Health-Related Exposures and Conditions among US Fishermen

Social determinants of occupational injuries among US-based commercial fishermen: a systematic review

BACKGROUND

Commercial fishing is a multibillion-dollar industry that supports job growth, small- to large- businesses, and port and city revenue. The commercial fishing industry continues to be one of the most dangerous in the US, with a fatality rate nearly 40 times higher than the national average. Dangers of the fishing industry are multi-faceted and include hazardous working conditions, strenuous labor, long work hours, and harsh weather. Moreover, a vast majority of fishermen suffer from economic insecurity, including safe and affordable housing and food insecurity.

METHODS

We followed the recommendations and standards set by the Campbell and Cochrane Equity Methods Group and the Measurement and Evidence Knowledge Network. The review covered 1992-2022 to assess the state of research and to identify new barriers of and facilitators to injury prevention among commercial fishermen using a social determinants of health lens.

RESULTS

Of 292 articles identified, 27 studies met our inclusion criteria. Out of 27 articles reviewed, social determinants of health factors included the built environment, social & community factors, economic stability, health care access, and educational attainment. A major finding was the inability for fishermen to access primary care services, which was often rooted in being a low-wage, im/migrant, or transient worker, and can further escalate injuries. A secondary finding related to injury was a feedback loop where fishermen's unsafe environments led to a culture of accepting risk and downplaying injury, which further created unsafe environments.

CONCLUSION

Our review shows how injury is connected to social factors, such as a lack of health care access, as well as political-economic factors, such as a lack of sick leave benefits.

Burden and social distribution of occupational psychosocial exposures in the United States workforce, 2022

OBJECTIVE

To characterize the burden and social distribution of occupational psychosocial exposures in the United States (US).

METHODS

We merged 2022 US employment and demographic data from the Current Population Survey (CPS) with occupational characteristic data from the Occupational Information Network (O*NET), wage data from the Occupational Employment and Wage Statistics Survey, and hours worked from the CPS, to estimate the number and proportion of US workers at risk of exposure to 19 psychosocial hazards. We additionally estimated the number and proportion of US workers over- or underrepresented in exposure burden.

RESULTS

Of the exposures examined, US workers were most commonly employed in occupations with high time pressure (67.5 million US workers exposed; 43.2% US workers exposed), high emotional labor (57.1 million; 36.6%), and low wages (47.8 million; 30.6%). The burden of exposures was uneven across sociodemographic strata, attributable to occupational segregation. The full data set is available online at https://deohs.washington.edu/us-exposure-burden.

CONCLUSIONS

Work-related psychosocial exposures are ubiquitous and should be considered in occupational and public health research, policy, and interventions to reduce the burden of disease and health inequities in the United States.

Examining the Facets of Burden from Agricultural Injury: Policy Implications

Agriculture is one of the most dangerous industries in the United States. Loss of life, injury, and illness estimates in the agriculture industry only measure a fraction of the total burden to society. The purpose of this review was to conduct a comprehensive scan of the peer-reviewed literature to catalog research that explores the burden of agricultural injury to synthesize what is currently known. In total, 116 full-text papers meeting eligibility criteria were reviewed. Publications documenting agricultural injury burden were scanned and observations were categorized using a priori themes previously identified by occupational safety and health researchers. Results from this review indicate the true burden of agricultural injury is more expansive and complex than previous narratives on injury burden would imply. Future research should consider policies that encourage the collection of more expansive injury burden data, as well as methods to incorporate them into standard injury surveillance efforts.

Understanding Stakeholder Dissemination Preferences for an Agriculture, Forestry, and Fishing Injury Surveillance System

Researchers and epidemiologists are working to improve the capture of agriculture, forestry, and fishing (AgFF) injuries in a variety of ways. A critical component of any surveillance system is the dissemination of information. The purpose of this paper is to report on a survey conducted with AgFF injury surveillance stakeholders to understand preferred dissemination strategies. The survey was distributed using REDCap via web link to organizational stakeholders, which included advisory board members, safety trainers, industry managers and workers, and research collaborators. In total, there were 75 respondents (21% response rate). Occupation and industry influenced preference in update methods. Regarding the length and breadth of updates, 63% of respondents prefer reports (one to five pages), followed by 57% desiring a summary (less than one page), while only 24% wanted a detailed analysis. Social media and news preferences were also different among stakeholders. Surveillance data were desired for 1) trend analysis, 2) tailoring activities and solutions for education, training, outreach and interventions and 3) for research purposes such as grant proposals and evaluation. The dissemination of injury surveillance data should be tailored to the intended audience. Greater attention needs to be paid to the ways in which we share our findings.

Dissemination and Implementation of a Text Messaging Campaign to Improve Health Disparities among Im/Migrant Workers

The use of short message service (SMS) text messaging technology has grown in popularity over the last twenty years, but there is limited data on the design and feasibility of campaigns to reduce work-related injury, particularly among rural workers, non-native English speakers, and illiterate or low-literacy populations. Although there is a critical need for tech equity or 'TechQuity' interventions that reduce injury and enhance the wellbeing of under-reached communities, the barriers and benefits to implementation must be empirically and systematically examined. Thus, our team used D&I science to design and implement an 18-week texting campaign for under-reached workers with a higher-than-average risk of fatal and non-fatal injury. The experimental project was conducted with English-, Spanish-, and Vietnamese-speaking commercial fishermen in the Gulf of Mexico to test the design and feasibility, and messaging focused on preventing injury from slips, trips, and falls, as well as hurricane preparedness. The ubiquity of mobile devices and the previous success of texting campaigns made this a promising approach for enhancing health and preventing injury among an under-reached population. However, the perceived benefits were not without their barriers. The lessons learned included the difficulty of navigating federal regulations regarding limits for special characters, enrolling migratory participants, and navigating areas with limited cellular service or populations with limited accessibility to technology. We conclude with short- and long-term suggestions for future technology interventions for under-reached worker populations, including ethical and policy regulations.

Prevalence of Adverse Health Behaviors and Conditions Among Maritime Workers, BRFSS 2014 to 2018, 38 States

OBJECTIVE

To analyze health behaviors and conditions among maritime workers using Behavioral Risk Factor Surveillance System (BRSS).

METHODS

BRFSS data from 2014 to 2018 were used to calculate weighted prevalence estimates and adjusted prevalence ratios (aPRs) for 10 health behaviors and conditions. Logistic regression was used to compare aPRs between maritime workers and all other US workers.

RESULTS

Compared with other workers, maritime workers had higher weighted prevalence estimates for six of 10 health behaviors and conditions: binge drinking, smoking, obese/overweight, diabetes, cancer, and chronic obstructive pulmonary disease. Maritime workers had significantly higher aPRs for binge drinking (aPR = 1.28) and smoking cigarettes (aPR = 1.39) compared with all other US workers.

CONCLUSIONS

This study uses BRFSS data to estimate the prevalence of adverse health conditions across maritime industries. This study can serve as the foundation for additional follow-on research.

Methylmercury and Polycyclic Aromatic Hydrocarbons in Mediterranean Seafood: A Molecular Anthropological Perspective

Eating seafood has numerous health benefits; however, it constitutes one of the main sources of exposure to several harmful environmental pollutants, both of anthropogenic and natural origin. Among these, methylmercury and polycyclic aromatic hydrocarbons give rise to concerns related to their possible effects on human biology. In the present review, we summarize the results of epidemiological investigations on the genetic component of individual susceptibility to methylmercury and polycyclic aromatic hydrocarbons exposure in humans, and on the effects that these two pollutants have on human epigenetic profiles (DNA methylation). Then, we provide evidence that Mediterranean coastal communities represent an informative case study to investigate the potential impact of methylmercury and polycyclic aromatic hydrocarbons on the human genome and epigenome, since they are characterized by a traditionally high local seafood consumption, and given the characteristics that render the Mediterranean Sea particularly polluted. Finally, we discuss the challenges of a molecular anthropological approach to this topic.