Classification of Heat-Related Illness Symptoms Among Florida Farmworkers.

BACKGROUND: Farmworkers working in hot and humid environments have an increased risk for heat-related illness (HRI) if their thermoregulatory capabilities are overwhelmed. The manifestation of heat-related symptoms can escalate into life-threatening events. Increasing ambient air temperatures resulting from climate change will only exacerbate HRI in vulnerable populations. We characterize HRI symptoms experienced by farmworkers in three Florida communities. METHODS: A total of 198 farmworkers enrolled in 2015-2016 were asked to recall if they experienced seven HRI symptoms during the previous work week. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between selected sociodemographic characteristics and reporting three or more symptoms. Latent class analysis was used to identify classes of symptoms representing the HRI severity range. We examined sociodemographic characteristics of the farmworkers across the latent classes. RESULTS: The mean age (±SD) of farmworkers was 38.0 (±8) years; the majority were female (60%) and Hispanic (86%). Most frequently reported symptoms were heavy sweating (66%), headache (58%), dizziness (32%), and muscle cramps (30%). Females had three times the odds of experiencing three or more symptoms (OR = 2.86, 95% CI 1.18-6.89). Symptoms fell into three latent classes, which included mild (heavy sweating; class probability = 54%), moderate (heavy sweating, headache, nausea, and dizziness; class probability = 24%), and severe (heavy sweating, headache, nausea, dizziness, muscle cramps; class probability = 22%). CONCLUSIONS: Farmworkers reported a high burden of HRI symptoms that appear to cluster in physiologic patterns. Unrecognized accumulation of symptoms can escalate into life-threatening situations if untreated. Our research can inform interventions to promote early recognition of HRI, on-site care, and appropriate occupational health policy. Administrative or engineering workplace controls may also reduce the manifestation of HRI. CLINICAL RELEVANCE: This study advances the current knowledge of HRI symptoms in farmworkers and moves beyond reporting individual symptoms by utilizing latent class analysis to identify how symptoms tend to co-occur together in this population. It acknowledges multiple symptoms occurring as a result of occupational heat exposure and highlights the importance of symptom recognition.

Occupational Health and Safety Issues among Vegetable Farmers in Trinidad and the Implications for Extension.

Trinidad has an aged farming population. For a host of reasons, young persons are not entering the agricultural sector; therefore, these aged farmers will continue to be the backbone of the industry. Hence, there is much need for improving the health and safety of the workers within this sector. This first-time study assessed the prevalence of occupational health and safety disorders and discomforts among Trinidad's vegetable farmers in an attempt to understand the extent of the problem within the general farm population. The implications for extension are highlighted, and several recommendations are provided. Small-scale commercial-oriented vegetable farmers (n = 100) from ten of the most populated agricultural areas across Trinidad were surveyed. Results indicated that there was an overall moderate prevalence of occupational injuries among vegetable farmers. Most prevalent were musculoskeletal disorders of the lower back and upper body extremities, watery/burning eyes, skin rashes/itching, headaches, fatigue, dehydration, stress, and injuries attributed to slips and falls. Based on the evidence that a problem exists with health and safety, the extension service can now prepare and deliver programs to educate farmers on the actions necessary to improve their personal health and safety and that of their workers. This type of study has not been done before among farmers in Trinidad. It brings a very important and timely issue to the fore because of the aged farming population. Additionally, since the farmer profile and farming systems are similar in the wider Caribbean, policy makers can take note of the findings and recommendations and embrace actions.

[Absenteeism due to occupational diseases among sugarcane workers]. / Absenteísmo por doença ocupacional de trabalhadores rurais no setor canavieiro.

The aim of this study was to analyze the frequency of work-related sick leave in sugarcane workers. A total of 1,230 medical excuses for 400 sugarcane workers were analyzed according to the International Classification of Diseases, 10th Revision (ICD-10). The following items were analyzed: diagnosis, sex, and length and season of sick leave. In all the seasons, musculoskeletal diseases showed the highest sick leave rate, following by respiratory diseases (p < 0.05). Sick leave due to musculoskeletal diseases was more frequent at the end of the sugarcane harvest than during the intercrop season (p < 0.05). Seventy-five percent of medical excuses were for one day. The longest sick leaves were for diseases of the genitourinary tract (p < 0.001). It is thus essential to have a multidisciplinary health team focused on the development of ergonomic activities, personal protective equipment, and health orientation specifically targeting this group's needs.

Absenteísmo por doença ocupacional de trabalhadores rurais no setor canavieiro / Absenteeism due to occupational diseases among sugarcane workers / Absentismo laboral por enfermedad profesional de los trabajadores rurales en la industria de la caña de azúcar

O objetivo do estudo foi analisar a frequência de afastamentos por doenças ocupacionais de trabalhadores rurais em uma safra canavieira. Foram analisados 1.230 atestados médicos classificados de acordo com a 10a revisão da Classificação Internacional de Doenças (CID-10) de 400 trabalhadores rurais. Nos atestados foram analisados: diagnóstico médico, sexo, dias de afastamento e período do afastamento. Em todos os períodos as doenças osteomusculares apresentaram maior frequência de atestados seguidos das doenças respiratórias (p < 0,05). Os atestados por doenças osteomusculares foram mais frequentes no fim da safra do que na entressafra (p < 0,05). Em relação ao número de dias afastados, 75% dos atestados foram de um dia. Os atestados por doenças do aparelho geniturinário obtiveram maior número de dias afastados (p < 0,001). Assim, é fundamental a atuação de uma equipe multidisciplinar de profissionais da saúde que atentem para o desenvolvimento de atividades de ergonomia, equipamentos de proteção individual e orientações de saúde direcionadas especificamente às necessidades dessa população.

The aim of this study was to analyze the frequency of work-related sick leave in sugarcane workers. A total of 1,230 medical excuses for 400 sugarcane workers were analyzed according to the International Classification of Diseases, 10th Revision (ICD-10). The following items were analyzed: diagnosis, sex, and length and season of sick leave. In all the seasons, musculoskeletal diseases showed the highest sick leave rate, following by respiratory diseases (p < 0.05). Sick leave due to musculoskeletal diseases was more frequent at the end of the sugarcane harvest than during the intercrop season (p < 0.05). Seventy-five percent of medical excuses were for one day. The longest sick leaves were for diseases of the genitourinary tract (p < 0.001). It is thus essential to have a multidisciplinary health team focused on the development of ergonomic activities, personal protective equipment, and health orientation specifically targeting this group’s needs.

El objetivo del estudio fue analizar la frecuencia de ausencias por enfermedades ocupacionales de trabajadores rurales en una zafra azucarera. Fueron analizados 1.230 certificados médicos de acuerdo con la 10a revisión de la Classificación Internacional de las Enfermedades (CID-10) de 400 trabajadores rurales. En los certificados se examinaron: diagnóstico médico, sexo, días de ausencia y período de ausencia. En los períodos descritos las enfermedades del aparato locomotor mostraron una mayor frecuencia en los certificados, seguidas de las enfermedades respiratorias (p < 0,05). Los certificados por enfermedades del aparato locomotor fueron más frecuentes al final que en al principio de la zafra (p < 0,05). En relación con el número de días de ausencias, un 75% de los certificados tenían un día. Los certificados médicos de las enfermedades del sistema genitourinario tenían un mayor número de días de ausencias (p < 0,001). Por ello, es esencial trabajar con un equipo multidisciplinar de profesionales de la salud que se centren en el desarrollo de actividades de ergonomía, equipo de protección individual y orientación, dirigidos específicamente a las necesidades de esta población.

Musculoskeletal disorders among Irish farmers.

BACKGROUND: Farming is an occupation that predisposes individuals to health problems including musculoskeletal disorders (MSDs). There is limited research regarding MSDs among farmers especially in Ireland. AIMS: To establish the prevalence of MSDs, identify the most commonly affected body regions and to explore what factors may influence the development of the most common MSDs among farmers in Ireland. METHODS: A questionnaire survey of Irish farmers was conducted. The study sample comprised 600 farmers (100 farmers from each of the six main farm enterprise systems in Ireland). RESULTS: Of the 600 farmers, 56% had experienced a MSD in the previous year. The most commonly experienced MSDs were back pain (37%) and neck/shoulder pain (25%). Other MSDs experienced in the previous year included knee pain (9%), hand-wrist-elbow pain (9%), ankle/foot pain (9%) and hip pain (8%). Overall, MSDs were more common in farmers working longer hours (P < 0.05). Back pain was more prevalent in full-time farmers (P < 0.05), while prevalence of hip pain was greater in farmers who were older (P < 0.01), full time (P < 0.05), farming for longer (P < 0.01) and working for longer hours (P < 0.01). Farm enterprise was not a factor in influencing the development of MSDs. CONCLUSIONS: These findings suggest that the number of hours worked by farmers, rather than enterprise specific tasks render farmers more susceptible to MSDs. Further investigation is needed to explore risk factors in the development of MSDs.

Mortality in the Baltimore union poultry cohort: non-malignant diseases.

BACKGROUND: Workers in poultry plants have high exposure to a variety of transmissible agents present in poultry and their products. Subjects in the general population are also exposed. It is not known whether many of these agents cause disease in humans. If they do, we reason this would be readily evident in a highly exposed group such as poultry workers. We report here on mortality from non-malignant diseases in a cohort of poultry workers. METHODS: Mortality was compared with that of the US general population, and with that of a comparison group from the same union. Risk was estimated by standardized mortality ratio, proportional mortality ratio, and directly standardized risk ratio. RESULTS: Poultry workers as a group had an overall excess of deaths from diabetes, anterior horn disease, and hypertensive disease, and a deficit of deaths from intracerebral hemorrhage. Deaths from zoonotic bacterial diseases, helminthiasis, myasthenia gravis, schizophrenia, other diseases of the spinal cord, diseases of the esophagus and peritonitis were non-significantly elevated overall by all analyses, and significantly so in particular race/sex subgroups. CONCLUSIONS: Poultry workers may have excess occurrence of disease affecting several organs and systems, probably originating from widespread infection with a variety of microorganisms. The results for neurologic diseases could well represent important clues to the etiology of these diseases in humans. The small numbers of deaths involved in some cases limit interpretation.

Risk factors for serious injury in Finnish agriculture.

BACKGROUND: Previous studies indicate 20% of injuries represent 80% of injury costs in agriculture. To help prevent the most costly injuries, we aimed to identify characteristics and risk factors associated with serious injuries. METHODS: We analyzed insurance records of 93,550 self-employed Finnish farmers. We ranked injury causes by claim cost and used multiple logistic regressions to identify risk factors for (any) injury and serious injury (injuries exceeding claim costs of 2000 euros). RESULTS: A total of 5,507 compensated injuries occurred in 2002 (rate 5.9/100 person-years), and 1,167 or 21% of them (rate 1.25/100 person-years) were serious. The causes/sources resulting in highest average claim costs were motor vehicles; stairs, scaffoldings, and ladders; trailers and wagons; floors, walkways, and steps; other structures and obstacles; augers, mills, and grain handling equipment; horses; combines and harvesting equipment; tractor steps; and uneven and slippery terrain. Older age, male gender, higher income level, greater field size, residing on the farm, Finnish language (vs. Swedish), occupational health service (OHS) membership, and animal production were risk factors for injury. The risk factors for serious injury were similar; however, the effects of age, income level, and the raising of horses were more prominent. Language, residence, ownership status, and OHS membership were not risk factors for serious injury. CONCLUSIONS: Cost-effective prevention efforts should address the following risk factors: older age, male gender, larger income and operation size, livestock production (particularly dairy, swine, and horses), motor vehicle incidents, falls from elevation, and slips, trips and falls.

Agricultural-related injury and illness in The Gambia: a descriptive survey of a rural nursing service and area farmers.

This is an exploratory, descriptive study based on a convenience sample from a rural nursing service and in-country area farmers from The Gambia. The purpose of the study was to provide descriptive information about agricultural-related injury and illness from area farmers and to obtain data from rural nurses about the time they spent caring for and treating farmers. Employees of the nursing service could read and write English fluently and thus completed a written questionnaire; the area farmers were unable to read and write English so they were interviewed by farm extension workers in their own tribal language. The most alarming findings were the nursing respondents' report of farm workers using pesticides in their homes, the poor condition of pesticide sprayers, and the lack of personal protective equipment. Despite their claim of following pesticide instructions, farm workers reported a surprisingly high number of respiratory and neurological signs and symptoms.

Common skin disorders seen in the migrant farmworker health care clinic setting.

BACKGROUND: Skin diseases are common occupational illnesses for farmworkers. Migrant farmworkers commonly access rural health clinics for diagnosis and treatment of skin disease. PURPOSE: To assess common skin conditions of migrant farmworkers treated in rural clinics and to describe effective and economic management of these conditions. METHODS: Seventy-nine farmworkers with a skin condition were seen as patients at 4 clinics in eastern North Carolina. A list of the most common conditions encountered was compiled and treatment methods were found in the literature. RESULTS: Twenty-three common conditions were identified. The most common conditions were contact dermatitis, melasma, tinea, seborrheic keratoses, and impetigo. A table of treatment recommendations was composed that can be used by clinicians in this setting. CONCLUSIONS: Generally, the most common skin conditions seen in the migrant farmworker population in eastern North Carolina are similar to conditions found in the general population.

Prevalence and predictors of respiratory symptoms among New York farmers and farm residents.

BACKGROUND: Data from telephone interviews with New York farmers and farm residents were used to study the prevalence and risk factors of symptoms that could be related to asthma and allergies. METHODS: Participants were asked if they had wheezing or whistling in the chest in the past year and about the occurrence of stuffy, itchy, runny nose or watery, itchy eyes in the past year. RESULTS: The prevalence of wheeze was 18.2% and of stuffy nose/watery eyes was 57.4% (N = 1,620). Significant risk factors for wheeze were cigarette smoking, a systemic reaction to allergy skin testing, immunotherapy, or insect sting, reactivity to a pet, having goats, and more acreage in corn for silage. Significant risk factors of stuffy nose/watery eyes were younger age, having more than a high school education, being a worker on the farm, and having done spraying. CONCLUSIONS: Wheeze may be indicative of existing or latent asthma, a potentially limiting respiratory illness. Stuffy, itchy, runny nose or watery, itchy eyes, which may cause irritation and discomfort, may also indicate an increased sensitivity to respirable dusts and chemicals. This cohort of New York farmers had significant farm-related risk factors for wheeze and stuffy nose/watery eyes.

Clinical and radiological prevalence of skeletal fluorosis among retired employees of Wonji-Shoa sugar estate in Ethiopia.

OBJECTIVE: To study the clinical and radiological prevalence of skeletal fluorosis among the retired employees of Wonji-Shoa sugar estate. DESIGN: Retrospective and cross-sectional study. SETTING: Wonji-Shoa sugar estate, an agro-industrial estate located in the Ethiopian Rift Valley. SUBJECTS: Two hundred and sixty three employees of the estate who retired between 1995 and 1996. MAIN OUTCOME MEASURES: Clinical evidence of impaired squatting, neck and lumbar mobility, kyphosis, and X-ray evidence of fluorosis. RESULTS: Skeletal fluorosis was more evident among the males (p<0.05), and the prevalence was higher among the factory and the agricultural workers than among the administrative workers (p<0.05). Clinical prevalence was 20% versus the radiological prevalence of 70.3%, indicating that many cases were asymptomatic. Impaired neck and lumbar mobility and impaired squatting significantly agreed with the radiological diagnosis (p<0.05) while kyphosis was not. CONCLUSION: Further clinical and epidemiological studies are suggested and strengthening of the existing defluoridation programmes within the area is recommended.

Sugarcane farming, occupational solvent exposures, and the risk of oral cancer in Puerto Rico.

The work history information from a population-based case-control study conducted in Puerto Rico was analyzed using a job exposure matrix to investigate the relationship between occupational exposures and cancers of the oral cavity or pharynx. After adjustment for age, alcohol, smoking, and residence in a logistic model, the risk for cancer of the oral cavity, but not the pharynx, was significantly elevated among farm workers in the sugarcane industry (OR = 4.4, 95% CI = 1.4-13.6). An exposure-response trend was seen for cumulative exposure to solvents, with an OR = 3.2 (95% CI = 0.8-12.6) in the highest exposure category. The overall contribution to the risk of cancer of the oral cavity or pharynx associated with occupational exposures in Puerto Rico appears to be small, however, the elevated risks were seen among sugarcane farmers and subjects with high cumulative exposure to solvents.

Shade tobacco and green tobacco sickness in Connecticut.

The prevalence of Green Tobacco Sickness (GTS) among shade tobacco farmworkers in Connecticut is unknown. We conducted a study to determine the prevalence of GTS in farmworkers working in shade tobacco fields who presented for clinical care at medical student-run clinics. A retrospective chart review of the tobacco workers seen at Farmworkers' Clinics during 2001 was instituted in this study. Although GTS was not clinically diagnosed in any of the patients, we found 15% diagnoses that could be attributed to possible GTS by ICD-9 code review. Using a stricter GTS case definition, the frequency rate decreased to 4%. Nonsmokers were significantly more likely than smokers to report GTS-like symptoms (P < 0.01). Isolated symptoms of headache and dizziness were significantly more frequent among nonsmokers than smokers (P < 0.05). In conclusion, cases of possible GTS were found in Connecticut shade tobacco workers. Nonsmokers were more at risk to have possible GTS than smokers.

Musculoskeletal symptoms among farmers and non-farmers: a population-based study.

Farming has been considered a high-risk occupation for musculoskeletal disorders. However, documentation of the increased risk is weak except for hip osteoarthritis. 1,013 full-time farmers in nine Swedish municipalities and 769 non-farmers (referents), matched for age, sex, and residential area, participated in the study. Information about medical history, consultations, and sick leave for musculoskeletal disorders was obtained by questionnaire and interview. The farmers reported significantly more symptoms affecting the hands and forearms, low back, and hips than did the non-farmers, and a non-significant trend in the same direction was found for symptoms from the neck, shoulders, and knees. However, the farmers did not seek medical advice more often than the referents, and they reported significantly less sick leave for these problems. Thus, farmers appear to have more musculoskeletal symptoms than do non-farmers.

Golpe de calor. Informe de siete casos ocurridos en trabajadores agrícolas / Heart stroke. 7 cases appeared between farmworkers

Se estudiaron siete trabajadores estacionales foráneos que presentaron golpe de calor (GDC) en campos agrícolas de Sinaloa en septiembre de 1994. Fueron recolectadas notas clínicas, y resultados de autopsia forense en los cinco pacientes que fallecieron. Se analizaron características toxicológicas de muestras biológicas, de agua, suelo y plantas; se indagó microclima durante la ocurrencia de los casos. Los trabajadores iniciaron a 24 horas del arribo a Sinaloa y la sintomatología inició entre 5-24 horas después, con pérdida súbita de conciencia e hipertermia mayor de 40ºC; el análisis toxicológico no indicó posible intoxicación por plaguicidas agroquímicos. Microclima: temperaturas máximas de 36-40.5ºC, temperaturas mínimas de 22.5-26.5ºC, humedad relativa: 77-86 por ciento; en el diagnóstico post mortem de cuatro casos prevaleció falla orgánica múltiple. GDC debe prevenirse en trabajadores estacionales que se expondrán a carga térmica ambiental

An epidemiological study on cutaneous diseases of agricultural workers authorized to use pesticides.

BACKGROUND: There is an increased risk for agricultural workers to acquire skin problems, but data so far published are still very scarce. OBJECTIVE: To individualize skin disorders that involved this class of workers. METHODS: Between 1990 and 1992, 426 agricultural workers, authorized to use pesticides, were examined. The control group consisted of 100 nonagriculture workers, who were age and sex matched. RESULTS: Some common dermatological diseases, such as vitiligo, psoriasis and seborrheic dermatitis, had an incidence overlapping with that found in the controls. Irritant plant dermatoses (2.5%), episodes of acute systemic intoxication from pesticides (6.8%), onychopathies due to chronic trauma (16%), contact dermatitis of the hands (12%), chilblains (7%) and Favre-Racouchot syndrome (2.5%) showed a higher prevalence in the study group. CONCLUSION: Farmers were affected mainly by diseases caused by the direct action of chemical agents, either natural or industrial, in addition to climatic and physical agents.

A proposed classification code for farm and agricultural injuries.

A fundamental problem with classifying agriculturally related injury is that there is neither a rational nor a comprehensive scheme for grouping incidents into categories describing actual exposures encountered on farms and in agricultural work. Current surveillance systems are unable to differentiate between work that is related to farm production and work that is not, and to include all exposed persons in the surveillance. The proposed Farm and Agricultural Injury Classification Code is a step toward overcoming these problems. When it was applied to previously analyzed fatality data, 40% of cases previously identified as farm production work were reclassified into other categories.

[Management of agricultural injuries at our department]. / Mezögazdasági sérültek ellátása osztályunkon.

Authors want to call attention with the presentation of 4 cases to the significance of the agricultural injuries and to the difficulties of the therapy. The importance of the primary wound care is stressed. An adequate excision of the wound, debridement and an open wound care are essential in severely crushed, soiled cases. Therapy of severely crushed injuries, complicated with multiple fractures needs individual weighing and a reconstruction in more sittings.