Why Farmworkers Need More Than New Laws for Protection From Heat-Related Illness

PARQUES: Dreaming a Future for Our Latinx Children, Youth, and Families

A growing body of evidence suggests that the COVID-19 pandemic has disproportionally affected Latinx children, youth, and families in the United States by increasing the prevalence and incidence of mental health problems. While it is important to document the repercussions of the pandemic, it is also necessary to articulate what a future of wellbeing and positive mental health will look like for Latinx children, youth, and families. To address this need, we propose PARQUES, a framework to dream about the future of Latinx children, youth, and families in the United States. We imagine PARQUES as communal spaces for connection, joy, play, rest, and healing that result from activism and collective action. We use the Spanish word for parks as an acronym "PARQUES," which stands for políticas (policies), alegría (joy), reparación (healing and reparations), querencia (love and belonging), unión (unity), empleo (employment), and seguridad (safety). These components work together to create an ecosystem to foster the physical and mental wellness and wholeness of Latinx children, youth, and families.

Deepening the Divide: Health Inequities and Climate Change among Farmworkers

Climate change amplifies social inequities, disproportionately impacting the health and well-being of populations already vulnerable to social risk factors associated with race, ethnicity, immigration status, and occupation. Recent hurricanes, extreme temperatures, wildfires, and droughts have directly impacted vulnerable populations, including farmworkers in the US and its territories. Understanding how systems increase poor health outcomes for farmworkers is important to create solutions that are practical, feasible, and sustainable. In this commentary, we discuss a framework to assess the climate crisis and its impact on farmworkers. Although environmental stressors impact all populations, the difference in the systems or structures surrounding individuals can increase the risks and diseases of vulnerable populations when responding to the effects of the climate crisis. This framework presents policies and systems that could be limiting for agricultural workers when exposed to environmental stressors and the direct or indirect consequences of not addressing them.

Extreme Heat and COVID-19: A Dual Burden for Farmworkers

Currently, there is an extensive literature examining heat impacts on labor productivity and health, as well as a recent surge in research around COVID-19. However, to our knowledge, no research to date examines the dual burden of COVID-19 and extreme heat on labor productivity and laborers' health and livelihoods. To close this research gap and shed light on a critical health and livelihood issue affecting a vulnerable population, we urge researchers to study the two topics in tandem. Because farmworkers have a high incidence of COVID-19 infections and a low rate of inoculation, they will be among those who suffer most from this dual burden. In this article, we discuss impacts from extreme heat and COVID-19 on farm laborers. We provide examples from the literature and a conceptual framework showing the bi-directional nature of heat impacts on COVID-19 and vice versa. We conclude with questions for further research and with specific policy recommendations to alleviate this dual burden. If implemented, these policies would enhance the wellbeing of farmworkers through improved unemployment benefits, updated regulations, and consistent implementation of outdoor labor regulations. Additionally, policies for farmworker-related health needs and cultural aspects of policy implementation and farmworker outreach are needed. These and related policies could potentially reduce the dual burden of COVID-19 and extreme heat impacts while future research explores their relative cost-effectiveness.

Heatstroke-induced coagulopathy: Biomarkers, mechanistic insights, and patient management

Heatstroke is increasingly becoming a significant concern due to global warming. Systemic inflammation and coagulopathy are the two major factors that provoke life-threatening organ dysfunction in heatstroke. Dysregulated thermo-control induces cellular injury, damage-associated molecular patterns release, hyperinflammation, and hypercoagulation with suppressed fibrinolysis to produce heatstroke-induced coagulopathy (HSIC). HSIC can progress to disseminated intravascular coagulation and multiorgan failure if severe enough. Platelet count, D-dimer, soluble thrombomodulin, and inflammation biomarkers such as interleukin-6 and histone H3 are promising markers for HSIC. In exertional heatstroke, the measurement of myoglobin is helpful to anticipate renal dysfunction. However, the optimal cutoff for each biomarker has not been determined. Except for initial cooling and hydration, effective therapy continues to be explored, and the use of antiinflammatory and anticoagulant therapies is under investigation. Despite the rapidly increasing risk, our knowledge is limited, and further study is warranted. In this review, we examine current information and what future efforts are needed to better understand and manage HSIC.