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Clinic investigators established a clinic outreach advisory committee to evaluate the survey results and suggest ways of responding to the needs of clinic staff and their patients. After reviewing and discussing survey results, the committee recommended that investigators conduct train-the-trainer workshops for representatives of various clinics. In addition, they encouraged investigators to identify and develop reference materials for use by clinic personnel, suggesting that both training and resources focus on pesticide toxicological information and pesticide illness reporting procedures. The committee also urged Center investigators to provide a forum for clinic staff members to interact with pesticide regulators and enforcement agencies. "We worked very closely with our clinic outreach advisory committee to design this workshop, and we were very pleased with the results," said Patrick O'Connor-Marer, Center outreach coordinator and director of the UC Statewide IPM Project's Pesticide Education Program. "In fact, many of the committee members served as workshop instructors and were able to provide broad experience and a variety of perspectives to this important issue." Instructors included O'Connor-Marer, Melanie Zavala and Jennifer Weber of the UC Statewide IPM Project's Pesticide Education Program; Barry Wilson, UC Davis Departments of Animal Science and Environmental Toxicology; Michael O'Malley, UC Davis Employee Health Services and Department of Pesticide Regulation's Worker Health and Safety Branch; Rupali Das, California Department of Health Services; and Maria Vidauri, Monterey County Agricultural Commissioner's office. The training was initially designed and promoted as a workshop for health care providers interested in extending pesticide information and resources to other medical personnel. "We were surprised to discover that the program appealed not only to physicians and clinic staff members, but also to farmworker advocacy groups, growers and Workers' Compensation insurance company representatives, " O'Connor-Marer said. "This mix of diverse interest groups added a unique dynamic to the program and greatly contributed to the success of the training." Workshop participants attended six interactive sessions from which they received information on reporting requirements and pesticide use in California. Participants were given reference materials (e.g., books, Internet sites, guides) for recognizing and treating pesticide illnesses and injuries, as well as an overview of the latest tools for medical monitoring of pesticide exposure. Training techniques and hands-on activities were emphasized to help participants develop interesting and effective programs for training medical personnel. The final joint session was designed to bring all of these pieces together. In a role-playing exercise, three participants volunteered to act as patients suffering from symptoms that could have been caused by pesticide exposure. The remaining participants were asked to be health care providers trying to assess the situation using currently available resources. "I was impressed by the interaction and by the energy the trainees put into these scenarios. These are real situations that people face every day, and I think participants felt the difficulty in addressing these issues as they tried to diagnose the cases, seek information about the exposure, and decide how to respond in the patient's best interest, while still complying with the law." O'Connor-Marer added that the cases contributed to some great discussions following the session. These discussions focused on legal issues, worker's rights, and what really happens in these situations. "We realized there is still more work to be done to identify barriers, issues and informational gaps faced by health care providers and their patients," said O'Connor-Marer. "We intend to make a concerted effort to provide not only useful workshops and resources, but to continue developing links among medical personnel, farmworker advocacy groups, insurance companies, enforcement agencies and others." O'Connor-Marer was very pleased with one unexpected outcome of this workshop. "By accident, we discovered an effective way to bring members of the community together to explore common concerns and contribute to ongoing efforts to solve important problems," he said. The workshop was sponsored by the UC Statewide IPM Project, UC Agricultural Health and Safety Center, UC Davis Center for Environmental Health Sciences and UC Davis Health System Continuing Medical Education. Funding was provided by the National Institute of Occupational Safety and Health (NIOSH) and the National Institute of Health's Center for Environmental Health Sciences on the UC Davis Campus. Jennifer Weber is a pesticide safety educator for the UC Statewide IPM Project's Pesticide Education Program. 1999-02-04 CONTACT WITH ANIMALS COULD RESULT IN DISEASE Everyone is at risk of infectious diseases, but agricultural workers may be especially vulnerable. Infectious agents may originate in animals or in humans and may be transmitted in the workplace or at home under conditions of substandard housing accommodations, says Dean O. Cliver, a professor in the Department of Population Health and Reproduction, UC Davis School of Veterinary Medicine. Cliver, who conducts research on disease transmission through food and water, also leads a team that teaches foodborne disease courses through the UC Davis veterinary school.
"In 1993,Cryptosporidium parvum was transmitted through the Milwaukee city water supply, causing 403,000 illnesses and eventually 100 deaths," said Cliver, who also serves as a food science communicator for the Institute of Food Technologists. "Now that they're surveying waterways, we're finding it very widespread. A great deal of contamination is alleged to be a result of animal manure, although not necessarily from domestic animals." How do people become exposed to Cryptosporidium? Direct contact with infected animals presents a high risk of infection, as does working with manure as a soil amendment that is contaminated with Cryptosporidium parvum. "The organic growers' manual warns against using fresh manure within 60 days before harvest, but we can't be sure that soil that receives fresh manure is going to wipe out all pathogens within 60 days, or that it isn't still there at harvest time," says Cliver. "Nor can growers be certain of the content of composted manure. There are no legal standards for compost." In addition to Cryptosporidium parvum, farmworkers may be at risk of exposure to a variety of infectious agents. They include zoonoses, which are diseases and disease-carrying agents that are communicable from animals to humans, and human agents, which are transmitted due to unfavorable sanitary conditions. Farmworkers face multiple risks in becoming infected either from animals or from agricultural sources that may not threaten the population at large. Cliver asserts that if the threat of consumer infections is as real as those mentioned in the National Food Safety Initiative, a report to the president issued in May 1997, then the threat to farmworkers should be greater by a substantial margin. "The way to monitor infections in farmworkers is by stool testing," says Cliver. "But the greatest challenge (beyond financial support) is obtaining samples in a way that will ultimately relate specific modes of exposure with infections." Cliver hopes to work with the Center to further investigate the risks of infectious diseases among agricultural workers. His UC Davis laboratory is the World Health Organization's Collaborating Center for Food Virology. Cliver can be contacted by e-mail at docliver@ucdavis.edu, or by phone at (530) 754-9120. 1999-02-05 CHILD LABOR LAWS: FAIR HARVEST/SAFE HARVEST By Sharon L. Brunson This summer the U.S. Department of Labor will again launch its Fair Harvest/Safe Harvest campaign. The purpose of the campaign is to help farmworkers learn of their rights and provide information to keep all children safe who live on, work at, or visit farms and fields. Campaign literature includes a wallet card, poster, and a children's book, all of which have been printed in English and Spanish. The wallet card contains basic information about farmworkers' legal rights and also lists a toll-free number that workers can call for more detailed information. The book,Stay Safe on the Farm, contains colorful pictures that provide a lesson about the dangers on a farm and how to stay safe. Federal Child Labor laws prohibit children under 16 from working
in specific situations that are deemed too dangerous. In agriculture-related
work, these include, but are not limited to: Children under age 16 may work in agricultural-related jobs outside of school hours. Children ages 12 and 13 may be employed only with written parental consent or on a farm at which a parent is also employed. Fair Harvest/Safe Harvest materials may be obtained by contacting the local office of the U.S. Department of Labor's Wage and Hour Division, or by visiting the department's Web site at www.dol.gov Sharon Brunson is Regional Child Labor Coordinator for the U.S. Department of Labor, Wage & Hour Division's Western Region. 1999-02-06 EPIDEMIOLOGIST EXAMINES WORK PRACTICES AND HEALTH CONDITIONS OF FARM FAMILIES About the time the UC Davis Department of Epidemiology was searching for an epidemiologist in 1997, Marla Orenstein was completing coursework for her M.Sc. degree in epidemiology at the University of Edinburgh, Scotland. She had developed a Web page containing her resumé, and sent a brief e-mail message to several epidemiologic-related list servers searching for potential employers.
Orenstein, who also has a degree in English literature and served as a professional editor for five years, recently produced a newsletter that was mailed to Farmer Health Study participants containing study results and other information of interest to farmworkers and their families. Similar to some of the studies conducted by agricultural health and safety investigators, Orenstein's M.Sc. dissertation, "Indoor Air Pollution and Acute Respiratory Infection Among Children Under 5 Years Old in Developing Countries," explored children's exposures to indoor air pollution (wood, crop residues, animal dung) and environmental tobacco smoke. "Not surprisingly, there was a fairly strong association between children's exposures and respiratory infections," says Orenstein. "However, many of the studies that were carried out in developing countries had problems assessing both exposure and disease. I felt that it would be more useful to pose research questions that could help lead to a solid scientific base for managing risk." Orenstein submitted an edited version of her report to the Environmental Health Group of the World Health Organization (WHO) in Geneva, Switzerland. In addition to the Farmer Health Study, Orenstein is working on a project examining particle deposits in the lungs of deceased men in Fresno County. The study's aim is to determine the relationship between dust accumulation in human lungs and lung disease. A citizen of Canada and the United States, Orenstein grew up in Needham, Mass., and received her bachelor's degree in English literature in 1990 from McGill University in Montreal, where she met her husband, Murray Lee. He is originally from Calgary, Alberta, Canada, and works as a family physician for UC Davis. Orenstein then spent two years in Ishinomaki, Japan, teaching English, before joining Evergreen Communications, a public relations and marketing communications firm in Calgary, Alberta, Canada. From 1993 to 1995 she served as associate editor of Synchronicity Magazine, a bimonthly publication with a circulation of more than 60,000 in Western Canada, and started her own graphic design and Web page writing and production service. When Orenstein decided to change careers, she interviewed several people about what they did for a living. "Laura Derby, an epidemiologist at Boston University, got me really excited about epidemiologic research," says Orenstein. "It seemed to employ all of the skills I liked to use, such as problem-solving and analytical reasoning, in a way that could potentially be of real help to humanity." She was thrilled when she was accepted into the epidemiology program at the University of Edinburgh, Scotland. Orenstein was named Science Coordinator for the Agricultural Health and Safety Center in April. "I`m responsible for coordinating research and scientific activities of the Agricultural Health and Safety Center at Davis, under the supervision of the Center director," said Orenstein. In this new position, Orenstein will also develop and implement annual RFAs for research grants; coordinate communications between investigators, support staff members and external agencies; develop effective strategies for communicating with the news media; and provide grant-writing and outreach assistance to center investigators. 1999-02-07 SMALL FARM CENTER TEACHES SAFE FARM PRACTICES TO SOUTHEAST ASIAN FARMWORKERS In 1979 the California Legislature created the Small Farm Program, administered through the University of California Division of Agriculture and Natural Resources (DANR). The purpose of the program was to provide marketing and other information to small-scale, family-owned or managed farms, often with limited resources and not reached by traditional extension programs. The statewide Small Farm Program consists of the Small Farm Center at its core; California county-based farm advisors; the Small Farm Workgroup, including UC farm advisors and faculty members; and an external advisory committee. The center's director, Desmond Jolly, an agricultural economist, has led the program since 1995.
Working together, Molinar and Jolly contracted with a group called the California Latino Agricultural Association (CLAA) to help develop a survey to identify key characteristics and practices of recent immigrants and to offer suggestions about the kinds of exposures and risks these people face. From results of their survey, Jolly and Molinar learned that most of the farmworker respondents immigrated between 1960 and 1980, and 80 percent had other family members working with them on the farm. A total of 70 percent said they belong to the CLAA, but only a smattering belong to other organizations, mainly due to linguistic or cultural restraints. The majority (98 percent) do not speak or read English and a percentage of them don't read at all. Jolly therefore concluded that printed materials would not be the most effective means of communicating information on health and safety among these workers. "That's why we try to innovate with other technologies," said Jolly, who helped to translate the English videotape "Pesticide Safety For Small Farms," originally produced by the Statewide Integrated Pest Management (IPM) Project at UC Davis, into Hmong, Laotian and Spanish. The Small Farm Program also developed audio versions of the tape for people who don't have access to video players. "I'm not a toxicologist," said Jolly, "but the materials these farmworkers are handling have risks about which we are concerned, even conditions as seemingly innocuous as a skin rash." The symptoms survey respondents identified included skin rash, burning in the throat, nausea, aches, vomiting and blurred vision. Jolly and his colleagues stress to farmworkers the importance of wearing suits, gloves and goggles and discuss safe IPM practices with them. Molinar works with a Hmong assistant (paid for, in part, by Jolly's office) named Michael Yang. "Language is a very large constraint," says Molinar, who speaks English and Spanish. "Michael, who can speak to the Southeast Asians, has accelerated my program considerably." The Small Farm Center also subsidizes a 30-minute program on Hmong radio in Fresno County on Mondays at 9:30 p.m. every other week, in which Yang discusses various issues involved in growing crops. "Michael Yang is on the radio for about 15-20 minutes, and we have about 10 minutes of call-in time, which is good for five to seven phone calls," says Molinar. "He's able to help farmworkers or direct them for additional help with issues such as marketing, obtaining loans, disaster systems or pest management." Jolly says he is beginning to utilize more community-based organizations as a way to further penetrate the cultures he would like to reach. "We also want to expand the program geographically into new counties that have not yet been part of this particular agenda to reach more people," says Jolly. "We're using the skills of Pat O'Connor-Marer and Jenny Weber [of IPM Education and Publications] to help us increase the number of train-the-trainer programs presented throughout the state." The Small Farm Center also maintains a library of books, scientific and popular journals, reports, directories and periodicals covering production, marketing and policy issues, and produces a quarterly newsletter,Small Farm News. For more information about the Small Farm Center or its programs, please contact Birgit Hempel at (530) 752-8136.
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