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Established in 1986, the Centre for Agricultural Medicine at the University of Saskatchewan is the only diversified research unit in Canada dedicated to studying the health effects of agricultural exposures on rural populations. The Centre works closely with scientists in many Canadian and international agencies, including several in the United States. The symposium was intended to elucidate the emerging science of health, safety and sustainability in agriculture and rural life, and to probe issues related to future sustenance of agriculture. A multitude of talks covered a variety of topics, including rural health delivery, chemical exposures, control technologies, health issues of migrant and seasonal workers, infectious diseases in agriculture, economics and social matters, occupational health and safety, cancer risks, injury surveillance and prevention, ecosystem health, respiratory disorders, and sustainable rural development. The UC Agricultural Health and Safety Center at Davis was well-represented, with Center investigators Marc Schenker, Steve McCurdy, John Miles, Barry Wilson, Rose Krebill-Prather, Don Villarejo and Marla Orenstein all participating in the conference. The Center maintained an informational display interpreting its administrative, thematic and service core organizational pattern and describing current research projects and outreach programs. Marc Schenker and Don Villarejo were keynote speakers for a session on Migrant and Seasonal Workers. Schenker gave an overview of health problems among migrant and seasonal farmworkers, and Villarejo spoke about new frontiers in occupational safety and health research among hired farm-workers. In the same session, Steve McCurdy presented results of a study involving work-related injuries among California migrant Hispanic farmworkers. In other sessions, Barry Wilson presented results from a study of fingerstick measurements of blood cholinesterase from residents of California migrant centers, and John Miles discussed the ergonomic risk factors involved in wine grape vineyard work. Marc Schenker and Marla Orenstein exhibited posters on the use of protective equipment by California farmers and on the relationship between respiratory disease and inorganic dust exposure among California farmworkers. Paivikki Susitaival, who served a sabbatical term at the UC Davis Center from 1996 to 1997 and who currently works for the Finnish Institute of Occupational Health, was also on hand to present results of her work on skin diseases in farmers and farmworkers, and on skin diseases and prick test results in rural Iowa.
Saskatoon, eh? 1999-01-04 RESPIRATORY HAZARDS: JOURNAL PUBLISHES EXTENSIVE WORK Unlike most occupational settings, the farm is frequently both residence and worksite for the agricultural worker. Consequently, even family members not directly engaged in farm work may be incidentally exposed to respiratory hazards. Nonfarming rural residents living near farming operations may also be at significant risk from exposure to agricultural dusts and pesticides and other chemicals carried by aerial drift. While agriculture is typically regarded as a single industry, it is extremely diverse with substantial respiratory hazards occurring from organic and inorganic dusts, chemicals, gases and infectious agents. Unlike most traditional industries, many features of the agricultural workplace have limited the investigation and control of occupational respiratory hazards, since agriculture is spread over large distances with only a few persons at each location. The migrant lifestyle of many farmworkers further limits the ability to perform epidemiologic investigations. A comprehensive compilation of respiratory health hazards in agriculture
sponsored by the American Thoracic Society and the National Institute
for Occupational Safety and Health (NIOSH) has been published by
the American Thoracic Society in the November supplement of the
American Journal of Respiratory and Critical Care Medicine.
Edited by Center Director Marc B. Schenker, the supplement consists
of a comprehensive review of agricultural respiratory diseases by
30 researchers from throughout the world. Seven chapters cover the
following topics: Dusts and agricultural chemicals are major respiratory health concerns in Western agriculture, but many other respiratory hazards exist. For example, animal confinement facilities may result in generation of ammonia and hydrogen sulfide, which can cause acute and chronic toxicity to the lungs. Oxides of nitrogen may also be generated in storage facilities, resulting in an acute danger to health as well as chronic disease. A major respiratory problem that has been better characterized in recent years is the Organic Dust Toxic Syndrome (ODTS). This syndrome results from exposure to endotoxins and other chemical agents that occur from fungal contamination in agricultural worksites. The syndrome manifests itself in the form of systemic symptoms resembling the flu (i.e., fever, chills, myalgias, weakness and prostration). Recent research has suggested that exposure to disinfectants in dairy farms may cause respiratory symptoms. Other exposures of farmers and agricultural workers that may affect the respiratory system include welding fumes, fertilizers, solvents and fuels. Agricultural workers are at increased risk of contracting a number of infectious diseases, although few studies have characterized the nature and magnitude of this risk in this population. Tuberculosis has been found to be prevalent in some agricultural worker populations. In California, farmworkers may be at increased risk of coccidiomycosis (Valley Fever) because of activities that disturb the soil and release the cocci spores. The ultimate goal of this effort is to both identify the causes
of increased respiratory morbidity and mortality in the agricultural
workplace, and to implement strategies for reducing that disease
burden. The most appropriate focus of future work in all areas of
respiratory hazards in agriculture is in identifying risk factors
and developing specific prevention strategies. Many intervention
strategies have been established but much more needs to be done,
including: For information on obtaining copies of the American Journal of Respiratory and Critical Care Medicine's supplement,Respiratory Health Hazards in Agriculture, please call the Center at (530) 752-4050, or e-mail agcenter@epm.ucdavis.edu. 1999-01-05 NEW CENTER INVESTIGATOR BRINGS 20 YEARS OF ECONOMICS EXPERTISE TO UC DAVIS J. Paul Leigh, a 20-year veteran in the field of econometrics, health and labor economics, joined the UC Davis Department of Epidemiology and Preventive Medicine, and the Center for Health Services Research in Primary Care at the UC Davis Medical Center in August. Since 1981, Leigh served on the faculty of San Jose State University, from which he received three Meritorious Performance Cash Awards. In 1986 Leigh accepted a concurrent appointment as a research economist at Stanford University, which he served until accepting a professorship at UC Davis.
Data are available for 3,852 youths and 683 children, and Leigh proposes to describe the medical and indemnity cost for these 4,535 claims along several dimensions, including type of farm or crop, Workers' Compensation categories for injuries and illnesses, nature of accident and injury, body part affected, age of claimant, and month and year of claim. Workers' Compensation categories include death, permanent total and permanent partial disability, temporary total and temporary partial disability as well as non-disability medical visits. "Farm injuries are an under-appreciated social problem," says Leigh. "If we can show that the economic costs resulting from these injuries are borne by society at large and taxpayers, these injuries should receive the attention they deserve." Leigh received his bachelor's degree in economics from the University of Oregon, Eugene, where he graduated Phi Beta Kappa in 1973. He continued his education, earning a Ph.D. in economics at the University of Wisconsin, Madison, in 1979. He has received numerous grants, serving most recently as a consultant for the National Public Services Research Institute, and National Institute for Occupational Safety and Health (NIOSH) researching the costs of occupational hazards. He was also a consultant and principal investigator on projects for Stanford Medical School, Mt. Sinai School of Medicine, San Jose State University and the University of Kentucky, and has written or co-written numerous articles on the cost of occupational injuries and illnesses.
1999-01-06 RESEARCH ON CUMULATIVE INJURIES IN THE NURSERY INDUSTRY PAVES WAY FOR NEW STUDIES Musculoskeletal injuries and illnesses represent a rapidly growing pro-portion of all Workers' Compensation injury costs. They are expensive to treat, recur easily and, if not treated properly, can result in permanent disability. Center investigators have been working with nursery and vineyard operators and workers to determine the risks and modify some of the tasks and tools used in order to prevent cumulative trauma disorders.
"When John Miles, Jim Meyers, Ira Janowitz and I looked at the injury data, it was our assumption that a lot of musculoskeletal disorders that are hidden may not be acute injuries but may be what we call cumulative trauma disorders--musculoskeletal disorders that are presumed to develop over a period of time from exposures to repetition, force, lifting and bending," explained Faucett. "So hidden in the statistics for overexertion, sprains and strains, we expect that there are a number of long-term musculoskeletal injuries." Cumulative trauma disorders primarily affect the upper extremities--shoulders, neck, hands and wrists, and back. But farmworkers also are at risk for injury to hips, knees and feet because of frequent stooping and bending. Faucett and her colleagues began their investigations in the nursery industry because of the similarities with the manufacturing industry, in which many ergonomic studies have taken place. The cooperating nurseries in which researchers were invited to investigate are located in Orange County and mainly grow flowering plants and shrubs. Investigators set out to gather ergonomic data, including the amount of twisting, bending, lifting and repetition to which workers are subjected on the job, as well as collecting health outcome data from the OSHA log. "We noticed a surprisingly low number of reported injuries. There's a disincentive to report injuries because of labor force oversupply," said Faucett. "We also found that the people who are keeping the OSHA logs tend to be front-office staff with very little training about what to include in the log." Investigators also developed a Spanish language, culture-specific survey, asking workers specific information about their muskuloskeletal symptoms, work history, self care treatments, and whether they had seen health care providers for any type of possibly work-related injury. "We began the process by developing focus groups drawn from the populations in the nursery setting. We had two women's groups and two men's groups who met with us," explained Faucett. "We tried to draw people who were articulate and would be comfortable talking to us, and we discussed their symptoms in order to build some sections of the questionnaire." To determine an appropriate method for measuring symptoms, investigators asked volunteers to pick three symptoms and showed them a body diagram. Using colors to indicate symptoms, investigators asked volunteers the colors in which their coworkers in the nursery industry would respond best. Blue was designated by the focus groups to be an aching, moderate pain. Red indicated a sharp and severe pain, and yellow was designated to show numbness, which was particularly important because of nerve impingement. The scale in which focus groups chose to indicate pain was a series of simple drawings of facial expressions, originally developed for pediatric populations in the United States. The scale has been tested extensively for validity in English-speaking and minority populations for the past five years. "One of the things that we learned early on was that the Mexican workers would never use the word pain (dolor in Spanish), because if you are capable of working then it isn't pain (dolor), it's a discomfort (molestia), it's bothersome, it's an annoyance," said Faucett. "But they don't label it the way we would. So we're looking for the milder level of pain." Faucett and her colleagues developed a questionnaire and translated it into Spanish. A professional translator then translated it back into English to determine how well it had been translated before taking it to key volunteers in the nursery setting for review and pilot testing. "The process of translation and back-translation takes a phenomenally long time," admitted Faucett. "But I gained respect for the process of doing it this way because Spanish language differs from one part of the country to another. It takes multiple translations to get an instrument that is culturally and linguistically appropriate and can be widely used." The nursery project report is expected to be competed in December. The questionnaire developed for this project will be used in other ongoing agricultural ergonomics intervention projects. For more information call Julia Faucett at (415) 476-3221, or e-mail jaf@itsa.ucsf.edu. 1999-01-07 NIOSH ESTABLISHES NINTH AG CENTER IN FLORIDA In October, the National Institute for Occupational Safety and Health (NIOSH) announced the establishment of a ninth agricultural health and safety center, located at the University of South Florida College of Public Health in Tampa. The Deep-South Agricultural Health and Safety Center will provide coverage to a three-state region, including Alabama, Florida, and Mississippi. In addition to the NIOSH agricultural center program objectives listed below, this center is charged with addressing the occupational health and safety needs of special agricultural populations in the region, including minority and migrant farmworkers.The Deep-South Center's program consists of multi-disciplinary efforts in research, education and prevention. NIOSH's Centers for Agricultural Disease and Injury Research, Education and Prevention Program represents a major effort to protect the health and safety of agricultural workers and their families. The NIOSH agricultural centers were established as part of a Centers for Disease Control and Prevention (CDC) / NIOSH Agricultural Health and Safety Initiative in 1990. The ag centers were established by cooperative agreement to conduct research, education and prevention projects in response to health and safety problems in agriculture. This program brings external partners, from the agricultural centers and other institutes, together with NIOSH investigators in a collaborative effort to prevent occupational disease and injury among agricultural workers and their families. Since 1990, nine agricultural health and safety centers have been established in nine geographic regions throughout the United States. The centers are distributed throughout the nation to be responsive to the unique agricultural health and safety issues of those regions. The NIOSH ag centers include:
Center objectives: The director of the new Deep-South Agricultural Health and Safety
Center is Yehia Y. Hammad, Sc.D. He can be reached at the University
of South Florida College of Public Health |
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