articles included in the review used educational interventions for farmers with the purpose of preventing farm-induced diseases and injuries, increasing the health and well-being of farmers, and promoting good manufacturing practices. The educational approaches considered varied from lectures, videos, newsletters, games, and community fairs, to involving the community in designing the intervention and training farmers to deliver the intervention to the community. Interventions that used evidence-based theories, which took into account cultural aspects and individual factors, used biomarkers as a behavior change measurement, and involved the community in the development of the intervention had the best results in terms of behavior change. The strategies of educational interventions identified in this review that produced good results have the potential to inform future researchers and policy makers in the design and implementation of public health interventions, programs and policies to improve the health of farmers and their families.

Mycotoxins feed contamination in a dairy farm - potential implications for milk contamination and workers' exposure in a One Health approach.

BACKGROUND: Dairy farming feed can be contaminated with mycotoxins, affecting animals' health and milk quality. Dairy farming is also prone to occupational exposure to mycotoxins, and feed is recognized as a source of contamination in the workplace. An exploratory study was developed in a dairy farm located in Portugal intending to assess the mycotoxins present in the feed. RESULTS: All the samples analyzed presented contamination by at least two mycotoxins and up to a maximum of 13 mycotoxins in the same sample. Zearalenone (ZEA) was detected in all the samples (n = 10) followed by deoxynivalenol (DON), which was reported in eight samples, and ochratoxin A (OTA), reported in five samples. CONCLUSION: The results point to the possible contamination of milk by several mycotoxins and raise the possibility of occupational exposure to mycotoxins due to feed contamination. An adequate One Health approach for dairy production should address these issues through effective preventive actions such as avoiding the use of feed contaminated with mycotoxins. This represents an important challenge due to climate change. It requires proper attention and accurate management measures. © 2019 Society of Chemical Industry.

[Evaluation of the effect of pesticide use on the health of rural workers in irrigated fruit farming]. / Avaliação do efeito do uso de agrotóxicos sobre a saúde de trabalhadores rurais da fruticultura irrigada.

This study refers to the impact of the use of pesticides on human health in the São Francisco River Valley region, in which, through semi-structured interviews, the objective was to analyze the influence of social, cultural and economic determinants on the health-disease process of workers exposed to agrochemicals. For data collection, 339 rural workers from irrigated perimeters of the cities of Juazeiro, in the State of Bahia, and Petrolina, in the State of Pernambuco, were interviewed. All were male, of which 182 (53,7%) were rural owners and 157 (46,3%) were employees, predominantly between 40 and 59 years of age among owners and under 39 among workers. Over 50% have a low level of schooling and 55.2% of them have monthly incomes less than or equal to 2 minimum wages. Many of them know about the importance of wearing personal protective equipment (PPE) and the mandatory license for the use and purchase of agrochemicals. However, about 40% do not use PPE or use it inadequately and 28.9% do not have a license to purchase. More than 9% of participants reported cases of intoxication, however, less than 7% sought specialized care. Workers are aware of the risks that the use of agrochemicals expose them to risk situations, but this does not encourage them to change their worksite behavior.

O presente estudo refere-se ao impacto do uso de agrotóxicos sobre a saúde humana no Submédio do Vale do São Francisco. Por meio de entrevistas objetivou-se analisar a influência dos condicionantes sociais, culturais e econômicos no processo saúde-doença dos trabalhadores expostos a agrotóxicos. Para a coleta de dados foram entrevistados 339 trabalhadores rurais de perímetros irrigados dos municípios de Juazeiro-BA e Petrolina-PE. Todos do sexo masculino, sendo 182 (53,7%) proprietários rurais e 157 (46,3%) empregados, predominando indivíduos entre 40 e 59 anos entre os proprietários e abaixo de 39 anos entre os trabalhadores. Mais de 50% apresentou baixo nível de escolaridade e 55,2% tinha rendimentos mensais menor ou igual a 2 salários mínimos. Muitos sabem da importância do uso de EPIs e da obrigatoriedade do receituário agronômico para a utilização e a compra de agrotóxicos, entretanto cerca de 40% não usam EPIs ou fazem uso de forma incompleta e 28,9% não apresentam receituário durante a compra. Mais de 9% dos participantes relataram casos de intoxicação, no entanto, menos de 7% procuraram atendimento especializado. Os trabalhadores sabem que o uso de agrotóxicos nas lavouras os expõem a situações de risco, mas essa informação não é suficiente para alterar a conduta no exercício laboral.

Avaliação do efeito do uso de agrotóxicos sobre a saúde de trabalhadores rurais da fruticultura irrigada / Evaluation of the effect of pesticide use on the health of rural workers in irrigated fruit farming

Resumo O presente estudo refere-se ao impacto do uso de agrotóxicos sobre a saúde humana no Submédio do Vale do São Francisco. Por meio de entrevistas objetivou-se analisar a influência dos condicionantes sociais, culturais e econômicos no processo saúde-doença dos trabalhadores expostos a agrotóxicos. Para a coleta de dados foram entrevistados 339 trabalhadores rurais de perímetros irrigados dos municípios de Juazeiro-BA e Petrolina-PE. Todos do sexo masculino, sendo 182 (53,7%) proprietários rurais e 157 (46,3%) empregados, predominando indivíduos entre 40 e 59 anos entre os proprietários e abaixo de 39 anos entre os trabalhadores. Mais de 50% apresentou baixo nível de escolaridade e 55,2% tinha rendimentos mensais menor ou igual a 2 salários mínimos. Muitos sabem da importância do uso de EPIs e da obrigatoriedade do receituário agronômico para a utilização e a compra de agrotóxicos, entretanto cerca de 40% não usam EPIs ou fazem uso de forma incompleta e 28,9% não apresentam receituário durante a compra. Mais de 9% dos participantes relataram casos de intoxicação, no entanto, menos de 7% procuraram atendimento especializado. Os trabalhadores sabem que o uso de agrotóxicos nas lavouras os expõem a situações de risco, mas essa informação não é suficiente para alterar a conduta no exercício laboral.

Abstract This study refers to the impact of the use of pesticides on human health in the São Francisco River Valley region, in which, through semi-structured interviews, the objective was to analyze the influence of social, cultural and economic determinants on the health-disease process of workers exposed to agrochemicals. For data collection, 339 rural workers from irrigated perimeters of the cities of Juazeiro, in the State of Bahia, and Petrolina, in the State of Pernambuco, were interviewed. All were male, of which 182 (53,7%) were rural owners and 157 (46,3%) were employees, predominantly between 40 and 59 years of age among owners and under 39 among workers. Over 50% have a low level of schooling and 55.2% of them have monthly incomes less than or equal to 2 minimum wages. Many of them know about the importance of wearing personal protective equipment (PPE) and the mandatory license for the use and purchase of agrochemicals. However, about 40% do not use PPE or use it inadequately and 28.9% do not have a license to purchase. More than 9% of participants reported cases of intoxication, however, less than 7% sought specialized care. Workers are aware of the risks that the use of agrochemicals expose them to risk situations, but this does not encourage them to change their worksite behavior.

The association between awareness and behavior concerning the need for protection when using pesticide sprays and neurologic symptoms: A latent class cluster analysis.

Pesticide exposure is a major health risk factor among agricultural workers, and poor protective behavior and a lack of awareness concerning the risks of pesticide use in developing countries may increase the intensity of pesticide exposure. This cross-sectional study aimed to explore the relationship between neurologic symptoms and protective behavior and awareness in relation to pesticide use in China. Latent class cluster analysis was used to categorize participants into 3 latent cluster subgroups, namely, a poor protective behavior subgroup, an excellent protective awareness and behavior subgroup, and a poor protective awareness subgroup, using a person-centered approach. Multivariate regression models were used to detect the association between the latent class cluster subgroups and self-reported neurologic symptoms. The results showed that poor protective behavior in pesticide use was an important negative predicator of neurologic symptoms such as reduced sleep quality, frequency of nightmares, debility, hypopsia, and hypomnesis. These findings suggest that targeted interventions for agricultural workers, especially local greenhouse farmers, are urgently needed to improve pesticide protection behavior.

Electrical Burns During Fruit Harvesting.

Electrocutions during tree trimming or fruit harvesting are occasionally reported in the public media, but the actual incidence is unknown. Some fruit trees (eg, mango and avocado) can exceed 30 feet, with dense foliage concealing the fruit and overlying power lines so burns associated with harvesting these fruits are often exacerbated with falls. However, there are limited data on this subject. To fill this gap, we provide some of the first information on this unique injury pattern. All electrocutions from 2013 to 2018 were retrospectively reviewed at an ABA-verified burn center. Demographics, injury patterns, and complications were analyzed. Of 97 electrocutions, 22 (23%) were associated with fruit procurement. This population was aged 43 ± 14 years, 95% (n = 21) male, injury severity score of 15 ± 13, and total body surface area burned 4% [1%-9%]. Third-degree burns were present in 36% (n = 8). ICU admission was required in 59% (n = 13) and 39% of the survivors required operative interventions for the burn. Compartment syndrome occurred in 18% (n = 4) and 14% (n = 3) patients required amputations. Falls complicated the care in 50% (n = 11), with associated head, chest, and/or extremity trauma. Mortality was 32% (n = 7), with three patients presenting dead on arrival. All but 3 injuries occurred between June and December, coinciding with mango and avocado season. Electrocution during fruit picking is a seasonal injury often exacerbated by falls. Management is challenging, and favorable outcome depends on recognition of the complexity of the polytrauma.

Impacts of weather, work rate, hydration, and clothing in heat-related illness in California farmworkers.

BACKGROUND: The primary aim of this study was to investigate the effects of work rate, hydration status, and clothing on core body temperature (CBT) on California farmworkers. METHODS: Two hundred and eighty-seven farmworkers were recruited in Summer 2015, with 259 participants having sufficient data for analysis. We collected CBT, ambient temperature, work rate, body weight loss, and clothing worn by each participant throughout the work day and demographic data from a questionnaire. RESULTS: Multiple regression with CBT as the outcome was used to determine the adjusted associations between CBT, environmental heat load, and worker characteristics. The multivariate regression model showed statistically significant associations of CBT with work rate (ß = .006, 95% CI [0.004, 0.009]) and wet-bulb globe temperature (ß = .03, 95% CI [0.017, 0.05]). CONCLUSION: Results suggest that among our population workload is the primary modifiable risk factor for heat-related illness. As expected, the ambient temperature was also associated with higher risk.

'Try to make good hay in the shade - it won't work!' A qualitative interview study on the perspectives of Bavarian farmers regarding primary prevention of skin cancer.

BACKGROUND: Extensive exposure to solar ultraviolet radiation (UVR) is the main risk factor for keratinocyte carcinoma (KC), making outdoor workers, including farmers, a high-risk population for KC. The use of sun protection is crucial for KC prevention but is not typically implemented by outdoor workers during their daily tasks. OBJECTIVES: To explore the attitudes of Bavarian farmers regarding sun-protective measures in their daily work and to understand perceived barriers and unmet needs. METHODS: Farmers were recruited through the Bavarian Farmers Association in Bavaria, Southern Germany. Qualitative semi structured interviews were conducted with participants between December 2017 and March 2018. Interviews were recorded, transcribed verbatim and analysed using qualitative content analysis. RESULTS: Twenty farmers (11 women, nine men; nine aged 18-30 years, 11 aged > 60 years) participated. Knowledge and awareness of UVR exposure and KC, perceived individual barriers to implementing sun-protective measures, individual experiences and farm life-specific circumstances emerged as key areas influencing the perspectives of farmers regarding the primary prevention of KC. Female farmers tended to take a more positive stance on sun protection, whereas male farmers showed a lower overall interest. CONCLUSIONS: Knowledge and awareness of KC and UVR exposure is very limited in Bavarian farmers with serious perceived barriers due to the demands of daily agricultural work. Further qualitative studies are needed to identify intervention options that can increase skin cancer awareness and that can successfully overcome real barriers to implementing sun protection.