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Surveillance of Hired Farm Worker Health and Occupational
Safety
Appendix C: List of Research Priorities
Priority #1: Pesticides
-
Exposure studies
- Exposure vs. health effect
-
Burden
- What are "safe" levels of exposure to specific pesticides for
pregnant women x days after application?
-
Biomarkers
- Changes over time, metabolites
-
Other points
- Antibody test to determine cholinesterase inhibition in absence
of baseline
- Recognition of some systemic exposure with dermal exposure
- Cumulative effect of repeated, long-term exposure
-
Poisonings
- Need for diagnostic criteria (including clinical source, lab
tests often not done at time of event)
- Need for functional case definition
-
Other points
- Recognize that definite exposure, without specific illness, is
legitimate workers' compensation claim case
- Distribution of cases by sector of agriculture, the SIC
code
-
Pregnancy/reproductive outcomes
- Birth defects
- Neural tube
- Sterility
-
Neurologic
-
Neuropsychiatric outcomes
- Neuropsychologic effects such as anxiety or "nervios."
- Prevalence, Causes - work, living conditions, money
- Parkinson's disease
- Muscle weakness
- Alzheimer's disease
-
Other Points
- Impossible to demonstrate cause/effect in individual cases with
Parkinson's and Alzheimer's
- Headaches
-
Multiple chemical sensitivity
- Allergies
- Other conditions
-
Other points
- Flashback symptoms, pesticide exposure produces symptoms caused
by prior poisoning
- Eye conditions
- Extent of disability
-
Genotoxicity/chromosomal damage related to exposure
- Inform physicians/health personnel of prevalence
-
Ongoing longitudinal health study
- Compare applicators and field workers
- Compare farm workers and non-farm workers
-
Immunological
- Allergies - including upper respiratory
- Allergies - including asthma vs. control population
- Impaired host defenses to infectious diseases
-
Control population difficult to obtain
- Study migrants and control in home base *see study by Dever,
1991
Priority #2: Ergonomic/Musculoskeletal Conditions
-
Case definition
- Mechanism of injury
- Cervical/shoulder
- Affect of migration
- Chronic back problems in individuals with major injury event
-
Diagnostic Criteria
- Studies done when patient has been inactive for weeks/days. If
working up until testing done?
- Clinical judgments, gradation of severity of overuse injury
- Incidence/prevalence data
- Workers' compensation
- Distribution of cases by sector of agriculture, SIC code
- Type and prevalence by crop
Priority #3: Injuries
-
Workers' Compensation
- Prevalence of conditions
- Reporting and recognition of WC claims and acceptance and payment
of claims
- Barriers (such as Proposition 187)
-
Rehabilitation
- Effectiveness of rehabilitation
- What percentage of disabled farm workers can obtain
rehabilitation
- Barriers to rehabilitation services, Proposition 187
- Availability of services
-
Prevalence/incidence
- Labor camp-related vs. on the job injuries
-
Prevention/intervention
- Education re: safety on job, on highway, in labor camps
- Personal protective equipment
- Effectiveness
-
Transportation
- State laws on licensing raiteros (people who transport
workers to job-sites for a fee)
-
Disability
- How many 50-year-old farm workers are still able to do farm
work?
- How many disabled farm workers are able to find alternative work,
especially if monolingual Spanish?
- Permanent vs. temporary
Priority #4: Effect of Protective Measures
-
Evaluate pesticide restricted entry intervals
- Effectiveness of REIs
- Quality of data used by EPA to make REI decisions
-
Personal protective equipment
- Design of gear (comfort and cost issues, appropriateness)
- Effectiveness
- Compliance with recommended use foot gear and respiratory
equipment (frequency of cartridge changes)
- Compare use of PPE in pesticide application done by small farmer
vs. hired farm workers
- Use of leather boots in mixer/sprayer workers
- Retrofitting equipment
-
Others
- Safe distance from drift?
- Evaluate effectiveness of training
- Enforcement of protective regulations (extent of voluntary
compliance)
- Pesticide alternatives/integrated pest management
- Evaluate worker training programs in relation to workers' control
in the workplace
- Evaluate effects of disincentives on chemical use, cholinesterase
testing requirement
- Safety interlocks on machinery
- Ventilation in greenhouses
Priority #5: Cancer
-
Breast Cancer
- Assess access to services
- Assess impact of intervention
-
Childhood Cancers
- Compare farmer and farm worker
- Compare farm worker and non-farm workers
- Availability of tumor registry information
-
Leukemia
- Compare farmer and farm worker
- Compare farm worker and non-farm workers
- Availability of tumor registry information
-
Other
- Prostate
- Hodgkin's and non-Hodgkin's lymphomas
- Skin
- National study
Priority #6: Choice of Control/Comparison Population
-
Non-agricultural populations
- Hispanic (health characteristics)
- Hispanic HANES
- Residents of same community
-
Other
- Farm worker vs. non-farm worker (similar ethnicity)
-
Migrant vs. permanent, year-round population on pesticides
- Access to personal protective equipment
- Prevalence of poisoning and injury
- Simultaneous surveillance vs. retrospective case control
- Migrant population (US resident, Mexican, other)
- Seasonal population
- Insurance actuarial data profile for a "typical" U. S.
resident?
Priority #7: Mental Health
-
Stress
- Occupational causes
- Contributing factor in illness or injury
- Low wage employment
- Repeated interruption of employment
- Residence in unfamiliar cultural setting
-
Pesticides
- Diagnoses and conditions linked to pesticide exposures
- Personality profiles (example: anxiety, depression, insomnia
among mixers/sprayers during season vs. off-season)
-
Others
-
Depression
- Occupational causes
- Link to pesticide exposure
- Link to stress
- Measure suicide/homicide rates and impact of intervention such as
access to mental health, community health education, outreach
- Impact of Proposition 187 on reporting of domestic violence
- Effects of migrant status
- Substance use/abuse
- Women vs. men
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